Analysis of the prevalence and influencing factors of anxiety and depression in the Chinese population: A cross-sectional survey.

To explore the prevalence and influencing factors of anxiety and depression symptoms among Chinese people in 2021. Investigation teams were recruited in 120 cities across the country. Based on the data from "the Seventh National Population Census in 2021″, quota sampling was conducted on the residents of these cities to obtain samples that conformed to population characteristics. Next, baseline information on research objects was collected, and the questionnaire survey was conducted through the online questionnaire Wenjuanxing platform. The Patient Health Questionnaire-9 (PHQ-9) rating scale was used to evaluate the mental state of the subjects. The correlation between baseline information and different PHQ-9 risk intervals was analyzed using the Chi-square test and Logit model. The impact of relevant risk factors on PHQ-9 scores was analyzed using the decision tree. The Chi-square test results revealed that place of residence (p = 0.438) and obesity (p = 0.443) was not significantly correlated with PHQ-9 risk intervals. According to Logit model analysis, age (p = 0.001, 95%CI 0.84-0.96), marital status (p < 0.001, 95%CI 0.71-0.89), drinking (p < 0.001, 95%CI 1.07-1.18), diabetes or hypertension (p = 0.001, 95%CI 1.11-1.47), health care (p < 0.001, 95%CI 0.53-0.66), economic welfare (p = 0.022, 95%CI 0.85-0.99), COVID-19 vaccine (p < 0.001, 95%CI 1.28-1.72), and HPV vaccine (p < 0.001, 95%CI 0.46-0.57) were potential influencing factors of PHQ-9 risk intervals. Decision tree analysis results showed that the grouping strategy in the PHQ-9 two-side groups had a better classification effect on the questionnaire population according to the PHQ-9 score characteristics. The prevalence rate of moderate to severe depression among Chinese people was about 8.29%. Age, marital status, drinking, diabetes or hypertension, health care, economic well, COVID-19 vaccine, and HPV vaccine were potential influencing factors of anxiety and depression symptoms in Chinese people.

Prevalence of depressive symptoms and associated factors during the COVID-19 pandemic: A national-based study.

BACKGROUND: Previous studies have reported that the prevalence of depression and depressive symptoms was significantly higher than that before the COVID-19 pandemic. This study aimed to explore the prevalence of depressive symptoms and evaluate the importance of influencing factors through Back Propagation Neural Network (BPNN). METHODS: Data were sourced from the psychology and behavior investigation of Chinese residents (PBICR). A total of 21,916 individuals in China were included in the current study. Multiple logistic regression was applied to preliminarily identify potential risk factors for depressive symptoms. BPNN was used to explore the order of contributing factors of depressive symptoms. RESULTS: The prevalence of depressive symptoms among the general population during the COVID-19 pandemic was 57.57 %. The top five important variables were determined based on the BPNN rank of importance: subjective sleep quality (100.00 %), loneliness (77.30 %), subjective well-being (67.90 %), stress (65.00 %), problematic internet use (51.20 %). CONCLUSIONS: The prevalence of depressive symptoms in the general population was high during the COVID-19 pandemic. The BPNN model established has significant preventive and clinical meaning to identify depressive symptoms lay theoretical foundation for individualized and targeted psychological intervention in the future.

Willingness to Use Mobile Health Devices in the Post-COVID-19 Era: Nationwide Cross-sectional Study in China.

BACKGROUND: Despite the increased development and use of mobile health (mHealth) devices during the COVID-19 pandemic, there is little knowledge of willingness of the Chinese people to use mHealth devices and the key factors associated with their use in the post-COVID-19 era. Therefore, a more comprehensive and multiangle investigation is required. OBJECTIVE: We aimed to probe Chinese attitudes regarding the use of mHealth and analyze possible associations between the attitude of willingness to use mHealth devices and some factors based on the socioecological model. METHODS: A survey was conducted using quota sampling to recruit participants from 148 cities in China between June 20 and August 31, 2022. Data from the survey were analyzed using multiple stepwise regression to examine the factors associated with willingness to use mHealth devices. Standardized regression coefficients (ß) and 95% CIs were calculated using multiple stepwise regression. RESULTS: The survey contained a collection of 21,916 questionnaires and 21,897 were valid questionnaires, with a 99.91% effective response rate. The median score of willingness to use mHealth in the post-COVID-19 era was 70 points on a scale from 0 to 100. Multiple stepwise regression results showed that the female gender (ß=.03, 95% CI 1.04-2.35), openness personality trait (ß=.05, 95% CI 0.53-0.96), higher household per capita monthly income (ß=.03, 95% CI 0.77-2.24), and commercial and multiple insurance (ß=.04, 95% CI 1.77-3.47) were factors associated with the willingness to use mHealth devices. In addition, people with high scores of health literacy (ß=.13, 95% CI 0.53-0.68), self-reported health rating (ß=.22, 95% CI 0.24-0.27), social support (ß=.08, 95% CI 0.40-0.61), family health (ß=.03, 95% CI 0.03-0.16), neighbor relations (ß=.12, 95% CI 2.09-2.63), and family social status (ß=.07, 95% CI 1.19-1.69) were more likely to use mHealth devices. CONCLUSIONS: On the basis of the theoretical framework of socioecological model, this study identified factors specifically associated with willingness of the Chinese people to use mHealth devices in the post-COVID-19 era. These findings provide reference information for the research, development, promotion, and application of future mHealth devices.

Megastudies: A New Approach to Reducing Vaccine Hesitation Worldwide.

Vaccine hesitancy is a considerable obstacle to achieving vaccine protection worldwide. There needs to be more evidence-based research for interventions for vaccine hesitancy. Existing effectiveness evaluations are limited to one particular hypothesis, and no studies have compared the effectiveness of different interventions. A megastudy takes a large-scale, multi-intervention, uniform participant and the same evaluation criteria approach to evaluate many interventions simultaneously and find the most effective ones. Therefore, megastudies can help us find the most effective interventions for vaccine hesitancy. Additionally, considering the complex causes of vaccine hesitancy, we design interventions that involve social factors in megastudies. Lastly, quality control and justice are critical issues for megastudies in the future.

College Students' Degree of Support for Online Learning during the COVID-19 Pandemic and Associated Factors: A Cross-Sectional Study.

BACKGROUND: Educational institutions worldwide have experienced the suspension of offline teaching activities in favor of online teaching due to the outbreak of the COVID-19 pandemic. However, few studies have focused on the degree of support for online learning among college students in mainland China. Therefore, the aim of this study was to investigate the degree of support for online learning among Chinese college students during the epidemic and whether depression, loneliness, family communication, and social support were associated factors. METHODS: A questionnaire was used to collect cross-sectional data from 9319 college students in mainland China, and a structural equation model was analyzed. RESULTS: The results of the study showed high degrees of support for online learning among Chinese college students during the COVID-19 pandemic, with more than half expressing support. The SEM (Structural Equation Modeling) results showed that depression had a negative and significant effect on college students' support for online learning (ß = -0.07; p < 0.001); family communication had a positive and significant effect on college students' support for online learning (ß = 0.09; p < 0.001); social support had a positive and significant effect on college students' support for online learning (ß = 0.11; p < 0.001). CONCLUSIONS: Social support and family communication can alleviate the negative psychological status of college students, and depression plays a mediating role in the effect of social support and family communication on college students' degree of support for online learning. In addition, a significant chain-mediating effect was found of family communication, loneliness, and depression between social support and college students' degree of support for online learning. Government and education institutions must focus on college students' mental health issues and consider family interventions and general support that college students require.

Effects of information sources on public preventive behaviors in health emergencies: Evidence from a digital epidemiologic study during the COVID-19 pandemic

Introduction It has been approved that information sources would affect public behaviors. However, due to the outbreak of COVID-19, this influence was enhanced and showed a distinctive pattern among different populations, which has been less noticed before. We aimed to investigate the potential roles of different information sources in COVID-19 preventive behaviors of different publics. Methods A cross-sectional online survey with 11,190 participants from 33 province-level regions in China was conducted during the COVID-19 pandemic. Sociodemographic characteristics, COVID-19 preventive behaviors, and information sources for COVID-19-related information were assessed. A mixed linear model was used to analyze risk factors of COVID-19 preventive behaviors. The effects of different information sources on COVID-19 prevention behaviors of different publics were analyzed. Results Generally, the Chinese public had good COVID-19 preventive behaviors, and the top three COVID-19 preventive behaviors with the higher action rate were avoiding eat bushmeat (76.1%), a healthy diet (74.8%), and avoiding contact with people with symptoms of respiratory diseases (73.0%). About information sources, 12320 telephone (National Public Health Hotline) (−0.62, 95% CI: −0.94 to −0.31) and acquaintances consulting (−1.00, 95% CI: −1.31 to −0.69) were negatively associated with COVID-19 preventive behaviors, while internet resources, family doctors, hospitals, and community health centers were positively associated with COVID-19 preventive behaviors (1.00 vs. 0.47 vs. 0.46 vs. 0.33, P < 0.05). For older adults, accessing to COVID-19-related information through family doctors and community health centers were positively associated with COVID-19 preventive behaviors. For the non-educated, family doctors and community health centers had positive effects on their COVID-19 preventive behaviors. Family doctors and internet resources were positively associated with COVID-19 preventive behaviors among those earning 5,000 yuans and above. The effects of family doctors, hospitals, and internet resources were higher for COVID-19 preventive behaviors of urban publics than for rural publics. Finally, the effect of internet resources on COVID-19 preventive behaviors of females was lower than males. Conclusions Obtaining COVID-19-related information through internet resources had the most significant effect on COVID-19 preventive behaviors, but was not significant among publics with old age, low education, low income, and living in rural area.

Exploring Depression among the Elderly during the COVID-19 Pandemic: The Effects of the Big Five, Media Use, and Perceived Social Support.

The mental health of the elderly is vulnerable during public health emergencies, such as the COVID-19 pandemic, and the risks of depression is increased. The study aimed to explore the effects of physical health, the Big Five personality traits, media use, and different kinds of perceived social support as predictors of levels of depression among the elderly during the COVID-19 pandemic. A cross-sectional survey was conducted in more than 120 cities in China with a sample of 1147 older adults, and hierarchical regression was established to examine the predictors of the level of depression. The results showed that almost half of the elderly (48%) had a status of mild or much more severe depression during the COVID-19 pandemic. The level of depression was negatively associated with physical health, extraversion, conscientiousness, agreeableness, and family support, while it was positively associated with neuroticism and media use. The study emphasized the effects of physical health, the Big Five personality traits, media use, and perceived social support from family as the predictors of levels of depression, providing further measures to help the elderly better react to a public health emergency.

Impact of Media Use on Chinese Public Behavior towards Vaccination with the COVID-19 Vaccine: A Latent Profile Analysis.

(1) Background: research on vaccines has received extensive attention during epidemics. However, few studies have focused on the impact of media use on vaccination behavior and the factors influencing vaccination in groups with different media use degrees; (2) Method: Based on seven items related to media use, a total of 11,031 respondents were categorized by the frequency of media use by using latent profile analysis (LPA). Binary regression analysis was used to study the factors that influence the vaccination behaviors of people with different media use frequencies; (3) Results: All respondents were classified into the following three groups: media use low frequency (9.7%), media use general (67.1%), and media use high frequency (23.2%). Media use low frequency (ß = -0.608, p < 0.001) was negatively associated with COVID-19 vaccination behavior. In the media use low frequency, analysis showed that "aged 41 years or older" ß = 1.784, p < 0.001), had religious belief (ß = 0.075, p < 0.05), were ethnic minorities (ß = 0.936, p < 0.01) and had friends support (ß = 0.923, p < 0.05) were associated with a preference to accept the COVID-19 vaccine. In the media use general, those who aged 41 years old and older (ß = 1.682, p < 0.001), had major depression (ß = 0.951, p < 0.05), had friends support (ß = 0.048, p < 0.001) would be more likely to receive COVID-19 vaccination. However, respondents who live in towns (ß = -0.300, p < 0.01) had lower behaviors to receive vaccination for COVID-19. In the media use high frequency, the respondents who aged 41 or older (ß = 1.010, p < 0.001), were ethnic minorities (ß = 0.741, p < 0.001), had moderate depression (ß = 1.003, p < 0.05) would receive the vaccination for COVID-19 positively; (4) Conclusions: The more occluded the media use is, the less likely the respondents are to get vaccinated against COVID-19. Vaccination behavior is influenced by different factors in groups with different frequencies of media use. Therefore, the government and appropriate departments should make individualized and targeted strategies about COVID-19 vaccination and disseminate the vaccination information to different media use groups.

Effects of an mHealth Intervention for Pulmonary Tuberculosis Self-management Based on the Integrated Theory of Health Behavior Change: Randomized Controlled Trial.

BACKGROUND: Improving the health self-management level of patients with tuberculosis (TB) is significant for reducing drug resistance, improving the cure rate, and controlling the prevalence of TB. Mobile health (mHealth) interventions based on behavioral science theories may be promising to achieve this goal. OBJECTIVE: This study aims to explore and conduct an mHealth intervention based on the Integrated Theory of Health Behavior Change (ITHBC) in patients with pulmonary TB to increase their ability of self-care management. METHODS: A prospective randomized controlled study was conducted from May to November 2020. A total of 114 patients who were admitted consecutively to the TB clinic of Harbin Chest Hospital, China from May 2020 to August 2020 were recruited by convenience sampling. Patients were divided into the control group and intervention group, and all received a 3-month intervention. Patients in the intervention group and the control group received routine medical and nursing care in the TB clinic, including the supervision of their medications. In addition, pharmacist-assisted mHealth (WeChat) intervention based on the ITHBC theory about TB management was provided to the intervention group. The primary outcome was self-management behavior, while the secondary outcomes were TB awareness, self-efficacy, social support, and degree of satisfaction with health education. The outcomes were measured using web-based self-designed and standard questionnaires administered at baseline and at the end point of the study. Intergroup data were assessed using the Mann-Whitney U test, whereas intragroup data were assessed with the Wilcoxon test (for paired samples). RESULTS: A total of 112 patients (59 in intervention group and 53 in control group) completed the study. After the intervention, a statistically significant increase was noted in the scores of each item of self-care management behaviors compared with the scores at the baseline (P<.001) in the intervention group. The scores of all self-care management behaviors of the control group were lower than those of all self-care management behaviors in the intervention group (all P<.05), except for the item "cover your mouth and nose when coughing or sneezing" (P=.23) and item "wash hands properly" (P=.60), which had no statistically significant difference from those in the intervention group. Compared with those at baseline, TB knowledge awareness, self-efficacy, social support, and degree of satisfaction with health education in the intervention group increased significantly (P<.001), and the intervention group had significantly higher scores than the control group (P<.001). CONCLUSIONS: mHealth intervention for TB self-management based on ITHBC could deepen the understanding of patients with TB about their disease and improve their objective initiative and self-care management behaviors, which were beneficial for promoting compliance behavior and quality of prevention and control for pulmonary TB. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200055557; https://tinyurl.com/4ray3xnw.

Influence factors analysis of COVID-19 Prevention behavior of chinese Citizens: a path analysis based on the hypothetical model.

BACKGROUND: Under the outbreak of Coronavirus disease 2019 (COVID-19), a structural equation model was established to determine the causality of important factors that affect Chinese citizens' COVID-19 prevention behavior. METHODS: The survey in Qingdao covered several communities in 10 districts and used the method of cluster random sampling. The research instrument used in this study is a self-compiled Chinese version of the questionnaire. Of the 1215 questionnaires, 1188 were included in our analysis. We use the rank sum test, which is a non-parametric test, to test the influence of citizens'basic sociodemographic variables on prevention behavior, and the rank correlation test to analyze the influencing factors of prevention behavior. IBM AMOS 24.0 was used for path analysis, including estimating regression coefficients and evaluating the statistical fits of the structural model, to further explore the causal relationships between variables. RESULTS: The result showed that the score in the prevention behavior of all citizens is a median of 5 and a quartile spacing of 0.31. The final structural equation model showed that the external support for fighting the epidemic, the demand level of health information, the cognition of (COVID-19) and the negative emotions after the outbreak had direct effects on the COVID-19 prevention behavior, and that negative emotions and information needs served as mediating variables. CONCLUSIONS: The study provided a basis for relevant departments to further adopt epidemic prevention and control strategies.

Personality Effects on Chinese Public Preference for the COVID-19 Vaccination: Discrete Choice Experiment and Latent Profile Analysis Study.

Objective: This study aims to investigate the differences in public vaccination preference for the COVID-19 vaccine with different personality characteristics. Methods: Based on the Big Five Personality Inventory (BFI-10), a total of 1200 respondents were categorized by personality characteristics using Latent Profile Analysis (LPA). The preference of members the public with different personality characteristics for COVID-19 vaccination was investigated based on a discrete choice experiment (DCE). Results: All respondents were divided into three groups, named the General and Stable type (79.67%), Conscientious and Agreeable type (9.5%), and Open and Extroverted type (10.83%). For the percentage importance of vaccine attributes, both the General and Stable type and Conscientious and Agreeable type respondents considered cost to be the most important (41.93% and 34.95% respectively). However, the Open and Extroverted type respondents considered efficacy as the most important (31.05%). In our conditional logit model (CLOGIT), for vaccine adverse effects, the General and Stable type and Conscientious and Agreeable type respondents preferred "very mild", while the Open and Extroverted type preferred "mild" (OR:1.108, 95%CI 0.977-1.256). The Open and Extroverted type had a higher willingness to pay (WTP) for the most preferred vaccine level compared to the other types. Conclusions: The Open and Extroverted respondents have the highest willingness to vaccinate. The General and Stable type and Conscientious and Agreeable respondents think that the cost of the vaccine is the most important attribute, and prefer the mildest side effects. The Open and Extroverted type think that vaccine efficacy is the most important attribute, prefer "mild" side effects, and have higher willingness to pay for their favorite vaccine level.

A Comparison of Vaccine Hesitancy of COVID-19 Vaccination in China and the United States.

OBJECTIVES: To investigate the differences in vaccine hesitancy and preference of the currently available COVID-19 vaccines between two countries, namely, China and the United States (U.S.). METHOD: A cross-national survey was conducted in both China and the United States, and discrete choice experiments, as well as Likert scales, were utilized to assess vaccine preference and the underlying factors contributing to vaccination acceptance. Propensity score matching (PSM) was performed to enable a direct comparison between the two countries. RESULTS: A total of 9077 (5375 and 3702 from China and the United States, respectively) respondents completed the survey. After propensity score matching, over 82.0% of respondents from China positively accepted the COVID-19 vaccination, while 72.2% of respondents from the United States positively accepted it. Specifically, only 31.9% of Chinese respondents were recommended by a doctor to have COVID-19 vaccination, while more than half of the U.S. respondents were recommended by a doctor (50.2%), local health board (59.4%), or friends and families (64.8%). The discrete choice experiments revealed that respondents from the United States attached the greatest importance to the efficacy of COVID-19 vaccines (44.41%), followed by the cost of vaccination (29.57%), whereas those from China held a different viewpoint, that the cost of vaccination covered the largest proportion in their trade-off (30.66%), and efficacy ranked as the second most important attribute (26.34%). Additionally, respondents from China tended to be much more concerned about the adverse effect of vaccination (19.68% vs. 6.12%) and have a lower perceived severity of being infected with COVID-19. CONCLUSION: Although the overall acceptance and hesitancy of COVID-19 vaccination in both countries are high, underpinned distinctions between these countries were observed. Owing to the differences in COVID-19 incidence rates, cultural backgrounds, and the availability of specific COVID-19 vaccines in the two countries, vaccine rollout strategies should be nation-dependent.