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Mo PKH, Xie L, Fong VWI, Sum RKW, Leung EFL, Wong SWS, Kwok TCY, Lau JTF. Efficacy of a theory-based and setting-based intervention in promoting strength training among older adults in Hong Kong: A clustered randomized controlled trial. Appl Psychol Health Well Being 2024. [PMID: 38757468 DOI: 10.1111/aphw.12548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/11/2024] [Indexed: 05/18/2024]
Abstract
The present study aimed to examine the efficacy of an intervention, based on the Health Belief Model (HBM) and social support, in promoting strength training (ST) among older adults. A two-arm clustered randomized controlled trial (RCT) was conducted among 235 older adults from eight elderly centers in Hong Kong. The intervention group engaged in a 6-month intervention comprising ST sessions, exercise consultations, social gatherings, and a buddy program, while the control group participated in social gatherings. Assessments were conducted at baseline (Month 0), post-intervention (Month 6), and 3-month follow-up (Month 9), with primary outcome being the prevalence of meeting the American College of Sports Medicine (ACSM) recommendations of ST. Results showed that the intervention group reported significantly higher prevalence of meeting ACSM recommendations for ST at both post-intervention and follow-up. Linear mixed models showed significant interaction effect between condition and time on perceived susceptibility of sarcopenia and muscle strength and significant condition effect on self-efficacy for ST, perceived severity of sarcopenia, perceived barriers of ST, and intention to perform ST. Findings suggest that the intervention, guided by HBM and social support, improves older adults' ST participation, muscle strength, perceptions on sarcopenia, and self-efficacy for ST, which offers great potential for broader application in other settings.
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Affiliation(s)
- Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Hong Kong, China
| | - Luyao Xie
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Hong Kong, China
| | - Vivian W I Fong
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Hong Kong, China
| | - Raymond K W Sum
- Department of Sport Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Elean F L Leung
- Physical Education Unit, The Chinese University of Hong Kong, Hong Kong, China
| | - Sam W S Wong
- Physical Fitness Association of Hong Kong, Hong Kong, China
| | - Timothy C Y Kwok
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- Public Mental Health Center, School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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Xie L, Mo PKH, Wang Z, Tian X, Lau JTF. Men who have sex with men were more depressed than their counterparts because of lower social support and higher loneliness: A comparative survey among Chinese university students. J Affect Disord 2024; 353:11-18. [PMID: 38373515 DOI: 10.1016/j.jad.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 01/23/2024] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Poor mental health is prevalent among men who have sex with men (MSM), including MSM university students (MSMUS), causing a significant burden on their health and society. The study aimed to compare the difference in levels of depressive symptoms between Chinese MSMUS and non-MSMUS and test the mediating roles of social support and loneliness in the relationship between MSM status and depressive symptoms among male university students. METHODS From June to October 2018, a total of 305 MSMUS and 2447 non-MSMUS from two cities in Sichuan province (China) were investigated using questionnaires. RESULTS The proportion of depression in the MSMUS and non-MSMUS groups was 54.1 % and 36.4 %, respectively. MSM status, social support, and loneliness were all significantly associated with depressive symptoms among Chinese university students. Structural equation modelling showed that the association between MSM status and depressive symptoms was partially mediated by three indirect paths, including 1) via social support (mediated proportion = 19.4 %), 2) via loneliness (mediated proportion = 19.3 %), and 3) via social support and then loneliness (mediated proportion = 16.1 %). CONCLUSIONS Depression was prevalent among university students in China, especially MSMUS. The findings increased our understanding of the mediating roles of social support and loneliness in the link between MSM status and depressive symptoms among Chinese male university students, which have great implications for designing interventions to improve their mental health. LIMITATION The cross-sectional study design limited causal inferences.
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Affiliation(s)
- Luyao Xie
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Xiaobing Tian
- Department of Epidemiology and Biostatistics, School of Public Health, North Sichuan Medical University, Nanchong, China
| | - Joseph T F Lau
- Public Mental Health Center, School of Mental Health, Wenzhou Medical University, Wenzhou, China; Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
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Wong CS, Chidgey A, Lee KL, Mo PKH, Wong T, Banerjee S, Ho V, Leow Y, Gowindah R, Yew YJ, Fung R, Lau A. Empowering people living with HIV (PLHIV): unveiling care gaps and identifying opportunities for improving care for PLHIV in Singapore and Hong Kong. J Int AIDS Soc 2024; 27:e26250. [PMID: 38726655 PMCID: PMC11082721 DOI: 10.1002/jia2.26250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION This study explored the behaviours of people living with HIV in Singapore and Hong Kong in terms of achieving and maintaining their physical and psychological wellbeing in relation to HIV, to identify the challenges and support needed in HIV care. METHODS This qualitative study involved 90-minute interviews among Singapore and Hong Kong people living with HIV aged ≥18 years to explore health-related quality of life perceptions and gaps in patient empowerment in HIV care during February-May 2022. The COM-B (C: Capability; O: Opportunity; M: Motivation; B: Behaviour) framework was used during data analysis to identify behaviour facilitators and barriers for people living with HIV to achieve and maintain their wellbeing. Detailed accounts of respondents' experience of living with and managing HIV, that is what worked well, unmet needs and perceived significance of wellbeing indicators, were analysed qualitatively via a combination of inductive content and deductive frameworks. RESULTS A total of 30 and 28 respondents were recruited from Singapore (SG) and Hong Kong (HK), respectively. Most respondents were aged 20-49 years (SG: 83.3%; HK: 64.3%), males (SG: 96.7%; HK: 92.9%), men who have sex with men (SG: 93.3%; HK: 71.4%), had university or higher education (SG: 73.3%; HK: 50.0%) and were fully employed (SG: 73.3%; HK: 57.1%). In both Singapore and Hong Kong, physical health was considered a key focus of overall wellbeing, albeit attention to long-term health associated with cardiovascular and renal health was less salient. The impact of symptoms, side effects of treatment, mood and sleep were among the top wellbeing indicators of importance. Respondents felt that insufficient information was provided by physicians, citing consultation time and resource constraints impeding further expression of concerns to their physicians during consultation. Respondents prioritized functional wellness and delegated psychosocial health to supportive care professionals, patient groups, families and/or friends. CONCLUSIONS There is a need in Singapore and Hong Kong to empower people living with HIV to establish better communications with their physicians and be more involved in their treatment journey and equally prioritize their psychosocial wellbeing.
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Affiliation(s)
- Chen Seong Wong
- National Centre for Infectious DiseasesSingaporeSingapore
- Department of Infectious DiseasesTan Tock Seng HospitalSingaporeSingapore
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | | | | | - Phoenix K. H. Mo
- Centre for Health Behaviours ResearchThe School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong SARHong Kong SAR
- Hong Kong Coalition of AIDS Service OrganisationsHong Kong SARHong Kong SAR
| | - Timothy Wong
- Hong Kong AIDS FoundationHong Kong SARHong Kong SAR
| | | | | | | | | | | | - Ricky Fung
- Gilead SciencesHong Kong SARHong Kong SAR
| | - Agnes Lau
- Gilead SciencesHong Kong SARHong Kong SAR
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Mo PKH, Xin M, Wang Z, Lau JTF, Ye X, Hui KH, Yu FY, Lee HH. Patterns of sex behaviors and factors associated with condomless anal intercourse during the COVID-19 pandemic among men who have sex with men in Hong Kong: A cross-sectional study. PLoS One 2024; 19:e0300988. [PMID: 38573984 PMCID: PMC10994335 DOI: 10.1371/journal.pone.0300988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVES The present study examined the patterns of sex behaviors before and during COVID-19, and identified the factors associated with condomless anal intercourse during COVID-19 from individual, interpersonal, and contextual level among men who have sex with men (MSM) in Hong Kong. METHODS A cross-sectional study was conducted among MSM in Hong Kong. A total of 463 MSM completed a cross-sectional telephone survey between March 2021 and January 2022. RESULTS Among all participants, the mean number of regular sex partners, non-regular sex partners, and casual sex partners during the COVID-19 period were 1.24, 2.09, and 0.08 respectively. Among those who had sex with regular, non-regular, and casual sex partner during the COVID-19 period, respectively 52.4%, 31.8% and 46.7% reported condomless anal intercourse. Compared to the pre-COVID-19 period, participants reported significantly fewer number of regular and non-regular sex partners during the COVID-19 period. However, a higher level of condomless anal intercourse with all types of sex partners during the COVID-19 period was also observed. Adjusted for significant socio-demographic variables, results from logistic regression analyses revealed that perceived severity of COVID-19 (aOR = 0.72, 95% CI = 0.58, 0.88), COVID-19 risk reduction behaviors in general (aOR = 0.68, 95% CI = 0.48, 0.96), COVID-19 risk reduction behaviors during sex encounters (aOR = 0.45, 95% CI = 0.30, 0.66), condom negotiation (aOR = 0.61, 95% CI = 0.44, 0.86), and collective efficacy (aOR = 0.79, 95% CI = 0.64, 0.98) were protective factors of condomless anal intercourse with any type of sex partners during the COVID-19 period. CONCLUSION The COVID-19 control measures have caused a dramatic impact on the sexual behavior of MSM in Hong Kong. Interventions that promote condom use during the COVID-19 pandemic are still needed and such interventions could emphasize prevention of both COVID-19 and HIV.
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Affiliation(s)
- Phoenix K. H. Mo
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Meiqi Xin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Zixin Wang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joseph T. F. Lau
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Xinchen Ye
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kam Hei Hui
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Fuk Yuen Yu
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ho Hin Lee
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Cheung DH, Chen S, Fang Y, Sun F, Zhang Q, Yu FY, Mo PKH, Wang Z. Influences of mpox disease perceptions, sources and contents of information exposure on mpox vaccine uptake among gay, bisexual, and other men who have sex with men in Hong Kong, China. Vaccine 2024; 42:2337-2346. [PMID: 38480102 DOI: 10.1016/j.vaccine.2024.02.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Following the global mpox outbreak in 2022, multiple regions in Asia have been reporting ongoing mpox cases within high-risk groups, including gay, bisexual, and other men who have sex with men (GBMSM). An optimal level of vaccination rate is essential to prevent further mpox outbreaks. However, no existing studies have examined mpox vaccine uptake among GBMSM in East Asia. METHODS A cross-sectional survey was conducted among a sample of 531 GBMSM in Hong Kong, China, between March and October 2023. The study used multivariable logistic regression models to investigate the associations between mpox-related disease perceptions, exposures to sources and contents of mpox-related information, and mpox vaccine uptake. RESULTS The prevalence of mpox vaccine uptake among GBMSM in Hong Kong was 21.7%, with 7.7% completing one dose and 13.9% completing two doses. GBMSM who were younger or earning less monthly income were less likely to have been vaccinated. After adjusting for confounding variables, participants who perceived more negative impacts on their lives if they were to contract mpox, more severe symptoms, and a more coherent understanding of mpox were positively associated with mpox vaccine uptake. In addition, more frequent exposure to information through the following sources: TV, newspaper, radio and posters, government websites, news websites or apps, other people's social media, and communication over the phone or face-to-face was positively associated with mpox vaccine uptake. Finally, more frequent exposure to the following information contents: mpox statistics from other countries, the Hong Kong government's responses to mpox cases, negative information about patients with mpox, and information on prevention and treatment of mpox were positively associated with mpox vaccine uptake. CONCLUSIONS This study provides timely and evidence-based implications to address health communication and messaging needs in promoting mpox vaccination among GBMSM in Hong Kong, relevant to regions with similar sociocultural contexts.
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Affiliation(s)
- Doug H Cheung
- Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong Special Administrative Region.
| | - Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong Special Administrative Region
| | - Qingpeng Zhang
- Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong Special Administrative Region; Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Fuk-Yuen Yu
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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Li J, Luo R, Guo P, Zhang D, Mo PKH, Wu AMS, Xin M, Shang M, Cai Y, Wang X, Chen M, He Y, Zheng L, Huang J, Xu RD, Lau JTF, Gu J, Hall BJ. Effectiveness of a WHO self-help psychological intervention to alleviate stress among healthcare workers in the context of COVID-19 in China: a randomised controlled trial. Epidemiol Psychiatr Sci 2024; 33:e11. [PMID: 38450478 PMCID: PMC10940054 DOI: 10.1017/s2045796024000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 09/19/2023] [Accepted: 02/02/2024] [Indexed: 03/08/2024] Open
Abstract
AIMS To examine the effectiveness of Self-Help Plus (SH+) as an intervention for alleviating stress levels and mental health problems among healthcare workers. METHODS This was a prospective, two-arm, unblinded, parallel-designed randomised controlled trial. Participants were recruited at all levels of medical facilities within all municipal districts of Guangzhou. Eligible participants were adult healthcare workers experiencing psychological stress (10-item Perceived Stress Scale scores of ≥15) but without serious mental health problems or active suicidal ideation. A self-help psychological intervention developed by the World Health Organization in alleviating psychological stress and preventing the development of mental health problems. The primary outcome was psychological stress, assessed at the 3-month follow-up. Secondary outcomes were depression symptoms, anxiety symptoms, insomnia, positive affect (PA) and self-kindness assessed at the 3-month follow-up. RESULTS Between November 2021 and April 2022, 270 participants were enrolled and randomly assigned to either SH+ (n = 135) or the control group (n = 135). The SH+ group had significantly lower stress at the 3-month follow-up (b = -1.23, 95% CI = -2.36, -0.10, p = 0.033) compared to the control group. The interaction effect indicated that the intervention effect in reducing stress differed over time (b = -0.89, 95% CI = -1.50, -0.27, p = 0.005). Analysis of the secondary outcomes suggested that SH+ led to statistically significant improvements in most of the secondary outcomes, including depression, insomnia, PA and self-kindness. CONCLUSIONS This is the first known randomised controlled trial ever conducted to improve stress and mental health problems among healthcare workers experiencing psychological stress in a low-resource setting. SH+ was found to be an effective strategy for alleviating psychological stress and reducing symptoms of common mental problems. SH+ has the potential to be scaled-up as a public health strategy to reduce the burden of mental health problems in healthcare workers exposed to high levels of stress.
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Affiliation(s)
- Jinghua Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen University Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Health Informatics, Guangzhou, China
- Research Center of Health Informatics, Sun Yat-sen University, Guangzhou, China
| | - Rui Luo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Pengyue Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin District, Hong Kong, China
| | - Phoenix K. H. Mo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin District, Hong Kong, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Anise M. S. Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macao, China
| | - Meiqi Xin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Menglin Shang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuqi Cai
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xu Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Mingyu Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yiling He
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Luxin Zheng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jinying Huang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Roman Dong Xu
- Acacia Lab for Health Systems Strengthening and Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
| | - Joseph T. F. Lau
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
- Centre for Health Behaviors Research, The Chinese University of Hong Kong, Shatin District, Hong Kong, China
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen University Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Health Informatics, Guangzhou, China
- Research Center of Health Informatics, Sun Yat-sen University, Guangzhou, China
| | - Brian J. Hall
- Center for Global Health Equity, New York University (Shanghai), Shanghai, People’s Republic of China
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Yu Y, Lau JTF, Li J, Mo PKH, Li J, Chen Y, Ma L. Very tall female young adults tended to be smokers: A large-scale exploratory cross-sectional survey of 26,405 college students in China. J Am Coll Health 2024; 72:390-397. [PMID: 35595267 DOI: 10.1080/07448481.2022.2037612] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 01/09/2022] [Accepted: 01/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study investigated the sex-specific prevalence of smoking (past 30 days) and the associations with height among university/college students. PARTICIPANTS 25,405 (11,579/14,826 males/females) college students in Xi'an China. METHODS A cross-sectional, self-administered survey. RESULTS The male and female prevalence of smoking (past 30 days) was 32.9% and 7.4%, respectively. The prevalence of smoking of the male height groups ranged from 29.8% to 36.9%; only the ≥188 cm height group showed significantly higher prevalence than the reference group (i.e., 173-177cm; 33.0%). The female prevalence of smoking was 4.0-8.2% in the ≤170cm groups and increased to 12.3% in the 171-175 cm group and 36.1% in the ≥176 cm group, while it was 6.5% for the reference group (161-165 cm). CONCLUSIONS This exploratory study firstly revealed the significantly higher prevalence of smoking among the "tallest" height groups, especially among females. Future studies are warranted to confirm such findings and explore related mechanisms.
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Affiliation(s)
- Yanqiu Yu
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Jvhua Li
- Xianyang Caihong Hospital, Xianyang, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Jibin Li
- Department of Clinical Research, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, China
| | - Yonghua Chen
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
- Research Centre on College Students Ideological Education and Practice, Xi'an Jiaotong University, Xi'an, China
| | - Le Ma
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
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Yang X, Mo PKH, Ip MTK, Wang Z. Prevalence and Predictors of Psychoactive Drug Use among Chinese Men Who Have Sex with Men: A Longitudinal and Mediation Study. J Psychoactive Drugs 2024; 56:117-126. [PMID: 36355403 DOI: 10.1080/02791072.2022.2144556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/07/2022] [Accepted: 09/23/2022] [Indexed: 11/12/2022]
Abstract
Few longitudinal studies have examined the prevalence of psychoactive drug use and its related predictors among Chinese men who have sex with men (MSM) in Hong Kong. This longitudinal study aimed to investigate the prevalence of psychoactive drug use in this population and the relationships of background characteristics, health status, MSM-related self-stigma, and perceived stress with psychoactive drug use. Furthermore, the study tested the mediation effect of perceived stress in the relationship between MSM-related self-stigma and psychoactive drug use based on the minority stress model and the general strain model. A total of 600 MSM were recruited through multiple sources and completed a telephone interview at baseline, and 407 completed the 6-month follow-up survey. Prevalence of using any type of psychoactive drugs in the past 12 months at baseline and in the past six months at follow-up was 16.8% and 9.1% respectively. History of sexually transmitted infection (STI), self-stigma and perceived stress significantly predicted psychoactive drug use at 6-month follow-up. Bootstrapping analysis showed that self-stigma could, directly and indirectly, predict psychoactive drug use at 6-month follow-up through perceived stress. The results highlighted the need for interventions to reduce psychoactive drug use among local MSM and its potential modifiable factors.
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Affiliation(s)
- Xue Yang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, GD, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, GD, China
| | - Mary T K Ip
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, GD, China
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Xie L, Hu H, Lin J, Mo PKH. Psychometric validation of the Chinese digital health literacy instrument among Chinese older adults who have internet use experience. Int J Older People Nurs 2024; 19:e12568. [PMID: 37831059 DOI: 10.1111/opn.12568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/27/2023] [Accepted: 07/27/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION In this digital age, the Internet has become a major source of health information, and electronic health (eHealth) literacy becomes increasingly important for older individuals to properly use the extensive eHealth resources for self-care. A valid and reliable tool for assessing older people's eHealth literacy would help healthcare workers identify those disadvantaged groups in digital health and provide relevant health education. OBJECTIVES This study aimed to evaluate the psychometric properties of the Chinese version of DHLI in assessing eHealth literacy among older adults in China. METHODS A web-based, cross-sectional study was conducted among 277 Chinese older adults from September to November 2021. Two weeks after the first completion, 62 of them answered the C-DHLI again. The reliability (e.g. internal consistency and test-retest reliability), factorial structure and validity (i.e. content validity and convergent validity) of the C-DHLI were evaluated based on the survey data. RESULTS The results demonstrated good internal consistency (Cronbach's alpha: 0.94) and test-retest reliability (total intraclass correlation coefficient [ICC]: 0.94) of the C-DHLI. Principal component analysis revealed that the 18 items of C-DHLI loaded on three factors, accounting for 74.69% of the total variance; CFA supported its three-factor structure with good model fits. Convergent validity was examined by the significant associations between C-DHLI and C-eHEALS (r = 0.61), health literacy (r = 0.56), and whether having used the Internet for health information (ρ = 0.43) (ps <.001). A cut-off score of 45 was recommended for determining higher and lower literacy using the C-DHLI, with the area under curve of 0.82 (95% CI = 0.77-0.88). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The C-DHLI showed good psychometric performance in assessing eHealth literacy among Chinese older adults. The findings can support healthcare professionals to effectively measure eHealth literacy among older adults and conduct tailored eHealth interventions or training.
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Affiliation(s)
- Luyao Xie
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Huahua Hu
- Research Centre of Adolescent Psychology and Behaviour, School of Education, Guangzhou University, Guangzhou, China
| | - Jiaer Lin
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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10
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Chen S, Yu P, Fang Y, Xin M, Yu FY, Ip M, Mo PKH, Wang Z. Patterns and Factors of the Sexual Agreement for Extra-Dyadic Sex Among Men Who Have Sex with Men in Hong Kong, China: A Cross-Sectional Survey. J Sex Marital Ther 2023; 50:303-314. [PMID: 37981896 DOI: 10.1080/0092623x.2023.2279096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
This study investigated patterns of sexual agreement for extra-dyadic sex and their associations with sexual risk behaviors among men who have sex with men (MSM) having a regular male sex partner (RP) in China. A cross-sectional telephone survey was conducted among 530 MSM recruited through multiple sources in Hong Kong, China, between April and December 2020. This study was based on a subsample of 368 participants who had an RP in the past 6 months. Logistic regression models were fitted. Among the participants, 27.2%, 13.0%, and 3.0% had a closed agreement, an in-between agreement, and an open agreement, respectively. Compared to no agreement, a closed agreement was associated with fewer extra-dyadic partners and fewer instances of condomless sex with extra-dyadic partners. Those who had more positive attitudes toward a closed agreement, perceived more support from significant others to create a closed agreement, and perceived higher behavioral control of refraining from sex with extra-dyadic partners were more likely to have a closed agreement with RP. Those who were concerned that a closed agreement would impair freedom and sexual desire were less likely to have such an agreement. A closed agreement is a potentially useful risk reduction strategy for Chinese MSM with an RP.
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Affiliation(s)
- Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Peishi Yu
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong, China
| | - Meiqi Xin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, the Hong Kong Polytechnic University, Hong Kong, China
| | - Fuk-Yuen Yu
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Mary Ip
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Kawuki J, Nambooze J, Chan PSF, Chen S, Liang X, Mo PKH, Wang Z. Differential practice and associated factors of COVID-19 personal preventive measures among the slum and estate communities of Uganda: A community-based cross-sectional survey. J Glob Health 2023; 13:06039. [PMID: 37712388 PMCID: PMC10502765 DOI: 10.7189/jogh.13.06039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Background Compliance with personal preventive measures (PPMs) remains essential in the prevention and control of the coronavirus disease 2019 (COVID-19) pandemic and future infectious disease outbreaks. This study aimed at examining and comparing the practice of COVID-19 PPMs and associated factors in selected slum and estate communities of Uganda. Methods This was a cross-sectional survey conducted among 1025 slum and estate residents in Uganda. The outcome variable was compliance with COVID-19 PPMs, including face mask use, hand washing/hygiene, and social distancing. Logistic regression models were fitted to assess the associated factors, using SPSS (version 26). Results Of the 1025 participants, 511 and 514 were slum and estate residents, respectively. Compliance with PPMs was as follows; face mask use (slum 45.0% vs. estate 49.6%; P = 0.27), hand washing/hygiene (slum 38.4% vs. estate 44.9%; P = 0.04), and social distancing (slum 19.4% vs. estate 36.0%; P < 0.001). Compared to estate residents, slum residents had more knowledge related to COVID-19, perceived COVID-19 would have a longer timeline and larger impact on their life, had more depression and anxiety symptoms, and faced more difficulties to access information. Illness perceptions, infection risk, and severity perceptions were associated with higher odds of PPMs compliance in both groups, except for perceiving a high chance of contracting COVID-19, which was associated with lower odds of social distancing in the slum community. Depression and anxiety symptoms were associated with higher odds of PPMs compliance in both groups. Frequent exposure to COVID-19 information through health care workers and family members and friends was associated with higher odds of all the PPMs in both communities. Moreover, getting COVID-19 information from local channels was significantly associated with higher odds of mask use and hand hygiene, but only in the estate community. Conclusions Our findings provided implications to improve PPMs compliance in future infectious disease outbreaks. To improve PPMs compliance rates, redesigning community education to focus on fostering positive perceptions and addressing the water and sanitation needs of slum communities are essential. Moreover, designing programs that provide free or subsidised face masks and soap to the most vulnerable and engaging religious leaders are also vital strategies.
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Affiliation(s)
- Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joweria Nambooze
- Department of Nutritional Sciences and Dietetics, Kyambogo University, Kyambogo, Uganda
| | - Paul Shing-fong Chan
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xue Liang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Wang Z, Chan PSF, Fang Y, Yu FY, Ye D, Zhang Q, Wong MCS, Mo PKH. Chatbot-Delivered Online Intervention to Promote Seasonal Influenza Vaccination During the COVID-19 Pandemic: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2332568. [PMID: 37695585 PMCID: PMC10495860 DOI: 10.1001/jamanetworkopen.2023.32568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/30/2023] [Indexed: 09/12/2023] Open
Abstract
Importance Receiving seasonal influenza vaccination (SIV) is important for adults during the COVID-19 pandemic. There are few robust evaluations of tailored interventions for improving SIV uptake among adults 65 years or older. Objective To evaluate the relative efficacy of a stages of change (SOC)-tailored online intervention compared with a standard, non-SOC-tailored online intervention in increasing SIV uptake among Hong Kong residents 65 years or older. Design, Setting, and Participants This nonblinded parallel-group randomized clinical trial was conducted between December 1, 2021, and July 31, 2022, in Hong Kong, China. Eligible participants were 65 years or older, had Cantonese- and/or Mandarin-speaking skills, were community-dwelling, had Hong Kong residency, were smartphone users, and had not received SIV for the 2021 to 2022 influenza season. Participants were recruited through random telephone calls, and those who completed the baseline telephone survey were randomized to either the intervention or control group. Both complete case and intention-to-treat (ITT) analyses were performed. Intervention In the intervention group, a simplified rule-based chatbot first assessed participants' SOC related to SIV uptake and then automatically selected and sent participants SOC-tailored online health promotion messages (videos) through a messaging application (WhatsApp; Meta) once every 2 weeks for 4 sessions. In the control group, the chatbot sent a link to access through the messaging application a standard online health promotion message (video) covering general SIV information every 2 weeks for 4 sessions. Main Outcomes and Measures The primary outcome was self-reported SIV uptake at month 6, which was validated by the research team. The secondary outcome was SOC measured at both baseline and month 6 by validated questions. Results A total of 396 participants (mean [SD] age of 70.2 [4.3] years; 249 females [62.9%]) were randomized to the intervention (n = 198) or control (n = 198) group. The ITT analysis showed that the validated SIV uptake rate was higher in the intervention group than the control group at month 6 (50.5% vs 35.3%; P = .002). The mean (SD) SOC score was higher in the intervention group than the control group (2.8 [1.4] vs 2.4 [1.4]; P = .02). More participants in the intervention group completed at least 1 episode of intervention than in the control group (77.3% vs 62.6%; P < .001). Conclusions Results of this trial indicate that the SOC-tailored online intervention was more effective than the non-SOC-tailored intervention and may be a sustainable new method in increasing SIV uptake among adults 65 years or older. Trial Registration ClinicalTrials.gov Identifier: NCT05155241.
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Affiliation(s)
- Zixin Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Paul Shing-fong Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Fuk-yuen Yu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Danhua Ye
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Qingpeng Zhang
- Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong SAR, China
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Martin C. S. Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Phoenix K. H. Mo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Liang X, Li J, Fang Y, Zhang Q, Wong MCS, Yu FY, Ye D, Chan PSF, Kawuki J, Chen S, Mo PKH, Wang Z. Associations between COVID-19 Vaccination and Behavioural Intention to Receive Seasonal Influenza Vaccination among Chinese Older Adults: A Population-Based Random Telephone Survey. Vaccines (Basel) 2023; 11:1213. [PMID: 37515029 PMCID: PMC10385482 DOI: 10.3390/vaccines11071213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
During the Coronavirus Disease 2019 (COVID-19) pandemic, seasonal influenza remained a significant health threat for older adults. Seasonal influenza vaccination (SIV) is highly effective and safe for older adults. This study investigated the associations of COVID-19 vaccination, perceptions related to COVID-19 and SIV, with the behavioural intention to receive SIV among older adults in Hong Kong, China. A random telephone survey was conducted among 440 community-dwelling Hong Kong residents aged 65 years or above, between November 2021 and January 2022. Among the participants, 55.7% intended to receive SIV in the next year. After adjustment for significant background characteristics, concern about whether SIV and COVID-19 vaccination would negatively affect each other was associated with a lower intention to receive SIV, while a perceived higher risk of co-infection with COVID-19 and seasonal influenza was positively associated with the dependent variable. In addition, the perceived severe consequences of seasonal influenza, perceived benefits of SIV, received cues to action from doctors and participants' family members or friends, and the perception that more older people would receive SIV was associated with a higher behavioural intention. Future programmes promoting SIV among older adults should modify perceptions related to COVID-19 vaccination and SIV at the same time.
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Affiliation(s)
- Xue Liang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiming Li
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Qingpeng Zhang
- Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong, China
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Fuk-Yuen Yu
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Danhua Ye
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Paul Shing-Fong Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Siyu Chen
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Chen S, Zhang Q, Chan CK, Yu FY, Chidgey A, Fang Y, Mo PKH, Wang Z. Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e48447. [PMID: 37389935 PMCID: PMC10365592 DOI: 10.2196/48447] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Counseling support for HIV self-testing (HIVST) users is essential to ensure support and linkage to care among men who have sex with men (MSM). An HIVST service with web-based real-time instruction, pretest, and posttest counseling provided by trained administrators (HIVST-OIC) was developed by previous projects. Although the HIVST-OIC was highly effective in increasing HIVST uptake and the proportion of HIVST users receiving counseling along with testing, it required intensive resources to implement and sustain. The service capacity of HIVST-OIC cannot meet the increasing demands of HIVST. OBJECTIVE This randomized controlled trial primarily aims to establish whether HIVST-chatbot, an innovative HIVST service with web-based real-time instruction and counseling provided by a fully automated chatbot, would produce effects that are similar to HIVST-OIC in increasing HIVST uptake and the proportion of HIVST users receiving counseling alongside testing among MSM within a 6-month follow-up period. METHODS A parallel-group, noninferiority randomized controlled trial will be conducted with Chinese-speaking MSM aged ≥18 years with access to live-chat applications. A total of 528 participants will be recruited through multiple sources, including outreach in gay venues, web-based advertisement, and peer referral. After completing the baseline telephone survey, participants will be randomized evenly into the intervention or control groups. Intervention group participants will watch a web-based video promoting HIVST-chatbot and receive a free HIVST kit. The chatbot will contact the participant to implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through WhatsApp. Control group participants will watch a web-based video promoting HIVST-OIC and receive a free HIVST kit in the same manner. Upon appointment, a trained testing administrator will implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through live-chat applications. All participants will complete a telephone follow-up survey 6 months after the baseline. The primary outcomes are HIVST uptake and the proportion of HIVST users receiving counseling support along with testing in the past 6 months, measured at month 6. Secondary outcomes include sexual risk behaviors and uptake of HIV testing other than HIVST during the follow-up period. Intention-to-treat analysis will be used. RESULTS Recruitment and enrollment of participants started in April 2023. CONCLUSIONS This study will generate important research and policy implications regarding chatbot use in HIVST services. If HIVST-chatbot is proven noninferior to HIVST-OIC, it can be easily integrated into existing HIVST services in Hong Kong, given its relatively low resource requirements for implementation and maintenance. HIVST-chatbot can potentially overcome the barriers to using HIVST. Therefore, the coverage of HIV testing, the level of support, and the linkage to care for MSM HIVST users will be increased. TRIAL REGISTRATION ClinicalTrial.gov NCT05796622; https://clinicaltrials.gov/ct2/show/NCT05796622. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48447.
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Affiliation(s)
- Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Qingpeng Zhang
- School of Data Science, The City University of Hong Kong, Hong Kong, Hong Kong
| | | | - Fuk-Yuen Yu
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Wang Z, Chan PSF, Xin M, Fang Y, Chidgey A, Yu FY, Ip M, Chen S, Mo PKH. An Online Intervention Promoting HIV Testing Service Utilization Among Chinese men who have sex with men During the COVID-19 Pandemic: A quasi-experimental Study. AIDS Behav 2023:10.1007/s10461-023-04100-5. [PMID: 37284925 DOI: 10.1007/s10461-023-04100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/08/2023]
Abstract
The COVID-19 pandemic created disruptions in HIV testing service utilization among men who have sex with men (MSM). The present study was to evaluate the effectiveness of an online health promotion program implemented by a community-based organization (CBO) in increasing the uptake of any type of HIV testing and home-based HIV self-testing (HIVST) over a six-month follow-up period. Participants of an observational prospective cohort study conducted during the same period served as the comparison group. This study was conducted between September 2020 and December 2021. Participants were Chinese-speaking adult MSM who were HIV-negative/unknown sero-status recruited through multiple sources in Hong Kong, China. Participants in the intervention group were exposed to the following health promotion components: (1) viewing an online video promoting HIVST, (2) visiting the project webpage, and (3) having access to a chargeable HIVST service implemented by the CBO. Among 400 and 412 participants in the intervention group and the comparison group, 349 (87.3%) and 298 (72.3%) completed follow-up evaluation at Month 6. Multiple imputation was used to replace missing values. At Month 6, participants in the intervention group reported significantly higher uptake of any type of HIV testing (57.0% versus 49.0%, adjusted odds ratios [AOR]: 1.43, p = .03) and HIVST (25.8% versus 14.8%, AOR: 2.04, p = .001), as compared to those in the comparison group. Process evaluation of the health promotion components for the intervention group was positive. Promoting HIVST is a potentially useful strategy to increase HIV testing service utilization among Chinese MSM during the pandemic.
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Affiliation(s)
- Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | - Paul Shing-Fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China
| | - Meiqi Xin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, the Hong Kong Polytechnic University, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong, China
| | | | - Fuk-Yuen Yu
- JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China
| | - Mary Ip
- JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China
| | - Siyu Chen
- JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
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Wang Z, Lau JTF, Lam PPK, Chan P, Fong F, Mo PKH. Promotion of human papillomavirus vaccination among Chinese men who have sex with men: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 3:9-15. [PMID: 37357584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Affiliation(s)
- Z Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J T F Lau
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P P K Lam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - F Fong
- Neo-Health, Hong Kong SAR, China
| | - P K H Mo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Mo PKH, Xie L, Mak WWS. Is inadequate health literacy associated with worse health outcomes among Chinese individuals with depression? Health Promot Int 2023; 38:7189925. [PMID: 37279468 DOI: 10.1093/heapro/daad042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Inadequate health literacy is a risk factor for poorer outcomes across various conditions. The present study examined the level of health literacy, as measured by the Single Item Literacy Screener (SILS), and its association with a range of physical and mental outcomes [e.g. health-related quality of life, depression, anxiety, well-being, body mass index (BMI)] among individuals with depression in Hong Kong. A total of 112 individuals with depression were recruited from the community and invited to complete a survey. Among the participants, 42.9% of them were classified as having inadequate health literacy as screened by the SILS. After adjusting for significant sociodemographic and background variables, participants with inadequate health literacy had significantly poorer health-related quality of life and well-being, and had higher scores in depression, anxiety and BMI compared with those with adequate health literacy. Inadequate health literacy was associated with a range of negative physical and mental outcomes among individuals with depression. Interventions promoting the health literacy level of individuals with depression are highly warranted.
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Affiliation(s)
- Phoenix K H Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Luyao Xie
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
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Ye B, Lau JTF, Lee HH, Yeung JCH, Mo PKH. The mediating role of resilience on the association between family satisfaction and lower levels of depression and anxiety among Chinese adolescents. PLoS One 2023; 18:e0283662. [PMID: 37228075 DOI: 10.1371/journal.pone.0283662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/14/2023] [Indexed: 05/27/2023] Open
Abstract
PURPOSE This study aimed to explore the association between family satisfaction, resilience, and anxiety and depression among adolescents, and the mediating role of resilience in these relationships. METHODS A cross-sectional study was conducted among grade 8 to 9 students from 4 secondary schools in Hong Kong. A total of 1,146 participants completed the survey. RESULTS Respectively 45.8% and 58.0% of students scored above the cut-off for mild anxiety and mild depression. Results from linear regression analyses showed that family satisfaction was positively associated with resilience, and both family satisfaction and resilience were and negatively associated with anxiety and depression. The mediating effects of resilience on the relationship between family satisfaction and anxiety/ depression (26.3% and 31.1% effects accounted for, respectively) were significant. CONCLUSIONS Both family satisfaction and resilience have important influence on adolescent mental health. Interventions that seek to promote positive family relationships and resilience of adolescents may be effective in preventing and reducing anxiety and depression symptoms among adolescents.
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Affiliation(s)
- Beizhu Ye
- Department of Social Medicine and Health Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Joseph T F Lau
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou, China
| | - Ho Hin Lee
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jason C H Yeung
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Phoenix K H Mo
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Joseph K, Chan PSF, Fang Y, Chen S, Mo PKH, Wang Z. Knowledge and practice of personal protective measures against COVID-19 in Africa: a systematic review. JMIR Public Health Surveill 2023; 9:e44051. [PMID: 37058578 DOI: 10.2196/44051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/29/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs). OBJECTIVE This systematic review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries, as documented in the published literature. METHODS A systematic search was conducted on Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed-method studies) done in Africa, and published in the English language were included. The screening process and data extraction were performed according to a pre-registered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of included studies was assessed using the Mixed-Method Appraisal Tool. Thematic analysis was used to systematically summarise the studies into four predefined domains: i) knowledge and perception about PPMs, ii) mask use, iii) social/physical distancing, and iv) hand washing/hygiene, including their respective levels and associated factors. RESULTS A total of 58 studies across 12 African countries were included, and these were published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with lack of personal protective equipment (PPE) (mainly face masks), and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing/ hygiene were particularly noted in several African countries, especially among the urban poor and slum-dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), socio-demographic and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities on the regional level, where East Africa contributed 36.2%, West Africa 20.7%, North Africa 17.2%, Southern Africa 6.9%, and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good, as they satisfied most of the quality assessment criteria. CONCLUSIONS There is a need to enhance local capacity to produce and supply PPE. Consideration of various cognitive, demographic and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa. CLINICALTRIAL The study protocol was registered in PROSPERO (CRD42022355101).
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Affiliation(s)
- Kawuki Joseph
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Paul Shing-Fong Chan
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong, China, New Territories, HK
| | - Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
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20
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Xie L, Mo PKH. Comparison of eHealth Literacy Scale (eHEALS) and Digital Health Literacy Instrument (DHLI) in Assessing Electronic Health Literacy in Chinese Older Adults: A Mixed-Methods Approach. Int J Environ Res Public Health 2023; 20:3293. [PMID: 36833987 PMCID: PMC9967021 DOI: 10.3390/ijerph20043293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
This study compared the reliability, construct validity, and respondents' preference of the Chinese version of 8-item eHEALS (C-eHEALS) and 21-item DHLI (C-DHLI) in assessing older adults' electronic health (eHealth) literacy using a mixed-methods approach. A web-based, cross-sectional survey was conducted among 277 Chinese older adults from September to October 2021, and 15 respondents were subsequently interviewed to understand their preference of scale to use in practice. Results showed that the internal consistency and test-retest reliability of both scales were satisfactory. For the construct validity, the C-DHLI score showed stronger positive correlations with having Internet use for health information and higher educational attainments, occupational skill levels, self-rated Internet skills, and health literacy than the C-eHEALS score. In addition, younger age, higher household income, urban residence, and longer Internet use history were only positively correlated with C-DHLI score. Qualitative data suggested that most interviewees perceived the C-DHLI as more readable than C-eHEALS for its clear structure, specific description, short sentence length, and less semantic complexity. Findings revealed that both scales are reliable tools to measure eHealth literacy among Chinese older adults, and the C-DHLI seemed to be a more valid and favored instrument for the general Chinese older population based on the quantitative and qualitative results.
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Affiliation(s)
| | - Phoenix K. H. Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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21
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Mo PKH, Yu Y, Lau MMC, Ling RHY, Lau JTF. Time to Lift up COVID-19 Restrictions? Public Support towards Living with the Virus Policy and Associated Factors among Hong Kong General Public. Int J Environ Res Public Health 2023; 20:2989. [PMID: 36833683 PMCID: PMC9958650 DOI: 10.3390/ijerph20042989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
The fifth wave of the COVID-19 pandemic has caused an unprecedented toll on Hong Kong. As more countries are starting to lift COVID-19 restrictions, it would be important to understand the public attitudes towards lifting COVID-19 restrictions and to identify its associated factors. The present study examined the level of support towards the living with the virus (LWV) policy for COVID-19 among the public in Hong Kong and to identify the associations between resilient coping, self-efficacy and emotional distress with support towards the LWV policy. A random population-based telephone survey was conducted among 500 Hong Kong Chinese adults from 7 March to 19 April 2022, i.e., during the fifth wave of COVID-19 outbreak. Of the respondents, 39.6% showed a supportive attitude towards the LWV policy. Results from the structural equational modeling showed a positive correlation between resilient coping and self-efficacy. Resilient coping was associated with support towards the LWV policy directly and indirectly through a lower level of emotional distress. Self-efficacy had a direct association with support towards the LWV policy but its indirect association through emotional distress was not significant. Interventions that foster resilient coping and self-efficacy would be effective in reducing public emotional distress and promoting their positive view towards the LWV policy.
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Affiliation(s)
- Phoenix K. H. Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yanqiu Yu
- School of Public Health, Fudan University, Shanghai 200030, China
| | - Mason M. C. Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Rachel H. Y. Ling
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joseph T. F. Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, China
- School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China
- School of Public Health, Zhejiang University, Hangzhou 311100, China
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22
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Ye X, Lee HH, Hui KH, Xin M, Mo PKH. Effects of Negative Attitudes towards Vaccination in General and Trust in Government on Uptake of a Booster Dose of COVID-19 Vaccine and the Moderating Role of Psychological Reactance: An Observational Prospective Cohort Study in Hong Kong. Vaccines (Basel) 2023; 11:vaccines11020393. [PMID: 36851270 PMCID: PMC9961443 DOI: 10.3390/vaccines11020393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Uptake of a booster dose of COVID-19 vaccine is effective in preventing infection and severe consequences caused by COVID-19. The present study examined the effects of negative attitudes towards vaccination in general and trust in government on uptake of a COVID-19 booster dose, as well as the moderating role of psychological reactance to pro-vaccination messages in Hong Kong. An observational prospective cohort study using online survey was conducted among 264 adults. Findings showed that, after adjustment for significant background characteristics, negative attitudes towards vaccination in general negatively predicted uptake of a booster dose, and trust in government positively predicted uptake of a booster dose. In addition, the association between negative attitudes towards vaccination in general and uptake of a booster dose was weaker among those who reported a higher level of psychological reactance. The present study highlighted the importance of improving attitudes towards vaccination in general especially among those who are not experiencing psychological reactance, and building trust in government. This study also suggested that interventions aimed at improving attitudes towards vaccination in general should seek to avoid psychological reactance, and special attention should be given to people who are experiencing psychological reactance to pro-vaccination messages.
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Affiliation(s)
- Xinchen Ye
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ho-Hin Lee
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Kam-Hei Hui
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Meiqi Xin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- Correspondence: (M.X.); (P.K.H.M.)
| | - Phoenix K. H. Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Correspondence: (M.X.); (P.K.H.M.)
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23
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Xin M, Chan VWY, Kong APS, Lau JTF, Cameron LD, Mak WWS, Mo PKH. Using the common-sense model to explicate the role of illness representation in self-care behaviours and anxiety symptoms among patients with Type 2 diabetes. Patient Educ Couns 2023; 107:107581. [PMID: 36470126 DOI: 10.1016/j.pec.2022.107581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/29/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Based on the common-sense model of self-regulation, this study aimed to explicate the mechanism underlying the effect of illness representations on self-care behaviours and anxiety symptoms among patients with type 2 diabetes. METHODS A telephone survey was administered to 473 patients in Hong Kong. Structural equation modelling was used to test if threat and control perceptions regarding diabetes would be associated with self-reported self-care behaviours and anxiety symptoms through adoption of adaptive/maladaptive coping strategies and diabetes-related self-efficacy. RESULTS Control perceptions but not threat perceptions were positively associated with self-care behaviours. Control perceptions had a positive indirect association with self-care behaviours through more problem-focused coping and diabetes-related self-efficacy. Threat perceptions simultaneously had a positive indirect association through more problem-focused coping and a negative indirect association through more avoidant coping and lower diabetes-related self-efficacy. In contrast, threat and control perceptions were positively and negatively, respectively, associated with anxiety symptoms. Problem-focused and avoidant coping consistently mediated the indirect association between threat perceptions and anxiety symptoms. CONCLUSION Threat and control perceptions were associated with diabetes self-care behaviours and anxiety symptoms through different self-regulation pathways. PRACTICE IMPLICATIONS Our findings inform possible targets for self-management interventions to simultaneously enhance self-care behaviours and alleviate diabetes-associated anxiety.
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Affiliation(s)
- Meiqi Xin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | | | - Alice P S Kong
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Joseph T F Lau
- School of Mental Health, Wenzhou Medical University, Wenzhou, China; Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China; School of Public Health, Zhejiang University, Hangzhou, China; Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Linda D Cameron
- School of Social Science, Humanities, and the Arts, University of California, Merced, USA.
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
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24
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Ho JY, Lam HYC, Huang Z, Liu S, Goggins WB, Mo PKH, Chan EYY. Factors affecting outdoor physical activity in extreme temperatures in a sub-tropical Chinese urban population: an exploratory telephone survey. BMC Public Health 2023; 23:101. [PMID: 36641429 PMCID: PMC9840260 DOI: 10.1186/s12889-022-14788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/29/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Physical activity (PA) can be affected by extreme temperatures, however fewer studies have identified factors impacting this relationship. This study sought to identify factors associated with changes of outdoor PA during extreme cold/heat events in a sub-tropical Chinese urban population, including factors of sociodemographic, health conditions, temperature-related awareness and attitude, and protective behaviours. METHODS Two telephone surveys were conducted a week after extreme cold/heat events in 2016 and 2017 among a cohort of Hong Kong residents over age 15. Data was collected on self-reported changes in outdoor PA level during the periods of extreme temperatures, health status, comorbidities, sociodemographic, and temperature-related awareness, and behavioural variables. We conducted multivariable logistic regression analyses to assess predictors of change in outdoor PA over the two extreme temperature events. RESULTS AND CONCLUSION Among 435 participants (42.8% response rate), over a third of the participants reported decreased outdoor PA level in extreme temperature events, while 10% reported an increase in extreme heat. Self-reported cardiovascular diseases were associated with decreased PA level in extreme cold, while hypertension was associated with unchanged/increased PA level in extreme heat. These results suggest physical activity to be an important consideration in the understanding of climate change-and-health pathways and meriting further research.
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Affiliation(s)
- Janice Y. Ho
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly Y. C. Lam
- grid.7445.20000 0001 2113 8111Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Zhe Huang
- grid.10784.3a0000 0004 1937 0482Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Hong Kong, China
| | | | - William B. Goggins
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K. H. Mo
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y. Y. Chan
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China ,grid.10784.3a0000 0004 1937 0482Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Hong Kong, China ,GX Foundation, Hong Kong, China ,grid.4991.50000 0004 1936 8948Nuffield Department of Medicine, University of Oxford, Oxford, UK
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25
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Hu H, Yang X, Mo PKH, Zhao C, Kuang B, Zhang G, Lin G. How mobile phone addiction is associated with suicidal ideation in university students in China: Roles of depression and online social support. Front Psychol 2022; 13:1001280. [PMID: 36619077 PMCID: PMC9816797 DOI: 10.3389/fpsyg.2022.1001280] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Recent studies have highlighted mobile phone addiction (MPA) as a potential risk of suicidal ideation. However, the mechanisms underlying that association require attention. Objective This investigation aims to examine whether the relationship between MPA and suicidal ideation would be mediated by depression, and buffered by online social support (OSS) in university students. Methods A convenient sample of 1,042 Chinese university students completed the measures of mobile phone addiction, depression, suicidal ideation, OSS in classroom settings. Moderated mediation analyses were performed to test the roles of depression and OSS in the association between MPA and suicidal ideation. Results MPA was positively associated with suicidal ideation through depression (indirect effect =. 23, 95% CI: 0.18, 0.28, p < 0.001); OSS moderated the association between depression and suicidal ideation (B = - 0.09, 95% CI: -0.13, -0.04, p < 0.001). Specifically, the effect of depression on suicidal ideation was weaker in individuals with high (versus low) OSS. OSS moderated the association between MPA and suicidal ideation (B = 0.06, 95% CI: 0.02, 0.10, p = 0.001). The influence of MPA on suicidal ideation was non-significant among individuals with high OSS but negatively significant among students with low OSS. Conclusion The results enrich the understanding of how MPA may increase suicidal ideation, and highlight the potential importance of reducing depression and enhancing OSS to prevent suicidal ideation in university students.
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Affiliation(s)
- Huahua Hu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China
| | - Xue Yang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Phoenix K. H. Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Chengjia Zhao
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Beibei Kuang
- College of International Relation, National University of Defense Technology, Nanjing, China
| | - Guohua Zhang
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, China,The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China,*Correspondence: Guohua Zhang,
| | - Guangyao Lin
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China,Guangyao Lin,
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26
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Yeung NCY, Lau JTF, Wu AMS, Mo PKH, Jiang CL, Tong YF, Zhang Q, Tse KW. Multicomponent intervention to promote expression of organ donation wish to family members: a randomised controlled trial (abridged secondary publication). Hong Kong Med J 2022; 28 Suppl 6:36-38. [PMID: 36535798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- N C Y Yeung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - J T F Lau
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - A M S Wu
- Department of Psychology, University of Macau
| | - P K H Mo
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - C L Jiang
- Department of Media and Communication, The City University of Hong Kong
| | - Y F Tong
- Transplant Coordination Service, Prince of Wales Hospital
| | - Q Zhang
- School of Data Science, The City University of Hong Kong
| | - K W Tse
- The Chinese Association of Motivational Interviewing
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Wang X, Luo R, Guo P, Shang M, Zheng J, Cai Y, Mo PKH, Lau JTF, Zhang D, Li J, Gu J. Positive Affect Moderates the Influence of Perceived Stress on the Mental Health of Healthcare Workers during the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:ijerph192013600. [PMID: 36294184 PMCID: PMC9603543 DOI: 10.3390/ijerph192013600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 06/01/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed a profound psychological impact on healthcare workers. However, the role of positive affect in moderating the effect of perceived stress on the psychological states of healthcare workers remains unknown. This study aimed to analyze the moderating effect of positive affect on the association between stress and the mental health of healthcare workers during the COVID-19 pandemic. This cross-sectional study evaluated the relationships between perceived stress (the Perceived Stress Scale), positive affect (the Positive and Negative Affect Schedule), depression (the Patient Health Questionnaire-9), and anxiety (the Generalized Anxiety Disorder 7-item Scale) during the COVID-19 pandemic in 644 Chinese healthcare workers who completed online self-reports. The results revealed a significant negative association between positive affect and psychological problems, including stress, depression, and anxiety. At the total group level, multiple regression analysis showed that positive affect alleviated the influence of perceived stress on depression, but no significant moderating effect was found for anxiety. In the subgroups divided by perceived stress, the moderating effect of positive affect on depression was only significant in healthcare workers with a high level of perceived stress. These results suggested that positive affect played a moderative role in alleviating the effect of stress on depression among healthcare workers, particularly those with a high level of stress, thus emphasizing the importance of positive affect as an intervention strategy for promoting the mental health of healthcare workers in the context of the ongoing COVID-19 pandemic.
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Affiliation(s)
- Xu Wang
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan Second Road, Guangzhou 510080, China
| | - Rui Luo
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan Second Road, Guangzhou 510080, China
| | - Pengyue Guo
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan Second Road, Guangzhou 510080, China
| | - Menglin Shang
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan Second Road, Guangzhou 510080, China
| | - Jing Zheng
- Shenzhen Health Development Research and Data Management Center, Shenzhen 518028, China
| | - Yuqi Cai
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan Second Road, Guangzhou 510080, China
| | - Phoenix K. H. Mo
- Division of Behavioral Health and Health Promotion, The School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen 518172, China
| | - Joseph T. F. Lau
- Division of Behavioral Health and Health Promotion, The School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen 518172, China
- Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Jinghua Li
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan Second Road, Guangzhou 510080, China
- Sun Yat-sen University Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou 510080, China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan Second Road, Guangzhou 510080, China
- Sun Yat-sen University Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou 510080, China
- Center for Health Information Research, Sun Yat-sen University, Guangzhou 510080, China
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28
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Hu H, Mo PKH, She R, Lau JTF. Understanding the Pathways from Mindfulness to COVID-19 Vaccination Intention via Positive Psychology Attributes among Health Care Workers in China. J Psychol 2022; 156:535-551. [PMID: 36170676 DOI: 10.1080/00223980.2022.2101419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE The present study aims to examine the association between mindfulness and COVID-19 vaccination intention, and the mediating role of presence of meaning in life and moral elevation in such association. METHOD In a cross-sectional study design, a total of 1733 health care workers (81.1% females, Mage = 34.16 ± 9.03) from four cities in China were recruited and completed an online survey that measured mindfulness, moral elevation, presence of meaning in life and COVID-19 vaccination intention. RESULTS It has been found that 73.1% of the participants reported an intention to receive COVID-19 vaccination. Mindfulness was positively associated with COVID-19 vaccination intention; Mediation analyses using structural equation modeling showed a significant indirect effect of mindfulness on COVID-19 vaccination intention, accounting for 42.4% of the total effect. Mindfulness was positively associated with COVID-19 vaccination intention directly via presence of meaning in life, and indirectly via moral elevation and presence of meaning in life. CONCLUSIONS The findings add knowledge of how mindfulness may increase COVID-19 vaccination intention, and underscore the potential need for mindfulness training, positive emotion promotion, presence of meaning in life interventions to improve acceptance of COVID-19 vaccination among health care workers.
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Affiliation(s)
| | | | - Rui She
- The Chinese University of Hong Kong
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29
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Mo PKH, So GYK, Lu Z, Mak WWS. The Mediating Role of Health-Promoting Behaviors on the Association between Symptom Severity and Quality of Life among Chinese Individuals with Mental Illness: A Cross-Sectional Study. Psychopathology 2022; 56:194-205. [PMID: 35901786 DOI: 10.1159/000525495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 05/06/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Research has shown that people with mental illnesses (PMI) are found to show poorer lifestyle than the general population. Yet, the effect of their psychiatric symptoms in the association between gender difference, health-promoting behaviors, and quality of life have received little attention. The present study examined the association between symptom severity, health-promoting behaviors, and quality of life among PMI in Hong Kong. Gender difference on the association between these variables was also examined. METHOD A cross-sectional survey was conducted among 591 individuals with DSM-IV-TR Axis 1 diagnosis recruited from the community. RESULTS Results from MANOVA showed that PMI with more severe psychiatric symptoms engaged in a significantly lower level of health-promoting behaviors and reported a lower level of quality of life. Results from structural equation modeling showed that health-promoting behaviors mediated the association between psychiatric symptoms and quality of life. Multigroup analyses showed that the association between psychiatric symptoms and health-promoting behaviors was stronger among female participants, while the association between health-promoting behaviors and quality of life was stronger among male participants. DISCUSSION/CONCLUSION Despite clear evidence suggesting symptom severity to be negatively correlated with quality of life, the underlying mechanism has been less clear. There is a need to promote health-promoting behaviors in order to improve the quality of life of PMI. Gender-specific interventions are warranted.
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Affiliation(s)
- Phoenix K H Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Georgina Y K So
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhihui Lu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
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She R, Mo PKH, Cai Y, Ma T, Liu Y, Lau JTF. Mental health service utilisation among transgender women sex workers who are at risk of mental health problems in Shenyang, China: An application of minority stress theory. Health Soc Care Community 2022; 30:e981-e993. [PMID: 34240507 DOI: 10.1111/hsc.13501] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 05/26/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Transgender women sex workers (TGSW), as a highly stigmatised population, are at substantial risk for mental health problems but lack access to mental health care. This study investigated factors of mental health service utilisation (MHSU) behaviour and related behavioural intention among TGSW who were at risk of mental health problems in the past year [subsample 1: scored above the cut-off for probable depression or probable anxiety or had suicidal ideation (N = 126); subsample 2: perceived needs for mental health services (N = 109)]. A cross-sectional survey was conducted among TGSW in Shenyang, China during 2017-2018. Data on minority stress, coping, mental health and MHSU were collected. 10.3% of participants in subsample 1 and 14.7% in subsample 2 had sought help from mental health professionals in the last year. Unwillingness to disclose minority identity and gender non-affirmation were negatively associated with MHSU. Factors for behavioural intention of MHSU included unwillingness to disclose minority identity and social support for both subsamples and adaptive coping for subsample 2. Confidentiality concern, discrimination and cost were the most frequently endorsed barriers to mental health services. Interventions should promote gender affirmation, social support and adaptive coping as well as remove stigma to increase health service access and utilisation among minority populations.
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Affiliation(s)
- Rui She
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yong Cai
- Department of Community Health and Family Medicine, School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Tiecheng Ma
- Shenyang Consultation Centre of AIDS Aid and Health Service, Shenyang, China
| | - Yan Liu
- Shenyang Consultation Centre of AIDS Aid and Health Service, Shenyang, China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Wang Q, Fong VWI, Qin Q, Yao H, Zheng J, Wang X, Wang A, Gao Q, Mo PKH. Trends in the psychosocial and mental health of HIV-positive women in China from 2015 to 2020: Results from two cross-sectional surveys. Health Expect 2022; 25:1555-1562. [PMID: 35726358 PMCID: PMC9327813 DOI: 10.1111/hex.13498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background The human immunodeficiency virus (HIV) continues to be one of the major public health challenges in the world. Despite the advancement in medication and changes in views towards HIV in Chinese society, little is known about the changes in the psychosocial and mental health of HIV‐positive women in recent years. Objectives The present study examined the change in depression, anxiety, stigma, relationship with the child, intimacy with a partner, and social support from family, friends, and health professionals, for HIV‐positive women in China from 2015 to 2020. Methods Two cross‐sectional surveys were conducted in 2015 and 2020, and 429 and 382 HIV‐positive women were recruited from the Women's Health Department in Yunnan and Guangxi, China between November 2015 to May 2016, and November 2019 to January 2020, respectively. Results After controlling for significant sociodemographic variables, participants recruited in 2019–2020 had significantly lower levels of depression and anxiety and higher scores on emotional and tangible support from friends. On the other hand, they had lower scores in intimacy with partners and emotional and tangible support from family. No significant changes were found in stigma, relationship with the child, and support from health professionals. Conclusion Results provide important information on the changes in psychosocial and mental health, which offer insights into the design of interventions to promote psychosocial and mental health among HIV‐positive women in China. Patient or Public Contribution HIV‐positive women contributed to the data of this study. Health care professionals were involved in the discussion of the methods and results.
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Affiliation(s)
- Qian Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Vivian W I Fong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Qinghua Qin
- Antenatal Health Care Department, Maternal and Child Health Hospital of Guangxi, Zhuang Autonomous Region, Nanning, China
| | - Hui Yao
- Antenatal Health Care Department, Maternal and Child Health Hospital of Guangxi, Zhuang Autonomous Region, Nanning, China
| | - Jiarui Zheng
- Antenatal Health Care Department, Yunnan Maternal and Child Health Care Hospital, Kunming, China
| | - Xiaoyan Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Ailing Wang
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Qun Gao
- Antenatal Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Phoenix K H Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
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Ho JY, Goggins WB, Mo PKH, Chan EYY. The effect of temperature on physical activity: an aggregated timeseries analysis of smartphone users in five major Chinese cities. Int J Behav Nutr Phys Act 2022; 19:68. [PMID: 35701809 PMCID: PMC9195465 DOI: 10.1186/s12966-022-01285-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physical activity is an important factor in premature mortality reduction, non-communicable disease prevention, and well-being protection. Climate change will alter temperatures globally, with impacts already found on mortality and morbidity. While uncomfortable temperature is often perceived as a barrier to physical activity, the actual impact of temperature on physical activity has been less well studied, particularly in China. This study examined the associations between temperature and objectively measured physical activity among adult populations in five major Chinese cities. Methods Aggregated anonymized step count data was obtained between December 2017-2018 for five major Chinese cities: Beijing, Shanghai, Chongqing, Shenzhen, and Hong Kong. The associations of temperature with daily aggregated mean step count were assessed using Generalized Additive Models (GAMs), adjusted for meteorological, air pollution, and time-related variables. Results Significant decreases in step counts during periods of high temperatures were found for cold or temperate climate cities (Beijing, Shanghai, and Chongqing), with maximum physical activity occurring between 16 and 19.3 °C. High temperatures were associated with decreases of 800-1500 daily steps compared to optimal temperatures. For cities in subtropical climates (Shenzhen and Hong Kong), non-significant declines were found with high temperatures. Overall, females and the elderly demonstrated lower optimal temperatures for physical activity and larger decreases of step count in warmer temperatures. Conclusions As minor reductions in physical activity could consequentially affect health, an increased awareness of temperature’s impact on physical activity is necessary. City-wide adaptations and physical activity interventions should seek ways to sustain physical activity levels in the face of shifting temperatures from climate change. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01285-1.
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Affiliation(s)
- Janice Y Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y Y Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. .,Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Wang P, Hu H, Mo PKH, Ouyang M, Geng J, Zeng P, Mao N. How is Father Phubbing Associated with Adolescents' Social Networking Sites Addiction? Roles of Narcissism, Need to Belong, and Loneliness. J Psychol 2022; 156:331-348. [PMID: 35482939 DOI: 10.1080/00223980.2022.2034726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Parents' phubbing has been found to be positively associated with adolescents' internet-related addiction. However, it remains unknown whether father phubbing would influence adolescents' social networking sites addiction (SNSA), and the mechanisms underlying this association stays largely unknown. This study aims to expand previous research by testing the mediating effect of loneliness, as well as the moderating effects of narcissism and need to belong in the association between father phubbing and adolescents' SNSA. METHOD In a cross-sectional design, 4,172 participants (2,189 boys and 1,983 girls; Mage = 16.41 ± .77) from 5 high schools in China completed measures of demographic variables, father phubbing, loneliness, narcissism, need to belong, and SNSA. RESULTS Results from regression analyses found that (a) Father phubbing had a positive association with adolescents' SNSA; (b) Loneliness partially mediated this association; (c) Narcissism and need to belong concurrently moderated the association between father phubbing and loneliness. In particular, the effect of father phubbing on loneliness was weaker among students with high narcissism, and among students with low need to belong. CONCLUSIONS The findings enrich our understanding of how father phubbing may increase the risk of SNSA among adolescents, and underscore the potential importance of reducing father phubbing and loneliness to prevent adolescents' SNSA.
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Xie L, Mo PKH, Tang Q, Zhao X, Zhao X, Cai W, Feng Y, Niu Y. Skeletal Muscle Mass Has Stronger Association With the Risk of Hyperuricemia Than Body Fat Mass in Obese Children and Adolescents. Front Nutr 2022; 9:792234. [PMID: 35419385 PMCID: PMC8995646 DOI: 10.3389/fnut.2022.792234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hyperuricemia has been increasing among children with obesity in recent years. However, few studies in such a study group had explored the relationship between obesity-anthropometric indexes and hyperuricemia. This study aimed to examine the associations between hyperuricemia and different body components in children and adolescents with obesity, and further explore gender differences in these associations. Methods In this cross-sectional study, a total of 271 obese children and adolescents (153 boys and 118 girls) aged 6–17 years were recruited from Shanghai Xinhua Hospital. Data about basic information, anthropometric assessments, body composition, and laboratory tests of participants were collected. Results In this study, 73 boys (47.71%) and 57 girls (48.31%) were diagnosed to have hyperuricemia. The impacts of percentage of skeletal muscle (PSM) (OR = 1.221, P < 0.001) and skeletal muscle mass (SMM) (OR = 1.179, P < 0.001) on the risk of hyperuricemia was the largest, followed by hip circumference (HC) (OR = 1.109, P < 0.001), waist circumference (WC) (OR = 1.073, P < 0.001), and body fat mass (BFM) (OR = 1.056, P < 0.05) in whole sample, which was adjusted for age, gender and body mass index (BMI). After being stratified by gender, PSM (boys: OR = 1.309, P < 0.001) and SMM (boys: OR = 1.200, P < 0.001; girls: OR = 1.147, P < 0.05) were still the most predictors of hyperuricemia, followed by HC (boys: OR = 1.147, P < 0.001; girls: OR = 1.080, P < 0.05). WC showed a significant association with hyperuricemia only in boys (OR = 1.083, P < 0.05), while BFM showed no association with hyperuricemia in both gender groups after adjusting for age and BMI. Conclusion Our findings suggested that SMM was a stronger predictor of hyperuricemia than BFM in children and adolescents with obesity, especially in boys.
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Affiliation(s)
- Luyao Xie
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Phoenix K H Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Qingya Tang
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuan Zhao
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuelin Zhao
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Cai
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute for Pediatric Research, Shanghai, China
| | - Yi Feng
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Niu
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Mo PKH, Wong ELY, Yeung NCY, Wong SYS, Chung RY, Tong ACY, Ko CCY, Li J, Yeoh EK. Differential associations among social support, health promoting behaviors, health-related quality of life and subjective well-being in older and younger persons: a structural equation modelling approach. Health Qual Life Outcomes 2022; 20:38. [PMID: 35246166 PMCID: PMC8895671 DOI: 10.1186/s12955-022-01931-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 01/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Extensive studies have confirmed social support as a critical protective factor of people’s health-related quality of life (HRQoL) and subjective well-being (SWB). However, health promoting behaviors as a potential mechanism and age differences in this mechanism has received fewer attention. This study aims to examine the associations among social support, health promoting behaviors, HRQoL and SWB in older and younger persons in Hong Kong. Method A convenience sample of both younger (12–35 years old) and older persons (55 years old and above) were recruited from three non-government organizations to complete a survey. Structural Equation Model (SEM) was conducted to test both the measurement model and structural models to examine the relationship between social support, health promoting behaviors, HRQoL and SWB. Multi-group SEM was also performed and compared to test whether there were significant age differences in the pathways between the key variables. Results A final sample of 408 participants (older-persons: N = 200 (mean age: 71.63 (8.16); 180/200 female), younger-persons: N = 208 (mean age: 18.10 (5.04); 155/208 female) were included in the final analysis. Results showed that social support was positively associated with SWB directly and indirectly through health promoting behaviors for the whole sample (CFI = .95, IFI = .94, RMSEA = .07, SRMR = 0.056). Results suggested that the association between the variables differed across age samples. While social support showed a positive association with health promoting behaviors for both younger and older persons, how each of them associated with HRQoL and SWB was different. Conclusion Findings suggest that the pathway which social support linked with HRQoL and SWB might differ across age groups. Age-specific strategies should be considered when promoting HRQoL and SWB among the younger and older population. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-01931-z.
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Affiliation(s)
- Phoenix K H Mo
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Eliza L Y Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Nelson C Y Yeung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Samuel Y S Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Roger Y Chung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Alan C Y Tong
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chris C Y Ko
- Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Jia Li
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
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Mo PKH, She R, Yu Y, Li L, Yang Q, Lin J, Ye X, Wu S, Yang Z, Guan S, Zhang J, Hu H, Xie L, Lau JTF. Resilience and intention of healthcare workers in China to receive a COVID-19 vaccination: The mediating role of life satisfaction and stigma. J Adv Nurs 2022; 78:2327-2338. [PMID: 35195300 PMCID: PMC9111598 DOI: 10.1111/jan.15143] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/06/2021] [Accepted: 12/18/2021] [Indexed: 11/30/2022]
Abstract
Aims The present study investigated the association between resilience, stigma, life satisfaction and the intention to receive a COVID‐19 vaccination among Chinese HCWs. It also explored the mediating role of stigma and life satisfaction on the association between resilience and intention to receive a COVID‐19 vaccination. Design An anonymous cross‐sectional survey. Methods 1733 HCWs from five hospitals in four provinces of mainland China completed a cross‐sectional online survey in October and November 2020. Results Among the HCWs, the rate of intention to receive a COVID‐19 vaccination was 73.1%. Results from structural equation modelling showed that resilience was associated both directly, and indirectly with greater intent to receive a COVID‐19 vaccination through two pathways: first by increasing life satisfaction, and second by reducing stigma and increasing life satisfaction. Conclusion Promoting the resilience of HCWs has the potential to increase the COVID‐19 vaccination uptake rate among HCWs in China. Impact This study tested the relationship between several psychological factors and the COVID‐19 vaccination intention of HCWs in China, finding that resilience played a significant role in improving COVID‐19 vaccination intention rates by reducing stigma and increasing life satisfaction.
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Affiliation(s)
- Phoenix K H Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Rui She
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yanqiu Yu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Lijuan Li
- School of Public Health, Dali University, Dali, Yunnan, China
| | - Qian Yang
- Center for Health Policy Studies, School of Public Health and Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Jianyan Lin
- The Fourth People's Hospital of Nanning, Guangxi, China
| | - Xiaoli Ye
- The Children's Hospital Zhejiang University School of Medicine, Zhejiang, China
| | - Suliu Wu
- Wuyi First People's Hospital, Zhejiang, China
| | - Zhenggui Yang
- The Fourth People's Hospital of Ningxia Hui Autonomous Region, Ningxia, China
| | - Suzhen Guan
- School of Public Health and Management, Ningxia Medical University, Ningxia, China
| | - Jianxin Zhang
- Huaxi School of Public Health, Sichuan University, Sichuan, China
| | - Huahua Hu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Luyao Xie
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Mo PKH, Cheng Y, Lau JTF. Work-related factors on mental health among migrant factory workers in china: Application of the Demand-Control and Effort-Reward Imbalance Model. Health Soc Care Community 2022; 30:656-667. [PMID: 32989898 DOI: 10.1111/hsc.13176] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 06/11/2023]
Abstract
Mental health problems are prevalent among migrant workers in China. The present study examined the prevalence of mental health problems (depression, anxiety and suicidal ideation) among migrant workers in China, and identified the work-related factors associated with their mental health problems based on the Demand-Control and Effort-Reward Imbalance Model. A total of 807 migrant workers were recruited from three factories in Shenzhen using stratified randomized sampling. The prevalence of moderate-to-severe anxiety, mild-to-severe depression and suicidal ideation in the past year was 17.8%, 60.3% and 4.8% respectively. Results from stepwise regression analyses reported that role conflict and effort were risk factors, whereas utilization of job skills and reward were protective factors for anxiety and depression. Social support was also associated with lower level of depression. Effort was the only factor associated with suicidal ideation in the stepwise analysis. Interventions to improve their mental health are warranted and they should work to reduce their role conflict, improve effort-reward balance, promote utilization of skills and increase social support.
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Affiliation(s)
- Phoenix K H Mo
- Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Yu Cheng
- Department of Anthropology, School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, China
| | - Joseph T F Lau
- Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
- Centre for Medical Anthropology, Behavioral Health, Sun Yat-Sen University, Guangzhou, China
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Yu Y, Peng L, Mo PKH, Yang X, Cai Y, Ma L, She R, Lau JTF. Association between relationship adaptation and Internet gaming disorder among first-year secondary school students in China: Mediation effects via social support and loneliness. Addict Behav 2022; 125:107166. [PMID: 34782208 DOI: 10.1016/j.addbeh.2021.107166] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/31/2022]
Abstract
Adolescents encounter numerous challenges and need to restructure their social relationships when they enter secondary schools. Relationship adaptation is critical and failure in adaptation may be associated with Internet gaming disorder (IGD). This novel study investigated the association between relationship adaptation and IGD and related mediation mechanisms via social support and loneliness among first-year secondary school students in Shanghai and Xi'an, China in 2018. Of 2573 participants, the prevalence of IGD was 13.1%. Relationship adaptation, social support, and loneliness were all significantly associated with IGD. The association between relationship adaptation and IGD was fully mediated by three indirect paths, including relationship adaptation → social support → IGD (effect size = 35.5%), relationship adaptation → loneliness → IGD (effect size = 34.3%), and relationship adaptation → social support → loneliness → IGD (effect size = 6.1%). In conclusion, the observed high prevalence of IGD among first-year secondary school students in China was associated with poor relationship adaptation. The full mediation effects via social support and loneliness suggest that modification of these two psychosocial attributes may effectively reduce the harmful impacts of poor relationship adaptation on adolescent IGD. Future longitudinal studies are warranted to confirm the findings.
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Affiliation(s)
- Yanqiu Yu
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Luanting Peng
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Hangzhou TigerMed Consulting Co., Ltd., Hangzhou, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xue Yang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yong Cai
- School of Public Health, Faculty of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Le Ma
- School of Public Health, Xi'an Jiao Tong University Health Science Center, Xi'an, China
| | - Rui She
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Joseph T F Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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Mo PKH, Yu Y, Luo S, Wang S, Zhao J, Zhang G, Li L, Li L, Lau JTF. Dualistic Determinants of COVID-19 Vaccination Intention among University Students in China: From Perceived Personal Benefits to External Reasons of Perceived Social Benefits, Collectivism, and National Pride. Vaccines (Basel) 2021; 9:vaccines9111323. [PMID: 34835254 PMCID: PMC8620481 DOI: 10.3390/vaccines9111323] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/04/2021] [Accepted: 11/11/2021] [Indexed: 02/05/2023] Open
Abstract
Vaccination is one of the most effective ways of controlling the COVID-19 pandemic. However, vaccine hesitancy is prevalent, and relatively few studies have explored how variables related to personal and external motives have affected the intention to vaccinate. The present study investigated the association between perceived personal benefits, variables reflecting external motives (i.e., perceived social benefits, collectivism, and national pride) and intention to receive COVID-19 vaccination among university students in China. The interaction between perceived personal benefits and the three factors reflecting external motives on intention to receive COVID-19 vaccination was also examined. A total of 6922 university students from five provinces of China completed a cross-sectional survey. Results showed that adjusting for significant background variables, perceived personal benefits, perceived social benefits, collectivism, and national pride were all significant factors of intention to receive COVID-19 vaccination. Results from interaction analyses also showed that the association between perceived personal benefits and COVID-19 vaccination intention was stronger among those with lower levels of national pride. Findings highlighted the important role of self-directed interest and external motives in promoting uptake of COVID-19 vaccination.
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Affiliation(s)
- Phoenix K. H. Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.K.H.M.); (Y.Y.)
| | - Yanqiu Yu
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.K.H.M.); (Y.Y.)
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China;
| | - Suhua Wang
- Graduate School of Baotou Medical College, Baotou Medical College, Baotou 014040, China;
| | - Junfeng Zhao
- Department of Psychology, School of Education, Henan University, Kaifeng 475004, China;
| | - Guohua Zhang
- Department of Psychology, School of Psychiatry, Wenzhou Medical University, Wenzhou 325035, China;
| | - Lijuan Li
- School of Public Health, Dali University, Dali 671003, China;
| | - Liping Li
- School of Public Health, Shantou University Medical College, Shantou 515063, China;
| | - Joseph T. F. Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (P.K.H.M.); (Y.Y.)
- Correspondence:
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Li JB, Feng LF, Wu AMS, Mai JC, Chen YX, Mo PKH, Lau JTF. Roles of Psychosocial Factors on the Association Between Online Social Networking Use Intensity and Depressive Symptoms Among Adolescents: Prospective Cohort Study. J Med Internet Res 2021; 23:e21316. [PMID: 34546173 PMCID: PMC8493459 DOI: 10.2196/21316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/21/2020] [Accepted: 08/04/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The potential mechanisms underlying the association between online social networking use intensity and depressive symptoms are unclear and underresearched. OBJECTIVE We aimed to investigate the potential roles of interpersonal psychosocial factors on the association between online social networking use intensity and depressive symptoms among early adolescents. METHODS A total of 4237 adolescents from a 9-month longitudinal study were included. Score changes (indicated as △) for the social function use intensity (SFUI) and entertainment function use intensity (EFUI) subscales of the Online Social Networking Activity Intensity Scale and for friendship quality, perceived family support, perceived friend support, parent-adolescent conflict, social nonconfidence, and depressive symptoms were analyzed. The potential mediation effects of unfavorable psychosocial factors and suppression effects of favorable psychosocial factors on the association of △SFUI with △CES-D and the association of △EFUI with △CES-D were tested using hierarchical regression models. RESULTS The association between △SFUI and △CES-D was partially mediated by △mother-adolescent conflict (mediation effect size 5.11%, P=.02) and △social nonconfidence (mediation effect size 20.97%, P<.001) but partially suppressed by △friendship quality, △perceived family support, and △perceived friend support, with suppression effects of -0.011 (P=.003), -0.009 (P=.003), and -0.022 (P<.001), respectively. The association between △EFUI and △CES-D was partially mediated by △social nonconfidence (mediation effect size 30.65%, P<.001) but partially suppressed by △perceived family support and △perceived friend support, with suppression effects of -0.036 (P<.001) and -0.039 (P<.001), respectively. CONCLUSIONS The association between online social networking use intensity and depressive symptoms was partially mediated through the indirect increase in social nonconfidence and mother-adolescent conflict; however, better perceived social support and friendship quality would partially compensate for the harmful impact of online social networking use intensity on depressive symptoms among early adolescents.
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Affiliation(s)
- Ji-Bin Li
- Department of Clinical Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Center for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Li-Fen Feng
- Department of Statistics, Government Affairs Service Center of Health Commission of Guangdong Province, Guangzhou, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Jin-Chen Mai
- Department of Psychological Health Research, Center for Health Promotion of Primary and Secondary School of Guangzhou, Guangzhou, China
| | - Yu-Xia Chen
- Department of Psychological Health Research, Center for Health Promotion of Primary and Secondary School of Guangzhou, Guangzhou, China
| | - Phoenix K H Mo
- Center for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- Center for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Lau CYK, Kong APS, Lau JTF, Chan V, Mo PKH. Coping skills and glycaemic control: the mediating role of diabetes distress. Acta Diabetol 2021; 58:1071-1079. [PMID: 33768380 DOI: 10.1007/s00592-021-01679-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 01/11/2021] [Indexed: 10/21/2022]
Abstract
AIMS The present study examined the mediating role of diabetes distress on the relationship between coping and glycaemic control, and evaluated if the afore-mentioned mediation was moderated by insulin treatment in people with type 2 diabetes. METHODS A total of 473 adults with type 2 diabetes were recruited from an outpatient clinic in Hong Kong and invited to take part in a survey that measured adaptive coping, maladaptive coping, and diabetes stress. Glycaemic control was measured by glycated haemoglobin values extracted from medical records. PROCESS v3.4 macro was used to test the moderated mediation model. RESULTS Adaptive coping was negatively associated with diabetes distress (-0.29, 95% CI: -0.53, -0.06), whereas maladaptive coping was positively associated with diabetes distress (1.82, 95% CI: 1.12, 2.51). Diabetes distress had a positive relationship with glycated haemoglobin (0.04, 95% CI: 0.02, 0.05), but no correlations were found between glycated haemoglobin and adaptive coping or maladaptive coping. Insulin treatment not only weakened the diabetes distress-glycaemic control relationship (-0.04, 95% CI: -0.06, -0.01), but also weakened the mediation effect of maladaptive coping-glycaemic control relationship via diabetes distress (-0.07, 95% CI: -0.12, -0.02). CONCLUSIONS The study findings revealed the role of diabetes distress and insulin treatment in the link between coping skills and glycaemic control. Interventions to help boost confidence and autonomy in people with diabetes could help them lessen diabetes distress.
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Affiliation(s)
- Christine Y K Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Alice P S Kong
- Division of Endocrinology and Diabetes, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Joseph T F Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Virginia Chan
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR.
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Dekker J, Amitami M, Berman AH, Brown H, Cleal B, Figueiras MJ, Finney Rutten LJ, Fors EA, Griva K, Gu J, Keyworth C, Kleinstäuber M, Lahmann C, Lau JTF, Leplow B, Li L, Malmberg Gavelin H, Mewes R, Mo PKH, Mullan B, Penedo FJ, Prins J, Rodríguez Rodríguez T, Simpson SA, Stauder A, Tuomisto MT, Weiss DJ, Nater UM. Definition and Characteristics of Behavioral Medicine, and Main Tasks and Goals of the International Society of Behavioral Medicine-an International Delphi Study. Int J Behav Med 2021; 28:268-276. [PMID: 32909153 PMCID: PMC8121730 DOI: 10.1007/s12529-020-09928-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND In the past decades, behavioral medicine has attained global recognition. Due to its global reach, a critical need has emerged to consider whether the original definition of behavioral medicine is still valid, comprehensive, and inclusive, and to reconsider the main tasks and goals of the International Society of Behavioral Medicine (ISBM), as the umbrella organization in the field. The purpose of the present study was to (i) update the definition and scope of behavioral medicine and its defining characteristics; and (ii) develop a proposal on ISBM's main tasks and goals. METHOD Our study used the Delphi method. A core group prepared a discussion paper. An international Delphi panel rated questions and provided comments. The panel intended to reach an a priori defined level of consensus (i.e., 70%). RESULTS The international panel reached consensus on an updated definition and scope of behavioral medicine as a field of research and practice that builds on collaboration among multiple disciplines. These disciplines are concerned with development and application of behavioral and biomedical evidence across the disease continuum in clinical and public health domains. Consensus was reached on a proposal for ISBM's main tasks and goals focused on supporting communication and collaboration across disciplines and participating organizations; stimulating research, education, and practice; and supporting individuals and organizations in the field. CONCLUSION The consensus on definition and scope of behavioral medicine and ISBM's tasks and goals provides a foundational step toward achieving these goals.
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Affiliation(s)
- Joost Dekker
- Department of Rehabilitation Medicine and Department of Psychiatry, Amsterdam University Medical Centers, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
| | - Marie Amitami
- Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Anne H Berman
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Stockholm Region, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Helen Brown
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Bryan Cleal
- Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Maria João Figueiras
- Psychology Department, College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Lila J Finney Rutten
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Egil A Fors
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chris Keyworth
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maria Kleinstäuber
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Joseph T F Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territory, Hong Kong, China
| | - Bernd Leplow
- Institute for Psychology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Li Li
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hanna Malmberg Gavelin
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Ricarda Mewes
- Outpatient Unit for Research, Teaching, and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territory, Hong Kong, China
| | - Barbara Mullan
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Frank J Penedo
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Judith Prins
- Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Teresa Rodríguez Rodríguez
- Science and Technology Department, University Hospital "Dr. Gustavo Aldereguía Lima", Cienfuegos, Cuba
- Cienfuegos Medical School, Cienfuegos, Cuba
| | - Sharon A Simpson
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Adrienne Stauder
- Institute of Behavioural Sciences, Semmelweis University Budapest, Budapest, Hungary
| | - Martti T Tuomisto
- Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
| | - Deborah Jones Weiss
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Urs M Nater
- Faculty of Psychology, University of Vienna, Vienna, Austria
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Ho JY, Zijlema WL, Triguero-Mas M, Donaire-Gonzalez D, Valentín A, Ballester J, Chan EYY, Goggins WB, Mo PKH, Kruize H, van den Berg M, Gražuleviciene R, Gidlow CJ, Jerrett M, Seto EYW, Barrera-Gómez J, Nieuwenhuijsen MJ. Does surrounding greenness moderate the relationship between apparent temperature and physical activity? Findings from the PHENOTYPE project. Environ Res 2021; 197:110992. [PMID: 33705766 DOI: 10.1016/j.envres.2021.110992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/21/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Physical activity can be affected by both meteorological conditions and surrounding greenness, but few studies have evaluated the effects of these environmental factors on physical activity simultaneously. This multi-city comparative study aimed to assess the synergetic effects of apparent temperature and surrounding greenness on physical activity in four European cities. Specifically, we aimed to identify an interaction between surrounding greenness and apparent temperature in the effects on physical activity. METHODS Data were collected from 352 adult residents of Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands), and Kaunas (Lithuania) as part of the PHENOTYPE study. Participants wore a smartphone for seven consecutive days between May-December 2013 and provided additional sociodemographic survey data. Hourly average physical activity (Metabolic Equivalent of Task (MET)) and surrounding greenness (NDVI) were derived from the Calfit mobile application collecting accelerometer and location data. Hourly apparent temperature was calculated from temperature and relative humidity, which were obtained from local meteorological stations along with other meteorological covariates (rainfall, windspeed, and sky darkness). We assessed the interaction effects of apparent temperature and surrounding greenness on hourly physical activity for each city using linear mixed models, while adjusting for meteorological, demographic, and time-related variables. RESULTS We found significant interactions between apparent temperature and surrounding greenness on hourly physical activity in three of four cities, aside from the coastal city of Barcelona. Significant quadratic effects of apparent temperature were found in the highest level of surrounding greenness for Stoke-on-Trent and Doetinchem, with 4% decrease in median MET observed for a 10°C departure from optimal temperature (15.2°C and 14.6°C, respectively). Significant linear effects were found for higher levels of surrounding greenness in Kaunas, whereby an increase of 10°C was associated with ∼4% increase in median MET. CONCLUSION Apparent temperature and surrounding greenness interacted in the effect on hourly physical activity across three of four European cities, with varying effect between cities. While quadratic effects of temperature suggest diminishing levels of physical activity in the highest greenness levels in cities of temperate climates, the variation in surrounding greenness between cities could be further explored, particularly by looking at indoor-outdoor locations. The study findings support the need for evidence-based physical activity promotion and urban design.
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Affiliation(s)
- Janice Y Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wilma L Zijlema
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Margarita Triguero-Mas
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - David Donaire-Gonzalez
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia; Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, the Netherlands
| | - Antònia Valentín
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Ballester
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain
| | - Emily Y Y Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Hanneke Kruize
- Centre for Sustainability, Environment and Health, RIVM, Bilthoven, the Netherlands
| | | | | | - Christopher J Gidlow
- Centre for Sport, Health and Exercise Research, Staffordshire University, Stoke-on-Trent, UK
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Edmund Y W Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Barrera-Gómez
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark J Nieuwenhuijsen
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Wang Q, Mo PKH, Song B, Di JL, Zhou FR, Zhao J, Wu YL, Tian H, Qiu LQ, Xia J, Wang L, Li F, Wang LH. Mental health and preventive behaviour of pregnant women in China during the early phase of the COVID-19 period. Infect Dis Poverty 2021; 10:37. [PMID: 33761984 PMCID: PMC7988630 DOI: 10.1186/s40249-021-00825-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/12/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The COVID-19 has caused significant toll over the globe. Pregnant women are at risk of infection. The present study examined the frequency of washing hands with soap and wearing face mask when going out, prevalence of depression and anxiety, and identified their associated factors among pregnant women during the early phase of COVID-19 outbreak in China. METHODS A cross-sectional online survey was conducted between 24 February and 3 March 2020. A total of 15 428 pregnant women who were using maternal health care services in China completed a questionnaire which assessed their socio-demographic and pregnancy-related characteristics, contextual, cognitive and social factors related to COVID-19, frequency of washing hands and wearing face masks, and depression and anxiety. Logistics regression analyses were performed to identify the associated factors of preventive behaviours and mental health. RESULTS The prevalence of probable anxiety and depression was 28.2% and 43.6% respectively. 19.8% reported always wearing face mask when going out, and 19.1% reported washing hands with soap for more than 10 times per day. Results from logistic regression analyses showed that older age was associated with lower levels of depression and anxiety (OR = 0.42-0.67) and higher frequency of washing hands (OR = 1.57-3.40). Higher level of education level was associated with probable depression (OR = 1.31-1.45) and higher frequency of wearing face mask (OR = 1.50-1.57). After adjusting for significant socio-demographic and pregnancy-related factors, place of residence being locked down (aOR = 1.10-1.11), being quarantined (aOR = 1.42-1.57), personally knowing someone being infected with COVID-19 (aOR = 1.80-1.92), perception that COVID-19 would pose long term physical harm to human (aOR = 1.25-1.28) were associated with higher levels of depression and anxiety, while the perception that the disease will be under control in the coming month was associated with lower levels of depression and anxiety (aOR = 0.59-0.63) and lower tendency of always wearing face mask (aOR = 0.85). Social support was associated with lower levels of depression and anxiety (aOR = 0.86-0,87) and higher frequency of washing hands (aOR = 1.06). CONCLUSIONS The mental health and preventive behaviours of pregnant women during COVID-19 outbreak was associated with a range of socio-demographic, pregnancy-related, contextual, cognitive and social factors. Interventions to mitigate their mental health problems and to promote preventive behaviours are highly warranted.
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Affiliation(s)
- Qian Wang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Phoenix K H Mo
- Center for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Bo Song
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiang-Li Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng-Rong Zhou
- Shandong Province Hospital for Women and Children's Health, Jinan, China
| | - Juan Zhao
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Ying-Lan Wu
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Hong Tian
- Women and Children's Health Care Hospital of Liaoning Province, Shenyang, China
| | - Li-Qian Qiu
- School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Jianhong Xia
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Lan Wang
- Chong Qing Health Center for Women and Children, Chong Qing, China
| | - Fen Li
- First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, China
| | - Lin-Hong Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 13# Rd Nanwei, Xicheng, Beijing, China.
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Mo PKH, Hu H, Ip M, Dong W, Lau JTF, Wang Z. Effect of stress and avoidant coping on depression and the moderating role of age among men who have sex with men: Findings from a 6-month prospective cohort study. J Affect Disord 2021; 283:310-316. [PMID: 33578343 DOI: 10.1016/j.jad.2021.01.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/06/2021] [Accepted: 01/30/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) are at increased risk of mental health problems. Few studies have examined the risk factors for mental health problems of Chinese MSM and identified potential moderators using a longitudinal design. OBJECTIVES The present study examined the effect of stress and avoidant coping on depression among MSM, and the moderating role of age on such relationship. METHODOLOGY A 6-month observational prospective cohort study was conducted among Chinese MSM. Respectively 592 and 402 MSM completed a survey at baseline and 6-month follow-up. RESULTS The prevalence of probable depression was 36.1% at baseline and 34.1% at 6-month follow-up. After adjusting for background characteristics and baseline depression score, both stress (β = .22, p<.05) and avoidant coping (β = .14, p<.05) showed significant positive relationship with depression at 6-month follow-up. The interaction effect of age and stress / avoidant coping was also significant. The effect of stress on depression was stronger among younger MSM, and the effect of avoidant coping on depression was significant among younger MSM but non-significant among older MSM. CONCLUSIONS Mental health promotion for MSM should reduce stress and avoidant coping, and specific intervention should be designed for younger MSM.
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Affiliation(s)
- Phoenix K H Mo
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Huahua Hu
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Mary Ip
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Willa Dong
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, North Carolina, US.
| | - Joseph T F Lau
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Zixin Wang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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Wang Q, Wang Z, Ma X, Chan P, Lau JTF, Mo PKH. Chinese mothers' intent to disclose the HIV status to their children: the role of outcome expectations and self-efficacy. AIDS Care 2021; 34:95-104. [PMID: 33563048 DOI: 10.1080/09540121.2021.1882930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The present study examined the association between outcome expectations, self-efficacy, and intention to disclose HIV status to children among HIV-positive women in China, and the moderating and mediating role of self-efficacy on the association between outcome expectations and intention to disclose. A cross-sectional survey was conducted among 179 HIV-positive mothers who had at least one living child aged >5 years and had not yet disclosed their HIV status to her oldest child. Results from hierarchical regressions revealed that after adjusting for socio-demographic and medical variables, negative outcome expectations had a negative association (β = -0.22), while disclosure self-efficacy had a positive association (β = 0.43) with an intention to disclose HIV. The moderation effect of self-efficacy on the association between outcome expectations and intention to disclose HIV was not significant. Results from structural equation modeling showed that self-efficacy mediated the association between negative/positive outcome expectations and intention to disclose HIV. Findings support the importance of outcome expectations and self-efficacy and also the mediating role of self-efficacy in HIV disclosure among HIV-positive mothers in the Chinese context.
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Affiliation(s)
- Qian Wang
- Department of Prevention of Mother to Child Transmission of Disease, National Center for women and children's health, China Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, People's Republic of China.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, People's Republic of China
| | - Xiaomeng Ma
- Department of Health Policy and Management, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Polin Chan
- World Health Organization, Western Pacific Regional Office, Manila, Philippines
| | - Joseph T F Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, People's Republic of China.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, People's Republic of China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, People's Republic of China.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, People's Republic of China
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Wang Z, Lau JTF, Ip TKM, Yu Y, Fong F, Fang Y, Mo PKH. Two Web-Based and Theory-Based Interventions With and Without Brief Motivational Interviewing in the Promotion of Human Papillomavirus Vaccination Among Chinese Men Who Have Sex With Men: Randomized Controlled Trial. J Med Internet Res 2021; 23:e21465. [PMID: 33528372 PMCID: PMC7886619 DOI: 10.2196/21465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 01/09/2023] Open
Abstract
Background Human papillomavirus (HPV) vaccination is effective in the prevention of vaccine-type genital warts and cancers among men who have sex with men (MSM). Objective The primary objective of this randomized controlled trial (RCT) is to evaluate the efficacies of 2 web- and theory–based interventions with and without brief motivational interviewing (MI) over the phone to increase the completion of HPV vaccination among unvaccinated participants within a 24-month follow-up period compared with the control group. Methods A 3-arm parallel-group RCT was conducted between July 2017 and December 2019. Five telephone surveys were conducted at baseline and at 3, 6, 9, and 24 months by blinded interviewers. Participants were Hong Kong Chinese–speaking MSM aged between 18 and 45 years with regular internet access who were recruited from outreaching at venues, web-based recruitment, and peer referral. Those who had ever received HPV vaccination were excluded. A total of 624 participants were randomized into either the online tutorial (OT) only group (n=208), the OT plus MI group (OT-MI; n=208), or the control group (n=208). In total, 459 (459/624, 73.6%) completed the follow-up evaluation at 24 months. Participants in the OT group received a fully automated OT developed based on the health belief model. On top of the same OT, the OT-MI group received brief MI over the phone. Reminders were sent to the participants of the OT and OT-MI groups after 1, 2, 4, 6, and 8 months. Participants in the control group received web-based health communication messages unrelated to HPV or HPV vaccination. The research team validated the self-reported HPV vaccination uptake. Intention-to-treat analysis was used for outcome analyses. Logistic regression models and multivariable linear regression models were used to test the between-group differences in primary and secondary outcomes. Baron and Kenny’s methods were used to test the mediation hypothesis. Results The participants in the OT-MI group reported a significantly higher validated completion of HPV vaccination at 24 months than the control group (36/208, 17.3% vs 15/208, 7.2%; P=.006). However, the difference in HPV vaccination completion between the OT and the control groups (24/208, 11.5% vs 15/208, 7.2%; P=.17), or between OT-MI and OT groups (P=.13), was not statistically significant. The association between randomization status (OT-MI group vs control group) and HPV vaccination completion became statistically nonsignificant after controlling for changes in the perceived susceptibility to HPV (24 months vs baseline), whereas perceived susceptibility remained strongly associated with HPV vaccination uptake in the model (P<.001). Changes in perceived susceptibility fully mediated the intervention effect. Conclusions Theory-based OT with brief MI over the phone was effective in increasing HPV vaccination completion among Chinese MSM. Perceived susceptibility is an active theoretical component that causes behavioral changes. Trial Registration ClinicalTrials.gov NCT03286907; https://clinicaltrials.gov/ct2/show/NCT03286907
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Affiliation(s)
- Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Tsun Kwan Mary Ip
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yebo Yu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Yuan Fang
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Yang X, Song B, Wu A, Mo PKH, Di J, Wang Q, Lau JTF, Wang L. Social, Cognitive, and eHealth Mechanisms of COVID-19-Related Lockdown and Mandatory Quarantine That Potentially Affect the Mental Health of Pregnant Women in China: Cross-Sectional Survey Study. J Med Internet Res 2021; 23:e24495. [PMID: 33302251 PMCID: PMC7836909 DOI: 10.2196/24495] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/01/2020] [Accepted: 11/30/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although lockdown and mandatory quarantine measures have played crucial roles in the sharp decrease of the number of newly confirmed/suspected COVID-19 cases, concerns have been raised over the threat that these measures pose to mental health, especially the mental health of vulnerable groups, including pregnant women. Few empirical studies have assessed whether and how these control measures may affect mental health, and no study has investigated the prevalence and impacts of the use of eHealth resources among pregnant women during the COVID-19 outbreak. OBJECTIVE This study investigated (1) the effects of lockdown and mandatory quarantine on mental health problems (ie, anxiety and depressive symptoms), (2) the potential mediation effects of perceived social support and maladaptive cognition, and (3) the moderation effects of eHealth-related factors (ie, using social media to obtain health information and using prenatal care services during the COVID-19 pandemic) on pregnant women in China. METHODS An online cross-sectional survey was conducted among 19,515 pregnant women from all 34 Chinese provincial-level administrative regions from February 25 to March 10, 2020. RESULTS Of the 19,515 participants, 12,209 (62.6%) were subjected to lockdown in their areas of residence, 737 (3.8%) were subjected to mandatory quarantine, 8712 (44.6%) had probable mild to severe depression, 5696 (29.2%) had probable mild to severe anxiety, and 1442 (7.4%) had suicidal ideations. Only 640 (3.3%) participants reported that they used online prenatal care services during the outbreak. Significant sociodemographic/maternal factors of anxiety/depressive symptoms included age, education, occupation, the area of residence, gestational duration, the number of children born, complication during pregnancy, the means of using prenatal care services, and social media use for obtaining health information. Multiple indicators multiple causes modeling (χ214=495.21; P<.05; comparative fit index=.99; nonnormed fit index=.98; root mean square error of approximation=.04, 90% CI 0.038-0.045) showed that quarantine was directly and indirectly strongly associated with poor mental health through decreased perceived social support and increased maladaptive cognition (B=.04; β=.02, 95% CI 0.01-0.02; P=.001), while lockdown was indirectly associated with mental health through increased social support and maladaptive cognition among pregnant women (B=.03; β=.03, 95% CI 0.02-0.03; P=.001). Multigroup analyses revealed that the use of social media for obtaining health information and the means of using prenatal care services were significant moderators of the model paths. CONCLUSIONS Our findings provide epidemiological evidence for the importance of integrating mental health care and eHealth into the planning and implementation of control measure policies. The observed social and cognitive mechanisms and moderators in this study are modifiable, and they can inform the design of evidence-based mental health promotion among pregnant women.
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Affiliation(s)
- Xue Yang
- The Jockey Club School of Public Health and Primary, The Chinese University of Hong Kong, Hong Kong, China
| | - Bo Song
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Anise Wu
- Department of Psychology, University of Macau, Macao, Macao
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qian Wang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Joseph T F Lau
- The Jockey Club School of Public Health and Primary, The Chinese University of Hong Kong, Hong Kong, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Chan VWY, Kong APS, Lau JTF, Mak WWS, Cameron LD, Mo PKH. An Intervention to Change Illness Representations and Self-Care of Individuals With Type 2 Diabetes: A Randomized Controlled Trial. Psychosom Med 2021; 83:71-84. [PMID: 33141790 DOI: 10.1097/psy.0000000000000883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Suboptimal self-care by individuals with diabetes mellitus (DM) is a significant public health concern. The common-sense model (CSM) proposes that illness representations are associated with coping and health outcomes across various conditions. The present study examined the efficacy of a CSM-based intervention in improving illness representations, self-care, self-care self-efficacy, use of adaptive coping strategies, and glycated hemoglobin among individuals with type 2 DM (T2DM). METHODS A two-arm randomized controlled trial was used. A total of 455 T2DM patients were recruited from an outpatient DM clinic and randomized to an intervention group that consisted of five weekly group-based education sessions or a control group that received five weekly educational booklets. Evaluation was conducted at baseline and at 1- and 6-month follow-up. RESULTS The 2 × 3 linear mixed-model analysis using a modified intention to treat revealed a significant time by condition interaction effect on level of self-care (F(2,840) = 7.78, p < .001), self-care self-efficacy (F(1.89,794.57) = 14.40, p < .001), and use of adaptive coping strategies (F(1.94,812.93) = 4.75, p = .010) in which participants in the intervention group reported greater improvement in such aspects compared with those in the control group. A significant time effect was observed in some dimensions of illness representations. No significant effect was found in glycated hemoglobin. Participants reported positive feedback to the intervention and perceived improvement in various domains. CONCLUSIONS The CSM-based intervention was effective in improving self-care and coping among DM patients. The intervention also demonstrated high feasibility and acceptability. Findings provided important insights in improving health-related outcomes for patients with T2DM using the CSM framework.
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Affiliation(s)
- Virginia W Y Chan
- From the Centre for Health Behaviours Research, School of Public Health and Primary Care (Chan, Lau, Mo), and Departments of Medicine and Therapeutics (Kong) and Psychology (Mak), the Chinese University of Hong Kong, Shatin, Hong Kong; and Department of Psychological Sciences (Cameron), University of California Merced, Merced, California
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Wang Z, Fang Y, Dong W, Lau M, Mo PKH. Illness representations on pneumonia and pneumococcal vaccination uptake among community-living Chinese people with high-risk conditions aged ≥65 years --- a population-based study. Hum Vaccin Immunother 2020; 17:1455-1462. [PMID: 32991245 DOI: 10.1080/21645515.2020.1814653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
This study investigated the associations between illness representations of pneumonia and pneumococcal vaccination (PV) uptake among a group of community-living aging adults having at least one high-risk condition for severe invasive pneumococcal diseases (IPD). A total of 750 community-living Chinese-speaking individuals aged ≥65 y completed a random telephone survey. This study was based on 483 participants having at least one high-risk condition for severe IPD. The Illness Representation Questionnaire-Revised (IPQ-R) measured four dimensions of illness representations. These dimensions included timeline (whether pneumonia is believed to be acute/chronic), consequences (severity of pneumonia), treatment control (whether pneumonia is under volitional control), and emotional response (anger, guilty, or shame). Using PV uptake (among all participants) and behavioral intention to take up PV (among unvaccinated participants) as the dependent variables, logistic regression models were fitted. Among all participants (n = 483), 17.8% reported PV uptake; 18.6% of unvaccinated participants (n = 397) intended to take up two doses of free PV in the next year. After adjustment for significant background variables, participants who perceived more severe consequences of pneumonia (adjusted odds ratios, AOR: 1.18, 95%CI: 1.01, 1.40) and belief that treatment can control pneumonia (AOR: 1.41, 95%CI: 1.25, 1.58) reported higher PV uptake. Perceived pneumonia to be chronic (AOR: 1.44, 95%CI: 1.16, 1.78), belief that treatment can control pneumonia (AOR: 1.25, 95%CI: 1.12, 1.40) and having negative emotions related to pneumonia (AOR: 1.17, 95%CI: 1.09, 1.25) were positively associated with behavioral intention to take up PV. Results confirmed that illness representations were associated with PV-related behaviors.
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Affiliation(s)
- Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China.,Shenzhen Research Institute, the Chinese University of Hong Kong, Shenzhen, China
| | - Yuan Fang
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong SAR, China
| | - Willa Dong
- Department of Health Behavior, Gillings School of Global Public Health, the University of North Carolina at Chapel Hill, North Carolina, USA
| | - Mason Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
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