The Impact of Beliefs on Health Information Social Sharing for Users: The Perspectives of Social Psychology and Information Technology.

With the integration and penetration of digitization into healthcare services, the comprehensive health industrial market is developing flourishingly. Users are fast-changing the way of health communication. This study investigates psychosocial and technological factors on health information sharing adoption through social sharing services. Based on the unified theory of acceptance and use of technology, social influence theory, and innovation diffusion theory, we developed a hypothesized model for health information social sharing adoption (HISSA), and dimensions of attitude beliefs, control beliefs, and normative beliefs were created. We conducted an empirical study on the adoption intention using a survey for data collection. The results were obtained from 375 valid questionnaires, and their interactions were tested and analyzed using PLS-structural equation modeling. Results implied that (1) social identity of normative beliefs was the most critical variable affecting behavioral intention, which revealed the importance of psychosocial factors; (2) behavioral intention was also determined by user's performance expectancy, facilitating conditions, subjective norm; (3) personal innovativeness had a negative effect on behavioral intention and positive effect on effort expectancy; and (4) effort expectancy and social identity had a positive effect on performance expectancy. This study advances the understanding of social sharing for health and provides references for the development of both virtual health communities and social sharing services to upgrade their products from user's behavior and psychology. This empirical research model may also be useful for researchers who are interested in user's health information behavior.

Equating the PHQ-9 and GAD-7 to the HADS depression and anxiety subscales in patients with major depressive disorder.

OBJECTIVE: The present study aimed to equate the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7) to the Hospital Anxiety and Depression Scale (HADS) depression and anxiety subscales (HADS-D,HADS-A) respectively in patients with major depressive disorder (MDD) and generate crosswalks of raw scores. METHODS: As it is a single group design that adopts common-person equating method, a total of 460 patients with MDD completed the PHQ-9, GAD-7 and HADS at the same time. Rasch analysis was used to filter out invalid participants, investigate the psychometric properties of test items and participants, link the PHQ-9 and HADS-D as well as GAD-7 and HADS-A, and produce conversion tables respectively. The differences between original scores and converted scores were analyzed to validate the crosswalks. RESULT: 401 samples of depression part and 396 samples of anxiety part were left for final samples. Both the PHQ-9 / HADS-D and GAD-7 / HADS-A combined analysis adequately fit the unidimensional Rasch model, demonstrated acceptable reliability and item-person targeting and showed no disordering category. Slight differential item functioning across gender was found in item PHQ9 and item GAD6. The crosswalks were generated and verified to be validity. LIMITATIONS: The results might be restricted to patients with MDD recruited in a single mental health center. CONCLUSION: The PHQ-9, GAD-7 and HADS depression and anxiety subscales were successfully linked, producing conversion tables that could be used for directly converting raw score from one instrument to the other.

A Chinese adaptation of six items, self-report Hamilton Depression Scale: Factor structure and psychometric properties.

OBJECTIVES: The objective of this research was to verify the psychometric characteristics of the Chinese Adaptation of self-report HAMD-6. METHODS: Outpatients and inpatients who met the DSM-5 criterion for major depressive disorder (MDD) were evaluated by the Chinese self-report HAMD-6, seventeen items of Hamilton Depression Rating Scale (HAMD-17), Patient Health Questionnaire Depression Scale (PHQ-9) and Improved Clinical Global Impression Scale (iCGI-S). The internal consistency reliability, retest reliability, criterion validity and construct validity of the Chinese self-report HAMD-6 were tested. Pearson correlation coefficient was used to assess the correlativity between the total score and the item scores. By drawing the Receiver Operating Characteristics (ROC) curve, the best cut-off value, sensitivity and specificity of Chinese Adaptation self-report HAMD-6 were obtained. RESULTS: Cronbach's alpha coefficient of the Chinese self-report HAMD-6 was 0.91, and the intra-group correlation coefficient (ICC) of retest reliability was 0.81(P < 0.01). The Spearman correlation coefficients of the Chinese self-report HAMD-6, Chinese clinician version of HAMD-6, PHQ-9 and HAMD-17 were 0.86, 0.81 and 0.86, respectively (all P < 0.01). Results of the confirmatory factor analysis (CFA) supported a unidimensional construct. In addition, HAMD-17 ≤ 7 and iCGI-S= 1 were taken as the remission criteria for depression disorder, and the ROC curves of the Chinese self-report HAMD-6 were plotted with a cut-off value of 3/4, the specificity and sensitivity were 0.85/0.92 and 0.96/0.93 respectively. CONCLUSION: These results suggested that the abbreviated Chinese self-report HAMD-6 has good reliability and validity among the Chinese population. This study suggested that the remission cut-off value of the scale is 3/4.

Effect of disinfectant exposure and starvation treatment on the detachment of simulated drinking water biofilms.

Biofilms were one of the main habitats of microbes in the drinking water distribution system. The variation of environmental conditions can lead to the detachment of biofilms and the deterioration of water quality. In this study, the effects of disinfectant exposure and starvation treatment on the detachment of biofilms were investigated. The results showed that detaching rate increased with the concentration of chloramine in the inlet water and 1.0 mg/L of chloramine led to the largest detached biomass. The starvation treatment resulted in less biofilm biomass but the detaching rates of treated biofilms were higher than those without starvation. The 16S rRNA sequencing results showed that detached and stubborn biofilms had a significant difference in microbial diversity and richness. The microbial community composition of the two types of biofilm showed the difference in the abundance of Nitrospira, Bryobacter, Hyphomicrobium, and Pedomicrobium. Chloramine exposure did not have a significant impact on the microbial community while the starvation treatment led to a higher abundance of chemolithotrophs bacteria. Metagenomic results indicated that detached biofilms had higher abundances of ARGs and starvation treatment could enrich the ARGs. The results of this research could provide the knowledge of biofilm sloughing and help understand the health risk of antibiotic resistance in drinking water.

Psychometric Properties of the Chinese Version of the Clinically Useful Depression Outcome Scale for Patients with Major Depressive Disorder.

OBJECTIVE: This study aimed to evaluate the psychometric properties of the Chinese version of the Clinically Useful Depression Outcome Scale (CUDOS). METHODS: One hundred ninety patients with major depressive disorder (MDD) according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria were recruited to the study. The English version of the CUDOS was translated into Chinese using a forward and backward translation method, which was according to the guidelines of adaptation and validation of instruments in cross-cultural health care research. The Chinese version of the CUDOS, the 17-item Hamilton Rating Scale for Depression (HRSD) and the improved Clinical Global Impression-Severity Scale (iCGI-S) were used to evaluate depressive symptoms in one hundred ninety patients with MDD. One week after the first evaluation, sixteen patients were selected randomly for a second assessment. Reliability and validity tests and receiver operating characteristic curves were performed. RESULTS: The internal consistency of the CUDOS was 0.95, and the split-half reliability coefficient of the CUDOS was 0.92. The correlation coefficient of the retest in sixteen patients was 0.77 (P < 0.01). There was a significant difference in the total score of the Chinese version of the CUDOS between the different levels of depression severity groups (P < 0.01). The ability of the CUDOS to identify patients in remission was high (area under ROC curve= 0.97). A cut-off score of 14/15 yielded 90.20% sensitivity and 93.60% specificity when iCGI-S=1. CONCLUSION: The Chinese version of the CUDOS is valuable as a brief and reliable instrument to assess depressive symptoms and clinical outcome. The findings suggest that the optimal cut-off score to identify patients in remission was 14/15.