In this study, the trends, discontinuity, and their effect size of SMRPs of male and female middle-school, high-school, and university students from 2007 to 2022 were analyzed by joinpoint regression analysis (JPRA) using the Joinpoint Regression Program version 5.0.2 (National Cancer Institute).10 (link),12 (link),31 ,32 (link) The differences in SMRPs among sexes (male and female students) and schools (middle school, high school, and university) from 2007 to 2022 were compared using linear mixed-effect models with the Scheffe post hoc test using SPSS statistical software for Windows version 27 (IBM).11 (link),13 (link) The detailed statistical methods are described in the eAppendix in Supplement 1. Two-tailed P < .05 was considered statistically significant.
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