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Peng B, Ling L. Health service behaviors of migrants: A conceptual framework. Front Public Health 2023; 11:1043135. [PMID: 37124818 PMCID: PMC10140430 DOI: 10.3389/fpubh.2023.1043135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/14/2023] [Indexed: 05/02/2023] Open
Abstract
Universal health coverage is vital to the World Health Organization's (WHO's) efforts to ensure access to health as a human right. However, it has been reported that migrants, including both international immigrants and internal migrants, underuse health services. Establishing a conceptual framework to facilitate research on the health service behaviors (HSB) of migrants is particularly important. Many theoretical frameworks explaining the general population's HSB have been published; however, most theoretical frameworks on migrants' HSB only focus on international immigrants without the inclusion of internal migrants. Of note, internal migrants are much more abundant than immigrants, and this group faces similar barriers to HSB as immigrants do. Based on theoretical frameworks of immigrants' HSB and Anderson's behavior model, the author proposes a new conceptual framework of migrants' HSB that includes both immigrants and internal migrants. The new conceptual framework divides the determinants into macro-structural or contextual factors, health delivery system characteristics, and characteristics of the population at risk and describes subgroup-specific factors. The author added some variables and reclassified variables in some dimensions, including characteristics of health delivery systems and access to healthcare. The characteristics of health delivery systems comprise the volume, organization, quality, and cost of the health delivery system, while the characteristics of access to healthcare include time accessibility, geographic accessibility, and information accessibility. The outcomes of HSB have been expanded, and relationships between them have been reported. The mediating effects of some variables have also been described. This conceptual framework can facilitate a deep and comprehensive understanding of the HSB determination process for migrants, including internal migrants.
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Affiliation(s)
- Boli Peng
- Department of Actuarial Science, School of Insurance, Guangdong University of Finance, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Li Ling,
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Wen J, Mai X, Li W, Liu X. The Influence of Message Framing on Elderly Tourists' Purchase Intentions of Health Services: A Case Study of Guangxi Bama. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14100. [PMID: 36360978 PMCID: PMC9658176 DOI: 10.3390/ijerph192114100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Traveling has become an increasingly important lifestyle for the elderly to realize active aging. The elderly are more inclined to pay attention to wellbeing-related products whilst on vacations, representing a market opportunity for providers of tourism health services. This study conducted an experiment to explore how message framing affects intentions to purchase health services in elderly tourists over the age of 59 years. A total of 216 elderly tourists from Bama, a famous wellness tourism destination in China, were recruited as participants for a single-factor (message framing: positive versus negative) experiment. Our results indicate the following: (1) message framing has a significant impact on elderly tourists' intentions to purchase health services. Compared with messages that are negatively framed, positive messages are more persuasive. (2) Perceived benefits mediate the above relationship. (3) Perceived susceptibility moderates the impact of message framing around perceived benefits, as well as the indirect effect of perceived benefits on purchase intention. Theoretically, this paper clarifies the mechanism and conditions of message framing in relation to its effects on consumer intentions, enriching knowledge about the intersection between tourism and health consumption. This paper also provides guidance for providers of health tourism who are seeking to capture the market of elderly tourists.
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Affiliation(s)
- Ji Wen
- Shenzhen Tourism College, Jinan University, Shenzhen 518053, China
| | - Xiaolin Mai
- School of Management, Jinan University, Guangzhou 510632, China
| | - Wei Li
- School of Management, Jinan University, Guangzhou 510632, China
| | - Xin Liu
- Shenzhen Tourism College, Jinan University, Shenzhen 518053, China
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Shi X, Zong D, Lu Z, Li S, Kong F. Effects of childcare disagreement with children, social support, and health status on unmet healthcare-seeking behavior among the migrant older with children to Jinan, China. Front Public Health 2022; 10:957619. [PMID: 36299760 PMCID: PMC9589225 DOI: 10.3389/fpubh.2022.957619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/11/2022] [Indexed: 01/24/2023] Open
Abstract
Due to the acceleration of China's urbanization, the number of migrant older with children (MOC) continued to increase. This study aimed to clarify the effects of childcare disagreement with children, social support, and health status on unmet healthcare-seeking behavior among the MOC to Jinan, China. A cross-sectional study included 656 MOC (36.3% men and 63.7% women) using multi-stage cluster random sampling in Jinan, China. Childcare disagreement was evaluated by the differences between parents and grandparents on the diet, dressing, education, and childcare consumption. Social support was assessed using the social support rating scale (SSRS). Descriptive analysis, chi-squared test, and binary logistic regression were applied to analyze the association between childcare disagreement with children, social support, health status, and unmet healthcare-seeking behavior of the MOC. Approximately 41.3% of participants had unmet healthcare-seeking behavior. Logistic regression analysis showed that the MOC whose health status compared to last year get better were more likely to have unmet healthcare-seeking behavior, while who were women, had partial will of migration, hired a nanny, had smaller childcare disagreement with children on dressing, had smaller childcare disagreement with children on consumption, and had moderate social support, were less likely to experience unmet healthcare-seeking behavior. Recommendations were given to the government and family members to improve the health services-seeking behavior of the MOC.
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Affiliation(s)
- Xinfei Shi
- 1Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, China,2NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Di Zong
- 1Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, China,2NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Zhongqian Lu
- 1Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, China,2NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shixue Li
- 1Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, China,2NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China,*Correspondence: Shixue Li
| | - Fanlei Kong
- 1Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, China,2NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China,Fanlei Kong
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Mai S, Cai J, Li L. Factors associated with access to healthcare services for older adults with limited activities of daily living. Front Public Health 2022; 10:921980. [PMID: 36276353 PMCID: PMC9583939 DOI: 10.3389/fpubh.2022.921980] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/02/2022] [Indexed: 01/22/2023] Open
Abstract
Background Limited studies focused on the situation and related factors of access to healthcare services for older adults with limited activities of daily living (ADL) in China. This study explores factors associated with access to healthcare services of them based on Andersen's healthcare utilization model (namely, need, predisposing, and enabling dimensions). Methods A total of 3,980 participants aged 65 years and older adults with limited ADL from the latest wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included. Binary logistic regression was used to explore the influencing factors. Results Factors in enabling dimension were associated with access to healthcare services for older adults with limited ADL. Those who lived with better economic status (fair vs poor, OR = 2.98, P < 0.01; rich vs poor, OR = 7.23, P = 0.01), could afford daily life (yes vs no, OR = 2.33, P = 0.03), and lived in the eastern or central region of China (eastern vs western, OR = 2.91, P < 0.01; central vs western, OR = 2.40, P = 0.02) could access to healthcare services more easily. However, factors in predisposing dimension and need dimension showed no statistical significance. Meanwhile, inconvenience in the movement was the major barrier reported by some participants for not going to the hospital when they got sick. Conclusion Access to healthcare services for older adults with ADL limitation was mainly related to the factors of economic status, affordability for daily life, and living regions in enabling dimension. Strategies focused on health insurance, healthcare system, barrier-free facilities, and social support were proposed to increase the access to healthcare services for participants, which could benefit their health.
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Affiliation(s)
- Shumin Mai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingjing Cai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lu Li
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China,Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China,*Correspondence: Lu Li
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Du Q, Gong N, Hu Q, Chen G, Xie J, Luo L, Cheng Y, Zhang M. Why do older adults living alone in cities cease seeking assistance? A qualitative study in China. BMC Geriatr 2022; 22:540. [PMID: 35768784 PMCID: PMC9241305 DOI: 10.1186/s12877-022-03217-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Against the background of an aging population, older adults living alone in cities are increasingly dependent. However, their use of home and community-based services in China is unsatisfactory. This study attempted to figure out why older adults living alone in cities do not actively seek assistance in China. Methods In-depth interviews were conducted. A total of 29 older adults were recruited. Content analysis was used to analyze the interview data. Results Three themes were identified. (1) Desire for independence, despite hardship: The lives of older adults involve many inconveniences, but they preferred to solve problems by themselves, instead of asking for help; (2) Desire to not overburden jiaren (meaning family in Chinese): older adults did not want to disturb families or burden children with caring responsibilities. Moreover, previous experience of failing to obtain care made them reluctant to seek help from jiaren; (3) Desire to not bother wairen (meaning people other than family in Chinese): The lack of trust caused by being unfamiliar with wairen, and the fear of being a burden to others if they were not able to reciprocate, made older adults reluctant to seek help from wairen. Conclusions Changes in social, economic, and demographic structures have led to gradual failure of family care. Older adults accustomed to an “acquaintance society” have not yet adapted to seeking help from the community. When addressing the problem of care for older adults living alone in cities, it is important to focus on the profound impact of social change.
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Affiliation(s)
- Qianqian Du
- School of Nursing, Sun Yat-Sen University, No.74, Zhongshan Road II, Guangzhou, Guangdong, China
| | - Ni Gong
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Qin Hu
- School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Guicheng Chen
- Guangzhou Tianhe District Qizhi Social Work Service Center, Guangzhou, Guangdong, China
| | - Jingyue Xie
- School of Nursing, Sun Yat-Sen University, No.74, Zhongshan Road II, Guangzhou, Guangdong, China
| | - Lan Luo
- Huangpu District Hongshan Street Community Health Service Center, Guangzhou, Guangdong, China
| | - Yu Cheng
- The Seventh Affiliated Hospital Sun Yat-Sen University, No.628, Zhenyuan Road, Xinhu Street, Guangming New District, Shenzhen, Guangdong, China.
| | - Meifen Zhang
- School of Nursing, Sun Yat-Sen University, No.74, Zhongshan Road II, Guangzhou, Guangdong, China.
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How Different Is the Annual Physical Examination of Older Migrants than That of Older Nonmigrants? A Coarsened Exact Matching Study from China. Healthcare (Basel) 2022; 10:healthcare10050815. [PMID: 35627952 PMCID: PMC9141086 DOI: 10.3390/healthcare10050815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/09/2022] [Accepted: 04/25/2022] [Indexed: 02/01/2023] Open
Abstract
It has become a top priority to ensure equal rights for older migrants in China. This study aims to explore how different the annual physical examination of older migrants is compared to that of older nonmigrants in China by using a coarsened exact matching method, and to explore the factors affecting annual physical examination among older migrants in China. Data were drawn from the China Migrants Dynamic Survey 2015 and China Health and Retirement Longitudinal Survey 2015. The coarsened exact matching method was used to analyse the difference in the annual physical examination of older migrants and nonmigrants. A logistic regression was used to analyse the factors affecting annual physical examination among older migrants. The annual physical examination of older migrants was 35.6%, which was significantly lower than that of older nonmigrants after matching (Odds ratios = 0.91, p < 0.05). It was affected by education, employment, hukou, household economic status, health, health insurance, main source of income, type of migration, range of migration, years of migration, having health records in local community and number of local friends among older migrants in China. Older migrants adopted negative strategies in annual physical examination compared to older nonmigrants. Active strategies should be made to improve the equity of annual physical examination for older migrants in China.
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Public Health Service and Migration Destinations among the Labor of Xinjiang Uygur Autonomous Region of China. SUSTAINABILITY 2022. [DOI: 10.3390/su14084718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The relationship between public investment and population migration is a classic topic in developing regions. With social and economic development, the role of public health services is paid high attention. However, empirical studies on the relationship between public health services and labor migration are rare, especially for populations from minority areas. This study investigated the correlation between public health services and migration destinations and its heterogeneity among laborers from Xinjiang. Data of the annual Xinjiang Statistical Yearbook and the CMDS are used, and multinomial logit regressions are adopted. The results show that public health services in a county have a significant and negative correlation with the probability of migration with a long range among laborers from Xinjiang. This correlation is inclusive of gender, age, human capital, hukou, marital status, home region, and economic status. It implies that the improvement of public health services in Xinjiang can attract laborers to live and work there, which could contribute to the revitalization of Xinjiang and reduce the development gap between Xinjiang and other provinces.
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Family Support and Social Support Associated with National Essential Public Health Services Utilization among Older Migrants in China: A Gender Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031610. [PMID: 35162632 PMCID: PMC8835676 DOI: 10.3390/ijerph19031610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
China provides National Essential Public Health Services (NEPHS) free of charge to all citizens to ensure access to essential health services. The present study aimed to explore the associations between different sources of support and NEPHS service utilization among older migrants in China with a gender perspective. We used a national cross-sectional dataset derived from the 2015 China Migrants Dynamic Survey. Participants were included if they were aged ≥60 years and without household registration at the residence. Among 1989 participants, 35.2% enrolled in a free physical examination in the past year: 34.6% for males and 35.9% for females. Among male participants, having more local friends (OR = 1.47, 95% CI: 1.09, 1.99) and having insurance at the residence (OR = 1.75, 95% CI: 1.03, 2.96) were associated with enrolment in a free physical examination after controlling for age, education, and self-reported health status. Two additional factors, marital status and family structure, were found for female participants to be associated with enrolment in a free physical examination. NEPHS service utilization was far from satisfactory among older migrants in China, and both family support and social support played a role in it. There are common and unique factors associated with NEPHS service utilization in terms of gender.
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Ouyang Q, Li S, Gao M, Zhu L, Xu S, Meng S, Wu S, Huang L, Su F, Ren Z, Chen K, Min Peng. Risk factors associated with loss to follow-up of breast cancer patients: A retrospective analysis. Breast 2021; 57:36-42. [PMID: 33711698 PMCID: PMC7970119 DOI: 10.1016/j.breast.2021.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/05/2021] [Accepted: 02/17/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Loss to follow-up (LTFU) during post-operative surveillance of breast cancer patients is detrimental. The pattern of LTFU and its risk factors in Chinese breast cancer patients remains unknown. METHOD Eligible non-metastatic breast cancer patients who underwent surgery at our institution between 2009 and 2012 were included. The clinicopathological features, as well as the LTFU status, were retrieved from the REDCap database. LTFU was defined as the absence of patients for at least 12 months since her last contact. 5-year LTFU was defined as the LTFU status of each patients at 5 years after surgery. The incidence and potential risk factors of LTFU were analyzed. A LTFU-risk score was developed to quantify the risk of LTFU. RESULTS A total of 1536 patients with breast cancer were included, and 411(26.8%) patients were 5-year LTFU. 198 patients were LTFU in the first year. Univariate and multivariate analysis revealed that age (younger and older), a lack of medical insurance, longer distance from residence to the hospital, pathology (DCIS/Paget's/Phyllodes), lymph node metastasis, the absence of endocrine therapy and fewer than five contact numbers were significantly and independently associated with the risk of LTFU. A LTFU-risk score was developed and was predictive of LTFU. CONCLUSIONS A series of risk factors were significantly associated with post-operative LTFU of breast cancer patients. Patients with different risks of LTFU could possibly be identified, and surveillance plans could be individualized for different patients, so as to effectively reduce the overall LTFU rate, and optimize the allocation of medical resources.
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Affiliation(s)
- Qian Ouyang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Shunrong Li
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Ming Gao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Liling Zhu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Shiyun Xu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Shunhao Meng
- Disease Registry Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Siqiao Wu
- Disease Registry Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Liqiu Huang
- Disease Registry Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Fengxi Su
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China
| | - Zefang Ren
- Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China
| | - Kai Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China.
| | - Min Peng
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China; Disease Registry Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China.
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Ke P, Ke L, Liu B, Liu X. The Relationship Between Mental Health and Psychosocial Stress of Reservoir Migrants in the Middle Route of China's South-to-North Water Diversion Project (SNWDP): The Mediating Role of Social Support. Psychol Res Behav Manag 2021; 14:299-306. [PMID: 33727870 PMCID: PMC7955681 DOI: 10.2147/prbm.s297416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
Background South–North Water Diversion Project (SNWDP) migrants were vulnerable to developing mental health problems due to post-migration stresses and lack of social support. However, the evidence on the mental health, psychosocial stress and social support of SNWDP migrants and their interrelationships are limited and inconclusive. We aimed to explore the mechanism of influence of social support on the relationship between mental health and social psychosocial stress of SNWDP migrants. Methods We performed a cross-sectional analysis of the data of 983 SNWDP migrants. The mental health status, psychosocial stress and social support of the participants were evaluated by Symptom Checklist-90-Revised (SCL-90-R), Psychosocial Stress Survey for Groups (PSSG) and Social Support Rating Scale (SSRS). Multiple stepwise regression model was used to analyze the data. Results Among the 983 individuals, the average SCL-90-R score was 1.47, the PSSG score was 30.50, and the SSRS score was 40.30. The SCL-90-R was positively correlated with PSSG (r=0.483, P<0.001) and negatively correlated with SSRS (r=−0.257, P<0.001), PSSG was negatively correlated with SSRS (r=−0.516, P<0.001). Multiple regression analysis showed that PSSG and SSRS had significant effects on SCL-90-R prediction and that SSRS played a partial intermediary role in SCL-90-R and PSSG (46.87%). Conclusion The SNWDP migrants performed a strong correlation between social support, mental health and psychosocial stress. Social support plays a part role in mediating mental health and psychosocial stress.
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Affiliation(s)
- Pan Ke
- School of Public Health (SPH), Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, 430040, People's Republic of China
| | - Li Ke
- School of Nursing, Hubei University of Medicine, Shiyan, 442000, People's Republic of China
| | - Bing Liu
- School of Public Health, Hubei University of Medicine, Shiyan, 442000, People's Republic of China
| | - Xiang Liu
- Health Management Center, Shiyan People's Hospital, Affiliated Hubei University of Medicine, Shiyan, 442000, People's Republic of China
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Long C, Tang S, Wang R, Ji L, Wang Y, Wu T, Li Z, Feng Z. The migrating mediators and the interaction associated with the use of essential public health services: a cross-sectional study in Chinese older migrants. BMC Geriatr 2020; 20:475. [PMID: 33198656 PMCID: PMC7670818 DOI: 10.1186/s12877-020-01878-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 11/09/2020] [Indexed: 11/15/2022] Open
Abstract
Background Despite the incremental implementation of the essential public health services (EPHS) during the last decade, the goal of EPHS’s equalization is impossible to cannot be achieved without appropriate policies targeting older migrants. Therefore, this study aims to examine whether the supply side meets the needs of older migrants and to explore the relationships among health status, the use of health services, and diverse factors. Methods The data were derived from a national cross-sectional dataset (N = 11,161) of the 2015 Chinese Migrant Dynamic Monitoring Survey. Mediating effects analysis and moderating effects analysis were conducted to explore the interactions between physical status and the use of EPHS in older migrants such as physical examination, health record, and follow-up services. Results The use of physical examination, health record, and follow-up services were correlated with each other. Household income, migrating for employment, and migrating for offspring were negatively associated with the use of EPHS. A positive association was observed between the use of EPHS and willingness for long-stay. The mediating effects of household income, migrating for employment, migrating for offspring, and willingness for long-stay were observed on the relationship between physical status and the use of EPHS. The moderating effects of household income and migrating for employment were discovered. Conclusion Public health policies that may be worthy of consideration include further enhancing the delivery capacity of primary health institutions, integrating professional clinical resources into the primary health system, and launching the target policies to improve the accessibility of EPHS in older migrants.
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Affiliation(s)
- Chengxu Long
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Lu Ji
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Yang Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Tailai Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Zhifei Li
- China National Center for Biotechnology Development, 16 West Sihuan Middle Road, Beijing, 100039, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
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The Association between Social Integration and Utilization of Essential Public Health Services among Internal Migrants in China: A Multilevel Logistic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186524. [PMID: 32911649 PMCID: PMC7559733 DOI: 10.3390/ijerph17186524] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/30/2020] [Accepted: 09/04/2020] [Indexed: 12/26/2022]
Abstract
This study investigated the association between social integration and utilization of essential public health services among internal migrants. Data were from the 2017 China Migrants Dynamic Survey. Social integration was measured through four dimensions: economic integration, structural integration, sociocultural adaptation, and self-identity. Multilevel logistic regressions were used taking into account heterogeneity in the level of regional development. The utilization of health records and health education was less than 40% and varied widely across regions. Social integration was related to a higher likelihood of utilization of health records and health education. Moreover, sociocultural adaptation had a stronger effect on the utilization of health records in developed regions than in developing regions, and structural integration was strongly and positively related to the utilization of health education in developed regions. Hence, it appears that the relationship of some dimensions of social integration and utilization of essential public health services is moderated by the level of economic development. Promoting structural integration and sociocultural adaptation could strongly improve utilization of essential public health services in developed regions.
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