Prevalence of myopia among primary and secondary school students and its influencing factors in Xinjiang, China: a cross sectional study

Prevalence of myopia among primary and secondary school students and its influencing factors in Xinjiang, China: a cross sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Prevalence of myopia among primary and secondary school students and its influencing factors in Xinjiang, China: a cross sectional study Xiaopeng Hu, Xianyan Yuan, HUA LI, haoxuan Gong, Zhicong Fu, Yuting Xie, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4839150/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract OBJECTIVE To understand the prevalence of myopia and its influencing factors among primary and secondary school students in Shihezi City to provide a scientific basis for future interventions for improving, safeguarding and promoting the visual health of primary and secondary school students. METHODS The population comprised primary and secondary school students in Shihezi City. A stratified random sampling method was used to determine the research school, which was then stratified by grade. Two classes were randomly selected as sample classes for each grade. All students received a vision examination. Students of grade ≥ 4 completed the investigation of myopia-related influencing factors using questionnaires. RESULTS A total of 6732 people were surveyed in this study, and 6092 people were finally included (participation rate: 90.49%), of which boys represented 51.10%. The overall prevalence of myopia was 59.55%. The prevalence of myopia in urban areas was 68.17%, while in rural areas was 42.42%, and the difference was statistically significant. Being female students, having myopic parents, close-distance reading or writing, and receiving education at an older age were risk factors for myopia, while attending school in a rural area was a protective factor against myopia. Additionally, factors influencing myopia varied among subgroups, but parental myopia appeared in almost every subgroup. CONCLUSION Myopia rates in Shihezi City are higher than the national average and gradually increase with school age. In addition to inherent factors (gender, increasing school age and genetic factors), myopia prevention should include proper sitting, eye habits and health promotion. Health sciences/Medical research/Epidemiology Health sciences/Health care/Public health/Epidemiology Health sciences/Health care/Public health/Population screening Health sciences/Risk factors myopia primary and middle school students risk factors cross-sectional study Introduction Myopia was listed by the World Health Organisation as one of the five eye diseases that must addressed or eliminated worldwide by 2020 1 , becoming a major focus of global public health 2 . Holden predicted that myopia will affect 4,758 million people globally by 2050 (approximately 49.8% of the total population) 3 . In China, the prevention of myopia is an important public health task because the prevalence of myopia among Chinese school-age children is one of the highest in the world 4,5 . The overall myopia rate among children and adolescents in China was 52.7% in 2020, showing an increase of 2.5% from that in 2019 (50.2%), and some studies predicted that the myopia rate among children and adolescents aged 3–19 years in China will reach 84.0% by 2050 6 . This alarmingly high myopia prevalence compared to Western countries might be attributed to Chinese-specific culture, including parents' educational philosophy, increasingly strict admission criteria and children spending more time studying and less time outdoors 7 . In addition to increasing the socio-economic burden, myopia not only affects the physical, psychological, cognitive and social functioning and quality of life in China 8 but is also associated with the development of serious pathological diseases, such as macular degeneration, retinal detachment, glaucoma and cataracts 9 . The physical and psychological damage caused by vision problems in children and adolescents seriously affects the healthy development of human society. Myopia prevalence is increasing, which prompted researchers to investigate its underlying causes. However, reported risk factors causally associated with myopia might also be overestimated or underestimated due to residual confounding or other biases. In recent years, myopia has been reported among primary and secondary school students in some large cities in inland China 10-14 . In contrast, myopia among primary and secondary school students in northwestern China, especially in Xinjiang, and the factors influencing it have rarely been reported. Xinjiang has certain special characteristics in China, with large differences compared with the mainland. Shihezi City, as an important city in Xinjiang, has a representative level of public health surveillance. In this context, we investigated myopia prevalence among primary school children in Shihezi City and explored influencing factors to fill the existing knowledge gap regarding myopia in China. We provided valuable guidance and a theoretical framework for the effective prevention and management of myopia in children and adolescents. Methods Subjects of the study Data used in this project were obtained from the National Students' Common Diseases and Health Influencing Factors Surveillance and Intervention in Shihezi City Area, a project performed by the Chinese Centre for Disease Control and Prevention (CDC). The project was conducted and completed by all levels of education and health departments, providing good-quality surveys and data. This study was performed in 2022, with school students in Shihezi City selected as study subjects. A multi-stage stratified cluster sampling method was used to first determine research point schools evenly distributed throughout the city, which were then stratified by grade level and sampled by teaching class to constitute research and sampling samples. In random cluster sampling, a certain number of classes was chosen to meet the minimum research and sample size requirements, including 3 primary schools, 5 middle schools, and 4 high schools in the city, as well as 3 primary schools and 2 middle schools in rural areas (there is no high school in rural areas). All students underwent a vision examination, while only students in grade ≥ 4 of primary school completed the questionnaire. The final sample size was 6,092 students (3,113 boys and 2,979 girls), of whom 4,578 students were in grade ≥ 4. Additionally, 4,511 and 2,039 students were from urban and rural areas, respectively. Parent of each student was informed to sign a written consent forms before the ophthalmological examinations.This study followed the tenets of Declaration of Helsinki and was approved by the Ethical Review Committee of The First Affiliated Hospital of Shihezi University. Participants gave informed consent to participate in the study before taking part(KJ2024-036-02). Survey Methods Visual acuity examination A standard logarithmic visual acuity chart and computerised automated optometry under non-ciliary muscle paralysis (non-dilated pupils) were used to test visual acuity in the right and left eyes. The standard GB/T 115332011 logarithmic 5-point record visual acuity chart was used. Refraction was assessed by objective examination using desktop automatic computer optometry under non-ciliary muscle paralysis conditions. Three measurements were taken in each eye and averaged. If any 2 of these spherical lens dioptre measurements differed by ≥ 0.50 D, additional measurements were taken and then averaged. The test results were recorded by the on-site testing physician in the CDC Student Common Diseases and Health Factors Monitoring Information System. Questionnaire The questionnaire was developed by the Chinese CDC and completed on-site by grade ≥ 4 students. Before the questionnaire, the researcher explained the survey significance, emphasised the confidentiality of the questionnaire and asked students to keep an appropriate distance from each other to ensure that they answered carefully. Additionally, any questions that were not understood would be explained by the researcher until the students could understand the questions correctly to ensure the credibility of the results. The survey covered several aspects, including parental myopia, eye environment, eye habits, screen use, outdoor activities and sleep. The results of the questionnaire were directly uploaded to the CDC Student Common Diseases and Health Factors Monitoring Information System. Myopia Screening Criteria The criteria for determining myopia comprised a standard logarithmic visual acuity < 5.0 in the naked eye (without correction) and a computerised optometric spherical equivalent visual acuity < − 0.50 D in the case of non-ciliary muscle paralysis. Anyone with myopia in at least one eye, or those wearing keratoconus lenses, was counted in the total number of myopia cases. Quality Control The screeners were certified national practitioners, technicians or nurses related to optometry who received relevant training. During the survey, retest subjects were randomly selected according to 5% of the number of students tested on that day. Non-corrected visual acuity and best-corrected visual acuity were retested. Data Analysis Based on the standard questionnaire provided by the CDC, the data were double-entered into the database using EpiData 3.1 parallel data entry. The data were verified by the National Centre for Disease Control and Prevention (NCDC). SPSS 27.0 was used for statistical analysis. Count data were expressed as the number of cases (percentage), and the analysis of variance for count data was performed using the χ 2 test. Myopia influencing factors were analysed using unconditional binary logistic regression, with myopia-related influencing factors as independent variables and the presence or absence of myopia as the dependent variable. The test level was α = 0.05 (two-sided). Results Prevalence of Myopia Overall analysis A total of 6092 students with a median age of 12.56 years (range: 9.65 to 15.07) were surveyed: 1514 in grades 1–3 and 4578 in grades ≥ 4, with a male-to-female ratio of 51.10% and 48.90%, respectively. According to screening results, 1,747 cases of myopia were detected in 3,113 male students, with a myopia rate of 56.12% (1,747/3,113, 95% CI: 0.5436 to 0.5787). A total of 1,881 cases of myopia were detected in 2,979 female students, with a myopia rate of 63.14% (1881/2979, 95% CI: 0.6138 to 0.6488 ). The overall myopia rate was 59.55% (3628/6092, 95% CI: 0.5831 to 0.6079), with myopia rates of 41.01% in primary school, 74.11% in middle school and 86.02% in high school. Additionally, the difference in myopia rates between males and females was statistically significant ( χ 2 = 31.166, P = 0.001). The prevalence of myopia generally increased with the increase in grade (Table 1 ). Table 1 Current status of myopia among primary and secondary school students in Shihezi City in 2022 Grade Male Female Total χ 2 P Total (N) Myopia n (%) Total (N) Myopia n (%) Total (N) Myopia n (%) 1 256 44(17.19) 250 42(16.80) 506 86(17.00) 0.013 0.908 2 269 69(25.65) 227 63(27.75) 496 132(26.61) 0.279 0.598 3 274 92(33.58) 238 79(33.19) 512 171(33.40) 0.008 0.927 4 283 135(47.70) 241 134(55.60) 524 269(51.34) 3.250 0.071 5 286 142(49.65) 247 130(52.63) 533 272(51.03) 0.471 0.492 6 264 153(57.95) 259 186(71.81) 523 339(64.82) 11.013 0.001 7 314 199(63.38) 327 245(74.92) 641 444(69.27) 10.034 0.002 8 317 232(73.19) 295 236(80.00) 612 468(76.47) 3.943 0.047 9 315 231(73.33) 278 225(80.94) 593 456(76.90) 4.804 0.028 10 183 155(84.70) 215 190(88.37) 398 345(86.68) 1.155 0.282 11 171 143(83.63) 213 188(88.26) 384 331(86.20) 1.714 0.190 12 181 152(83.98) 189 163(86.24) 370 315(85.14) 0.375 0.540 Total 3113 1747(56.12) 2979 1881(63.14) 6092 3628(59.55) 31.166 0.001 1. Grades 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 correspond to primary school 1st grade, primary school 2nd grade, primary school 3rd grade, primary school 4th grade, primary school 5th grade, primary school 6th grade, middle school 1st grade, middle school 2nd grade, middle school 3rd grade, high school 1st grade, high school 2nd grade and high school 3rd grade, respectively . 2. The chi−square test was used to compare male and female students in the same grade . Stratified analysis A total of 2,763 myopia cases were screened in 4,053 people in urban areas, with a myopia rate of 68.17% (2,763/4053, 95% CI: 0.6671 to 0.6960). In rural areas, 865 myopia cases were screened in 2,039 people, with a myopia rate of 42.42% (865/2039, 95% CI: 0.4027 to 0.4460). Among identified cases, myopia rates between urban and rural areas for boys in grades 3–5 and junior grades, girls in grades 1–5, overall grades 1–5 and junior grades and overall urban and rural were statistically different, as shown in Table 2 . Table 2 Current status of myopia among urban and rural primary and secondary school students in Shihezi City in 2022 District Grade Male Female Total χ 2 P Total (N) Myopia n (%) Total (N) Myopia n (%) Total (N) Myopia n (%) City 1 130 25(19.23) 129 28(21.71)* 259 53(20.46)* 0.244 0.622 2 137 39(28.47) 118 45(38.14)* 255 84(32.94)* 2.683 0.101 3 137 39(28.47)* 112 46(41.07)* 249 107(42.97)* 0.300 0.584 4 139 79(56.83)* 123 81(65.85)* 262 160(61.07)* 2.233 0.135 5 144 85(59.03)* 123 77(62.60)* 267 162(60.67)* 0.355 0.551 6 141 85(59.03) 133 97(72.93) 274 186(67.88) 3.022 0.082 7 228 151(66.23) 235 182(77.45) 463 333(71.92)* 7.212 0.007 8 226 172(76.11) 216 173(80.09) 442 345(78.05) 1.025 0.311 9 223 171(76.68)* 207 171(82.61) 430 342(79.53)* 2.317 0.128 10 183 155(84.70) 215 190(88.37) 398 345(86.68) 1.155 0.282 11 171 143(83.63) 213 188(88.26) 384 331(86.20) 1.714 0.190 12 181 152(83.98) 189 163(86.24) 370 315(85.14) 0.375 0.540 Total 2040 1322(64.80)** 2013 1441(71.58)** 4053 2763(68.17)** 21.470 0.001 Countryside 1 126 19(15.08) 121 14(11.57)* 247 33(13.36)* 0.657 0.418 2 132 30(22.73) 109 18(16.51)* 241 48(19.92)* 1.445 0.229 3 137 31(22.63)* 126 33(26.19)* 263 64(24.33)* 0.452 0.501 4 144 56(38.89)* 118 53(44.92)* 262 109(41.60)* 0.969 0.325 5 142 57(40.14)* 124 53(42.74)* 266 110(41.35)* 0.185 0.667 6 123 64(52.03) 126 89(70.63) 249 153(61.45) 9.092 0.003 7 86 48(55.81) 92 63(68.48) 178 111(62.36)* 3.037 0.081 8 91 60(65.93) 79 63(79.75) 170 123(72.35) 4.033 0.045 9 92 60(65.22)* 71 54(76.06) 163 114(69.94)* 2.239 0.135 Total 1073 425(39.61)** 966 440(45.55)** 2039 865(42.42)** 7.343 0.007 1. Grades 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 correspond to primary school 1st grade, primary school 2nd grade, primary school 3rd grade, primary school 4th grade, primary school 5th grade, primary school 6th grade, middle school 1st grade, middle school 2nd grade, middle school 3rd grade, high school 1st grade, high school 2nd grade and high school 3rd grade, respectively . 2. The chi−square test was used to compare male and female students in the same grade . 3. No high school in rural areas 4. *: There is a significant difference in myopia rates between urban and rural areas of the same grade and gender, P < 0.05 . 5. **: There is a statistically significant difference between urban and rural areas for boys and girls and overall myopia rates, P < 0.05 . Univariate analysis of factors influencing myopia Only students in grade ≥ 4 completed the questionnaire survey, in which the presence of myopia (myopia = 1) as the dependent variable and factors influencing myopia as independent variables were used to perform unconditional binary logistic regression analysis. One-way logistic regression showed the correlation of myopia development with female gender, family history of myopia, low frequency of changing seats, not changing tables and chairs according to height, doing homework or reading and writing for ≥ 2 hours after school, reducing exercise time because of studying, non-restricted use of electronic devices by parents, reading and writing at a distance < 1 foot away from the book, reading and writing with fingers < 1 inch away from the tip of the pen, teachers not reminding about the correct posture for reading and writing, loading eyes for ≥ 1 hour continuously at a close distance, spending ≤ 1 hour outdoors during the daytime, not having a visual acuity checkup within one year, reading or watching electronic screens in direct sunlight, switching off the light after dark, watching electronic screens, having no visual acuity checkup within one year, reading electronic screens, squatting or lying down to read books or electronic screens and walking or travelling to read books or electronic screens. Additional, rural areas and resting outdoors during school hours were correlated with myopia prevention, with results detailed in Table 3 . Table 3 Univariate analysis of factors influencing myopia Variables β S.E. Wald P OR 95% CI for OR Lower Upper Gender 0.278 0.051 30.062 0.001 1.321 1.196 1.459 1: Male 2༚Female District −1.101 0.055 398.302 0.001 0.333 0.299 0.371 1: City 2༚Countryside Segments 1.065 0.038 805.314 0.001 2.901 2.695 3.123 1: Primary schools 2༚Middle school 3༚High school Frequency of seat transfers 0.312 0.122 6.546 0.011 1.367 1.076 1.737 1: Weekly, fortnightly or monthly 2: Once a term or never Adjusting tables and chairs to height 0.439 0.063 48.358 0.001 1.55 1.37 1.754 1: Once every 2–3 months, once a semester or once a school year 2: Never Location of recess activities −0.641 0.063 102.922 0.001 0.527 0.466 0.596 1: Inside the school building 2: Outdoors Duration of homework after school 0.819 0.076 116.531 0.001 2.268 1.955 2.632 1: No homework, 3 hours 3: Don't know (not involved in analysis) Frequency of reducing exercise time due to learning 0.174 0.059 8.708 0.003 1.19 1.06 1.335 1: Never 2: Sometimes 3: Often Do parents limit the time spent using electronic devices? 0.477 0.073 42.982 0.001 1.612 1.397 1.859 1: Yes 2: No Reading and writing with with the chest a punch away from the table 0.361 0.068 28.111 0.001 1.434 1.255 1.639 1: Always, often 2: Occasionally, never Reading and writing with your eyes 1 foot away from the book (33 cm) 0.462 0.068 45.917 0.001 1.588 1.389 1.815 1: Always, often 2: Occasionally, never Reading and writing with your fingers 1 inch from the tip of the pen (3 cm) 0.359 0.074 23.786 0.001 1.431 1.239 1.653 1: Always, often 2: Occasionally, never Does the teacher remind about reading and writing postures? 0.433 0.070 37.956 0.001 1.542 1.344 1.770 1: Always, often 2: Occasionally, never Do parents remind about reading and writing postures? 0.206 0.071 8.352 0.004 1.229 1.069 1.414 1: Always, often 2: Occasionally, never How often should you rest your eyes when loading your eyes up close 0.516 0.075 47.143 0.001 1.675 1.446 1.94 1: ≤15 minutes, > 15 minutes but < 0.5 hours, 0.5–1 hour 2: 1–2 hours, 2–3 hours, ≥ 3 hours Time spent outdoors during the day 0.446 0.089 25.082 0.001 1.562 1.312 1.859 1: ≥3 hours, 2–3 hours or 1–2 hours 2: <1 hour 3: don't know (not involved in analysis) Parental myopia 0.491 0.056 76.927 0.001 1.634 1.464 1.824 1: Neither parent is myopic 2: Only the mother or father is myopic 3: Both parents are myopic How many vision tests have been done in the past year? 0.272 0.096 8.045 0.005 1.312 1.088 1.583 1: ≥1 2: 0 Reading books or electronic screens in direct sunlight 0.431 0.067 41.014 0.001 1.538 1.348 1.755 1: Always, often or occasionally 2: Never Turning off the lights when watching electronic screens after dark 0.574 0.065 76.821 0.001 1.775 1.561 2.018 1: Always, often or occasionally 2: Never Crouching or lying down to read a book or electronic screen 0.421 0.063 44.616 0.001 1.524 1.347 1.724 1: Always, often or occasionally 2: Never Reading books or electronic screens while walking or travelling in a car 0.499 0.069 51.763 0.001 1.647 1.438 1.887 1: Always, often or occasionally 2: Never Sleeping time −0.625 0.046 184.240 0.001 0.535 0.489 0.586 1: <8 hours 2: 8–10 hours 3: ≥10 Multifactorial analysis of factors influencing myopia With the presence of myopia (myopia = 1) as the dependent variable and factors influencing myopia as independent variables, univariate analysis results were evaluated by unconditional binary logistic regression. The multifactorial analysis showed that parental myopia and reading and writing with eyes no more than one foot away from books were closely associated with myopia development after removing the effects of gender, school year, urban and rural areas (Table 4 ). Table 4 Multifactorial analysis of factors influencing myopia Variables β S.E. Wald P OR 95% CI for OR Lower Upper Constant −2.017 0.265 58.037 0.001 0.133 Gender 0.384 0.07 30.453 0.001 1.468 1.281 1.682 District −0.438 0.078 31.825 0.001 0.645 0.554 0.751 Segments 0.71 0.053 176.797 0.001 2.034 1.832 2.258 Parental myopia 0.521 0.061 72.683 0.001 1.684 1.494 1.899 Reading and writing without keeping your eyes > 1 foot away from the book (< 33 cm) 0.163 0.08 4.123 0.042 1.177 1.006 1.376 Subgroup analysis of factors influencing myopia With myopia presence (myopia = 1) as the dependent variable and factors influencing myopia as independent variables, we performed unconditional binary logistic regression analysis according to the school section, urban-rural and gender multilayer grouping. The results showed that each subgroup of children’s factors influencing myopia was different. Specifically, reading and writing with fingers < 1 inch away from the tip of the pen, teachers not reminding about the correct posture for reading and writing were risk factors for myopia in urban primary school boys. Parental failure to limit the time spent watching television and playing on the computer and turning off the lights after dark to watch electronic screens were risk factors for myopia in rural primary school girls, while sleeping ≥ 8 hours was a protective factor against myopia in rural primary school girls. However, there were two interesting results: parental failure to remind reading and writing postures was a protective factor for myopia in rural primary school girls, and time spent outdoors during the day < 1 hour was a protective factor for myopia in rural primary school boys. For urban junior high school girls, parents not restricting the time of watching TV and playing computer was still a protective factor against myopia, while reading and writing with fingers < 1 inch away from the tip of the pen and reading or watching books or electronic screens in direct sunlight were risk factors for myopia in rural junior high school boys. Moreover, outdoor activity time < 1 hour during the day was a risk factor for myopia in urban high school boys. However, parental myopia was a risk factor for myopia in almost every group. Table 5 provides these results in detail. Table 5 Multifactorial analysis of factors influencing myopia in multilayered subgroups Segments District Gender Variables β S.E. Wald P OR 95% CI for OR Lower Upper Primary school City Male Constant −0.576 0.516 1.245 0.264 0.562 Fingers not ≥ 1 inch from the tip of the pen when writing (3 cm) −0.772 0.314 6.07 0.014 0.462 0.25 0.854 Teachers did not warn about reading and writing posture 0.709 0.304 5.428 0.020 2.031 1.119 3.686 Parental myopia 0.683 0.168 16.478 0.001 1.979 1.423 2.751 Female Constant −0.489 0.284 2.955 0.086 0.613 Parental myopia 0.838 0.191 19.281 0.001 2.311 1.59 3.358 Countryside Male Constant −0.07 0.524 0.018 0.894 0.932 Parental myopia 0.509 0.177 8.248 0.004 1.663 1.175 2.353 Outdoor activities < 1 hour during the day −0.84 0.425 3.911 0.048 0.432 0.188 0.993 Female Constant −1.075 0.697 2.379 0.123 0.341 Sleeping time ≥ 8 hours −0.696 0.232 9.007 0.003 0.498 0.316 0.785 Parents do not limit time spent watching TV and playing computer or video games 0.969 0.447 4.706 0.030 2.635 1.098 6.325 Parents do not remind about reading and writing postures −0.81 0.281 8.315 0.004 0.445 0.256 0.771 Turning off the lights when looking at electronic screens after dark 0.823 0.35 5.522 0.019 2.276 1.146 4.521 Middle school City Male Constant 0.035 0.228 0.024 0.877 1.036 Parental myopia 0.704 0.166 18.076 0.001 2.023 1.462 2.798 Female Constant 1.229 0.39 9.929 0.002 3.419 Parental myopia 0.603 0.186 10.532 0.001 1.827 1.27 2.629 Parents do not limit time spent watching TV and playing computer or video games −0.52 0.218 5.669 0.017 0.595 0.387 0.912 Countryside Male Constant −1.339 0.583 5.272 0.022 0.262 Fingers not ≥ 1 from the tip of the pen when writing (3 cm) 0.881 0.424 4.308 0.038 2.413 1.05 5.542 Reading books or electronic screens in direct sunlight 0.676 0.308 4.812 0.028 1.967 1.075 3.598 High school City Male Constant 0.903 0.38 5.644 0.018 2.466 Outdoor activities < 1 hour during the day 0.637 0.297 4.594 0.032 1.89 1.056 3.384 Discussion The current state of myopia in Shihezi is not encouraging Myopia in children and adolescents is a public health problem of global concern. Myopia prevalence among children and adolescents in China is not only one of the highest in the world but is also on the rise and occurs at a younger age. According to the data released by the Chinese National Health and Health Commission in 2020, the overall myopia rate of children and adolescents in China was 52.7%, with an increase of 2.5% compared to that in 2019 (50.2%). Of this overall rate, the myopia rate in primary school students was 35.6%, the myopia rate in junior high school students was 71.1%, and the myopia rate in high school students was 80.5%. In this study, the overall myopia prevalence was 60.66%, of which myopia occurred in 41.01% of primary school students, 74.11% of secondary school students and 86.02% of high school students. All these rates are higher than the national level, requiring measures to stop the rapid development of myopia. Factors influencing myopia in primary and secondary school students in Shihezi are different The present study showed a high genetic predisposition to myopia, similar to previous studies demonstrating that children with myopic parents are more likely to be myopic than those with non-myopic parents 15 – 18 . Jones et al. 19 stated that myopia in one parent increases the risk of myopia in the child by 2.08, while myopia in both parents increases the risk of myopia in the child by 5.07. However, genes do not explain the rapid increase in myopia incidence, and the more significant causes might be environmental and behavioural factors. Compared to the past, young people are increasingly involved in indoor and close work activities and electronic devices fill daily life with the advancement of time. Additionally, increasingly stringent entry barriers and the need for higher qualifications keep students studying in school for long periods, leaving less time for relaxation. This study found that the prevalence of myopia tends to increase as the grade increases. The highest myopia prevalence among high school students reached 86.02%, possibly related to the heavy school workload and the longer and more frequent eye load. This might also explain the difference in myopia prevalence between urban and rural students, where myopia prevalence is lower in rural students since rural students might be under less study pressure than urban students. This shows that the amount of time students spend studying is closely related to myopia occurrence, which is also consistent with our results showing a 1.253-times higher risk for myopia for ≥ 2 hours of homework/reading and writing after school each day compared to < 2 hours of such activities. In this study, a statistically significant difference in myopia prevalence was found between boys and girls (male: 57.43%, female: 64.06%, χ 2 = 30.118, P = 0.001), with the risk for myopia in girls being 1.445-times higher than that in boys, similar to the results of most studies 20 , 21 . This gender difference might occur because boys spend more time outdoors compared to girls; however, it could also be mediated by social factors, with females having access to better educational opportunities in recent years 22 . The multivariate analysis results showed that keeping eyes ≤ 1 foot (33 cm) away from the book while reading was a risk factor for myopia (OR = 1.177, P = 0.042). Furthermore, studies demonstrated that shorter reading distance leads to faster myopia progression 23 , which suggests that maintaining good reading and writing postures is beneficial in preventing myopia. Stratified by gender, urban and rural areas and school segments, the factors influencing myopia were different. Compared with previous studies, we also conducted a multilevel stratified study to assess influences on myopia for each group more precisely. After further stratification, we could find that fingers not ≥ 1 from the tip of the pen when writing (3 cm) and teachers' failure to remind to pay attention to reading and writing postures were independent risk factor for myopia occurrence in urban primary school boys. Turning off the lights when looking at electronic screens after dark was an independent risk factor for myopia, whereas sleeping ≥ 8 hours was a protective factor against myopia in rural primary school girls. We did not obtain such results in our previous analyses, which is consistent with previous studies 24 , 25 . Furthermore, reading books or electronic screens in direct sunlight was an independent risk factor for myopia in rural junior high school boys, and outdoor activities < 1 hour during the day was an independent risk factor for myopia in urban high school boys. For rural children, < 1 hour of outdoor activity during the day was a protective factor against myopia. The reason for this result might be that rural children spend more time outdoors, and the number of children with < 1 hour of outdoor activity is small, causing unstable results. Intervention efforts for myopia should consider population differences Exploring the factors influencing myopia aims to improve interventions in the future and provide valuable guidelines for effective myopia prevention in children and adolescents. According to Lin et al. 11 , myopia prevention in primary and secondary school students needs to be differentiated and targeted according to region, school type and climatic conditions. Some inherent factors cannot be changed, e.g. family history, gender and school age. Additionally, it seems unlikely that the increasing demands for higher grades will allow children to reduce their workload. Therefore, it is our common aspiration to prevent myopia without affecting students' normal learning. Based on our results, students need to sit upright and keep their hands 1 inch away from the tip of the pen, their chests 1 fist away from the table, and their eyes 1 foot away from the books when reading and writing. When engaging in prolonged eye load, taking a break, going outdoors for a few minutes and looking into the distance are important. Recess activities should be outdoors as much as possible at school, with some studies showing that outdoor activities can prevent myopia 26 . It is also important to avoid loading eyes when lighting conditions are poor, crouching or lying down to read and reading while walking or travelling in a car. Teachers should do more to urge students to maintain good sitting posture in class or during studying and go outdoors between classes, as some studies demonstrated that proper monitoring of outdoor intervention adherence is essential for the protective effect of the intervention 27 . Additionally, avoiding removing time from students' physical education classes or outdoor activities is necessary. For parents, limiting the amount of time their children spend playing on electronic devices, such as mobile phones, tablets and computers is necessary. Furthermore, they should also supervise their children at home to maintain good reading and writing postures and purchase eye-protecting desk lamps to ensure good lighting conditions when reading and writing. Strengths and Limitations Our study has certain advantages despite abundant research on myopia prevalence and influencing factors. First, our study was a part of the Monitoring and Intervention Programme for Common Diseases and Health Influencing Factors of Chinese Students. Additionally, the research methodology was uniform across the country, the quality of the study had specific control measures, and the researchers were professional and technical personnel who passed the uniform training. This makes the quality of the study more reliable, realistic and reflective of myopia among students in the XJPC. Moreover, the study comprehensively examined the factors influencing myopia and used a multilevel stratification to accurately assess these factors in each group. The group of rural students was also included in our study, different to many previous studies. Although the sample size of this study was not small, it was a cross-sectional survey, limiting our ability to draw conclusions about causality regarding the onset of myopia. In subsequent studies, we will impose further interventions and verify our findings through follow-ups. Conclusions Myopia rates in Shihezi are higher than the national average and increase gradually with school age. In addition to inherent factors (gender, increasing school age and hereditary factors), myopia prevention should include proper sitting posture, eye habits and health promotion. In addition, based on this study, myopia prevention measures should be tailored to different target groups. Declarations Founding Sources Research reported in this publication received financial support from the Chinese Centre for Disease Control and Prevention (CDC); however, there was no CDC involvement of influence with any aspect of the study/initiative/activity supported by grant. Acknowledgments The authors would like to acknowledge the Centre for Disease Control and Prevention of Shihezi City for providing data for this study. Conflicts of interest Xiaopeng Hu, Xianyan Yuan have contributed equally to this work and share frst authorship, beyond which the authors have no conflicts of interest to declare. Data availability statement If asked to provide raw data, the corresponding author can be contacted to provide it. Ethics approval statement This study followed the tenets of Declaration of Helsinki and was approved by the Ethical Review Committee of The First Affiliated Hospital of Shihezi University. Participants gave informed consent to participate in the study before taking part(KJ2024-036-02). Author contributions Xiaopeng Hu : Resources, Conceptualization, Methodology, Formal analysis, Writing - Original Draft Xianyan Yuan : Investigation, Funding acquisition Hua Li : Writing - Original Draft Haoxuan Gong : Investigation Zhicong Fu : Investigation Yuting Xie : Investigation Lin Zhu : Data Curation Haina Chen : Data Curation Yingli Yang : Data Curation Dongsheng Rui : Supervision, Project administration, Conceptualization References Jonas, J. B. et al. IMI Prevention of Myopia and Its Progression. Invest. Ophthalmol. Vis. Sci. 62 , 6. 10.1167/iovs.62.5.6 (2021). Grzybowski, A., Kanclerz, P., Tsubota, K., Lanca, C. & Saw, S. M. A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmol. 20 , 27. 10.1186/s12886-019-1220-0 (2020). Holden, B. A. et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology . 123 , 1036–1042. 10.1016/j.ophtha.2016.01.006 (2016). Wang, J. et al. Prevalence of myopia and vision impairment in school students in Eastern China. BMC Ophthalmol. 20 10.1186/s12886-019-1281-0 (2020). Guo, L. et al. Prevalence and associated factors of myopia among primary and middle school-aged students: a school-based study in Guangzhou. Eye (Lond) . 30 , 796–804. 10.1038/eye.2016.39 (2016). Dong, L. et al. A Systemic Review and Meta-Analysis. Retina . 40 , 399–411. 10.1097/IAE.0000000000002590 (2020). Li, L., Zhong, H., Li, J., Li, C. R. & Pan, C. W. Incidence of myopia and biometric characteristics of premyopic eyes among Chinese children and adolescents. BMC Ophthalmol. 18 , 178. 10.1186/s12886-018-0836-9 (2018). Swenor, B. K., Lee, M. J., Varadaraj, V., Whitson, H. E. & Ramulu, P. Y. Aging With Vision Loss: A Framework for Assessing the Impact of Visual Impairment on Older Adults. Gerontologist . 60 , 989–995. 10.1093/geront/gnz117 (2020). Cooper, J. & Tkatchenko, A. V. A Review of Current Concepts of the Etiology and Treatment of Myopia. Eye Contact Lens . 44 , 231–247. 10.1097/ICL.0000000000000499 (2018). Ye, L. et al. Increasing prevalence of myopia and the impact of education in primary-school students in Xi'an, north-western of China. Front. Public. Health . 10 , 1070984. 10.3389/fpubh.2022.1070984 (2022). Lin, T., Hu, J., Lin, J., Chen, J. & Wen, Q. Epidemiological investigation of the status of myopia in children and adolescents in Fujian Province in 2020. Jpn J. Ophthalmol. 67 , 335–345. 10.1007/s10384-023-00991-y (2023). Zhang, J. et al. Prevalence of myopia: A large-scale population-based study among children and adolescents in weifang, china. Front. Public. Health . 10 , 924566. 10.3389/fpubh.2022.924566 (2022). Zhuang, M. et al. Prevalence and influence factors for myopia and high myopia in schoolchildren in Shandong, China. Cent. Eur. J. Public. Health . 30 , 190–195. 10.21101/cejph.a7158 (2022). Cheng, P. et al. Prevalence and related factors of children myopia in Pudong New Area, Shanghai: a cross-sectional study. BMJ Open. 13 , e079330. 10.1136/bmjopen-2023-079330 (2023). Saw, S. M. et al. Familial clustering and myopia progression in Singapore school children. Ophthalmic Epidemiol. 8 , 227–236 (2001). Mutti, D. O., Mitchell, G. L., Moeschberger, M. L., Jones, L. A. & Zadnik, K. Parental myopia, near work, school achievement, and children's refractive error. Invest. Ophthalmol. Vis. Sci. 43 , 3633–3640 (2002). Saw, S. M. et al. A cohort study of incident myopia in Singaporean children. Invest. Ophthalmol. Vis. Sci. 47 , 1839–1844 (2006). Ip, J. M. et al. Ethnic differences in the impact of parental myopia: findings from a population-based study of 12-year-old Australian children. Invest. Ophthalmol. Vis. Sci. 48 , 2520–2528 (2007). Jones, L. A. et al. Parental history of myopia, sports and outdoor activities, and future myopia. Invest. Ophthalmol. Vis. Sci. 48 , 3524–3532 (2007). Ovenseri-Ogbomo, G. et al. Systematic review and meta-analysis of myopia prevalence in African school children. PLoS One . 17 , e0263335. 10.1371/journal.pone.0263335 (2022). Czepita, M., Czepita, D. & Safranow, K. Role of Gender in the Prevalence of Myopia among Polish Schoolchildren. J Ophthalmol 9748576, doi: (2019). 10.1155/2019/9748576 (2019). Morgan, I. G., French, A. N. & Rose, K. A. Risk Factors for Myopia: Putting Causal Pathways into a Social Context. (2019). Hsu, C. C. et al. Risk factors for myopia progression in second-grade primary school children in Taipei: a population-based cohort study. Br. J. Ophthalmol. 101 , 1611–1617. 10.1136/bjophthalmol-2016-309299 (2017). Zhou, J. et al. Prevalence of myopia and influencing factors among primary and middle school students in 6 provinces of China]. Zhonghua Liu Xing Bing Xue Za Zhi . 37 , 29–34. 10.3760/cma.j.issn.0254-6450.2016.01.006 (2016). Xu, S. J. et al. [Association between time spent on physical exercise, sleep, homework and suspected myopia among students]. Zhonghua Liu Xing Bing Xue Za Zhi . 37 , 183–186. 10.3760/cma.j.issn.0254-6450.2016.02.006 (2016). Zhang, J. & Deng, G. Protective effects of increased outdoor time against myopia: a review. J. Int. Med. Res. 48 , 300060519893866. 10.1177/0300060519893866 (2020). He, X. et al. Time Outdoors in Reducing Myopia: A School-Based Cluster Randomized Trial with Objective Monitoring of Outdoor Time and Light Intensity. Ophthalmology . 129 , 1245–1254. 10.1016/j.ophtha.2022.06.024 (2022). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4839150","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":360343725,"identity":"5bb5d3e2-818f-4e36-8df9-09059f06e3e4","order_by":0,"name":"Xiaopeng Hu","email":"","orcid":"","institution":"Shi Hezi University","correspondingAuthor":false,"prefix":"","firstName":"Xiaopeng","middleName":"","lastName":"Hu","suffix":""},{"id":360343728,"identity":"cdeaff60-93ff-49fd-b548-61294298049e","order_by":1,"name":"Xianyan Yuan","email":"","orcid":"","institution":"Shihezi City Centre for Disease Control and Prevention","correspondingAuthor":false,"prefix":"","firstName":"Xianyan","middleName":"","lastName":"Yuan","suffix":""},{"id":360343731,"identity":"d0716e70-ea4c-49db-9500-de61485c40e6","order_by":2,"name":"HUA LI","email":"","orcid":"","institution":"Kindergarten No. 4","correspondingAuthor":false,"prefix":"","firstName":"HUA","middleName":"","lastName":"LI","suffix":""},{"id":360343734,"identity":"b9dbe20f-114e-4077-9ef5-0ed70542ab3a","order_by":3,"name":"haoxuan Gong","email":"","orcid":"","institution":"Shi Hezi University","correspondingAuthor":false,"prefix":"","firstName":"haoxuan","middleName":"","lastName":"Gong","suffix":""},{"id":360343737,"identity":"b9419e2b-64fd-4e99-b337-d2450f20bbea","order_by":4,"name":"Zhicong Fu","email":"","orcid":"","institution":"Shi Hezi University","correspondingAuthor":false,"prefix":"","firstName":"Zhicong","middleName":"","lastName":"Fu","suffix":""},{"id":360343738,"identity":"fce04bb4-7c18-40d8-8159-99b57f7c8a94","order_by":5,"name":"Yuting Xie","email":"","orcid":"","institution":"Shi Hezi University","correspondingAuthor":false,"prefix":"","firstName":"Yuting","middleName":"","lastName":"Xie","suffix":""},{"id":360343739,"identity":"c558acd8-73c3-4cfb-a19c-bdb77e78f1bc","order_by":6,"name":"Lin Zhu","email":"","orcid":"","institution":"Shi Hezi University","correspondingAuthor":false,"prefix":"","firstName":"Lin","middleName":"","lastName":"Zhu","suffix":""},{"id":360343740,"identity":"b13be229-a586-413b-bb06-7af8533e4fca","order_by":7,"name":"Haina Chen","email":"","orcid":"","institution":"Shi Hezi University","correspondingAuthor":false,"prefix":"","firstName":"Haina","middleName":"","lastName":"Chen","suffix":""},{"id":360343742,"identity":"fe7a8cbc-ec00-49a7-b2d4-7367fd97bee3","order_by":8,"name":"Yingli Yang","email":"","orcid":"","institution":"Shi Hezi University","correspondingAuthor":false,"prefix":"","firstName":"Yingli","middleName":"","lastName":"Yang","suffix":""},{"id":360343745,"identity":"d4d7771d-6a87-411e-8394-ba7c03f96b92","order_by":9,"name":"Dongsheng Rui","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/klEQVRIiWNgGAWjYFACxgYJEGUAIj4wHACLSRCthXEGcVqgCkBamHmI0WI+I7nxxscdtfbm7L2HX9v8uWNvcID54G0eBrs8XFpkbiQ2W848czxxZ8+5NOvctmfMBgfYkq15GJKLcTpKIrFNmrftWILBjRwz49yGw2wGB3jMpIEuTGwgoMXe4P4bM2OLP4d5DA7wfyNGSw3jhhs8xo8Z2A5LAG1hw6+F5yHQL20HEjecyTFj7G07bCB5mM3Yco5BMm4t7OkPb3xsq7M3OH7G+MOPP4ft+Y43P7zxpsIOpxYoOAwi2CDRwQwiDPCrB4I6sNoPBNWNglEwCkbBiAQAWIhZiyE9QuwAAAAASUVORK5CYII=","orcid":"","institution":"Shi Hezi University","correspondingAuthor":true,"prefix":"","firstName":"Dongsheng","middleName":"","lastName":"Rui","suffix":""}],"badges":[],"createdAt":"2024-08-01 04:15:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4839150/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4839150/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":69264257,"identity":"7894789a-9a8a-47ab-80ad-3c1a6898175f","added_by":"auto","created_at":"2024-11-18 14:17:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1325442,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4839150/v1/7f45e559-6c6e-4810-a53d-e3abd90a7197.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003ePrevalence of myopia among primary and secondary school students and its influencing factors in Xinjiang, China: a cross sectional study\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMyopia was listed by the World Health Organisation as one of the five eye diseases that must addressed or eliminated worldwide by 2020\u003csup\u003e1\u003c/sup\u003e, becoming a major focus of global public health\u003csup\u003e2\u003c/sup\u003e. Holden predicted that myopia will affect 4,758 million people globally by 2050 (approximately 49.8% of the total population)\u003csup\u003e3\u003c/sup\u003e. In China, the prevention of myopia is an important public health task because the prevalence of myopia among Chinese school-age children is one of the highest in the world\u003csup\u003e4,5\u003c/sup\u003e.\u0026nbsp;The overall myopia rate among children and adolescents in China was 52.7% in 2020, showing an increase of 2.5% from that in 2019 (50.2%), and some studies predicted that the myopia rate among children and adolescents aged 3\u0026ndash;19 years in China will reach 84.0% by 2050\u003csup\u003e6\u003c/sup\u003e. This alarmingly high myopia prevalence compared to Western countries might be attributed to Chinese-specific culture, including parents\u0026apos; educational philosophy, increasingly strict admission criteria and children spending more time studying and less time outdoors\u003csup\u003e7\u003c/sup\u003e. In addition to increasing the socio-economic burden, myopia not only affects the physical, psychological, cognitive and social functioning and quality of life in China\u003csup\u003e8\u003c/sup\u003e but is also associated with the development of serious pathological diseases, such as macular degeneration, retinal detachment, glaucoma and cataracts\u003csup\u003e9\u003c/sup\u003e. The physical and psychological damage caused by vision problems in children and adolescents seriously affects the healthy development of human society.\u003c/p\u003e\n\u003cp\u003eMyopia prevalence is increasing, which prompted researchers to investigate its underlying causes. However, reported risk factors causally associated with myopia might also be overestimated or underestimated due to residual confounding or other biases. In recent years, myopia has been reported among primary and secondary school students in some large cities in inland China\u003csup\u003e10-14\u003c/sup\u003e. \u0026nbsp;In contrast, myopia among primary and secondary school students in northwestern China, especially in Xinjiang, and the factors influencing it have rarely been reported. Xinjiang has certain special characteristics in China, with large differences compared with the mainland. Shihezi City, as an important city in Xinjiang, has a representative level of public health surveillance. In this context, we investigated myopia prevalence among primary school children in Shihezi City and explored influencing factors to fill the existing knowledge gap regarding myopia in China. We provided valuable guidance and a theoretical framework for the effective prevention and management of myopia in children and adolescents.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eSubjects of the study\u003c/p\u003e \u003cp\u003eData used in this project were obtained from the National Students' Common Diseases and Health Influencing Factors Surveillance and Intervention in Shihezi City Area, a project performed by the Chinese Centre for Disease Control and Prevention (CDC). The project was conducted and completed by all levels of education and health departments, providing good-quality surveys and data. This study was performed in 2022, with school students in Shihezi City selected as study subjects. A multi-stage stratified cluster sampling method was used to first determine research point schools evenly distributed throughout the city, which were then stratified by grade level and sampled by teaching class to constitute research and sampling samples. In random cluster sampling, a certain number of classes was chosen to meet the minimum research and sample size requirements, including 3 primary schools, 5 middle schools, and 4 high schools in the city, as well as 3 primary schools and 2 middle schools in rural areas (there is no high school in rural areas). All students underwent a vision examination, while only students in grade\u0026thinsp;\u0026ge;\u0026thinsp;4 of primary school completed the questionnaire. The final sample size was 6,092 students (3,113 boys and 2,979 girls), of whom 4,578 students were in grade\u0026thinsp;\u0026ge;\u0026thinsp;4. Additionally, 4,511 and 2,039 students were from urban and rural areas, respectively. Parent of each student was informed to sign a written consent forms before the ophthalmological examinations.This study followed the tenets of Declaration of Helsinki and was approved by the Ethical Review Committee of The First Affiliated Hospital of Shihezi University. Participants gave informed consent to participate in the study before taking part(KJ2024-036-02).\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eSurvey Methods\u003c/h2\u003e \u003cp\u003eVisual acuity examination\u003c/p\u003e \u003cp\u003eA standard logarithmic visual acuity chart and computerised automated optometry under non-ciliary muscle paralysis (non-dilated pupils) were used to test visual acuity in the right and left eyes. The standard GB/T 115332011 logarithmic 5-point record visual acuity chart was used. Refraction was assessed by objective examination using desktop automatic computer optometry under non-ciliary muscle paralysis conditions. Three measurements were taken in each eye and averaged. If any 2 of these spherical lens dioptre measurements differed by \u0026ge;\u0026thinsp;0.50 D, additional measurements were taken and then averaged. The test results were recorded by the on-site testing physician in the CDC Student Common Diseases and Health Factors Monitoring Information System.\u003c/p\u003e \u003cp\u003eQuestionnaire\u003c/p\u003e \u003cp\u003eThe questionnaire was developed by the Chinese CDC and completed on-site by grade\u0026thinsp;\u0026ge;\u0026thinsp;4 students. Before the questionnaire, the researcher explained the survey significance, emphasised the confidentiality of the questionnaire and asked students to keep an appropriate distance from each other to ensure that they answered carefully. Additionally, any questions that were not understood would be explained by the researcher until the students could understand the questions correctly to ensure the credibility of the results. The survey covered several aspects, including parental myopia, eye environment, eye habits, screen use, outdoor activities and sleep. The results of the questionnaire were directly uploaded to the CDC Student Common Diseases and Health Factors Monitoring Information System.\u003c/p\u003e \u003cp\u003eMyopia Screening Criteria\u003c/p\u003e \u003cp\u003eThe criteria for determining myopia comprised a standard logarithmic visual acuity\u0026thinsp;\u0026lt;\u0026thinsp;5.0 in the naked eye (without correction) and a computerised optometric spherical equivalent visual acuity\u0026thinsp;\u0026lt;\u0026thinsp;\u0026minus;\u0026thinsp;0.50 D in the case of non-ciliary muscle paralysis. Anyone with myopia in at least one eye, or those wearing keratoconus lenses, was counted in the total number of myopia cases.\u003c/p\u003e \u003cp\u003eQuality Control\u003c/p\u003e \u003cp\u003eThe screeners were certified national practitioners, technicians or nurses related to optometry who received relevant training. During the survey, retest subjects were randomly selected according to 5% of the number of students tested on that day. Non-corrected visual acuity and best-corrected visual acuity were retested.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eBased on the standard questionnaire provided by the CDC, the data were double-entered into the database using EpiData 3.1 parallel data entry. The data were verified by the National Centre for Disease Control and Prevention (NCDC). SPSS 27.0 was used for statistical analysis. Count data were expressed as the number of cases (percentage), and the analysis of variance for count data was performed using the χ\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e test. Myopia influencing factors were analysed using unconditional binary logistic regression, with myopia-related influencing factors as independent variables and the presence or absence of myopia as the dependent variable. The test level was α\u0026thinsp;=\u0026thinsp;0.05 (two-sided).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003ePrevalence of Myopia\u003c/p\u003e \u003cp\u003eOverall analysis\u003c/p\u003e \u003cp\u003eA total of 6092 students with a median age of 12.56 years (range: 9.65 to 15.07) were surveyed: 1514 in grades 1\u0026ndash;3 and 4578 in grades\u0026thinsp;\u0026ge;\u0026thinsp;4, with a male-to-female ratio of 51.10% and 48.90%, respectively. According to screening results, 1,747 cases of myopia were detected in 3,113 male students, with a myopia rate of 56.12% (1,747/3,113, 95% CI: 0.5436 to 0.5787). A total of 1,881 cases of myopia were detected in 2,979 female students, with a myopia rate of 63.14% (1881/2979, 95% CI: 0.6138 to 0.6488 ). The overall myopia rate was 59.55% (3628/6092, 95% CI: 0.5831 to 0.6079), with myopia rates of 41.01% in primary school, 74.11% in middle school and 86.02% in high school. Additionally, the difference in myopia rates between males and females was statistically significant (\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;31.166, P\u0026thinsp;=\u0026thinsp;0.001). The prevalence of myopia generally increased with the increase in grade (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCurrent status of myopia among primary and secondary school students in Shihezi City in 2022\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMyopia n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMyopia n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eTotal (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMyopia n (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e256\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44(17.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42(16.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e506\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e86(17.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.908\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69(25.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63(27.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e496\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e132(26.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.598\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92(33.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e238\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e79(33.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e512\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e171(33.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.927\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e135(47.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e241\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e134(55.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e524\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e269(51.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e142(49.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e130(52.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e533\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e272(51.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.471\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.492\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e153(57.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e186(71.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e523\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e339(64.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e11.013\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e314\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e199(63.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e327\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e245(74.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e641\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e444(69.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e10.034\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e232(73.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e295\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e236(80.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e612\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e468(76.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e3.943\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.047\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e315\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e231(73.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e225(80.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e593\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e456(76.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e4.804\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e155(84.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e190(88.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e398\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e345(86.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.282\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e143(83.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e188(88.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e331(86.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.190\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e152(83.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e163(86.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e370\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e315(85.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.540\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1747(56.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2979\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1881(63.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6092\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3628(59.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e31.166\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003csup\u003e1. Grades 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 correspond to primary school 1st grade, primary school 2nd grade, primary school 3rd grade, primary school 4th grade, primary school 5th grade, primary school 6th grade, middle school 1st grade, middle school 2nd grade, middle school 3rd grade, high school 1st grade, high school 2nd grade and high school 3rd grade, respectively\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e2. \u003csup\u003eThe chi\u0026minus;square test was used to compare male and female students in the same grade\u003c/sup\u003e.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eStratified analysis\u003c/p\u003e \u003cp\u003eA total of 2,763 myopia cases were screened in 4,053 people in urban areas, with a myopia rate of 68.17% (2,763/4053, 95% CI: 0.6671 to 0.6960). In rural areas, 865 myopia cases were screened in 2,039 people, with a myopia rate of 42.42% (865/2039, 95% CI: 0.4027 to 0.4460). Among identified cases, myopia rates between urban and rural areas for boys in grades 3\u0026ndash;5 and junior grades, girls in grades 1\u0026ndash;5, overall grades 1\u0026ndash;5 and junior grades and overall urban and rural were statistically different, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCurrent status of myopia among urban and rural primary and secondary school students in Shihezi City in 2022\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDistrict\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMyopia n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMyopia n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMyopia n (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"12\" rowspan=\"13\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25(19.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e28(21.71)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e53(20.46)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.244\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.622\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39(28.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e45(38.14)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e84(32.94)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.683\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e39(28.47)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e46(41.07)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e107(42.97)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.584\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e79(56.83)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e81(65.85)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e160(61.07)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.135\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e85(59.03)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e77(62.60)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e162(60.67)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.355\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.551\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85(59.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e97(72.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e186(67.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.082\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e151(66.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e182(77.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e463\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e333(71.92)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e7.212\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e172(76.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e173(80.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e442\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e345(78.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.311\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e171(76.68)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e171(82.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e430\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e342(79.53)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.128\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e155(84.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e190(88.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e398\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e345(86.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.282\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e143(83.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e188(88.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e331(86.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.190\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e152(83.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e163(86.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e370\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e315(85.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.540\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e1322(64.80)**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1441(71.58)**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e2763(68.17)**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e21.470\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"9\" rowspan=\"10\"\u003e \u003cp\u003eCountryside\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19(15.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e14(11.57)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e33(13.36)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.657\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.418\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30(22.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e18(16.51)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e241\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e48(19.92)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.445\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e31(22.63)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e33(26.19)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e263\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e64(24.33)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.452\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.501\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e56(38.89)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e53(44.92)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e109(41.60)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.969\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.325\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e57(40.14)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e53(42.74)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e266\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e110(41.35)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.667\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64(52.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e89(70.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e153(61.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e9.092\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48(55.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63(68.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e111(62.36)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.081\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60(65.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63(79.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e123(72.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e4.033\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.045\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e60(65.22)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e54(76.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e114(69.94)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.135\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e425(39.61)**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e440(45.55)**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e865(42.42)**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e7.343\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003e\u003csup\u003e1. Grades 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 correspond to primary school 1st grade, primary school 2nd grade, primary school 3rd grade, primary school 4th grade, primary school 5th grade, primary school 6th grade, middle school 1st grade, middle school 2nd grade, middle school 3rd grade, high school 1st grade, high school 2nd grade and high school 3rd grade, respectively\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e2. \u003csup\u003eThe chi\u0026minus;square test was used to compare male and female students in the same grade\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e3. \u003csup\u003eNo high school in rural areas\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e4. \u003csup\u003e*: There is a significant difference in myopia rates between urban and rural areas of the same grade and gender, \u003cem\u003eP \u0026lt; 0.05\u003c/em\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e5. \u003csup\u003e**: There is a statistically significant difference between urban and rural areas for boys and girls and overall myopia rates, \u003cem\u003eP \u0026lt; 0.05\u003c/em\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eUnivariate analysis of factors influencing myopia\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eOnly students in grade\u0026thinsp;\u0026ge;\u0026thinsp;4 completed the questionnaire survey, in which the presence of myopia (myopia\u0026thinsp;=\u0026thinsp;1) as the dependent variable and factors influencing myopia as independent variables were used to perform unconditional binary logistic regression analysis. One-way logistic regression showed the correlation of myopia development with female gender, family history of myopia, low frequency of changing seats, not changing tables and chairs according to height, doing homework or reading and writing for \u0026ge;\u0026thinsp;2 hours after school, reducing exercise time because of studying, non-restricted use of electronic devices by parents, reading and writing at a distance\u0026thinsp;\u0026lt;\u0026thinsp;1 foot away from the book, reading and writing with fingers\u0026thinsp;\u0026lt;\u0026thinsp;1 inch away from the tip of the pen, teachers not reminding about the correct posture for reading and writing, loading eyes for \u0026ge;\u0026thinsp;1 hour continuously at a close distance, spending\u0026thinsp;\u0026le;\u0026thinsp;1 hour outdoors during the daytime, not having a visual acuity checkup within one year, reading or watching electronic screens in direct sunlight, switching off the light after dark, watching electronic screens, having no visual acuity checkup within one year, reading electronic screens, squatting or lying down to read books or electronic screens and walking or travelling to read books or electronic screens. Additional, rural areas and resting outdoors during school hours were correlated with myopia prevention, with results detailed in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis of factors influencing myopia\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eS.E.\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eWald\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e95% \u003cem\u003eCI\u003c/em\u003e for \u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.321\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.196\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.459\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Male 2༚Female\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistrict\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;1.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e398.302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.333\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.299\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.371\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: City 2༚Countryside\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSegments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e805.314\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.901\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e2.695\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e3.123\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Primary schools 2༚Middle school 3༚High school\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrequency of seat transfers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.312\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.546\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.367\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.076\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.737\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Weekly, fortnightly or monthly 2: Once a term or never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdjusting tables and chairs to height\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.439\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.55\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.37\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.754\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Once every 2\u0026ndash;3 months, once a semester or once a school year 2: Never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocation of recess activities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.641\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102.922\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.527\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.466\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.596\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Inside the school building 2: Outdoors\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of homework after school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e116.531\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.268\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.955\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e2.632\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: No homework, \u0026lt;\u0026thinsp;1 hour or 1\u0026ndash;2 hours 2: 2\u0026ndash;3 hours or \u0026gt;\u0026thinsp;3 hours 3: Don't know (not involved in analysis)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrequency of reducing exercise time due to learning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.708\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.19\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.06\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.335\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Never 2: Sometimes 3: Often\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo parents limit the time spent using electronic devices?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.477\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.612\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.397\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.859\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Yes 2: No\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReading and writing with with the chest a punch away from the table\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.361\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.434\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.255\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.639\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often 2: Occasionally, never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReading and writing with your eyes 1 foot away from the book (33 cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.588\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.389\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.815\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often 2: Occasionally, never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReading and writing with your fingers 1 inch from the tip of the pen (3 cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.359\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.074\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.431\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.239\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.653\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often 2: Occasionally, never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDoes the teacher remind about reading and writing postures?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.433\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.956\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.542\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.344\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.770\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often 2: Occasionally, never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo parents remind about reading and writing postures?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.229\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.069\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.414\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often 2: Occasionally, never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow often should you rest your eyes when loading your eyes up close\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.675\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.446\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.94\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: \u0026le;15 minutes, \u0026gt;\u0026thinsp;15 minutes but \u0026lt;\u0026thinsp;0.5 hours, 0.5\u0026ndash;1 hour 2: 1\u0026ndash;2 hours, 2\u0026ndash;3 hours, \u0026ge;\u0026thinsp;3 hours\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime spent outdoors during the day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.446\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.089\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.082\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.562\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.312\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.859\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: \u0026ge;3 hours, 2\u0026ndash;3 hours or 1\u0026ndash;2 hours 2: \u0026lt;1 hour 3: don't know (not involved in analysis)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParental myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.491\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.927\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.634\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.464\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.824\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Neither parent is myopic 2: Only the mother or father is myopic 3: Both parents are myopic\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow many vision tests have been done in the past year?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.312\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.088\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.583\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: \u0026ge;1 2: 0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReading books or electronic screens in direct sunlight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.431\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.538\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.348\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.755\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often or occasionally 2: Never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTurning off the lights when watching electronic screens after dark\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.574\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.821\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.775\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.561\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e2.018\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often or occasionally 2: Never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCrouching or lying down to read a book or electronic screen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.421\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.616\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.524\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.347\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.724\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often or occasionally 2: Never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReading books or electronic screens while walking or travelling in a car\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.499\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.069\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.763\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.647\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.438\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.887\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: Always, often or occasionally 2: Never\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSleeping time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.625\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e184.240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.535\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.489\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.586\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e1: \u0026lt;8 hours 2: 8\u0026ndash;10 hours 3: \u0026ge;10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMultifactorial analysis of factors influencing myopia\u003c/p\u003e \u003cp\u003eWith the presence of myopia (myopia\u0026thinsp;=\u0026thinsp;1) as the dependent variable and factors influencing myopia as independent variables, univariate analysis results were evaluated by unconditional binary logistic regression. The multifactorial analysis showed that parental myopia and reading and writing with eyes no more than one foot away from books were closely associated with myopia development after removing the effects of gender, school year, urban and rural areas (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultifactorial analysis of factors influencing myopia\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eS.E.\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eWald\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c9\" namest=\"c7\"\u003e \u003cp\u003e95% \u003cem\u003eCI\u003c/em\u003e for \u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c9\" namest=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;2.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c9\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.468\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.281\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.682\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c9\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistrict\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.438\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.825\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.645\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.554\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.751\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c9\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSegments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e176.797\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.034\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.832\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e2.258\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c9\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParental myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.521\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.683\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.684\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.494\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.899\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c9\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReading and writing without keeping your eyes\u0026thinsp;\u0026gt;\u0026thinsp;1 foot away from the book (\u0026lt;\u0026thinsp;33 cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.042\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.177\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1.376\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c9\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSubgroup analysis of factors influencing myopia\u003c/p\u003e \u003cp\u003e With myopia presence (myopia\u0026thinsp;=\u0026thinsp;1) as the dependent variable and factors influencing myopia as independent variables, we performed unconditional binary logistic regression analysis according to the school section, urban-rural and gender multilayer grouping. The results showed that each subgroup of children\u0026rsquo;s factors influencing myopia was different. Specifically, reading and writing with fingers\u0026thinsp;\u0026lt;\u0026thinsp;1 inch away from the tip of the pen, teachers not reminding about the correct posture for reading and writing were risk factors for myopia in urban primary school boys. Parental failure to limit the time spent watching television and playing on the computer and turning off the lights after dark to watch electronic screens were risk factors for myopia in rural primary school girls, while sleeping\u0026thinsp;\u0026ge;\u0026thinsp;8 hours was a protective factor against myopia in rural primary school girls. However, there were two interesting results: parental failure to remind reading and writing postures was a protective factor for myopia in rural primary school girls, and time spent outdoors during the day\u0026thinsp;\u0026lt;\u0026thinsp;1 hour was a protective factor for myopia in rural primary school boys. For urban junior high school girls, parents not restricting the time of watching TV and playing computer was still a protective factor against myopia, while reading and writing with fingers\u0026thinsp;\u0026lt;\u0026thinsp;1 inch away from the tip of the pen and reading or watching books or electronic screens in direct sunlight were risk factors for myopia in rural junior high school boys. Moreover, outdoor activity time\u0026thinsp;\u0026lt;\u0026thinsp;1 hour during the day was a risk factor for myopia in urban high school boys. However, parental myopia was a risk factor for myopia in almost every group. Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e provides these results in detail.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultifactorial analysis of factors influencing myopia in multilayered subgroups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSegments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDistrict\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eS.E.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eWald\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e \u003cp\u003e95% \u003cem\u003eCI\u003c/em\u003e for \u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"13\" rowspan=\"14\"\u003e \u003cp\u003ePrimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.576\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.562\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFingers not \u0026ge;\u0026thinsp;1 inch from the tip of the pen when writing (3 cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.772\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.314\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.462\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.25\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e0.854\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTeachers did not warn about reading and writing posture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.709\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.304\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.428\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2.031\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.119\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e3.686\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParental myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.683\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.478\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e1.979\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.423\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e2.751\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.489\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParental myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.838\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2.311\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.59\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e3.358\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003eCountryside\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.524\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.894\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.932\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParental myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.509\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e1.663\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.175\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e2.353\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOutdoor activities\u0026thinsp;\u0026lt;\u0026thinsp;1 hour during the day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.911\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.048\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.432\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.188\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e0.993\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;1.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.697\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSleeping time\u0026thinsp;\u0026ge;\u0026thinsp;8 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.696\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.232\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.498\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.316\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e0.785\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParents do not limit time spent watching TV and playing computer or video games\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.969\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.447\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.706\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.030\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2.635\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.098\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e6.325\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParents do not remind about reading and writing postures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.315\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.445\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.256\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e0.771\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTurning off the lights when looking at electronic screens after dark\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.823\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.522\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2.276\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.146\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e4.521\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.877\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParental myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.704\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2.023\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.462\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e2.798\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9.929\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.419\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParental myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.603\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10.532\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e1.827\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.27\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e2.629\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParents do not limit time spent watching TV and playing computer or video games\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.669\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.017\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.595\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.387\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e0.912\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCountryside\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;1.339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.583\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFingers not \u0026ge;\u0026thinsp;1 from the tip of the pen when writing (3 cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.881\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.424\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.308\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.038\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2.413\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.05\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e5.542\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReading books or electronic screens in direct sunlight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.676\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.308\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.812\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e1.967\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.075\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e3.598\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.903\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.644\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOutdoor activities\u0026thinsp;\u0026lt;\u0026thinsp;1 hour during the day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.637\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.594\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.032\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e1.89\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e1.056\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e3.384\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe current state of myopia in Shihezi is not encouraging\u003c/p\u003e \u003cp\u003eMyopia in children and adolescents is a public health problem of global concern. Myopia prevalence among children and adolescents in China is not only one of the highest in the world but is also on the rise and occurs at a younger age. According to the data released by the Chinese National Health and Health Commission in 2020, the overall myopia rate of children and adolescents in China was 52.7%, with an increase of 2.5% compared to that in 2019 (50.2%). Of this overall rate, the myopia rate in primary school students was 35.6%, the myopia rate in junior high school students was 71.1%, and the myopia rate in high school students was 80.5%. In this study, the overall myopia prevalence was 60.66%, of which myopia occurred in 41.01% of primary school students, 74.11% of secondary school students and 86.02% of high school students. All these rates are higher than the national level, requiring measures to stop the rapid development of myopia.\u003c/p\u003e \u003cp\u003eFactors influencing myopia in primary and secondary school students in Shihezi are different\u003c/p\u003e \u003cp\u003eThe present study showed a high genetic predisposition to myopia, similar to previous studies demonstrating that children with myopic parents are more likely to be myopic than those with non-myopic parents\u003csup\u003e\u003cspan additionalcitationids=\"CR16 CR17\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. Jones et al.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e stated that myopia in one parent increases the risk of myopia in the child by 2.08, while myopia in both parents increases the risk of myopia in the child by 5.07. However, genes do not explain the rapid increase in myopia incidence, and the more significant causes might be environmental and behavioural factors.\u003c/p\u003e \u003cp\u003eCompared to the past, young people are increasingly involved in indoor and close work activities and electronic devices fill daily life with the advancement of time. Additionally, increasingly stringent entry barriers and the need for higher qualifications keep students studying in school for long periods, leaving less time for relaxation.\u003c/p\u003e \u003cp\u003eThis study found that the prevalence of myopia tends to increase as the grade increases. The highest myopia prevalence among high school students reached 86.02%, possibly related to the heavy school workload and the longer and more frequent eye load. This might also explain the difference in myopia prevalence between urban and rural students, where myopia prevalence is lower in rural students since rural students might be under less study pressure than urban students. This shows that the amount of time students spend studying is closely related to myopia occurrence, which is also consistent with our results showing a 1.253-times higher risk for myopia for \u0026ge;\u0026thinsp;2 hours of homework/reading and writing after school each day compared to \u0026lt;\u0026thinsp;2 hours of such activities.\u003c/p\u003e \u003cp\u003eIn this study, a statistically significant difference in myopia prevalence was found between boys and girls (male: 57.43%, female: 64.06%, χ\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;30.118, P\u0026thinsp;=\u0026thinsp;0.001), with the risk for myopia in girls being 1.445-times higher than that in boys, similar to the results of most studies\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. This gender difference might occur because boys spend more time outdoors compared to girls; however, it could also be mediated by social factors, with females having access to better educational opportunities in recent years\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe multivariate analysis results showed that keeping eyes\u0026thinsp;\u0026le;\u0026thinsp;1 foot (33 cm) away from the book while reading was a risk factor for myopia (OR\u0026thinsp;=\u0026thinsp;1.177, P\u0026thinsp;=\u0026thinsp;0.042). Furthermore, studies demonstrated that shorter reading distance leads to faster myopia progression\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e, which suggests that maintaining good reading and writing postures is beneficial in preventing myopia. Stratified by gender, urban and rural areas and school segments, the factors influencing myopia were different. Compared with previous studies, we also conducted a multilevel stratified study to assess influences on myopia for each group more precisely. After further stratification, we could find that fingers not \u0026ge;\u0026thinsp;1 from the tip of the pen when writing (3 cm) and teachers' failure to remind to pay attention to reading and writing postures were independent risk factor for myopia occurrence in urban primary school boys. Turning off the lights when looking at electronic screens after dark was an independent risk factor for myopia, whereas sleeping\u0026thinsp;\u0026ge;\u0026thinsp;8 hours was a protective factor against myopia in rural primary school girls. We did not obtain such results in our previous analyses, which is consistent with previous studies\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. Furthermore, reading books or electronic screens in direct sunlight was an independent risk factor for myopia in rural junior high school boys, and outdoor activities\u0026thinsp;\u0026lt;\u0026thinsp;1 hour during the day was an independent risk factor for myopia in urban high school boys. For rural children, \u0026lt;\u0026thinsp;1 hour of outdoor activity during the day was a protective factor against myopia. The reason for this result might be that rural children spend more time outdoors, and the number of children with \u0026lt;\u0026thinsp;1 hour of outdoor activity is small, causing unstable results.\u003c/p\u003e \u003cp\u003eIntervention efforts for myopia should consider population differences\u003c/p\u003e \u003cp\u003e Exploring the factors influencing myopia aims to improve interventions in the future and provide valuable guidelines for effective myopia prevention in children and adolescents. According to Lin et al.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e, myopia prevention in primary and secondary school students needs to be differentiated and targeted according to region, school type and climatic conditions. Some inherent factors cannot be changed, e.g. family history, gender and school age. Additionally, it seems unlikely that the increasing demands for higher grades will allow children to reduce their workload. Therefore, it is our common aspiration to prevent myopia without affecting students' normal learning. Based on our results, students need to sit upright and keep their hands 1 inch away from the tip of the pen, their chests 1 fist away from the table, and their eyes 1 foot away from the books when reading and writing. When engaging in prolonged eye load, taking a break, going outdoors for a few minutes and looking into the distance are important. Recess activities should be outdoors as much as possible at school, with some studies showing that outdoor activities can prevent myopia\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. It is also important to avoid loading eyes when lighting conditions are poor, crouching or lying down to read and reading while walking or travelling in a car. Teachers should do more to urge students to maintain good sitting posture in class or during studying and go outdoors between classes, as some studies demonstrated that proper monitoring of outdoor intervention adherence is essential for the protective effect of the intervention\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. Additionally, avoiding removing time from students' physical education classes or outdoor activities is necessary. For parents, limiting the amount of time their children spend playing on electronic devices, such as mobile phones, tablets and computers is necessary. Furthermore, they should also supervise their children at home to maintain good reading and writing postures and purchase eye-protecting desk lamps to ensure good lighting conditions when reading and writing.\u003c/p\u003e \u003cp\u003eStrengths and Limitations\u003c/p\u003e \u003cp\u003eOur study has certain advantages despite abundant research on myopia prevalence and influencing factors. First, our study was a part of the Monitoring and Intervention Programme for Common Diseases and Health Influencing Factors of Chinese Students. Additionally, the research methodology was uniform across the country, the quality of the study had specific control measures, and the researchers were professional and technical personnel who passed the uniform training. This makes the quality of the study more reliable, realistic and reflective of myopia among students in the XJPC. Moreover, the study comprehensively examined the factors influencing myopia and used a multilevel stratification to accurately assess these factors in each group. The group of rural students was also included in our study, different to many previous studies. Although the sample size of this study was not small, it was a cross-sectional survey, limiting our ability to draw conclusions about causality regarding the onset of myopia. In subsequent studies, we will impose further interventions and verify our findings through follow-ups.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eMyopia rates in Shihezi are higher than the national average and increase gradually with school age. In addition to inherent factors (gender, increasing school age and hereditary factors), myopia prevention should include proper sitting posture, eye habits and health promotion. In addition, based on this study, myopia prevention measures should be tailored to different target groups.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFounding Sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResearch reported in this publication received financial support from the Chinese Centre for Disease Control and Prevention (CDC); however, there was no CDC involvement of influence with any aspect of the study/initiative/activity supported by grant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge the Centre for Disease Control and Prevention of Shihezi City for providing data for this study.\u003cstrong\u003e\u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eXiaopeng Hu, Xianyan Yuan have contributed equally to this work and share frst authorship, beyond which the authors have no conflicts of interest to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIf asked to provide raw data, the corresponding author can be contacted to provide it.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study followed the tenets of Declaration of Helsinki and was approved by the Ethical Review Committee of The First Affiliated Hospital of Shihezi University. Participants gave informed consent to participate in the study before taking part(KJ2024-036-02).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eXiaopeng Hu\u003c/strong\u003e:\u0026nbsp;Resources,\u0026nbsp;Conceptualization,\u0026nbsp;Methodology,\u0026nbsp;Formal analysis,\u0026nbsp;Writing - Original Draft\u0026nbsp;\u003cstrong\u003eXianyan Yuan\u003c/strong\u003e:\u0026nbsp;Investigation,\u0026nbsp;Funding acquisition\u0026nbsp;\u003cstrong\u003eHua Li\u003c/strong\u003e:\u0026nbsp;Writing - Original Draft \u003cstrong\u003eHaoxuan Gong\u003c/strong\u003e:\u0026nbsp;Investigation \u003cstrong\u003eZhicong Fu\u003c/strong\u003e:\u0026nbsp;Investigation \u003cstrong\u003eYuting Xie\u003c/strong\u003e:\u0026nbsp;Investigation \u003cstrong\u003eLin Zhu\u003c/strong\u003e:\u0026nbsp;Data Curation \u003cstrong\u003eHaina Chen\u003c/strong\u003e:\u0026nbsp;Data Curation \u003cstrong\u003eYingli Yang\u003c/strong\u003e:\u0026nbsp;Data Curation \u003cstrong\u003eDongsheng Rui\u003c/strong\u003e: Supervision, Project administration, Conceptualization\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eJonas, J. 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Time Outdoors in Reducing Myopia: A School-Based Cluster Randomized Trial with Objective Monitoring of Outdoor Time and Light Intensity. \u003cem\u003eOphthalmology\u003c/em\u003e. \u003cb\u003e129\u003c/b\u003e, 1245\u0026ndash;1254. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ophtha.2022.06.024\u003c/span\u003e\u003cspan address=\"10.1016/j.ophtha.2022.06.024\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2022).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"myopia, primary and middle school students, risk factors, cross-sectional study","lastPublishedDoi":"10.21203/rs.3.rs-4839150/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4839150/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eOBJECTIVE\u003c/h2\u003e \u003cp\u003eTo understand the prevalence of myopia and its influencing factors among primary and secondary school students in Shihezi City to provide a scientific basis for future interventions for improving, safeguarding and promoting the visual health of primary and secondary school students.\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e \u003cp\u003eThe population comprised primary and secondary school students in Shihezi City. A stratified random sampling method was used to determine the research school, which was then stratified by grade. Two classes were randomly selected as sample classes for each grade. All students received a vision examination. Students of grade\u0026thinsp;\u0026ge;\u0026thinsp;4 completed the investigation of myopia-related influencing factors using questionnaires.\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e \u003cp\u003eA total of 6732 people were surveyed in this study, and 6092 people were finally included (participation rate: 90.49%), of which boys represented 51.10%. The overall prevalence of myopia was 59.55%. The prevalence of myopia in urban areas was 68.17%, while in rural areas was 42.42%, and the difference was statistically significant. Being female students, having myopic parents, close-distance reading or writing, and receiving education at an older age were risk factors for myopia, while attending school in a rural area was a protective factor against myopia. Additionally, factors influencing myopia varied among subgroups, but parental myopia appeared in almost every subgroup.\u003c/p\u003e\u003ch2\u003eCONCLUSION\u003c/h2\u003e \u003cp\u003eMyopia rates in Shihezi City are higher than the national average and gradually increase with school age. In addition to inherent factors (gender, increasing school age and genetic factors), myopia prevention should include proper sitting, eye habits and health promotion.\u003c/p\u003e","manuscriptTitle":"Prevalence of myopia among primary and secondary school students and its influencing factors in Xinjiang, China: a cross sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-03 06:04:27","doi":"10.21203/rs.3.rs-4839150/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"39539549-79b4-4919-aadc-d144ffbe33a5","owner":[],"postedDate":"October 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":38482535,"name":"Health sciences/Medical research/Epidemiology"},{"id":38482536,"name":"Health sciences/Health care/Public health/Epidemiology"},{"id":38482537,"name":"Health sciences/Health care/Public health/Population screening"},{"id":38482538,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2024-11-18T14:09:19+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-03 06:04:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4839150","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4839150","identity":"rs-4839150","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}