Corrigendum: Impact of a mobile health intervention based on multi-theory model of health behavior change on self-management in patients with differentiated thyroid cancer: protocol for a randomized controlled trial.

[This corrects the article DOI: 10.3389/fpubh.2024.1327442.].

Impact of a mobile health intervention based on multi-theory model of health behavior change on self-management in patients with differentiated thyroid cancer: protocol for a randomized controlled trial.

Introduction: Theoretical models of health behavior are important guides for disease prevention and detection, treatment and rehabilitation, and promotion and maintenance of physical and mental health, but there are no intervention studies related to differentiated thyroid cancer (DTC) that use theoretical models of health as a guide. In this study, we used a microblogging platform as an intervention vehicle and mobile patient-doctor interactive health education as a means of intervention, with the aim of improving the health behaviors of DTC patients as well as the corresponding clinical outcomes. Methods: This research project is a quantitative methodological study, and the trial will be a single-blind, single-center randomized controlled trial conducted at the Fourth Hospital of Harbin Medical University in Harbin, Heilongjiang Province. The study subjects are patients over 18 years of age with differentiated thyroid cancer who were given radioactive iodine-131 therapy as well as endocrine therapy after radical surgery for thyroid cancer. The intervention group will receive MTM-mhealth, and the realization of health education will rely on the smart terminal WeChat platform. Routine discharge education will be given to the control group at discharge. The primary outcome will be change in thyroid-stimulating hormone (TSH) from baseline and at 3 and 6 months of follow-up, and secondary outcomes will include change in self-management behavior, social cognitive and psychological, and metabolic control. Discussion: This study will explore a feasible mHealth intervention program applied to a population of DTC patients using the Multi-theory model of health behavior change (MTM) as a guide, with the aim of evaluating the MTM-based intervention program for clinical outcome improvement in DTC patients, as well as determining the effectiveness of the MTM-based intervention program in improving self-management skills in DTC patients. The results of this study will indicate the feasibility as well as the effectiveness of the application of health theoretical modeling combined with mHealth applications in disease prognostic health management models, and provide policy recommendations and technological translations for the development of mobility-based health management applications in the field of health management.

The influence of media use degree on public depressive symptoms: mediating role of big five personality.

BACKGROUND: Mixed results have been found regarding the relationship between media use degree and depressive symptoms. The purpose of this study is to explore the relationship between media use degree, big five personality and depressive symptoms with a mediation model. METHOD: This was a cross-sectional study. With 9-item Patient Health Questionnaire (PHQ-9), 10-item Big Five Inventory (BFI-10) and self-designed media usage scale, 11,031 participants aged 12 and above in 120 cities in China were collected. Pearson correlation analysis and regression analysis were performed on the data. The Process plug-in was used to construct the mediation model and explore the relationship among media use degree, big five personality and depressive symptoms. The nonparametric percentile Bootstrap method was used to test the mediating effect of personality traits. RESULTS: The degree of media use was positively correlated with depressive symptoms (r = 0.20, P < 0.001), and big five personality played a mediating role between the degree of media use and depressive symptoms. Among five traits, extroversion (r=-0.12, P < 0.001), conscientiousness (r=-0.23, P < 0.001), openness (r=-0.03, P < 0.01) and agreeableness (r=-0.22, P < 0.001) were negatively correlated with depressive symptoms, and neuroticism (r = 0.25, P < 0.001) were positively correlated with depressive symptoms. In addition, extraversion (-0.004, -0.001), conscientiousness (-0.015, -0.008), agreeableness (-0.008, -0.001) and neuroticism (-0.015, -0.007) in big five personality played a mediating role between media use and depressive symptoms. CONCLUSION: The degree of media use positively predicted depressive symptoms, and excessive media use may bring risks to mental health. People with high neuroticism, low agreeableness, low conscientiousness and low extroversion are more likely to suffer from depressive symptoms.

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.

Effect of Artificial Intelligence-based Health Education Accurately Linking System (AI-HEALS) for Type 2 diabetes self-management: protocol for a mixed-methods study.

BACKGROUND: Patients with type 2 diabetes (T2DM) have an increasing need for personalized and Precise management as medical technology advances. Artificial intelligence (AI) technologies on mobile devices are being developed gradually in a variety of healthcare fields. As an AI field, knowledge graph (KG) is being developed to extract and store structured knowledge from massive data sets. It has great prospects for T2DM medical information retrieval, clinical decision-making, and individual intelligent question and answering (QA), but has yet to be thoroughly researched in T2DM intervention. Therefore, we designed an artificial intelligence-based health education accurately linking system (AI-HEALS) to evaluate if the AI-HEALS-based intervention could help patients with T2DM improve their self-management abilities and blood glucose control in primary healthcare. METHODS: This is a nested mixed-method study that includes a community-based cluster-randomized control trial and personal in-depth interviews. Individuals with T2DM between the ages of 18 and 75 will be recruited from 40-45 community health centers in Beijing, China. Participants will either receive standard diabetes primary care (SDPC) (control, 3 months) or SDPC plus AI-HEALS online health education program (intervention, 3 months). The AI-HEALS runs in the WeChat service platform, which includes a KBQA, a system of physiological indicators and lifestyle recording and monitoring, medication and blood glucose monitoring reminders, and automated, personalized message sending. Data on sociodemography, medical examination, blood glucose, and self-management behavior will be collected at baseline, as well as 1,3,6,12, and 18 months later. The primary outcome is to reduce HbA1c levels. Secondary outcomes include changes in self-management behavior, social cognition, psychology, T2DM skills, and health literacy. Furthermore, the cost-effectiveness of the AI-HEALS-based intervention will be evaluated. DISCUSSION: KBQA system is an innovative and cost-effective technology for health education and promotion for T2DM patients, but it is not yet widely used in the T2DM interventions. This trial will provide evidence on the efficacy of AI and mHealth-based personalized interventions in primary care for improving T2DM outcomes and self-management behaviors. TRIAL REGISTRATION: Biomedical Ethics Committee of Peking University: IRB00001052-22,058, 2022/06/06; Clinical Trials: ChiCTR2300068952, 02/03/2023.

Association of smoking status and nicotine dependence with multi-morbidity in China: A nationally representative crosssectional study.

INTRODUCTION: Multi-morbidity is a public health priority as it is associated with an increased risk of mortality and a substantial healthcare burden. Smoking is considered a predisposing factor for multi-morbidity, but evidence for an association between multi-morbidity and nicotine dependence is insufficient. This study aimed to explore the association between smoking status, nicotine dependence, and multi-morbidity in China. METHODS: We recruited 11031 Chinese citizens from 31 provinces in 2021 using a multistage stratified cluster sampling strategy to ensure the study population represented national population characteristics. The association between smoking status and multi-morbidity was analyzed using binary logistic regression and multinomial logit regression models. We then analyzed the associations between four kinds of smoking status (age at smoking initiation, cigarette consumption per day, smoking when ill in bed, and inability to control smoking in public places), nicotine dependence, and multi-morbidity among participants who were current smokers. RESULTS: Compared with non-smokers, the odds of multi-morbidity were higher among ex-smokers (adjusted odd ratio, AOR=1.40, 95% CI: 1.07-1.85). The risk of multi-morbidity was greater in participants who were underweight/overweight/obese (AOR=1.90; 95% CI: 1.60-2.26) compared with those who were normal weight. and also greater for drinkers (AOR=1.34; 95% CI: 1.09-1.63) than non-drinkers. Compared with children who began smoking at the age of <15 years, participants aged >18 years had a lower likelihood of multi-morbidity (AOR=0.52; 95% CI: 0.32-0.83). People who consumed ≥31 cigarettes per day (AOR=3.77; 95% CI: 1.47-9.68) and those who smoked when ill in bed (AOR=1.70; 95% CI: 1.10-2.64) were more likely to have multi-morbidity. CONCLUSIONS: Our findings show that smoking behavior, including initiation age, frequency of daily smoking, and still smoking during illness or in public, is a critical risk factor for multi-morbidity, especially when combined with alcohol consumption, physical inactivity, and abnormal weight (underweight, overweight, or obese). This highlights the crucial effect of smoking cessation in the prevention and control of multi-morbidity, especially in patients with three or more diseases. Implementing smoking and lifestyle interventions to promote health would both benefit adults and prevent the next generation from initiating habits that increase the risk of multi-morbidity.

The self-medication behaviors of residents and the factors related to the consideration of drug efficacy and safety-A cross-sectional study in China.

Background: Over-the-counter (OTC) drugs facilitates residents self-medication. However, inappropriate self-medications have become a serious problem in China and even all over the world. Objectives: To make an investigation on the current status of Chinese residents' self-medication behaviors and important considerations, and to explore the factors related to the considerations of drug efficacy and safety. Design: A quantitative, cross-sectional study. Methods: Multi-stage sampling was used to conduct a cross-sectional investigation in China 22 provinces, 5 autonomous regions and 4 municipalities directly under the Central Government. State that an interviewer-administrated questionnaire, was used for data collection. The questionnaire that was used in the investigation included demographic sociological characteristics, health literacy scale-short form (HLS-SF), the 10-item Big Five Inventory (BFI-10), the EuroQol-5D visual analogue scale (EQ-5D VAS), self-medication status and important considerations when self-medicating. Descriptive statistics were performed, and the Chi-square test was used for univariate analysis. Log-binomial regression was used for multivariate analysis on whether residents regard drug efficacy or safety as an important consideration. Results: 9256 respondents were included in the data analysis. The self-medication rate of Chinese adults was as high as 99.1%. Paracetamol and other analgesics were the most common types of OTC medication that respondents purchased, followed by vitamins/minerals. Medical staff recommendations, drug safety and efficacy were the top three important considerations. The residents in the east, central and western regions who consider safety is 63.5%, 61.5%, and 66.8% respectively. The proportion of curative effect was 60.2%, 55.7%, and 61.4% respectively. Log-binomial regression showed that western respondents, retired people, those who mainly used ways including basic medical insurance for employees, commercial medical insurance, free medical treatment to cover their medical cost, respondents with high neuroticism, high health literacy were more likely to consider drug safety as an important factor (p < 0.05). Eastern respondents, employed, main way of medical expenses borne was Out-of-pocket Payment, those with chronic disease were more likely to consider drug efficacy as an important factor (p < 0.05). Female, respondents with high levels of agreeableness, conscientiousness, openness, and self-rated health status were more likely to regard both drug safety and efficacy as important considerations (p < 0.05). Conclusion: Self-medication is practiced by most Chinese adults. Whether Chinese adults take drug efficacy or safety as an important consideration is related to their demographic and sociological characteristics, Big Five personality characteristics, health literacy and self-assessed health status. There is a need to strengthen the management of OTC drugs and public education about self-medication.

Dietary Management Tools Improve the Dietary Skills of Patients with T2DM in Communities.

Dietary management is of paramount importance in the prevention and control of type 2 diabetes mellitus (T2DM). This one-year cluster-randomized controlled trial aims to evaluate the effect of dietary management tools on the dietary skills of patients with T2DM. Twenty-two communities were randomly assigned to an intervention group and a control group, and participants in the intervention group received a food guiding booklet (G) and a dinner set (D). The frequency of dietary management tools usage was collected at baseline and every three months, and different use patterns were identified by a group-based trajectory model. A self-compiled diabetic dietary skills scale and blood glucose were collected at baseline, 3, and 12 months, and a using generalized linear mixed model (GLMM) to explore the influence factors of dietary skills and blood glucose. The finding revealed four dietary tool-usage patterns among the participants: Insist using G/D, Give up gradually G/D, Give up after use G, and Never use G/D. GLMM indicated that dietary skills were higher over time (p < 0.05), and in participants using the guiding booklet (p < 0.001) or dinner set (p < 0.001), or with higher education (p < 0.001). Additionally, blood glucose were lower among participants with higher dietary skills (p = 0.003), higher educational level (p = 0.046), and a 3000−5000 monthly income (p = 0.026). These findings support using food management tools like the guiding booklet and dinner set as a useful strategy in primary health care centers for individuals with T2DM to increase their dietary skills and blood glucose control.

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.

The Role of Family Health in Mediating the Association between Smartphone Use and Health Risk Behaviors among Chinese Adolescent Students: A National Cross-Sectional Study.

The direct impact of smartphones on health risk behaviors of adolescent students has been verified. However, the mediating mechanisms that underly this relationship remain largely unknown. Therefore, the aim of the study is to explore the role of family health in mediating the relationship between the frequency of smartphone use and adolescent students' health risk behaviors. A questionnaire was used to collect cross-sectional data from 693 adolescent students aged 12-18 in China and a structural equation model was analyzed. Among the nine health risk behaviors, the most frequent health risk behaviors in Chinese adolescent students were non-compliance walking behaviors (M=Mean; SD = Standard deviation) (M ± SD) (2.78 ± 1.747), eating unhygienic food (M ± SD) (2.23 ± 1.299), being subjected to physical violence (M ± SD) (2.19 ± 0.645), and leaving home (M ± SD) (2.13 ± 0.557). The SEM results showed that the adolescent students' smartphone use had a positive impact on delaying the age of first alcohol consumption (ß = 0.167, CI:0.067 0.287) and a negative impact on the non-compliance walking behaviors (ß = 0.176, CI:0.011 0.266). Family health plays an indirect-only mediated role (the proportions of indirect-only mediated roles are 11.2%, 12.4%, and 11.5%) in the relationship between smartphone use and adolescent students' partial health risk behaviors: (CI: -0.042 -0.002), (CI: -0.049 -0.005), and (CI: -0.043 -0.002). These findings provided a theoretical and practical basis for better interventions in adolescent health risk behaviors.

Self-medication in Chinese residents and the related factors of whether or not they would take suggestions from medical staff as an important consideration during self-medication.

Objective: To investigate the status of Chinese residents' self-medication behavior and the important factors to consider when purchasing OTC drugs, and to explore the related factors of the possibility that Chinese residents take medical staff's suggestions as important factors to consider when purchasing OTC drugs. Study design: A cross-sectional survey. Methods: A questionnaire was developed for exploring the sociodemographic characteristics of the respondents, their self-medication status, and important considerations. The questionnaire includes several scales including Health Literacy Scale-Short Form (HLS-SF), EQ-5D Visual Analog Scale (EQ-5D-VAS), Big Five Inventary-10 Items (BFI-10), and New General Self Efficacy Scale (NGSES). After carrying out a multi-stage sampling method, the questionnaire was conducted nationwide from July 10 to September 15, 2021. Next, descriptive statistics were conducted to analyze the general features. Logistic regression was then used to analyze the related factors of the possibility that the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs. Results: Nine thousand two hundred fifty-six qualified questionnaires were received. 99.06% of Chinese adults had self-medication behaviors. The types of OTC drugs purchased most by the respondents were NSAIDs (5,421/9,256 people, 58.57%) and vitamins/minerals (4,851/9,256 people, 52.41%). 86.2% of the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs. The results of multi-factor logistic regression showed that women, those living in the central and western regions of China, those suffering from chronic diseases, those with high agreeableness, high conscientiousness, high neuroticism and openness, high health literacy, high EQ-5D-VAS, and those with high self-efficacy are more likely to take medical staff's suggestions as important factors to consider. Conclusion: The vast majority of Chinese adults have self-medication behavior. Important considerations when purchasing OTC drugs include medical staff's suggestions, drug safety and drug efficacy. Whether residents take the suggestions of medical staff as an important consideration is related to their sociological characteristics, agreeableness, conscientiousness, neuroticism, openness, health literacy, self-assessment health status, and self-efficacy. When purchasing and using OTC drugs, residents should carefully listen to the suggestions from medical staff. They should also carefully consider their own conditions before buying OTC drugs.

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.

Relation of eating behavior and family health and personality traits in adolescents / 中国学校卫生

Objective@#To explore the relation of eating behavior to family health and personality traits in adolescents, and to provide empirical support for personality based prediction of adolescents susceptibility to poor eating behavior and family intervention.@*Methods@#A total of 563 adolescents aged 12 to 17 years old from nuclear families, who were selected from "Survey of Chinese Family Health Index(2021)". A general characteristic questionnaire, Short form of Family Health Scale, 10 item Big Five Inventory, and Short form of Sakata Eating Behavior Scale were used to collect information. The relationships of eating behavior to family health and personality traits were analyzed by structural equation modeling.@*Results@#Group comparison indicated that there was a significant difference in scores of the big five personalities and eating behaviors among adolescents from diverse family health statuses( P <0.01). Additionally, there were significant correlations among family health, personality traits, and eating behavior( P <0.01). Structural equation modeling showed that family health resources (-0.34), conscientiousness (-0.17), extraversion ( 0.14 ), agreeableness (-0.13) directly affected eating behavior( P <0.05). Meanwhile, family external social support associated with eating behavior by affecting extraversion (0.22), and family health resources associated with eating behavior by affecting agreeableness(0.12)( P <0.05).@*Conclusion@#Not only could family health directly affect eating behavior, but it could indirectly associate with eating behavior by affecting personality traits among adolescents in nuclear families. The role of the family in improving adolescent poor eating behavior should be emphasized.