What Drives Health Information Exchange on Social Media? Social Media Affordances and Social Support Perspectives.

Despite the prevalence of health communication on social media, the mechanisms by which social media affect health information exchange have received less than adequate investigation. By integrating the lenses of affordance and social support, this study examines the effect of social media affordances on health information exchange, with a particular focus on the mediation effect of social support and the boundary condition of health consciousness. Results of an online survey indicated that the affordances of information accessibility and metavoicing are positively related to both general and experiential informational support. Moreover, the affordance of association is positively related to experiential informational support and emotional support. Additionally, three types of social support have positive effects on health information exchange, and health consciousness positively moderates the effect of experiential informational support on health information exchange. This study enriches existing literature by revealing the underlying mechanisms and boundary conditions of the relationship between social media affordances and health information exchange. Furthermore, it provides new insights for practitioners to promote health information exchange on social media.

Success Factors of Medical Crowdfunding Campaigns: Systematic Review.

BACKGROUND: Medical crowdfunding provides opportunities for individuals who lack financial resources to access the health services that they need. Despite the popularity of medical crowdfunding, the current understanding of the success of medical crowdfunding campaigns is fragmented and inadequate. OBJECTIVE: We aimed to comprehensively investigate which factors lead to the success of medical crowdfunding campaigns. METHODS: A search was conducted in PubMed, PsycINFO, Web of Science, ACM Digital Library, and ScienceDirect from 2010 to June 2020. Papers directly and indirectly related to the success of medical crowdfunding campaigns were included. Two reviewers independently extracted information on the success of medical crowdfunding campaigns. RESULTS: Our search yielded 441 articles, of which 13 met the inclusion criteria. Medical crowdfunding is increasingly attracting academic attention, and most studies leverage text analysis as their research methods; however, there is a lack of consensus on the definition of medical crowdfunding among researchers. Four categories of factors that affect the success of medical crowdfunding were identified: platforms, raisers, donors, and campaigns. CONCLUSIONS: Although some limitations exist in our systematic review, our study captured and mapped literatures of the success of medical crowdfunding campaigns systematically, which can be used as the basis for future research on this topic.

Value Cocreation in Health Care: Systematic Review.

BACKGROUND: Value cocreation in health care (VCCH), mainly based on service-dominant logic, emphasizes that participants, including both patients and physicians, can effectively enroll in the health care value creation process. Effective VCCH is of great significance for realizing value-based health care and improving doctor-patient relationships. Therefore, a comprehensive understanding of VCCH is critical. However, the current literature on VCCH is fragmented and not well studied. OBJECTIVE: The goal of the research is to investigate the antecedents, consequences, and dimensions of VCCH by systematically searching, selecting, summarizing, and evaluating relevant literature. METHODS: English-language articles on VCCH in the Web of Science, PubMed, and Scopus databases published from January 2008 to December 2019 were identified. The articles were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, and the quality of studies included were appraised using the Mixed Methods Appraisal Tool. RESULTS: Out of the 181 publications initially identified through the bibliographic searches, 28 publications met the inclusion criteria. This review summarizes antecedents, consequences, and dimensions of VCCH, as well as possible associations among them. An integrative framework is also proposed for mapping the literature of VCCH grounded on social cognitive theory to reveal the whole process of VCCH. CONCLUSIONS: The findings of this systematic review provide implications for continued development of VCCH and contribute to inspire more research in the future.

Active Usage of Mobile Health Applications: Cross-sectional Study.

BACKGROUND: Mobile health applications are being increasingly used for people's health management. The different uses of mobile health applications lead to different health outcomes. Although active usage of mobile health applications is shown to be linked to the effectiveness of mobile health services, the factors that influence people's active usage of mobile health applications are not well studied. OBJECTIVE: This paper aims to examine the antecedents of active usage of mobile health applications. METHODS: Grounded on the 3-factor theory, we proposed 10 attributes of mobile health applications that influence the active usage of mobile health applications through consumers' satisfaction and dissatisfaction. We classified these 10 attributes into 3 categories (ie, excitement attributes, performance attributes, and basic attributes). Using the survey method, 494 valid responses were collected and analyzed using structural equation modeling. RESULTS: Our analysis results revealed that both consumer satisfaction (ß=0.351, t=6.299, P<.001) and dissatisfaction (ß=-0.251, t=5.119, P<.001) significantly influenced active usage. With regard to the effect of attributes, excitement attributes (ß=0.525, t=12.861, P<.001) and performance attributes (ß=0.297, t=6.508, P<.001) positively influenced consumer satisfaction, while performance attributes (ß=-0.231, t=3.729, P<.001) and basic attributes (ß=-0.412, t=7.132, P<.001) negatively influenced consumer dissatisfaction. The results of the analysis confirmed our proposed hypotheses. CONCLUSIONS: Our study provides a novel perspective to study the active usage of mobile health applications. By categorizing the attributes of mobile health applications into 3 categories, the differential effects of different attributes can be tested. Meanwhile, consumer satisfaction and dissatisfaction are confirmed to be independent from each other.

The migrating mediators and the interaction associated with the use of essential public health services: a cross-sectional study in Chinese older migrants.

BACKGROUND: Despite the incremental implementation of the essential public health services (EPHS) during the last decade, the goal of EPHS's equalization is impossible to cannot be achieved without appropriate policies targeting older migrants. Therefore, this study aims to examine whether the supply side meets the needs of older migrants and to explore the relationships among health status, the use of health services, and diverse factors. METHODS: The data were derived from a national cross-sectional dataset (N = 11,161) of the 2015 Chinese Migrant Dynamic Monitoring Survey. Mediating effects analysis and moderating effects analysis were conducted to explore the interactions between physical status and the use of EPHS in older migrants such as physical examination, health record, and follow-up services. RESULTS: The use of physical examination, health record, and follow-up services were correlated with each other. Household income, migrating for employment, and migrating for offspring were negatively associated with the use of EPHS. A positive association was observed between the use of EPHS and willingness for long-stay. The mediating effects of household income, migrating for employment, migrating for offspring, and willingness for long-stay were observed on the relationship between physical status and the use of EPHS. The moderating effects of household income and migrating for employment were discovered. CONCLUSION: Public health policies that may be worthy of consideration include further enhancing the delivery capacity of primary health institutions, integrating professional clinical resources into the primary health system, and launching the target policies to improve the accessibility of EPHS in older migrants.

Salidroside promotes rat spinal cord injury recovery by inhibiting inflammatory cytokine expression and NF-κB and MAPK signaling pathways.

Spinal cord injury (SCI) is a public health problem in the world. The SCI usually triggers an excessive inflammatory response that brings about a secondary tissue wreck leading to further cellular and organ dysfunction. Hence, there is great potential of reducing inflammation for therapeutic strategies of SCI. In this study, we aim to investigate if Salidroside (SAD) exerts an anti-inflammatory effect and promotes recovery of motor function on SCI through suppressing nuclear factor-κB (NF-κB) and the mitogen-activated protein kinase (MAPK) pathways. In vitro, real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) were used to examine the inhibitory effect of SAD on the expression and release of interleukin-1ß (IL-1ß), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) activated by lipopolysaccharide (LPS) in astrocytes. In addition, SAD was found to inhibit NF-κB, p38 and extracellular-regulated protein kinases (ERK) signaling pathways by western blot analysis. Further, in vivo study showed that SAD was able to improve hind limb motor function and reduce tissue damage accompanied by the suppressed expression of inflammatory cytokines IL-1ß, IL-6, and TNF-α. Overall, SAD could reduce the inflammatory response and promote motor function recovery in rats after SCI by inhibiting NF-κB, p38, and ERK signaling pathways.

Utilisation of national community-based blood pressure monitoring service among adult Chinese and its association with hypertension treatment and blood pressure control-a mediation analysis.

BACKGROUND: Community-based blood pressure (BP) monitoring plays an important role in national hypertension management in China. However, the utilisation of this service, together with its associations on hypertension treatment and BP control has not been fully investigated. METHODS: The study population was from the China Health and Retirement Longitudinal Study (CHARLS) in 2015. Cross-sectional data of 2487 hypertensive persons were included as subjects. Stratified sample households were selected from 450 villages or communities of 150 counties from 28 provinces. Finally, 21,097 individuals were interviewed successfully. The main outcome was hypertension control (having average BP under 140-90 mmHg). The main independent variable was utilisation of community-based BP monitoring service (having BP examination once a season or more). The mediators were hypertension treatment (currently taking any antihypertensive medicine) and lifestyle factors (alcohol intake, physical activity, smoke). We performed chi-square and binary logistic regression to analyse associations of BP monitoring with hypertension treatment and blood pressure control. The mediation model was examined by the Sobel test. RESULTS: Mean age of the population was 64.2 (0.24). The percentage of males was 42.8%. Prevalence of community-based BP monitoring was 32.1%. Patients who used this service had higher odds of hypertension treatment (ß = 1.259, P < 0.01, OR = 3.52, CI = 2.467-5.030), and BP control (ß = 0.220, P < 0.05, OR = 1.246, CI = 1.035-1.499). Medication treatment played a complete mediating role between monitoring and hypertension control in this study (t = 4.51, P < 0.001). Those who underwent BP monitoring tended to be those who did not finish primary school education (χ2 = 30.300, P < 0.001), had poorer household income (χ2 = 18.298, P < 0.05), and lived in rural areas rather than in urban areas (χ2 = 40.369, P < 0.001). CONCLUSIONS: Although the use of BP monitoring service had no direct effect on BP control, it had a positive effect on BP control through the full mediation effect of hypertension treatment. Termly BP monitoring by community-based health expertise among hypertensive persons, for instance, once a season, can be recommended to public health policymakers for BP control through instructions on medication treatment and health behaviours.

Correction: Predictors of Patients' Loyalty Toward Doctors on Web-Based Health Communities: Cross-Sectional Study.

[This corrects the article DOI: 10.2196/14484.].

Predictors of Patients' Loyalty Toward Doctors on Web-Based Health Communities: Cross-Sectional Study.

BACKGROUND: Web-based health communities provide means for patients to not only seek care but also to promote their relationship with doctors. However, little is known about the predictors of patients' loyalty toward doctors in Web-based health communities. OBJECTIVE: This study aimed to investigate the predictors of patients' loyalty toward doctors in Web-based health communities. METHODS: On the basis of sociotechnical systems theory and attachment theory, we propose that social factors including emotional interaction, perceived expertise, and social norm influence patients' loyalty through their emotional attachment, whereas technical factors including sociability, personalization, and perceived security affect patients' loyalty through functional dependence. To validate our proposed research model, we used the survey method and collected 373 valid answers. Partial least square was used to analyze the data. RESULTS: Our empirical analysis results showed that all the social factors including emotional interaction (beta=.257, t350=2.571; P=.01), perceived expertise (beta=.288, t350=3.412; P=.001), and social norm (beta=.210, t350=2.017; P=.04) affect patients' emotional attachment toward doctors significantly, whereas except sociability (beta=.110, t350=1.152; P=.25), technical factors such as personalization (beta=.242, t350=2.228; P=.03) and perceived security (beta=.328, t350=3.438; P=.001) impact functional dependence significantly. Considering the effect of working mechanisms, both emotional attachment (beta=.443, t350=4.518; P<.001) and functional dependence (beta=.303, t350=2.672; P=.008) influence patients' loyalty toward doctors in Web-based health communities significantly. CONCLUSIONS: Patients' loyalty toward doctors in Web-based health communities is important for the effectiveness of doctors' advice or service in Web-based health communities. The research results not only fill the gaps in the literature of the patient-doctor relationship and Web-based health communities but also has many implications for establishing patients' loyalty on Web-based health communities and in physical context.

Predictors of Patients' Intention to Interact With Doctors in Web-Based Health Communities in China: Cross-Sectional Study.

BACKGROUND: Web-based health communities provide opportunities for doctors and patients to interact with each other and change the traditional communication mode between doctors and patients. However, little is known about the predictors of patients' intention to interact with doctors in Web-based health communities in China. OBJECTIVE: The purpose of this study was to investigate what are the predictors of patients' intention to interact with doctors in Web-based health communities in China. METHODS: On the basis of two-factor theory and service convenience theory, we propose that the attributes of Web-based health communities including ease of use and perceived synchronicity influence patients' intention to interact through convenience of Web-based health communities, whereas the attributes of physical health facilities such as inaccessibility and discontinuity affect patients' intention to interact through inconvenience of physical health facilities. We employed the survey method to validate our hypothesized relationships. Through developing the measurement instruments, we collected 334 valid answers from Web health community users and utilized partial least square to analyze the data. RESULTS: Ease of use (t311=2.924, P=.004) and perceived synchronicity (t311=2.353, P=.019) were found to influence convenience of Web-based health communities significantly, whereas inaccessibility (t311=3.189, P=.002) and discontinuity (t311=3.149, P=.002) were found to impact inconvenience of physical health facilities significantly. Meanwhile, both convenience of Web-based health communities (t311=2.353, P=.019) and inconvenience of physical health facilities (t311=2.787, P=.006) were found to affect patients' intention to interact with doctors in Web-based health communities significantly. Therefore, all the proposed hypotheses were supported. CONCLUSIONS: Through including factors from both Web-based health communities and physical health facilities, we can understand patients' intention to interact comprehensively. This study not only contributes to literature of doctor-patient interaction and Web-based health platforms but also provides implications to promote doctor-patient interaction online and offline.

The Effect of Doctor-Consumer Interaction on Social Media on Consumers' Health Behaviors: Cross-Sectional Study.

BACKGROUND: Both doctors and consumers have engaged in using social media for health purposes. Social media has changed traditional one-to-one communication between doctors and patients to many-to-many communication between doctors and consumers. However, little is known about the effect of doctor-consumer interaction on consumers' health behaviors. OBJECTIVE: The aim of this study was to investigate how doctor-consumer interaction in social media affects consumers' health behaviors. METHODS: On the basis of professional-client interaction theory and social cognitive theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interactions influence consumers' health behaviors through declarative knowledge (DK), self-efficacy (SE), and outcome expectancy (OE). To validate our proposed research model, we employed the survey method and developed corresponding measurement instruments for constructs in our research model. A total of 352 valid answers were collected, and partial least square was performed to analyze the data. RESULTS: Instrumental doctor-consumer interaction was found to influence consumers' DK (t294=5.763, P<.001), SE (t294=4.891, P<.001), and OE (t294=7.554, P<.001) significantly, whereas affective doctor-consumer interaction also impacted consumers' DK (t294=4.025, P<.001), SE (t294=4.775, P<.001), and OE (t294=4.855, P<.001). Meanwhile, consumers' DK (t294=3.838, P<.001), SE (t294=3.824, P<.001), and OE (t294=2.985, P<.01) all significantly affected consumers' health behaviors. Our mediation analysis showed that consumers' DK, SE, and OE partially mediated the effect of instrumental interaction on health behaviors, whereas the three mediators fully mediated the effect of affective interaction on health behaviors. CONCLUSIONS: Compared with many intentional intervention programs, doctor-consumer interaction can be treated as a natural cost-effective intervention to promote consumers' health behaviors. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. DK, SE, and OE are working mechanisms of doctor-consumer interaction.

Economic burden of malaria inpatients during National Malaria Elimination Programme: estimation of hospitalization cost and its inter-province variation.

BACKGROUND: Apart from its direct impact on public health and well-being, malaria had placed significant socioeconomic burden on both individuals and whole health systems. This study was conducted to investigate the hospitalization cost of malaria and explore the inter-province variation during the National Malaria Elimination Programme in China. METHODS: Information on medical expenditure for malaria treatment was extracted from inpatient medical records in Henan, Hainan and Guangxi Province. The costs were adjusted to the price in 2014 and converted to USD (United States Dollars). Non-parametric and parametric methods were employed to estimate hospitalization costs and non-parametric bootstrap method was used for the comparison of hospitalization costs among sample provinces and to estimate the uncertainty of differences in inter-province hospitalization costs. RESULTS: The hospitalization cost and daily cost of 426 malaria inpatients were 929.8 USD and 143.12 USD respectively. The average length of stay was 11.95 days. The highest cost of hospitalization services occurred in tertiary hospitals (956 USD per episode). Whereas the lowest ones occurred in internal departments (424 USD). Medications, laboratory tests and supportive resources for treatment were the most important components of hospitalization costs, respectively responsible for 45.31, 24.70, and 20.09% of the total hospitalization costs. The hospitalization cost per episode in Henan Province was significantly higher than that in Hainan an in Guangxi Province, with incremental costs of 713 USD (95% confidence interval 419.70, 942.50) and of 735.58 USD (95% CI 606.50, 878.00), respectively. The differences in the daily costs between Henan and Hainan along with Guangxi provinces were 75.33 USD (95% CI 40.33, 96.67) and 93.56 USD (95% CI 83.58, 105.28), respectively. CONCLUSIONS: Although the prevalence of malaria cases has considerably declined, the direct hospitalization costs of malaria in the household remain high and the inter-province variations need to be seriously considered in the formulation the further interventions regarding hospitalization cost control. This study suggests that economic risk protection mechanisms targeting at malaria inpatients should be redesigned. The drug price addition policy in public hospitals should be gradually reformed or abolished coupling with increasing government subsidies along with the charges for treatment services to reduce the hospitalization cost. The policy for cost control in the provincial hospitals should be implemented in comparison with the policy in other provinces, where the status of economic and geography are similar.

Enhancing COVID-19 Epidemic Forecasting Accuracy by Combining Real-time and Historical Data From Multiple Internet-Based Sources: Analysis of Social Media Data, Online News Articles, and Search Queries.

BACKGROUND: The SARS-COV-2 virus and its variants pose extraordinary challenges for public health worldwide. Timely and accurate forecasting of the COVID-19 epidemic is key to sustaining interventions and policies and efficient resource allocation. Internet-based data sources have shown great potential to supplement traditional infectious disease surveillance, and the combination of different Internet-based data sources has shown greater power to enhance epidemic forecasting accuracy than using a single Internet-based data source. However, existing methods incorporating multiple Internet-based data sources only used real-time data from these sources as exogenous inputs but did not take all the historical data into account. Moreover, the predictive power of different Internet-based data sources in providing early warning for COVID-19 outbreaks has not been fully explored. OBJECTIVE: The main aim of our study is to explore whether combining real-time and historical data from multiple Internet-based sources could improve the COVID-19 forecasting accuracy over the existing baseline models. A secondary aim is to explore the COVID-19 forecasting timeliness based on different Internet-based data sources. METHODS: We first used core terms and symptom-related keyword-based methods to extract COVID-19-related Internet-based data from December 21, 2019, to February 29, 2020. The Internet-based data we explored included 90,493,912 online news articles, 37,401,900 microblogs, and all the Baidu search query data during that period. We then proposed an autoregressive model with exogenous inputs, incorporating real-time and historical data from multiple Internet-based sources. Our proposed model was compared with baseline models, and all the models were tested during the first wave of COVID-19 epidemics in Hubei province and the rest of mainland China separately. We also used lagged Pearson correlations for COVID-19 forecasting timeliness analysis. RESULTS: Our proposed model achieved the highest accuracy in all 5 accuracy measures, compared with all the baseline models of both Hubei province and the rest of mainland China. In mainland China, except for Hubei, the COVID-19 epidemic forecasting accuracy differences between our proposed model (model i) and all the other baseline models were statistically significant (model 1, t198=-8.722, P<.001; model 2, t198=-5.000, P<.001, model 3, t198=-1.882, P=.06; model 4, t198=-4.644, P<.001; model 5, t198=-4.488, P<.001). In Hubei province, our proposed model's forecasting accuracy improved significantly compared with the baseline model using historical new confirmed COVID-19 case counts only (model 1, t198=-1.732, P=.09). Our results also showed that Internet-based sources could provide a 2- to 6-day earlier warning for COVID-19 outbreaks. CONCLUSIONS: Our approach incorporating real-time and historical data from multiple Internet-based sources could improve forecasting accuracy for epidemics of COVID-19 and its variants, which may help improve public health agencies' interventions and resource allocation in mitigating and controlling new waves of COVID-19 or other relevant epidemics.

Sharing of Verified Information about COVID-19 on Social Network Sites: A Social Exchange Theory Perspective.

Background: Verified and authentic information about coronavirus disease (COVID-19) on social networking sites (SNS) could help people make appropriate decisions to protect themselves. However, little is known about what factors influence people's sharing of verified information about COVID-19. Thus, the purpose of this study was to explore the factors that influence people's sharing of verified information about COVID-19 on social networking sites. Methods: Based on social exchange theory, we explore the factors that influence sharing of verified information about COVID-19 from two perspectives: benefits and costs. We employed the survey method to validate our hypothesized relationships. By using our developed measurement instruments, we collected 347 valid responses from SNS users and utilized the partial least squares method to analyze the data. Results: Among the benefits of sharing verified information about COVID-19, enjoyment in helping (ß = 0.357, p = 0.000), altruism (ß = 0.133, p = 0.029) and reputation (ß = 0.202, p = 0.000) were significantly associated with verified information sharing about COVID-19. Regarding the costs of sharing verified information about COVID-19, both verification cost (ß = -0.078, p = 0.046) and executional cost (ß = -0.126, p = 0.011) also significantly affect verified information sharing about COVID-19. All the proposed hypotheses were supported. Conclusions: By exploring factors from both benefits and costs perspectives, we could understand users' intention to share verified information about COVID-19 comprehensively. This study not only contributes to the literature on information sharing, but also has implications concerning users' behaviors on SNS.

Impact of Communicating With Doctors Via Social Media on Consumers' E-Health Literacy and Healthy Behaviors in China.

This study investigated the relationship between consumers' communication with doctors and their e-Health literacy and healthy behaviors based on the theory of reasoned action. Five communication activities were identified: following doctors' social media accounts, reading doctors' posts, responding to doctors' posts, favoring (clicking "like" of) doctors' posts, and recommending doctors to other patients. E-Health literacy and healthy behaviors were measured based on instruments used in previous literature. Survey method was used to collect data and a hierarchical regression analysis was used to analyze the relationship between communication activities and consumers' e-Health literacy and healthy behaviors. We found that following doctors' accounts (r = 0.127, P < .001), responding to doctors' posts (r = 0.141, P < .001) and recommending doctors to others (r = 0.133, P < .001) were significantly associated with e-Health literacy, while following doctors' accounts (r = 0.091, P < .001), responding to doctors' post (r = 0.072, P < .01), favoring doctors' posts (r = 0.129, P < .001), and recommending doctors to others (r = 0.220, P < .001) were significantly associated with healthy behaviors. Our study demonstrated that the social network communication between doctors and consumers could be cost-effective in improving intermediary consumers' health outcomes. To be specific, following doctors' posts, responding to doctors' posts, favoring doctors' posts, and recommending doctors to others were positively associated with consumers' e-Health literacy and healthy behaviors. The results suggested that leveraging information technology could be an important tool to health policymakers and health providers in order to improve outcomes.

Carotid atherosclerosis biomarkers in cardiovascular diseases prevention: A systematic review and bibliometric analysis.

PURPOSE: While carotid atherosclerosis (CA) biomarkers are valuable surrogates for cardiovascular events, their inadequate utility is highlighted by clinical practice. We performed an interdisciplinary systematic review and bibliometric analysis to identify the knowledge gaps and offer directions for future research. METHODS: We applied a comprehensive search strategy to construct a representative dataset of the bibliographic records of CA from 1997 to 2018. A total of 31,793 retrieved articles and 407,473 cited references were included in the analysis. The co-word network and co-citation network were derived to describe the major disciplines and topics of CA research. Milestones detected by burst analysis were reviewed to delineate the evolutionary patterns and emerging trends of research on CA biomarkers. RESULTS: CA is a multidisciplinary field of study which could be divided into 3 communities: the primary prevention of CVD, the secondary prevention of CVD and imaging techniques to characterize carotid atherosclerosis. The evolution of a CA biomarker may go through 3 stages: the conceptualization stage, the validation stage and the reclassification stage. Measurements that include different CA plaque features, rather than separately, have shown greater value for cardiovascular risk or clinical decision-making. CONCLUSIONS: Although wide variability exists in the evolutionary stages of CA biomarkers, combined evaluation of CA plaque imaging features shows potential value to improve risk prediction and clinical decision-making for CVD prevention.

Why Patients with Chronic Disease Keep Silent? Analysis of Item Nonresponse in Rural China.

BACKGROUND: This study aimed to identify the characteristics of item nonresponse and examine the factors affecting the refusal or failure to respond of patients with chronic disease in rural China. METHODS: A cross-sectional survey data from patients with chronic disease from rural China were analyzed. A total of 1,099 patients were enrolled. Chi-square test and cumulative logistic regression determined the predictors of having item nonresponse. RESULTS: The respondents in central provinces (OR = 2.311, 95%CI = 0.532∼1.144, P < 0.001) with over eight household members (OR = 0.067, 95%CI = -1.632∼-0.349, P = 0.002), multiple chronic diseases (OR = 0.301, 95%CI = -1.673∼-0.727, P < 0.001), and low health knowledge level (OR = 2.112, 95%CI = 0.405∼1.090, P < 0.001) had more item nonresponse numbers. Compared with the participants with high school education level and above, the item nonresponse number seemed to increase when the participants were illiterate (OR = 2.159, 95%CI = 0.254∼1.285, P = 0.003), had primary school education (OR = 2.161, 95%CI = 0.249∼1.294, P = 0.004) and junior school education (OR = 2.070, 95%CI = 0.160∼1.296, P = 0.012). CONCLUSION: This study indicates the influencing factors of the item nonresponse in survey of patients with chronic disease in rural China. This study contributes to investigation practice and highlights that health institutions should improve the quality of follow-up services. Moreover, the government should pay more attention to the care of vulnerable groups, especially patients with chronic disease in rural areas.

Intensity, frequency, duration, and volume of physical activity and its association with risk of depression in middle- and older-aged Chinese: Evidence from the China Health and Retirement Longitudinal Study, 2015.

BACKGROUND: The general benefit of physical activity (PA) to one's mental health has been widely acknowledged. Nevertheless, the specific type and amount of PA that associates with lower risk of depression in China awaits further investigation. The present study was conducted on middle- and older-aged Chinese population with two objectives: 1) to understand the patterns of PA; 2) to measure the associations between depression and PA at different levels from various aspects. METHODS: Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2015), we selected 9118 community residents aged 45 years and older. Depressive symptoms were measured by 10-item Center for Epidemiologic Studies (CES-D 10). Multivariate logistic regression model was performed to examine the association between risk of depression and PA from four aspects including intensity, frequency, duration, and volume. RESULTS: Spending 1-2 days/week (OR = 0.58, 95% CI: 0.36, 0.91), less than 30 minutes each time (OR = 0.66, 95% CI: 0.42, 1.03) or 150-299 min/week (OR = 0.49, 95% CI: 0.28, 0.87) on Moderate Physical Activity (MPA) was associated with lower odds of depression in women. Spending 3-5 days/week (OR = 1.98, 95% CI: 1.29, 3.05) or 6-7 days/week (OR = 1.50, 95% CI: 1.07, 2.11), 4 hours and longer each time (OR = 1.65, 95% CI: 1.18, 2.32), 300 min/week or longer (OR = 1.65, 95% CI: 1.22, 2.24) on Vigorous Physical Activity (VPA) in total, or 2250 Metabolic Equivalent of Task (OR = 1.73, 95% CI: 1.26, 2.38) on Moderate-to-Vigorous PA was associated with higher risk of depression in men. CONCLUSIONS: The association between depression and PA depended largely on intensity and gender. Lower frequency, shorter duration, and moderate amount of MPA was associated with lower risk of depression in women. Risk of depression was higher in men who spent higher frequency, longer duration, and overlong time on VPA.

Seeking and using intention of health information from doctors in social media: The effect of doctor-consumer interaction.

OBJECTIVE: The aim of this study is to investigate how doctor-consumer interaction in social media influences consumers' health information seeking and usage intention. METHODS: Based on professional-client interaction theory and expectation confirmation theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interaction influence consumers' health information seeking and usage intention through consumer satisfaction and trust towards doctors. To validate our proposed research model, we employed the survey method. The measurement instruments for all constructs were developed based on previous literatures, and 352 valid answers were collected by using these instruments. RESULTS: Our results reveal that consumers' intention to seek health information significantly predicts their intention to use health information from social media. Meanwhile, both consumer satisfaction and trust towards doctors influences consumers' health information seeking and usage intention significantly. With regards to the impact of the interaction between doctors and consumers, the results show that both types of doctor-consumer interaction significantly affect consumer satisfaction and trust towards doctors. The mediation analysis confirms the mediation role of consumer satisfaction and trust towards doctors. CONCLUSIONS: Compared with many intentional intervention programs, doctor-consumer interaction can be treated as an effective intervention with low cost to promote consumers' health information seeking and usage. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. At last, consumer satisfaction and trust towards doctors could be considered as the important working mechanisms for the effect of doctor-consumer interaction.