Central and Bridge Symptoms of Suboptimal Health Status in Chinese Medical Students: a Network Analysis

Central and Bridge Symptoms of Suboptimal Health Status in Chinese Medical Students: a Network Analysis | 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 Research Article Central and Bridge Symptoms of Suboptimal Health Status in Chinese Medical Students: a Network Analysis Hongyan Yin, Huaizhi Cheng, Jiesen Shang, Dongquan Chen, Doudou Huang, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6284134/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background The prevalence of suboptimal health in Chinese medical students is high. However, the bridge symptoms within the three domains of suboptimal health remain ambiguous. The current study investigates the network structure of suboptimal health in Chinese medical students and identifies the central and bridge symptoms, thereby providing potential targets for prevention and intervention. Methods This study used a cross-sectional survey design and stratified random cluster sampling method to recruit participants from November 2022 to March 2023. 2865 medical students were recruited, and 2210 valid questionnaires were to be analyzed. We used R software to visualize the symptom network and identify central symptoms and bridge symptoms. Results The result shows that the B30 “Social relationships” node had the highest strength centrality (strength = 1.113) in the network. The bridge strength analysis identified B29 “Coping ability” (bridge strength = 0.582), B14 “Energy” (bridge strength = 0.399), B27 “Problem-solving ability”(bridge strength = 0.377), and B31 “Performance” (bridge strength = 0.375) as the bridge symptoms. The strongest edge connections across all dimensions included “Share happiness and sadness” with “Close relationships” (B34-B35, edge weight = 0.61) and “Appetite” with “Sleep” (B1-B2, edge weight = 0.51). Conclusions B30 “Social relationships” was the central symptom of the suboptimal health network and could be a target for intervention. Intervening and managing bridge symptoms such as B29 “Coping ability”, B14 “Energy”, B27 “Problem-solving ability”, and B31 “Performance” can effectively impede the spread of symptom activation, thereby decreasing the connections among three domains of suboptimal health in Chinese medical students. Suboptimal health status Network analysis Bridge symptoms Chinese medical students Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 24 Apr, 2026 Reviews received at journal 01 Jun, 2025 Reviewers agreed at journal 01 Jun, 2025 Reviewers invited by journal 15 May, 2025 Editor invited by journal 17 Apr, 2025 Editor assigned by journal 25 Mar, 2025 Submission checks completed at journal 25 Mar, 2025 First submitted to journal 22 Mar, 2025 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. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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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-6284134","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":456982057,"identity":"1aa7d362-3dbd-4b99-937e-e2bfdb3dff25","order_by":0,"name":"Hongyan Yin","email":"","orcid":"","institution":"Harbin Medical University (Daqing)","correspondingAuthor":false,"prefix":"","firstName":"Hongyan","middleName":"","lastName":"Yin","suffix":""},{"id":456982058,"identity":"43f595d2-9e37-4082-8653-d1c0df59d4d3","order_by":1,"name":"Huaizhi Cheng","email":"","orcid":"","institution":"Harbin Medical University 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Analysis","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Suboptimal health status, Network analysis, Bridge symptoms, Chinese medical students","lastPublishedDoi":"10.21203/rs.3.rs-6284134/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6284134/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe prevalence of suboptimal health in Chinese medical students is high. However, the bridge symptoms within the three domains of suboptimal health remain ambiguous. The current study investigates the network structure of suboptimal health in Chinese medical students and identifies the central and bridge symptoms, thereby providing potential targets for prevention and intervention.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study used a cross-sectional survey design and stratified random cluster sampling method to recruit participants from November 2022 to March 2023. 2865 medical students were recruited, and 2210 valid questionnaires were to be analyzed. We used R software to visualize the symptom network and identify central symptoms and bridge symptoms.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe result shows that the B30 \u0026ldquo;Social relationships\u0026rdquo; node had the highest strength centrality (strength\u0026thinsp;=\u0026thinsp;1.113) in the network. The bridge strength analysis identified B29 \u0026ldquo;Coping ability\u0026rdquo; (bridge strength\u0026thinsp;=\u0026thinsp;0.582), B14 \u0026ldquo;Energy\u0026rdquo; (bridge strength\u0026thinsp;=\u0026thinsp;0.399), B27 \u0026ldquo;Problem-solving ability\u0026rdquo;(bridge strength\u0026thinsp;=\u0026thinsp;0.377), and B31 \u0026ldquo;Performance\u0026rdquo; (bridge strength\u0026thinsp;=\u0026thinsp;0.375) as the bridge symptoms. The strongest edge connections across all dimensions included \u0026ldquo;Share happiness and sadness\u0026rdquo; with \u0026ldquo;Close relationships\u0026rdquo; (B34-B35, edge weight\u0026thinsp;=\u0026thinsp;0.61) and \u0026ldquo;Appetite\u0026rdquo; with \u0026ldquo;Sleep\u0026rdquo; (B1-B2, edge weight\u0026thinsp;=\u0026thinsp;0.51).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eB30 \u0026ldquo;Social relationships\u0026rdquo; was the central symptom of the suboptimal health network and could be a target for intervention. Intervening and managing bridge symptoms such as B29 \u0026ldquo;Coping ability\u0026rdquo;, B14 \u0026ldquo;Energy\u0026rdquo;, B27 \u0026ldquo;Problem-solving ability\u0026rdquo;, and B31 \u0026ldquo;Performance\u0026rdquo; can effectively impede the spread of symptom activation, thereby decreasing the connections among three domains of suboptimal health in Chinese medical students.\u003c/p\u003e","manuscriptTitle":"Central and Bridge Symptoms of Suboptimal Health Status in Chinese Medical Students: a Network Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-19 13:41:46","doi":"10.21203/rs.3.rs-6284134/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"193349791010762780713275426126188897526","date":"2026-04-24T15:07:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-01T15:37:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"324620864142692379366553008436241319688","date":"2025-06-01T14:57:44+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-15T09:13:32+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-17T14:35:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-03-25T11:59:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-25T11:56:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-03-22T14:09:07+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2fac90c5-be36-47c1-9d85-cbc34c7cb906","owner":[],"postedDate":"May 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-05-19T13:41:46+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-19 13:41:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6284134","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6284134","identity":"rs-6284134","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}