Gender, internet experience, Internet identification, and internet anxiety: a ten-year followup

Digital Therapeutics: Emerging New Therapy for Nonalcoholic Fatty Liver Disease

The increased prevalence of nonalcoholic fatty liver disease (NAFLD) worldwide is particularly worrisome, as no medication has been approved to treat the disease. Lifestyle modifications aimed at promoting weight loss and weight maintenance remain the current first-line treatment for NAFLD. However, due to the lack of standard and scientific guidance and out-of-hospital supervision, long-term outcomes of lifestyle interventions for patients with NAFLD are often unsatisfactory. In addition, the COVID-19 pandemic aggravated this dilemma. At the same time, digital therapeutics (DTx) are expected to be a new method for the convenient management and treatment of patients with NAFLD and are attracting a great deal of attention. DTx, which provide evidence-based medicine through software programs for remote intervention in preventing, treating, or managing diseases, overcome the drawbacks of traditional treatment. The efficacy of the approach has already been demonstrated for some chronic diseases, but DTx have not been fully developed for NAFLD. This study reviews the concepts, clinical value, and practical applications related to DTx, with an emphasis on recommendations based on unmet needs for NAFLD. A better understanding of the current state will help clinicians and researchers develop high-quality, standardized, and efficient DTx products, with the aim of optimizing the prognosis of patients with NAFLD.

Validity and reliability of the Persian version of the Patient readiness to engage in health information technology (PRE-HIT) instrument

Background

The Patient readiness to engage in health information technology (PRE-HIT) is a conceptually and psychometrically validated questionnaire survey tool to measure willingness of patients with chronic conditions to use health information technology (HIT) resources.

Objectives

This study aimed to translate and validate a health information technology readiness instrument, the PRE-HIT instrument, into the Persian language.

Methods

A rigorous process was followed to translate the PRE-HIT instrument into the Persian language. The face and content validity was validated by impact score, content validity index (CVI) and content validity ratio (CVR). The instrument was used to measure readiness of 289 patients with chronic diseases to engage with digital health with a four point Likert scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was used to check the validity of structure. The convergent and discriminant validity, and internal reliability was expressed by average variance extracted (AVE), construct reliability (CR), maximum shared squared variance (MSV), average shared square variance (ASV), and Cronbach's alpha coefficient. Independent samples, t-test and one-way ANOVA were used respectively to compare the impact of sex, education and computer literacy on the performance of all PRE-HIT factors.

Results

Eight factors were extracted: health information needs, computer anxiety, computer/internet experience and expertise, preferred mode of interaction, no news is good news, relationship with doctor, cell phone expertise, and internet privacy concerns. They explained 69% of the total variance and the KMO value was 0.79; Bartlett's test of sphericity was also statistically significant (sig < 0.001). The communality of items was higher than 0.5. An acceptable model fit of the instrument was achieved (CFI = 0.943, TLI = 0.931, IFI = 0.944, GFI = 0.893, RMSEA ≤ 0.06, χ2/df = 1.625, df = 292, P-value ≤ 0.001). The Cronbach's alpha coefficient achieved a satisfactory level of 0.729. The AVE for all factors was higher than 0.50 except for PMI (0.427) and CIEE (0.463) and also the CR for all factors was higher than 0.7, therefore, the convergent validity of the instrument is adequate. The MSV and ASV values for each factor were lower than AVE values; therefore, the divergent validity was acceptable.

Conclusion

The Persian version of the PRE-HIT was empirically proved for its validity to assess the level of readiness of patients to engage with digital health.

Distinct patterns of problematic smartphone use and related factors in Chinese college students

BACKGROUND

This study aimed to categorize different subgroups of problematic smartphone use in Chinese college students. Differences in gender and psychosocial characteristics of the categorized groups were also examined.

METHODS

A total of 1123 participants completed the Mobile Phone Addiction Index Scale, the Center for Epidemiologic Studies Depression Scale, the Perceived Social Support Scale, and the Perceived Stress Scale. Using latent profile analysis, we identified different subgroups of problematic smartphone use in college students. Multivariate logistic regression analysis was implemented to examine the relationship between latent classes and demographic and psychosocial covariates.

RESULTS

The four following latent classes were identified: a low-risk group, a moderate-risk with no evasiveness group, a moderate-risk with evasiveness group, and high-risk group that accounted for 11%, 24.1%, 35.5%, and 29.4% of the total sample, respectively. Further analysis revealed that female participants were more likely to be in the moderate-risk with evasiveness and high-risk groups, and individuals with depressed mood were more likely to be in the moderate-risk and high-risk groups.

CONCLUSIONS

Classifying college students according to the features of problematic smartphone use is potentially useful for understanding risk factors and developing targeted prevention and intervention programs.

Updating 'Stories' on social media and its relationships to contextual age and narcissism: A tale of three platforms - WhatsApp, Instagram and Facebook

This study extends the uses and gratifications research into the feature use of social media platforms by identifying the motives for updating ‘Stories’ on three social media platforms, i.e. WhatsApp, Instagram and Facebook. Using survey data from adults (N = 338), this research identified seven motivations (i.e. socially rewarding self-promotion, social sharing, social influence, disclosure, escape, entertainment, and trendy fashion) for updating Stories on WhatsApp, Instagram and Facebook. Age and gender differences were identified in the motivations for updating Stories on the three platforms. Cross-platform analysis revealed significant differences in the motivations for updating Stories across the three platforms. Social influence and disclosure motives positively predicted the intensity of updating Stories on all three platforms. Socially rewarding self-promotion predicted the intensity of updating Stories on Instagram and Facebook. Social sharing positively predicted the intensity of updating Stories on WhatsApp and Instagram, and trendy fashion emerged as a positive predictor of story updates only on Instagram. Finally, an analysis of social and psychological predictors revealed that Interpersonal interaction and Social activity positively predicted the intensity of updating Stories across the three platforms. Narcissists also exhibited high intensity of updating Stories on WhatsApp, Instagram, and Facebook.

Associations Between Internet Addiction and Gender, Anxiety, Coping Styles and Acceptance in University Freshmen in South China

Objective: Internet addiction (IA) has become a global public health issue. Although previous studies revealed several risk factors related to IA, most of them focused on the western societies. The present study assesses the relationships between gender and other factors with IA in university freshmen in the South China. Methods: A total of 3,380 first-year college students (1,995 males and 1,385 females) participated in an evaluation of their experiences surfing on the Internet. We investigated the severity of IA in the participants by considering their psychological characteristics, such as acceptance, anxiety levels, and coping styles. Then, we compared the results between males and females and between those in addiction group (Chinese Internet Addiction Scale, CIAS, scores≥64) and non-addiction group (CIAS scores ≤27). We also conducted a logistic regression analysis to detect the relationships between severity of IA and psychological characteristics and gender differences. Results: We observed that males showed significantly higher scores in CIAS than females. The addiction group exhibited significantly higher state anxiety and trait anxiety, and experienced less acceptance of self and others and acceptance by others, and adopted less positive coping style and preferred negative coping style than non-addiction group. The logistic regression analysis revealed that three factors (negative coping styles, acceptance of self and others, state anxiety levels) had a significant association with more severe IA. Conclusion: Gender differences affect the severity of IA in the first-year students in South China. Males with state anxiety and negative coping styles deserve attention because they are likely to be addicted to the Internet. Thus, health practitioners should perform efficient strategies while considering gender differences to precaution first-year college students with the risk factors for IA.

The Effects of Expected Benefits on Image, Desire, and Behavioral Intentions in the Field of Drone Food Delivery Services after the Outbreak of COVID-19

Food delivery services using drones have emerged, but there is not much research on it. Thus, this study was designed to examine how to form behavioral intentions based on the concept of expected benefits in the field of drone food delivery services. More specifically, this study proposed the five dimensions of expected benefits, such as compatibility, social influence, convenience, function, and emotion, have a positive influence on image. In addition, it was proposed that image has a positive influence on desire, which in turn positively affects behavioral intentions. Lastly, this study hypothesized the moderating role of gender in this process. To achieve this purpose, 343 responses were collected in South Korea. The data analysis results showed that five dimensions of expected benefits, such as compatibility, social influence, convenience, function, and emotion have a positive influence on image. In addition, the image aids to enhance desire, which in turn positively affects behavioral intentions. Lastly, gender moderated the relationship between desire and behavioral intentions. The important theoretical and practical implications of this study are discussed later in the paper.

The Quantified Woman: Exploring Perceptions on Health App Use among Austrian Females of Reproductive Age

Smartphones have become the most important commodity for today’s digitalized society. Besides direct interpersonal communication, their most used features are third-party applications (apps). Apps for monitoring health parameters (health apps) are extremely popular, and their users are part of the Quantified Self movement. Little knowledge is available on how health apps are perceived by a female target audience, the Quantified Woman. We conducted a study among Austrian females of reproductive age (n = 150) to analyze prevalence, perceived benefits, and readiness for health app use. In the cross-sectional online German survey, nearly all participants used these apps (98.0%), predominantly for monitoring physical activity and female health (both 31.3%). For the latter, participants used a large variety of different apps for monitoring contraception and menstruation. Perceived benefits and readiness of health app use were only of medium range. Our study assessed aspects of health app use in an understudied segment of the general population. From a Public Health perspective, the Quantified Woman could be empowered by health data collection by enabling her to take active control over how her health graphs develop. We suggest assuring data security and privacy for sensitive female health data collected by health apps.

Investigation of Correlated Internet and Smartphone Addiction in Adolescents: Copula Regression Analysis

Internet and smartphone addiction have become important social issues. Various studies have demonstrated their association with clinical and psychological factors, including depression, anxiety, aggression, anger expression, and behavioral inhibition, and behavioral activation systems. However, these two addictions are also highly correlated with each other, so the consideration of the relationship between internet and smartphone addiction can enhance the analysis. In this study, we considered the copula regression model to regress the bivariate addictions on clinical and psychological factors. Real data analysis with 555 students (age range: 14-15 years; males, N = 295; females, N = 265) from South Korean public middle schools is illustrated. By fitting the copula regression model, we investigated the dependency between internet and smartphone addiction and determined the risk factors associated with the two addictions. Furthermore, by comparing the model fits of the copula model with linear regression and generalized linear models, the best copula model was proposed in terms of goodness of fit. Our findings revealed that internet and smartphone addiction are not separate problems, and that associations between them should be considered. Psychological factors, such as anxiety, the behavioral inhibition system, and aggression were also significantly associated with both addictions, while ADHD symptoms were related to internet addiction only. We emphasize the need to establish policies on the prevention, management, and education of addiction.

How to Reach Technological Early Adopters? An Empirical Analysis of Early Adopters’ Internet Usage Behavior in Germany

Early adopters (EAs) represent a crucial group of consumers in the diffusion of innovations. Therefore, reaching potential technological EAs for up-and-coming innovations is of vital importance. However, little is known as to how potential EAs for new technologies use the Internet. Our study examines the Internet usage of EAs in comparison to the general public and gives an overview of 15 different channels. Consequently, we classified EAs and analyzed a vast set of data containing 119[Formula: see text]829 subjects. The results demonstrate significant differences between EAs and the remaining population and offer marketers new insights into EAs’ Internet usage behavior.

Treatment of Internet Addiction and Internet Gaming Disorder in Adolescence

Internet use is growing year after year and adolescents represent a large proportion of internet users. There is a scholarly interest in teen internet gaming disorder (IGD) and internet addiction (IA) is constantly increasing, but little is known about the treatments of IA and IGD. This study systematically reviews the literature of the last fifteen years, focusing on two main aspects: adolescence, and IA and IGD intervention programs. The inclusion criteria were (1) contain empirical data, (2) include an analysis relating to IA or IGD, (3) include teen samples aged between 13 and 19 years or with an average age within this range, and (4) provide a full-text article published in English. A total number of 17 papers were included, 7 focused on IA and 10 focused on IGD. Prevalence and different treatment-related outcomes are discussed.

Internet addiction detection rate among college students in the People's Republic of China: a meta-analysis

BACKGROUND

With the development of economy and technology, the Internet is becoming more and more popular. Internet addiction has gradually become a serious issue in public health worldwide. The number of Internet users in China has reached 731 million, with an estimated 24 million adolescents determined as having Internet addiction. In this meta-analysis, we attempted to estimate the prevalence of Internet addiction among College Students in the People's Republic of China in order to improve the mental health level of college students and provide evidence for the prevention of Internet addiction.

METHODS

Eligible articles about the prevalence of Internet addiction among college students in China published between 2006 and 2017 were retrieved from online Chinese periodicals, the full-text databases of Wan Fang, VIP, and the Chinese National Knowledge Infrastructure, as well as PubMed. Stata 11.0 was used to perform the analyses.

RESULTS

A total of 26 papers were included in the analyses. The overall sample size was 38,245, with 4573 diagnosed with Internet addiction. The pooled detection rate of Internet addiction was 11% (95% confidence interval [CI] 9-13%) among college students in China. The detection rate was higher in male students (16%) than female students (8%). The Internet addiction detection rate was 11% (95% CI 8-14%) in southern areas, 11% (95% CI 7-14%) in northern areas, 13% (95% CI 8-18%) in eastern areas and 9% (95% CI 8-11%) in the mid-western areas. According to different scales, the Internet addiction detection rate was 11% (95% CI 8-15%) using the Young scale and 9% (95% CI 6-11%) using the Chen scale respectively. Cumulative meta analysis showed that the detection rate had a slight upward trend and gradually stabilized in the last 3 years.

CONCLUSION

The pooled Internet addiction detection rate of Chinese college students in out study was 11%, which is higher than in some other countries and strongly demonstrates a worrisome situation. Effective measures should be taken to prevent further Internet addiction and improve the current situation.

Factors Statistically Predicting At-Risk/Problematic Internet Use in a Sample of Young Adolescent Boys and Girls in South Korea

Aims: This study aimed to investigate in a gender-sensitive manner factors related to at-risk/problematic Internet use (ARPIU) in a sample of young Korean adolescents. Given prior findings, we hypothesized we would observe specific temperamental, social and biological measures that would statistically predict ARPIU in boys and girls, respectively. Method: Subjects included 653 middle-school students from Chuncheon, Korea who completed measures assessing Internet addiction, mood, temperament, and social interactions. Finger digit (2D:4D) ratios were also assessed. Chi-square and logistic regression models were conducted. Results: Among boys and girls, the ARPIU and non-ARPIU groups showed differences in temperament, mood, social tendencies, and gaming behaviors. In boys, IAT correlated inversely with the 2D:4D digit ratio and novelty-seeking and positively with reward-dependence scores when controlling for BDI scores; these relationships were not found in girls. Multivariate analyses showed that among boys, novelty-seeking, harm avoidance, self-transcendence, and daily time spent gaming statistically predicted ARPIU. Among girls, daily time spent gaming, number of best friends, self-directedness, and cooperation statistically predicted ARPIU. Conclusion: ARPIU was linked to specific temperamental, behavioral and biological characteristics, with specific relationships observed in boys and girls. Specific risk factors may exist for boys and girls with respect to their propensities to developing ARPIU, suggesting the need for gender-sensitive approaches to prevent ARPIU in youth.

Los estereotipos de género y las TICs en estudiantes de secundaria

Este trabajo explora las diferencias de género en estudiantes de secundaria a la hora de interactuar con las TICs. La investigación fue realizada con una muestra de 351 alumnos de 6 centros educativos públicos de Galicia. Se aplicó un cuestionario en el que se medían aspectos relacionados con el acceso, experiencia, frecuencia y uso que hacían, tanto de los computadores como de internet, asi como la percepción de autoeficacia, actitudes y estereotipos de género.  

The effects of internet filtering on users’ information-seeking behaviour and emotions

Purpose

The purpose of this paper is to investigate the relationship between internet filtering, emotions and information-seeking behaviour.

Design/methodology/approach

In total, 15 postgraduate students at an Iranian university participated in the study which involved a questionnaire, search tasks with think aloud narratives, and interviews.

Findings

Internet content filtering results in some changes in the information-seeking behaviour of users. Users who face website blocking use a variety of methods to bypass filtering, mostly by using anti-filter software. Filtering encourages users to use channels such as social networking services to share resources and it increases the use of library material by some of the users. Users who face filtering during their search are more likely to visit more pages of results and click on more hits in the results, unlike users who do not experience filtering who rarely go past the first page. Blocking users’ access to content stimulates their curiosity and they become more determined to access the content. In terms of the affective aspect, filtering causes several negative emotions (e.g. anger, disgust, sadness and anxiety) and the main reason for these emotions is not the inability to access information but the feeling of being controlled and not having freedom.

Research limitations/implications

The study was limited to a small number of postgraduate students in social sciences and not generalisable to all user groups. The implication is that in countries where filtering is used, libraries can play an important role in serving users and reducing users negative emotions, especially if libraries can take advantage of technologies such as social media for their services.

Originality/value

This is first study to address the effects of internet filtering on information-seeking behaviour and emotions. The study shows that internet filtering causes negative emotions and results in some changes in information-seeking behaviour.

Internet-Based Resources for Disease Self-Care Among Middle-Aged and Older Women with Chronic Conditions

OBJECTIVE

This two-part study analyzed data collected from middle-aged (age 44-64) and older women (age 65+) with one or more chronic conditions who completed the National Council on Aging Chronic Care Survey.

MATERIALS AND METHODS

Part One analyzed data from 418 women to describe sociodemographics, disease types, and healthcare utilization associated with Internet use among middle-aged and older women with 1 or more chronic diseases. Part Two analyzed data from the 251 Internet-using women to identify the online self-care resources they are using (format, host organization) and for what purposes.

RESULTS

Approximately 31% of participants were age 65 years or older, 30% reported having three or more chronic condition types, and 65% reported using the Internet. A significantly larger proportion of older women reported multiple chronic conditions, and a significantly fewer number of older women reported using the Internet. A significantly smaller proportion of Internet users were non-Hispanic white, more educated, and employed. A significantly larger proportion of non-Internet users reported needing help learning what to do to manage their health conditions and needing help learning how to care for their health conditions. Among only Internet-using women, 18.7% participated in online discussions/chatrooms/listserv and 45.2% read about the experiences of others with chronic diseases. Interest in websites and online courses varied.

CONCLUSION

Understanding Internet use among women with chronic conditions can inform targeted efforts to increase Internet availability, educate potential users about the benefits of online resources, and effectively tailor Internet-based materials to self-care needs.

Cardiac patients show high interest in technology enabled cardiovascular rehabilitation

BACKGROUND

Cardiac rehabilitation (CR) can slow or reverse the progression of cardiovascular disease (CVD). However, uptake of community-based CR is very low. E-cardiology, e-health and technology solutions for physical activity uptake and monitoring have evolved rapidly and have potential in CVD management. However, it is unclear what the current technology usage is of CVD patients, and their needs and interests for technology enabled CR.

METHODS

A technology usage questionnaire was developed and completed by patients from a supervised ambulatory CR program and an adult congenital heart disease clinic and from two community-based CR programs. Results were described and related with age, gender and educational level by Spearman correlations.

RESULTS

Of 310 patients, 298 patients (77 % male; mean age 61,7 ± 14,5 years) completed at least 25 questions of the survey and were included in the analysis (completion rate 96 %). Most (97 %) patients had a mobile phone and used the internet (91 %). Heart rate monitors were used by 35 % and 68 % reported to find heart rate monitoring important when exercising at home. Physical activity monitoring was reported by 12 % of the respondents. Respondents were interested in CR support through internet (77 %) and mobile phone (68 %). Many patients reported interest in game-based CR (67 %) and virtual rehabilitation (58 %). At least medium interest in technology enabled CR was reported by 75 % of the patients. Interest decreased with increasing age (r = -0.16; p = 0.005).

CONCLUSIONS

CVD patients show interest for technology enabled home-based CR. Our results could guide the design of a technology-based, virtual CR intervention.

Latent class analysis on internet and smartphone addiction in college students

PURPOSE

This study aimed to classify distinct subgroups of people who use both smartphone and the internet based on addiction severity levels. Additionally, how the classified groups differed in terms of sex and psychosocial traits was examined.

METHODS

A total of 448 university students (178 males and 270 females) in Korea participated. The participants were given a set of questionnaires examining the severity of their internet and smartphone addictions, their mood, their anxiety, and their personality. Latent class analysis and ANOVA (analysis of variance) were the statistical methods used.

RESULTS

Significant differences between males and females were found for most of the variables (all <0.05). Specifically, in terms of internet usage, males were more addicted than females (P<0.05); however, regarding smartphone, this pattern was reversed (P<0.001). Due to these observed differences, classifications of the subjects into subgroups based on internet and smartphone addiction were performed separately for each sex. Each sex showed clear patterns with the three-class model based on likelihood level of internet and smartphone addiction (P<0.001). A common trend for psychosocial trait factors was found for both sexes: anxiety levels and neurotic personality traits increased with addiction severity levels (all P<0.001). However, Lie dimension was inversely related to the addiction severity levels (all P<0.01).

CONCLUSION

Through the latent classification process, this study identified three distinct internet and smartphone user groups in each sex. Moreover, psychosocial traits that differed in terms of addiction severity levels were also examined. It is expected that these results should aid the understanding of traits of internet and smartphone addiction and facilitate further study in this field.

Evaluation of a Web-based social network electronic game in enhancing mental health literacy for young people

BACKGROUND

Internet-based learning programs provide people with massive health care information and self-help guidelines on improving their health. The advent of Web 2.0 and social networks renders significant flexibility to embedding highly interactive components, such as games, to foster learning processes. The effectiveness of game-based learning on social networks has not yet been fully evaluated.

OBJECTIVES

The aim of this study was to assess the effectiveness of a fully automated, Web-based, social network electronic game on enhancing mental health knowledge and problem-solving skills of young people. We investigated potential motivational constructs directly affecting the learning outcome. Gender differences in learning outcome and motivation were also examined.

METHODS

A pre/posttest design was used to evaluate the fully automated Web-based intervention. Participants, recruited from a closed online user group, self-assessed their mental health literacy and motivational constructs before and after completing the game within a 3-week period. The electronic game was designed according to cognitive-behavioral approaches. Completers and intent-to-treat analyses, using multiple imputation for missing data, were performed. Regression analysis with backward selection was employed when examining the relationship between knowledge enhancement and motivational constructs.

RESULTS

The sample included 73 undergraduates (42 females) for completers analysis. The gaming approach was effective in enhancing young people's mental health literacy (d=0.65). The finding was also consistent with the intent-to-treat analysis, which included 127 undergraduates (75 females). No gender differences were found in learning outcome (P=.97). Intrinsic goal orientation was the primary factor in learning motivation, whereas test anxiety was successfully alleviated in the game setting. No gender differences were found on any learning motivation subscales (P>.10). We also found that participants' self-efficacy for learning and performance, as well as test anxiety, significantly affected their learning outcomes, whereas other motivational subscales were statistically nonsignificant.

CONCLUSIONS

Electronic games implemented through social networking sites appear to effectively enhance users' mental health literacy.

Comparing first and second generation digital natives' Internet use, Internet anxiety, and Internet identification

The aim of the study was to compare first and second generation Digital Natives' attitudes toward and use of the Internet. The sample of first generation Digital Natives consisted of 558 students who we surveyed in 2002 and who were born after 1980. The sample of second generation Digital Natives consisted of a sample of 458 students who we surveyed in 2012 and were born after 1993. They completed a questionnaire in the first semester of their first academic year, which consisted of a measure of Internet experience, an Internet anxiety scale, and an Internet identification scale. Second generation Digital Natives had more positive attitudes toward the Internet than first generation Digital Natives. They had higher scores on the Internet identification scale and lower scores on the Internet anxiety scale compared with first generation Digital Natives. Furthermore, we found that second generation Digital Natives used the Internet more than first generation Digital Natives. E-mail was the most popular activity for both generations, although second generation Digital Natives used it significantly more than first generation Digital Natives. Social networking sites emerged as very popular for second generation Digital Natives. Both generations reported low use of Web 2.0 technologies.