This study poses the following research questions: What is the prevalence of bullying in vocational schools in China? What are the differences between different genders and professions? How should individuals, families, and schools do to affect school bullying? What can we do to improve and to respond school bullying, to reduce its occurrence and consequences? This cross-sectional study was conducted in 2018 with 95,873 students from 85 vocational schools. The main outcome indicators were self-reported involvement in bullying (perpetrator, victim, perpetrator-victim, or uninvolved). Multinomial logistic regression analyses were conducted, with personal characteristics, relational characteristics, and school climate as predictors. A total of 30.4% of participants reported being bullied, 2.9% reported bullying others, and 21.7% reported being bullied and bullying others. Majors related to primary and secondary industries are more likely to involvement in bullying than majors related to tertiary industries. Boys were more involved in physical or verbal bullying, whereas girls were more involved in relational bullying and cyberbullying. Sex, history of fighting, and emotional/mental state were the strongest individual factors associated with bullying. Having friends was inversely associated with bullying involvement; moreover, a positive relationship with parents and a good parenting style (warmth, democracy, and mutual concern) protected students from bullying others as well as being bullied. School bullying programs, happiness at school, and insecurity at school were strong negative predictors of bullying. Bullying is prevalent among vocational school students in China. An appropriate response to school bullying requires strengthening student capacity to correctly understand and deal with bullying, identifying victims and vulnerable groups, developing school-based interventions, involving parents in prevention programs, and enhancing students’ sense of responsibility in supervision, reporting, and creating a friendly environment.

Background: Although multifaceted community-based programmes have been widely developed, there remains a paucity of evaluation of the effectiveness of multifaceted injury prevention programmes implemented in different settings in the community context. This study was to provide information for the evaluation of community-based health education programmes of injury prevention among high school students. Methods: The pre-intervention survey was conducted in November 2009. Health belief model (HBM) based health education for injury prevention started in January 2010 and stopped in the end of 2011 among high school students in the community context in Shanghai, China. A post-intervention survey was conducted six weeks after the completion of intervention. Injury-related health belief indicators were captured by a short questionnaire before and after the intervention. Health belief scores were calculated and compared using the simple sum score (SSS) method and the confirmatory factor analysis weighted score (CFAWS) method, respectively. Results: The average reliability coefficient for the questionnaire was 0.89. The factor structure of HBM was given and the data fit HBM in the confirmatory factor analysis (CFA) very well. The result of CFA showed that Perceived Benefits of Taking Action (BEN) and Perceived Seriousness (SER) had the greatest impact on the health belief, Perceived Susceptibility (SUS) and Cues to Action (CTA) were the second and third most important components of HBM respectively. Barriers to Taking Action (BAR) had no notable impact on HBM. The standardized path coefficient was only 0.35, with only a small impact on CTA. The health belief score was significantly higher after intervention (p < 0.001), which was similar in the CFAWS method and in the SSS method. However, the 95% confidential interval in the CFAWS method was narrower than that in the SSS method. Conclusions: The results of CFA provide further empirical support for the HBM in injury intervention. The CFAWS method can be used to calculate the health belief scores and evaluate the injury related intervention. The community-based school health education might improve injury-related health belief among high school students; however, this preliminary observation needs to be confirmed in further research.

Family- and school-based interventions for childhood obesity have been widely applied; however, the prevalence of childhood obesity remains high. The purpose of this RCT is to evaluate the effectiveness of a family-individual-school-based comprehensive intervention model. Cluster RCT. Fourteen primary schools were selected from 26 primary schools in a district of Shanghai, China, and then randomly divided into intervention and control groups with seven schools in each. The trial started with first-grade students. A total of 1,287 students in the intervention group and 1,159 in the control group were studied overall. The baseline study was conducted in January 2011, and family-individual-school-based interventions started in March 2011 and ended in December 2013 for intervention group students. Three follow-up studies were conducted in January 2012, January 2013, and January 2014. Data analysis was conducted in March 2014. Students' weight and height were measured. The prevalence of obesity/overweight and BMI z-scores were calculated and analyzed using a generalized estimating equation approach. The overall prevalence of overweight/obesity declined from 28.92% in 2011 to 24.77% in 2014, with a difference of 4.15% in the intervention group compared with a 0.03% decline (from 30.71% to 30.68%) in the control group. The intervention group had significantly lower odds of developing obesity or overweight and had decreased average BMI z-scores compared with the control group, especially for obese or overweight students. The family-individual-school-based comprehensive intervention model is effective for controlling childhood obesity and overweight.

Vulnerable road users (pedestrians, bicyclists, and motorcyclists) account for an increasing proportion of traffic injuries. We used a case-crossover study design to examine the association between cell-phone usage and traffic injuries among pedestrians, bicyclists, and electric bicycle riders during the course of their travel. We studied 643 pedestrians, bike riders, and electric bike riders aged 10–35 years who were involved in a road injury, visited the emergency department in one of the 3 hospitals in Shanghai, China, in 2019, and owned a cell phone. Half of the participants (n = 323; 50.2%) had used a cell phone within 1 minute before the injury happened. A pedestrian’s or rider’s use of a mobile phone up to 1 minute before a road injury was associated with a 3-fold increase in the likelihood of injury (odds ratio = 3.00, 95% confidence interval: 2.04, 4.42; P < 0.001). The finding was consistent across subgroups by sex, occupation, reason for travel, mode of transportation, and location of injury. Use of a cell phone when walking or riding was associated with an increased risk of road injury. Measures should be taken to make people aware of this detrimental impact on the risk of road injury.

To explore the relationship between Health belief model (HBM) and children and adolescents' unintentional injury risk behavior, to add some useful information for injury prevention. We investigated injury related health risk behavior and health belief status of students at primary schools grade 3 to 4, in a Safe Community, in Shanghai. Self-administered injury questionnaires were used to investigate risk behavior of students and HBM factors. The prevalence of risk behavior among students reported in this community was high. HBM scores showed differences between two groups of students classified by whether they had risk behavior or not. Self-efficacy was highly related with the status of socio-psychological behavior. HBM has been widely used in explaining the disease-related behavior; however, it has been seldom used in injury-related behavior. The study demonstrated important relation of HBM to students' injury issues, and HBM could explain injury related behavior as well, especially for traffic injury-related behavior. When developing injury prevention strategies, we can take it into account.

To apply the Health Belief Model (HBM) to fall prevention of the elderly and estimate fall health beliefs and their relationships with fall-related behaviors, a citywide cross-sectional study was conducted among people aged 60 years or over in 13 out of 16 districts in Shanghai, China, in September 2018. A total of 5833 participants were investigated. Of this, 43.4% were male; 48.8% were aged 60–69; 18.1% were uneducated; and 50.3% were living in urban areas. People who were older, less educated, living in rural areas generally had lower scores in the 7 HBM dimensions and also had lower proportions of fall risk-reduction behaviors, except that the less educated elderly were more likely to participate in exercise and training and the rural elderly were more likely to check house environment and participate in exercise and training (p < 0.001). The HBM dimensions were generally positively correlated with the risk-reduction behaviors except that “perceived severity” was negatively correlated with four risk-reduction behaviors and behavior number, “cues to action” was negatively correlated with purchasing shoes, and “perceived benefits” was negatively correlated with participating in exercise activities and fall prevention training (p < 0.05). When HBM is applied in the field of fall prevention, the interpretation of the results of each dimension has its characteristics in the fields of injury research. Fall prevention strategies should focus on improving the health beliefs and behaviors in those who were older, less educated and living in rural areas, implementing different levels of fall prevention activities to meet different needs, improving the accessibility and applicability of related resources, and raising the organizational level of related fall prevention activities.