[Factors associated with the care needs of the older adults based on different disability levels].

OBJECTIVE: To identify the factors associated with the care needs of the older adults aged 65-105 by age groups, and to compare these factors across different age groups. METHODS: A total of 12 244 older adults from the Chinese longitudinal healthy longevity survey (CLHLS) conducted in 2018 were included in the analyses. The participants were categorized into three age groups: young-old (aged 65-79), middle-old (aged 80-89), and oldest-old (aged 90-105). The level of disability was measured by the disability index (DI) in four dimensions, reflecting their care needs. Potential factors associated with care needs were selected based on the health ecological model (HEM), including perspectives of personal characteristics, behavioral characteristics, interpersonal network, living and working conditions, and policy environment. Multifactor analysis was performed using multinomial Logistic regression. RESULTS: Among China ' s 12 244 older adults, 43.4% had medium or high care needs. Factors for higher care needs of older adults included higher age, higher number of chronic diseases, no exercise habit, excessive sleep duration (≥9 h/d), depressive tendency, living with children or spouse, and uneducated (all P < 0.05). In addition, the young-old group who were past smokers (OR=2.009, 95% CI: 1.019-3.959), were past drinkers (OR=2.213, 95% CI: 1.141-4.291), and reported self-perceived poverty (OR=2.051, 95% CI: 1.189-3.540), had higher level of care needs. The middle-old group who were female (OR=1.373, 95% CI: 1.038-1.817), never drank alcohol (OR=1.551, 95% CI: 1.059-2.269), and were lack of medical insurance (OR=1.598, 95% CI: 1.053-2.426), and had higher level of care needs. The oldest-old group who were female (medium care needs vs. low care needs: OR=1.412, 95% CI: 1.062-1.878; high care needs vs. low care needs: OR=1.506, 95% CI: 1.137-1.993), reported self-perceived poverty (OR=2.064, 95% CI: 1.282-3.323), and were lack of medical insurance (OR=1.621, 95% CI: 1.148-2.291), and had higher level of care needs. CONCLUSION: The identical factors associated with care needs across different age groups include age, chronic disease, exercise, sleep, depression, living arrangement, and education. Smoking, alcohol consumption, and economic status are specific factors among the young-old group of the older adults, while gender and medical insurance are specific factors among the middle-old and the oldest-old group of the older adults. We recommend conducting prospective cohort studies and intervention studies among specific age groups on the above factors to provide reliable evidence for policy formulation.

Public's preferences for health science popularization short videos in China: a discrete choice experiment.

Background: Health science popularization short video disseminates health information to the public in an understandable way about health information. Objective: To investigate the preferences of Chinese residents for health science popularization short videos and provide suggestions for optimizing the production of short videos. Methods: An online survey of Chinese people was conducted using a self-administered questionnaire, and a discrete choice experiment (DCE) was used to explore the public's preferences for health science popularization short videos. Results: A total of 618 respondents were included, of which 306 (45.51%) were male and 312 (50.49%) were female, 271 (43.85%) were aged 18-25, 239 (38.67%) were aged 26-60, and 108 (17.48%) were aged 60 and above. Whether the video is charged or not (46.891%) and the account subject (28.806%) were both considered important. The results of the DCE revealed that the participants considered video free of charge as the most significant attribute of health science popularization short videos (OR 3.433, 95% CI 3.243-3.633). Overall, participants preferred and were more willing to pay for health science popularization short videos with a hospital account subject (OR 1.192, 95% CI 1.116-1.274), with the form of graphic narration (OR 1.062, 95% CI 1.003-1.126), free of charge (OR 3.433, 95% CI 3.243-3.633), with the content that satisfies their needs (very much needed: OR 1.253, 95% CI 95% CI 1.197-1.311; generally needed: OR 1.078, 95% CI 1.029-1.129), with platform certification (OR 1.041, 95% CI 1.011-1.073), without commercial advertisements (OR 1.048, 95% CI 1.018-1.080), with simple-to-understand content (OR 1.071, 95% CI 1.040-1.104), and with video content that evokes fear or dread of illness in the viewer (OR 1.046, 95% CI 1.015-1.078). Conclusion: Participants favor free health popularization short videos, which are hospital accounts, with content that is illustrated, understandable, meets their needs, and can serve as a warning. In the future, the production of health popularization short videos should focus on improving the diversity and relevance of video content, making it as easy to understand to achieve good science popularization effects.

Associations between media use, self-efficacy, and health literacy among Chinese rural and urban elderly: A moderated mediation model.

Objectives: The influence of media use on health literacy among urban and rural elderly has been unknown in China. This study aims to examine the association between media use and health literacy and to explore the mediating role of self-efficacy and the moderating role of urban-rural residency. Methods: Based on the cross-sectional study of the Psychology and Behavior Investigation of Chinese Residents (PBICR) in 2022, a total of 4,070 Chinese old people aged 60 years and above were included. We adopted the simplified New General Self-Efficacy Scale (NGSES) and the simplified Health Literacy Scale-Short Form (HLS-SF) to measure self-efficacy and health literacy. Media use was measured using a self-administrated questionnaire. Results: Results showed that Chinese urban elderly had a higher frequency of media use than rural ones in the aspects of social activities, self-presentation, social action, leisure and entertainment, information acquisition, and business transactions through media (P < 0.001). Among all participants, self-presentation (B = 0.217, 95% CI: 0.040, 0.394), leisure and entertainment (B = 0.345, 95% CI: 0.189, 0.502), and information acquisition (B = 0.918, 95% CI: 0.761, 1.076) were significantly associated with health literacy. Self-efficacy partially mediated the effect of media use on health literacy (Bindirect = 0.045, 95% CI: 0.032, 0.058), accounting for 18.37% of the total effect. Urban-rural residency (B = 0.049, 95% CI: 0.024, 0.075) moderated the relationship between media use and self-efficacy significantly. Conclusion: The urban-rural gap in health literacy requires more attention. The promotion of media use and self-efficacy may play a role in eliminating health disparities. Limitations: As a cross-sectional study, it could not establish cause-effect relationships.

Influence of promoting an "age-friendly cities" strategy on psychological capital and social engagement based on the scenario method.

Holding large conferences and events usually encourages the corresponding government to upgrade the host city. For this process, incorporating additional costs to increase accessibility for the elderly is a feasible means for a city to develop in an age-friendly manner. Providing evidence-based reports to policy makers is conducive to implementing the policies of age-friendly cities. This study used the scenario method to simulate the effect of promoting the "age-friendly cities" strategy on residents' psychological capital and social engagement (SE). We found that promoting the construction of age-friendly cities can significantly improve residents' psychological capital and SE and that residents from all age groups can benefit. This paper provides an economical means to influence policymakers through evidence-based reports in promoting the development of age-friendly cities.

Self-Medication Behaviors of Chinese Residents and Consideration Related to Drug Prices and Medical Insurance Reimbursement When Self-Medicating: A Cross-Sectional Study.

BACKGROUND: Self-medication has become a common phenomenon. Economic factors are important factors that affect the self-medication of residents. This study aimed to investigate the current status of self-medication behaviors in China and explored the related factors affecting considerations associated with medical insurance reimbursement or drug price in self-medication. METHODS: A national cross-sectional investigation was conducted among Chinese people over 18 years old under a multi-stage sampling method through a questionnaire, which includes demographic sociological characteristics, self-medication behaviors and scales. The Chi-square test was used to analyze whether the respondents consider medical insurance reimbursement or drug price as an important factor when purchasing over-the-counter (OTC) drugs. Logistic regression was used to examine the associated factors of considering medical insurance reimbursement or drug price. RESULTS: In total, 9256 respondents were included in this study; 37.52% of the respondents regarded drug prices as an important consideration, and 28.53% of the respondents attached great importance to medical insurance reimbursement. Elderly respondents who lived in the central region, had medical insurance, and had lower levels of health literacy were more likely to consider the medical insurance reimbursement, while respondents with high monthly family income as well as students were less likely to consider the same issue (p < 0.05). Respondents settled in the central and western regions, students, those without fixed occupations, those who suffered from chronic diseases, or those with lower health literacy were more likely to consider drug prices, while the respondents with bachelor degrees, urban population and high per capita monthly income were less likely to consider the drug prices (p < 0.05). CONCLUSION: Self-medication behaviors with OTC drugs were prevalent in China, and consideration factors of medical insurance reimbursement or drug prices were related to socio-demographic characteristics and health literacy. There is a need to take measures to reduce the economic burden of self-medication, improve the health literacy of residents and strengthen public health education.

Effectiveness of low-cost reminder package combined with case-based health education to improve hypertensive patients' medication adherence: a clustered randomized controlled trial.

PURPOSE: Medication adherence (MA) is a key factor for hypertensive patients' blood pressure control and forgetfulness is one of the main reasons that cause medication non-adherence. If effective, low-cost reminder package (LCRP) has great potentials for large-scale promotion. Therefore, this study aims to evaluate the effectiveness of combining LCRP and health education to improve MA among hypertensive patients. PATIENTS AND METHODS: A clustered randomized controlled trial was performed in Beijing. A total of 518 hypertensive patients recruited from 8 community health care centers were randomized to receive LCRP combined with case-based health education or usual care. Randomization was performed at community level. Multilevel modeling was used to evaluate the study effect. RESULTS: MA scores did not differ significantly at baseline between the intervention group and the control group. The results of multilevel modeling indicated that MA scores increased more in the intervention group, and the intervention effect on MA was 0.287 (95% CI: [0.103, 0.471], P=0.002). Patients' systolic blood pressure (SBP) and diastolic blood pressure (DBP) were not improved (SBP: difference=0.536, 95% CI [-3.207, 4.278]; DBP: difference=-0.927, 95% CI [-3.283, 1.428]). CONCLUSION: LCRP combined with case-based health education could significantly improve hypertensive patients' MA.

Are condom-promotion interventions reaching internal migrants in China? Integrated evidence from two cross-sectional surveys.

Behavioral interventions containing behavior change techniques (BCTs) that do not reach the target populations sufficiently will fail to accomplish their desired outcome. To guide sexually transmitted infection prevention policy for internal migrants in China, this study examines the extent to which BCTs aiming at increasing condom use reach the migrants and investigates the preference of the target population for these techniques among 364 migrants and 44 healthcare workers (HCWs) in Shenzhen, China. The results show that condom-promotion techniques that had been offered by HCWs to internal migrants reached a limited proportion of the population (range of reach ratio: 17.6-55.0%), although there appears to be a good match between what is offered and what is preferred by Chinese internal migrants regarding condom-promotion techniques (rank difference ≤ 1). Our findings highlight the need to increase the reach of condom-promotion techniques among Chinese internal migrants, and suggest techniques that are likely to reach the target population and match their preferred health education approaches.

Lack of health risk awareness in low-income Chinese youth migrants: assessment and associated factors.

OBJECTIVE: To analyze and assess health risk awareness of youth migrants in China and the factors that influence it, and to provide evidence for making health promotion interventions and decreasing health risks among Chinese youth migrants. METHOD: This was a cross-sectional survey conducted in 2009 among rural-to-urban migrants aged 15-24 years in Tianjin and Xi'an, China. A total of 1,838 youth migrants were enrolled by the stratified cluster sampling method. An anonymous questionnaire was self-administered to investigate health risk awareness. The t test and χ(2) test were used to analyze differences between different groups. Logistic regression analysis was used to test the influence of various sociodemographic, living condition, and occupational factors. RESULTS: The smoking rate of men (66.8%) was higher than that of women (6.8%; P < 0.05), the rate of sexual intercourse in men was higher than in women (56.8 vs 27.7%; P < 0.05), and 75.7% of participants had written into medical care systems with 40.4% of them having undergone a physical examination during the last year. Only 438 of the participants (26% of 1,647) were considered to have a satisfactory level of health risk awareness [273 (32.4% of 958) from Tianjin and 165 (28.8% of 689) from Xi'an]. No significant difference was found between the youth migrant populations of the two cities. The percentage of youth migrants with a satisfactory level of health risk awareness who thought they had a good health status was higher than that with an unsatisfactory health risk awareness who thought they had a good health status (P < 0.05). Logistic regression analysis showed that gender, age, education, reading the newspaper, and occupation significantly influenced on health risk awareness. CONCLUSION: Youth migrants in China have a low health risk awareness. Combined and targeted health education interventions should be promoted to increase their health risk awareness.

[Psychological resilience features of urban migrant children and rural left-behind children in Sichuan province of China].

OBJECTIVE: To explore the characteristics of resilience of urban migrant children and rural left-behind children of Chinese farmer workers and to figure out the discrepancy between them. METHODS: The samples consisted of 1 391 primary students and middle school students from Chengdu, Guangyuan, Yibin, and Mianyang in Sichuan Province. The revised version of the Healthy Kids Resilience Assessment was used for the measurement of resilience. And ANOVA was performed for data analysis. RESULTS: The results of the present study indicated that among all the junior high students, urban migrant children got a significantly lower score of resilience (128.11±21.70) than rural left-behind children (135.61±22.77) and the control group (132.87±23.22), F(0.05 (2, 884))=8.076, P<0.001. And migrant children got lower scores on three external protective factors of resilience-family, school, community as well as on resilience traits than left-behind children and the control group (Family: F(0.05(2, 884))=7.820, P<0.001; School: F(0.05(2, 884))=5.041, P=0.007; Community: F(0.05(2, 884))=9.261, P<0.001; Resilience traits: F(0.05(2, 884))=3.510, P=0.030). No significant difference was noted between left-behind children and control group. Gender difference and grade difference were noted for each group. CONCLUSION: The resilience of migrant children was not so good as non-migrant children. Migrant children were enjoying less intimate interpersonal relationship in their schools, their families as well as their community, and they could get less psychological support from the external environment, so that migrant children could not develop some resilience traits to promote the sound development of themselves. Suggestions for intervention were also discussed.

Social marketing improved the consumption of iron-fortified soy sauce among women in China.

OBJECTIVE: To test the feasibility and effectiveness of social marketing on the improvement of women's knowledge, attitudes, and behaviors regarding iron-fortified soy sauce (FeSS). DESIGN: A community-based intervention was conducted among 4 groups, experimental rural (E(R)), control rural (C(R)), experimental urban (E(U)), and control urban (C(U)). SETTING: Urban and rural areas in Guizhou province, China. PARTICIPANTS: Women 19 to 70 years old (n = 193 in rural areas and n = 179 in urban areas). INTERVENTION: A mass-media campaign to promote use of FeSS was conducted throughout Guizhou province. In the intervention areas, social marketing strategies using integrated 6 Ps (product, price, place, promotion, policy, and partnership) were implemented from December 2004 to February 2006. MAIN OUTCOME MEASURES: Knowledge of FeSS; benefits, barriers, and intention to purchase; availability of FeSS; behaviors regarding purchase and use of FeSS. ANALYSIS: Analysis of covariance, paired T test and cross-tabulations were used. The alpha level was set at .05. RESULTS: Compared with the baseline, perceived benefits of FeSS, barriers (BARRI) and intention to buy (INTEN) significantly improved within both experimental groups (P < .01 or .001). The only improvement in control groups was for BARRI in C(R) (P < .001). Availability of FeSS increased in all areas. Purchase and use of FeSS in rural and urban intervention groups increased by nearly 30% more than those in control groups. CONCLUSION AND IMPLICATION: Social marketing of FeSS is feasible and effective to improve knowledge, perception (perceived benefits and overcoming barriers), intention to purchase, and consumption of FeSS among women in Guizhou, China.