title: Measuring effort-reward imbalance in school settings: a novel approach and its association with self-rated health.
abstract: BACKGROUND
  We attempted to apply the model of effort-reward imbalance (ERI) to school settings in order to measure students' psychosocial stress and analyze its association with self-rated health in adolescents.
  
  
  METHODS
  A cross-sectional survey was conducted in Kunming, China among 1004 Chinese students (468 boys and 536 girls) in grades 7 through 12, using a 19-item effort-reward imbalance questionnaire.
  
  
  RESULTS
  Satisfactory internal consistencies for the scales for effort and reward were obtained; the value for the scale for overcommitment was acceptable. Factor analysis replicated the theoretical structure of the ERI construct in this sample of Chinese students. All 3 scales were associated with an elevated odds ratio for diminished self-rated health, and the effect was strongest for the effort-reward ratio, as predicted by the theory. Sex and grade differences were also observed.
  
  
  CONCLUSIONS
  The ERI questionnaire is a valid instrument for identifying sources of stressful experience, in terms of effort-reward imbalance, among adolescents in school settings.
authors.affiliation: Department of Medical Sociology, University of Duesseldorf, Duesseldorf, Germany. lijian1974@hotmail.com
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Li
authors.initials: L
authors.lastname: Shang
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Johannes
authors.initials: J
authors.lastname: Siegrist
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011594:Psychometrics / Q000379:methods*; D012201:Reward; D012574:Schools; D012647:Self-Assessment; D013315:Stress, Psychological / Q000453:epidemiology*; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires