Psychometric validation of the Chinese digital health literacy instrument among Chinese older adults who have internet use experience.

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.

Understanding the Pathways from Mindfulness to COVID-19 Vaccination Intention via Positive Psychology Attributes among Health Care Workers in China.

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.

How is Father Phubbing Associated with Adolescents' Social Networking Sites Addiction? Roles of Narcissism, Need to Belong, and Loneliness.

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.

Resilience and intention of healthcare workers in China to receive a COVID-19 vaccination: The mediating role of life satisfaction and stigma.

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.

How mobile phone addiction is associated with suicidal ideation in university students in China: Roles of depression and online social support.

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.

A longitudinal study of changes in smart phone addiction and depressive symptoms and potential risk factors among Chinese college students.

BACKGROUND: The current study aims to track the changes in the levels of smart phone addiction (SPA) and depressive symptoms between pre and during COVID-19 and potential risk factors of among Chinese college students in a four-wave longitudinal study. METHODS: The participants were recruited from a Chinese university (n = 195; 58.5% females). The first three-wave surveys were conducted before COVID-19 (during December of Year 1, June of Year 1, and December of Year 2 of their college study; Time 1, Time 2, Time 3), while the fourth survey (Time 4; during June of Year 2 of their college study) was conducted in June 2020 during COVID-19. COVID-19-related factors, including quarantine, lockdown, boredom, emotional loneliness, and social loneliness, were investigated. RESULTS: The results showed a significant increase in the levels of depressive symptoms and prevalence of probable depression during COVID-19 (69.2%) compared to those 18 months, 12 months and 6 months before COVID-19 (41.5, 45.6, 48.2%) but non-significant changes in SPA. Boredom and emotional loneliness were positively associated with both SPA and depressive symptoms during COVID-19. Social loneliness was also positively associated with depressive symptoms during COVID-19. Quarantine and lockdown were not significantly associated with SPA or depressive symptoms. DISCUSSION AND CONCLUSIONS: The results highlight that the study population may be a high risk group of probable depression. Future studies should continue to track these mental and behavioral status with the progression of the epidemic. The identified emotional factors could be used to reduce depressive symptoms during COVID-19 and prevent the potential risk of SPA.

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.

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 (ß = .22, p<.05) and avoidant coping (ß = .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.

Parent-adolescent congruence in phubbing and adolescents' depressive symptoms: A moderated polynomial regression with response surface analyses.

BACKGROUND: With the widespread of smartphones, there is an increased interest in exploring the influences of phubbing in modern society. However, little research has examined the impact of parent phubbing (Pphubbing) or adolescent phubbing (Aphubbing) on adolescent development. This conceptual and empirical work aims to explore the unique and joint impacts of Pphubbing and Aphubbing on adolescents' depressive symptoms. METHOD: Participants were 3322 students from 64 classes of a senior high school. The data were analyzed with polynomial regressions and response surface analyses. RESULTS: The results showed that Pphubbing was positively related to Aphubbing. Pphubbing and Aphubbing were both positively associated with adolescents' depressive symptoms. In addition, when Pphubbing and Aphubbing were in congruence, adolescents' depressive symptoms would increase as the former two increased. Moreover, adolescents' depressive symptoms would decrease as the discrepancy between parent and adolescent increased. Meanwhile, attachment avoidance moderated the congruence and incongruence effects of parent-adolescent phubbing on adolescents' depressive symptoms. LIMITATIONS: This study used cross-sectional data, which cannot infer causality. CONCLUSION: The effect between parent-adolescent congruence in phubbing and adolescents' depressive symptoms is significant, and it is moderated by attachment avoidance.