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指向儿童青少年“五健”的“阳光—绿色—包容”本土行动框架理论与应用研究. (2026). 环球医学研究, 3(5), 28-52. https://doi.org/10.62836/medicine.v3i5.1451
Copyright (c) 2026 杨廷忠, 章伟芳
This work is licensed under a Creative Commons Attribution 4.0 International License.
指向儿童青少年“五健”的“阳光—绿色—包容”本土行动框架理论与应用研究
杨廷忠1,2,3*，章伟芳1,4
1.浙江大学社会医学系，浙江杭州；
2.美国西弗吉尼亚大学伤害研究中心，摩根城；
3.俄罗斯 M.V. Lomonosov 社会与基础科学研究院，莫斯科；
4.浙江大学医学院附属儿童医院，浙江杭州
摘要：儿童青少年肥胖、近视、心理行为问题、骨骼发育异常和龋齿等健康问题往往并非彼此孤立，而是受到共同的心理、行为、环境和社会因素影响。现有儿童青少年健康促进实践仍较多采用针对单一健康问题分别干预的模式，不同健康领域之间缺乏有效整合与协同。本文基于心理学与健康促进等相关理论，并结合相关研究证据，提出“阳光—绿色—包容”（Sunshine–Green–Inclusion, SGI）儿童青少年健康促进行动框架。SGI框架提出，“开放—拓展—资源建构”是三个维度促进儿童青少年健康发展的共同作用机制。在此基础上，本文进一步整合SGI框架与健康体重、健康视力、心理健康、骨骼健康和口腔健康“五健”目标，形成SGI“五健”行动框架。该框架以协同整合为核心理念，旨在从共同健康形成基础出发，理解不同健康问题背后的共同影响机制，并探索促进儿童青少年多维健康发展的综合路径。在实践层面，本文提出SGI“五健”行动方案，并探索通过数字健康传播、健康教育和SGI“五健”校园建设三条主要路径推动实施。SGI“五健”框架具有一定的理论基础、研究证据支持和实践应用价值，有望推动儿童青少年健康促进模式由单一健康问题干预和风险控制，进一步转向多病共防、行为协同、环境支持和社会包容相结合的综合健康促进模式。该框架以环境支持和健康生活方式培养为双重抓手，协同推动”五键“目标的实现。
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[2] 杨廷忠.健康研究：社会与行为理论及方法[M].北京:人民卫生出版社,2025.
[3] Fredrickson BL. The role of positive emotions in positive psychology: the broaden-and-build theory of positive emotions[J]. American Psychologist, 2001, 56(3): 218-226.
[4] Fredrickson BL, Branigan C. Positive emotions broaden the scope of attention and thought-action repertoires[J]. Cognition and Emotion, 2005, 19(3): 313-332.
[5] Hartig T, Mitchell R, de Vries S, et al. Nature and health[J]. Annual Review of Public Health, 2014, 35: 207-228.
[6] Kaplan S. The restorative benefits of nature: toward an integrative framework[J]. Journal of Environmental Psychology, 1995, 15(3): 169-182.
[7] Zare Sakhvidi MJ, Mehrparvar AH, Zare Sakhvidi F, et al. Greenspace and health, wellbeing, physical activity, and development in children and adolescents: an overview of the systematic reviews[J]. Current Opinion in Environmental Science & Health, 2023, 32: 100445.
[8] Ly V, Vella-Brodrick DA. Effects of school-led greenspace interventions on mental, physical and social wellbeing in children and adolescents: a systematic review[J]. Educational Psychology Review, 2024, 36: 133.
[9] Yang T, Peng S, Cottrell RR. The impact of urban green spaces on obesity-related eating behaviours among university students across 31 Chinese cities[J]. Journal of Global Health, 2026, 16: 04059.
[10] Raniti M, Rakesh D, Patton GC, et al. The role of school connectedness in the prevention of youth depression and anxiety: a systematic review with youth consultation[J]. BMC Public Health, 2022, 22: 2152.
[11] Hunt X, Shakespeare T, Vilyte G, et al. Effectiveness of social inclusion interventions for anxiety and depression among adolescents: a systematic review[J]. International Journal of Environmental Research and Public Health, 2023, 20(3): 1895.
[12] World Health Organization. Improving the health and wellbeing of children and adolescents: guidance on scheduled child and adolescent well-care visits[EB/OL]. 2024.
[13] Tugade MM, Fredrickson BL. Resilient individuals use positive emotions to bounce back from negative emotional experiences[J]. Journal of Personality and Social Psychology, 2004, 86(2): 320-333.
[14] Lerner RM, Lerner JV, Almerigi JB, et al. Positive youth development, participation in community youth development programs, and community contributions of fifth-grade adolescents: findings from the first wave of the 4-H study of positive youth development[J]. The Journal of Early Adolescence, 2005, 25(1): 17-71.
[15] Ulrich RS, Simons RF, Losito BD, et al. Stress recovery during exposure to natural and urban environments[J]. Journal of Environmental Psychology, 1991, 11(3): 201-230.
[16] Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation[J]. Psychological Bulletin, 1995, 117(3): 497-529.
[17] Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being[J]. American Psychologist, 2000, 55(1): 68-78.
[18] Pettigrew TF, Tropp LR. How does intergroup contact reduce prejudice? Meta-analytic tests of three mediators[J]. European Journal of Social Psychology, 2008, 38(6): 922-934.
[19] Kashdan TB, Rottenberg J. Psychological flexibility as a fundamental aspect of health[J]. Clinical Psychology Review, 2010, 30(7): 865-878.
[20] Yang Y, Li R, Ge L, et al. Is spending more time outdoors able to prevent and control myopia in children and adolescents? A meta-analysis[J]. Ophthalmic Research, 2024, 67(1): 393-404.
[21] Hobfoll SE. Conservation of resources: a new attempt at conceptualizing stress[J]. American Psychologist, 1989, 44(3): 513-524.
[22] World Health Organization. Making every school a health-promoting school: implementation guidance for school health services[EB/OL]. 2026.
[23] 国家卫生健康委员会,国家疾病预防控制局,中央网络安全和信息化委员会办公室等.儿童青少年“五健”促进行动计划（2026—2030年）,2025.
[24] Mac Cárthaigh S, Griffin C, Perry J. The relationship between sleep and problematic smartphone use among adolescents: a systematic review[J]. Developmental Review, 2020, 55: 100897.
[25] Hisler GC, Twenge JM, Krizan Z. Associations between screen time and short sleep duration among adolescents varies by media type: evidence from a cohort study[J]. Sleep Medicine, 2020, 66: 92-102.
[26] World Health Organization. WHO guidelines on physical activity and sedentary behaviour[EB/OL]. 2020.
[27] World Health Organization. Obesity and overweight[EB/OL]. 2025.
[28] Wang K, Li Y, Liu H, et al. Can physical activity counteract the negative effects of sedentary behavior on the physical and mental health of children and adolescents? A narrative review[J]. Frontiers in Public Health, 2024, 12: 1412389.
[29] Mei Z, Zhang Y, Jiang W, et al. Efficacy of outdoor interventions for myopia in children and adolescents: a systematic review and meta-analysis of randomized controlled trials[J]. Frontiers in Public Health, 2024, 12: 1452567.
[30] World Health Organization. Sugars and dental caries: WHO technical note, May 2025[EB/OL]. 2025.
[31] Cipriano C, Strambler MJ, Naples LH, et al. The state of evidence for social and emotional learning: a contemporary meta-analysis of universal school-based SEL interventions[J]. Child Development, 2023, 94(5): 1181-1204.
[32] Pettigrew TF, Tropp LR. A meta-analytic test of intergroup contact theory[J]. Journal of Personality and Social Psychology, 2006, 90(5): 751-783.
[33] Yang T, Peng S, Li L, et al. The impact of urban road space on uncertainty stress: a population-based study across 43 cities in China[J]. Wellbeing, Space and Society, 2026, 10: 100394.
[34] Zhang W, Peng S, Bottorff JL, et al. The impact of urban regeneration, air pollution, green space, and paved roads on problematic alcohol use: a population-based study across 43 cities in China[J]. Substance Use & Misuse, 2026, 61(9): 1311-1318.
[35] Carleton RN. Into the unknown: a review and synthesis of contemporary models involving uncertainty[J]. Journal of Anxiety Disorders, 2016, 39: 30-43.
[36] United Nations Human Settlements Programme, United Nations Children’s Fund. Child-responsive urban policies, laws and standards: a guidance[M]. 2023.
[37] Chen X，Chen H, Kaspar V, et al. Adolescent social, emotional, and school adjustment in mainland China[J]. International Journal of Group Tensions, 2000，29：51–78.
[38] Yang T, Fisher K J, Li F,et al. Attitudes to smoking cessation and triggers to relapse among Chinese male smokers[J]. BMC public health, 2006, 6(1): 65.
[39] 杨廷忠.健康研究：社会与行为理论级方法[M].人民卫生出版社.2025:131-135.