Multiple Roads to Success: A Latent Class Analysis on Successful Aging in Hong Kong Near-Centenarians and Centenarians (NCC) Amidst COVID-19 (preprint)

Background: Notwithstanding successful aging being a multidimensional construct, measuring successful aging in adults of advanced age, such as nonagenarians and centenarians, has often been challenging. First, over reliance on physical health criteria could be unrealistic, considering most of these older adults are living with multimorbidity and disability. Second, enumerating the number of criteria fulfilled may not reflect the diversity of how they attain (partial) successful aging through soliciting different resources in their daily lives. Hence, this study investigated the subphenotypes of successful aging using the data from Hong Kong Centenarian Study 2 by referencing to two models which have been adopted in previous centenarian studies. Method: Between April 2021 and September 2022, we interviewed the family caregivers of 146 community dwelling older adults aged 95 or above by phone. A structured questionnaire with items on the physical, psychological, and social well-being of the older adults was administered. Latent class analysis was used to identify the classes of successful aging based on eleven dichotomized indicators - good health, happiness, good perceived economic status, absence of dementia diagnosis, ambulation, resistance, indoor transfer, dressing, vision and hearing impairment and weekly social activities. Results: Among the 146 older adults aged between 95 to 106 (mean (SD): 97.5 (2.5); 76.0% female), 13.0% fulfilled all successful aging criteria based on caregivers’ judgments of happiness, health, and economic status, and 2.1% fulfilled all criteria based on caregivers’ observation of their physical functions and social activities. LCA identified three latent classes: Class 1 (46.6%) characterized by poor cognitive and functional health, Class 2 (37.0%) with good functional health but poor mobility, and Class 3 (16.4%) with overall good health. Class membership was unrelated to gender, age, living arrangement, and education status of the older adults. Conclusions: Although we found a relatively low occurrence of successful aging among Hong Kong adults of advanced age, possibly due to the adverse impact of COVID on their physical, psychological, and social well-being, understanding how successful aging was (partially) attained by these long-lived individuals will enable social and health care professionals to encourage late-life productive involvement, especially in the post-COVID era.  (349 words)

Does Same-Sex Marriage Legalization Invoke Childbearing Desire in Gay and Bisexual Men in Taiwan: A Panel Study (preprint)

Background: Despite the globally rising recognition of same-sex relationships, sexual minority men continue to report lower childbearing desire and intention compared to their heterosexual counterparts, even though both groups tend to consider parenting as valuable. This study capitalized on the prospective process of legalization of same-sex marriage (SSM) in Taiwan to capture changes in gay and bisexual men’s desire and attitudes towards parenthood as a function of the legalization of SSM. Methods: 863 respondents (Mean age = 27.9 years ±5.8) completed an online survey shortly before and 1½ years after the legalization of SSM. They reported their childbearing desire, marital status, and attitudes towards childbearing and marriage. Results: Contrary to our expectation of an increase in childbearing desire due to enhanced legal recognition of same-sex relationships, our study found that fewer participants in the follow-up survey expressed a childbearing desire (59.0% vs 74.2%), and the perceived importance of childbearing dropped mildly (3.48 to 3.26, Cohen’s d=0.269). Those who expressed a consistent childbearing desire attached greater importance to SSM and regarded SSM as a source of a sense of security and recognition by friends/family. The perceived importance of SSM was mildly positively related to the perceived importance of childbearing. Conclusion: Although the decrease in childbearing desire and its perceived importance may be attributable to a lack of access to family building options (e.g., surrogacy and adoption) and the COVID-19 pandemic, our findings illustrate that parenthood can be a logical next-step for Taiwanese male same-sex couples and call for the development of affordable family building options for these men.

Risk perception as a double-edged sword in policy compliance in COVID-19 pandemic? A two-phase evaluation from Hong Kong (preprint)

The emphasis of risk has been recognized as a crucial component to effective and successful policy compliance amidst crisis. Yet, during the COVID-19 pandemic, when the dreadfulness of the risk may fluctuate with the severity of the prolonged pandemic, and the nature of public health policy is not confined purely to public health concerns, perceived risk may not always lead to policy compliance. Two surveys (during almost zero case period and during the biggest outbreak) were conducted to examine the dichotomous role of perceived risk and perceived susceptibility in influencing policy compliance in Hong Kong. Although policy compliance increases with the scale of the outbreak, results from path analysis showed that perceived susceptibility and perceived severity have an indirect role in policy complying behaviour when the objective risk is low. Risk variables, such as attitude, knowledge, benefit and trust, have directly shaped policy compliance. More importantly, perceived severity of COVID-19 boosts policy compliance but perceived susceptibility was associated with disobedience to public health policy. Meanwhile, Hong Kong citizens have a selective and conscious preference in regard to the stringency of public health policy: they welcome more law and order, with increasing magnitude of penalty, but reject lockdown measures such as curfew. Regression results implied that demography had a mild contribution to public health policy stringency, with only the female gender being statistically related to higher policy acceptance. This study calls for further reflection on the role of risk, especially perceived susceptibility, in mobilizing policy compliance to COVID-19 related measures.

What doesn’t kill you makes you stronger: Sense of coherence moderates growth from stress amidst the first wave of COVID-19 outbreak (preprint)

PurposeThis study explored the role of perceived severity of the pandemic, post-traumatic stress and sense of coherence in the development of post-traumatic growth from exposure to COVID-19 among Hong Kong citizens. MethodsA longitudinal online survey was launched during the first local outbreak in Spring 2020. Time 1 was collected at the peak of the outbreak (Mid-March to early-April) with measurements of post-traumatic stress, perceived severity, and sense of coherence; while Time 2 was conducted at the palliation of the outbreak (late-April to early May) with post-traumatic growth measured. Moderated mediation models were tested with SPSS PROCESS version 3.30. ResultsAmong the 327 participants who completed both T1 and T2 questionnaires, 28.4% exhibited probable post-traumatic stress disorder, while 18.0% experienced significant post-traumatic growth in at least one domain. Post-traumatic growth was more likely among people with higher socio-economic backgrounds and with family or close friends having experienced medical quarantine or being tested positive for SAR-CoV-2. The interaction between sense of coherence and post-traumatic stress significantly mediated the link relationship of perceived severity on post-traumatic growth, such that growth was more likely among participants with higher post-traumatic stress and sense of coherence. ConclusionEchoing with the transformational model, our findings highlight the importance of traumatic stress and adaptive coping resources in developing post-traumatic growth. Severe judgments of the novel and challenging pandemic could be conducive to growth, especially when the individuals possess high sense of coherence.

Self-compassion buffers the adverse mental health impacts of COVID-19-related threats: Results from a cross-sectional survey at the first peak of Hong Kong’s outbreak (preprint)

COVID-19 has brought tremendous and abrupt threats to various aspects of our daily lives, from school and work to interpersonal relationships. Self-compassion is put forth as a salutogenic perspective on oneself that buffers the adverse mental health impacts of these threats. During the peak of a local outbreak in Hong Kong in Spring 2020, 761 participants completed questionnaires on self-compassion, perceived threats, as well as perceived benefits and psychological distress. Controlling for demographic variables, negative indicators of self-compassion (aka self-coldness) was found to intensify the impacts of threats on psychological distress. The positive indicators of self-compassion also moderated the link between threats and perceived benefits, such that perceived benefits tend to be less related to threats in participants with higher self-compassion. Our findings highlight the impacts of both positive and negative indicators of self-compassion on the adjustment to such unprecedented challenges, and point to the possibility of enhancing people’s resilience through fostering self-compassion and alleviating self-coldness.