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.

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.

Associations between personality and problematic internet use among Chinese adolescents and young adults: A network analysis.

BACKGROUND: With the number of internet users booming, problematic internet use (PIU) has become a public health threat. This study aims to figure out the inter-relationships between PIU symptoms and personality traits with network-based analysis among young people and to discuss the gender difference in the above networks. METHODS: Based on a national cross-sectional study in 2022, 4655 Chinese adolescents and young adults aged 14 to 25 were included. We adopted the 6-item Short-Form Problematic Internet Use Questionnaire (PIUQ-SF-6) and the 10-item version of the Big Five Inventory (BFI-10) to measure PIU and personality traits, respectively. Network analysis was used to identify influential nodes and edges and compare the network models between male and female participants. RESULTS: The mean age of 4655 participants was 19.84, and 52.1 % (2424) of them were females. There are differences in age and gender between participants with and without PIU (P < 0.05). The network of personality and PIU showed that 22 out of the 28 edges were estimated to be nonzero, and "obsession-neuroticism" was the strongest positive edge between the two communities. Central symptoms (i.e., "obsession" and "control disorder") and bridge symptoms (i.e., "obsession" and "neuroticism") have been identified. Gender differences existed in network global strength: female = 3.71, male = 3.18 (p < 0.001). LIMITATIONS: The cross-sectional study needs more evidence to build causal inference. CONCLUSIONS: The results of PIU-personality networks may contribute to the personalized prevention and treatment of PIU. The gender difference in PIU-personality networks also requires more attention and discussion.

Does the COVID-19 Pandemic Increase or Decrease the Global Cyberbullying Behaviors? A Systematic Review and Meta-Analysis.

Although cyberbullying is an emerging public health problem, it is unclear how the COVID-19 pandemic affects cyberbullying. This systematic review and meta-analysis aimed to examine the effect of the COVID-19 pandemic on cyberbullying, to estimate the global cyberbullying prevalence and to explore factors related to cyberbullying during the COVID-19 pandemic. We searched the Medline, Embase, PubMed, Scopus, Eric, PsycINFO, Web of Science, Cochrane Library, Wanfang, Chinese CNKI, and EBSCO databases to identify relevant empirical studies published between 2019 and 2022. A total of 36 studies were included. Quality assessment, meta-analyses, and subgroup analyses were conducted. The pooled prevalences were 16% for overall cyberbullying, 18% for victimization and 11% for perpetration during the COVID-19 pandemic, which were lower than before the COVID-19 pandemic. The pooled prevalence of postpandemic cyberbullying perpetration is lower in children than in adults. In addition, both virus- and lockdown-related stressors were the main factors contributing to cyberbullying. The COVID-19 crisis may reduce cyberbullying, and the pooled prevalence of cyberbullying during the pandemic in adults is higher than in children and adolescents. In addition, the transient-enduring factor model of postpandemic cyberbullying built in this review could help identify people at high risk of cyberbullying during public health emergencies.

The Relationship Between Effort-Reward Imbalance and Depressive Symptoms Among Chinese Firefighters: Moderating by Coping Styles.

OBJECTIVES: This study aims to examine the association between effort-reward imbalance (ERI) and depressive symptoms among Chinese firefighters and the moderating role of positive and negative coping styles in the above association. METHODS: A cross-sectional study including 1328 male firefighters was conducted in China. We adopted the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms. RESULTS: Results showed that ERI was associated with depressive symptoms. Individuals with a higher ERI ratio and greater overcommitment were likely to have higher level of depressive symptoms. Furthermore, negative coping style strengthened the relationship between ERI ratio and overcommitment with depressive symptoms, whereas the positive coping style presented none significant moderation. CONCLUSIONS: These findings indicate that reforming the effort-reward system might be helpful for mental health promotion among Chinese firefighters.

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.

Relationship Between Work-Family Conflict and Depressive Symptoms Among Male Firefighters in China: Job Types and Family Structure as Moderators.

OBJECTIVES: This study aims to examine the relationship between work-family conflict and depressive symptoms while considering job types and family structure as moderators. METHODS: In July and August 2021, 1328 male Chinese firefighters completed an online cross-sectional survey. RESULTS: The results indicated that work-family conflicts among Chinese firefighters presented a significant association with worse depressive symptoms. More specifically, strain conflict and behavioral conflict had positive relationships with worse depressive symptoms, while time conflict had a negative relationship. In addition, job types moderated the association between work-family conflict, strain conflict, and behavior conflict with depressive symptoms. CONCLUSIONS: This study shows that work-family conflict is significantly associated with depressive symptoms among Chinese firefighters. Our findings advocate working system reform for Chinese firefighters, and more attention is needed on their mental health protection in the future.

Can smartphone use affect chronic disease self-management among Chinese middle-aged and older adults? A moderated mediation model.

Introduction: Chronic disease self-management is influenced by many factors. Previous studies have linked patients' media use with chronic disease self-management, but the underlying mechanisms of this relationship are less understood. Objectives: The purpose of this study is to explore the mediating role of family health (FH) between frequency of smartphone use (FOSU) and self-management behaviors among middle-aged and older patients with chronic diseases (SBAMAOPWCD) through a moderated mediation model, and whether this indirect relationship is modified by the solitary status of middle-aged and older Chinese patients with chronic disease. Methods: Surveys were collected from 1,424 (N = 1,424; age > 45) middle-aged and older with one or more chronic conditions in China on self-reports of FOSU, FH and Chronic disease self-management behaviors were used to examine the moderated mediation model. Results: The results showed that the FOSU was significantly and positively associated with SBAMAOPWCD (ß = 0.220, p < 0.001; ß = 0.170, p < 0.001; ß = 0.167, p < 0.001; ß = 0.158, p < 0.001); The Family health resources (FHR) dimension of FH and the Family external social supports (FESS) dimension mediated the relationship between the FOSU and SBAMAOPWCD (ß = -0.0758, CI: -0.1402, -0.0236; ß = 0.0721, CI: 0.0141, 0.1458), Among them, the FHR dimension mediated mainly among FOSU, exercise and cognitive symptom management practices (CSMP; ß = -0.0344, CI: -0.0652, -0.0102; ß = -0.0401, CI: -0.0725, -0.0138), the FESS dimension of the FH mediated the relationship between the FOSU and communication with physicians (CWP; ß = 0.0376, CI: 0.0116, 0.0705); Solitary state played a moderating role in the relationship between FHR dimension and SBAMAOPWCD (live alone ß = -0.2395, CI: -0.4574, -0.0661; not live-alone ß = -0.0599, CI: -0.1164, -0.0172). In addition, solitary state played a moderating role in the relationship among FHR dimension and CSMP for middle-aged and older patients (live alone ß = -0.1095, CI: -0.1961, -0.0378; not live-alone ß = -0.0334, CI: -0.0633, -0.0102). Interestingly, the relationship between FESS dimension and SBAMAOPWCD was moderated only by the non-live alone population (ß = 0.0676, CI: 0.0008, 0.1478), and not by the live-alone population (ß = 0.1026, CI: -0.1061, 0.3278).Unexpectedly, we found that when their FHR were lower, they reported higher levels of chronic disease self-management, middle-aged and older patients with chronic diseases who live alone are more significant in this impact relationship. Conclusions: The study further deepens our understanding of the mechanisms linking frequency of smartphone use with chronic disease self-management behaviors, and it helps to develop interventions to improve chronic disease self-management behaviors in middle-aged and older adults.