University Students' Knowledge, Attitudes, and Practices Regarding Cervical Spine Health

Prolonged sedentary behavior and electronic device use jeopardize university students' cervical spine health. This study investigated their knowledge, attitudes, and practices (KAP) concerning cervical spine health.

From May 25 to June 16, 2023, a cross-sectional survey was conducted among students at various Chinese universities. Demographic data and KAP scores were collected using self-developed questionnaires. Using 60% and 80% as cut-off values, KAP levels were categorized into three tiers: knowledge (inadequate: 0-7, moderate: 8-11, good: 12-15), attitudes (negative: 8-23, neutral: 24-31, positive: 32-39), and practices (inappropriate: 7-20, moderate: 21-28, proactive: 29-35).

Of 1,956 valid questionnaires, their mean age was 19.88 ± 1.40 years, with 71.8% of female gender. Notably, 75.9% reported daily electronic device use ≥4 hours. Regarding initial device acquisition, 37.1% obtained devices in middle school, 30.6% in high school, 22.5% in elementary school, and 9.9% in college. Mean knowledge, attitudes, and practices scores were 10.4 ± 2.1, 34.1 ± 3.9, and 20.9 ± 4.1. Multivariate logistic regression revealed that female students (OR = 1.39, 95% CI: 1.10-1.75), non-freshmen (OR = 1.74, 95% CI: 1.42-2.13), and acquiring knowledge through WeChat (OR = 1.86, 95% CI: 1.47-2.36) or community hospitals (OR = 1.60, 95% CI: 1.29-1.99) had higher probability of adequate knowledge. Non-medical majors (OR = 0.47, 95% CI: 0.39-0.58) and using electronic devices for 3-4 hours (OR = 0.67, 95% CI: 0.45-0.99) or ≥4 hours daily (OR = 0.64, 95% CI: 0.46-0.89) were negatively associated with attitudes. Positive attitudes (OR = 1.27, 95% CI: 1.22-1.31) and obtaining knowledge from medical experts (OR = 1.30, 95% CI: 1.03-1.63) were associated with better practices, while female students (OR = 0.56, 95% CI: 0.44-0.72) and frequent cervical discomfort (OR = 0.26, 95% CI: 0.13-0.53) were the opposite.

University students exhibited moderate knowledge, positive attitudes, and inappropriate practices regarding cervical spine health. Educational interventions are recommended, particularly for non-medical majors, individuals with prolonged digital device use, and freshmen.