Impacts of travel duration on urban-rural resident free vaccination behavior: Chinese COVID-19 vaccine booster dose evidence.

This study aimed to evaluate how the duration of travel affects the behavior of urban and rural residents regarding free COVID-19 vaccination, and provide scientific evidence for promoting free vaccination and building an immune barrier to cope with future epidemics. From August 3, 2022 to February,18,2023, A follow-up survey was conducted in urban and rural adults in four cities in China to collect information on socio-demographic factors, vaccination status and travel time for vaccination. Propensity score matching (PSM) analysis was deployed to measure the net difference of the enhanced vaccination rate between urban and rural residents in different traffic time distribution. A total of 5780 samples were included in the study. The vaccination rate of the booster dose of COVID-19 vaccine among rural residents was higher than that of urban residents with a significant P-value (69.36% VS 64.49%,p < .001). The traffic time had a significant negative impact on the COVID-19 booster vaccination behavior of urban and rural residents. There was a significant interaction between the travel time to the vaccination point and the level of trust in doctors. Travel time had a negative impact on the free vaccination behavior of both urban and rural residents. The government should optimize and expand the number of vaccination sites and enhance residents' trust in the medical system. This is crucial for promoting free vaccination and effective epidemic management in the future.

Assessing public health service capability of primary healthcare personnel: a large-scale survey in Henan Province, China.

BACKGROUND: The public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement. METHODS: We used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences. RESULTS: The total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones. CONCLUSIONS: The public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

The Expression of MAFB Gene in Circulating Monocytes Is Related to Chronic Inflammatory Status in T2DM Patients.

Immune cell-mediated chronic inflammation is one of the causes of type 2 diabetes mellitus (T2DM). Therefore, identifying inflammatory markers in circulating immune cells is highly important for predicting insulin resistance (IR) and the occurrence of T2DM. In this study, we discovered that differentially expressed genes (DEGs) in peripheral blood mononuclear cells (PBMCs) from T2DM patients were associated with innate immunity and chronic inflammatory responses through bulk transcriptome sequencing (bulk RNA-seq). Gene integration analysis revealed that nine DEGs were upregulated, and receiver operating characteristic (ROC) curve analysis revealed that V-maf musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB), a candidate biomarker, has a certain predictive value for T2DM. In population-based cohort studies, we found that MAFB expression was significantly upregulated in the PBMCs of T2DM patients and was significantly correlated with homeostasis model assessment of IR (HOMA-IR), tumor necrosis factor-α (TNF-α), adiponectin (Adipoq), etc. We further evaluated the sensitivity and specificity of MAFB and other clinical parameters for predicting and diagnosing T2DM and found that MAFB expression in PBMCs had a positive effect on the prediction and diagnosis of T2DM. Finally, single-cell RNA sequencing (scRNA-seq) analysis revealed that the increase in MAFB expression was mainly in nonclassical monocytes. Our results suggest that increased MAFB expression in circulating monocytes may mediate chronic inflammatory status in patients with T2DM. Therefore, MAFB gene expression in circulating monocytes has certain clinical significance for predicting and assisting in the diagnosis of T2DM.

Quantifying the Adverse Effects of Long COVID on Individuals' Health After Infection: A Propensity Score Matching Design Study.

Objective: To evaluate the prevalence and influencing factors of long COVID, and measure the difference in health status between long COVID and non-long COVID cases. Methods: A cross-sectional survey was conducted from February 1 to 8, 2023, using a stratified random sampling method in four regions (eastern [Changzhou], central [Zhengzhou], western [Xining] and northeastern [Mudanjiang]) of China. The survey collected COVID-19 patients' socio-demographic characteristics and lifestyles information. The scores of lifestyles and health status range from 5 to 21 and 0 to 100 points, respectively. The criteria of "persistent health problems after 4 weeks of COVID-19 infection" issued by the US Centers for Disease Control and Prevention was used to assess long COVID. Multiple linear regression was used to analyze the influencing factors of the health. The bootstrap method was used to analyze the lifestyles' mediating effect. Propensity score matching (PSM) was used to evaluate the net difference in health scores between long COVID and non-long COVID cases. Results: The study included 3165 COVID-19 patients, with 308 (9.73%) long COVID cases. The health score of the long COVID cases (74.79) was lower than that of the non-long COVID cases (81.06). After adjusting for potential confounding variables, we found that never focused on mental decompression was a common risk factor for the health of both groups. Lifestyles was the mediating factor on individuals' health. After PSM, the non-long COVID cases' health scores remained higher than that of long COVID cases. Conclusion: The proportion of long COVID cases was low, but they were worse off in health. Given the positive moderating effect of healthy lifestyles on improving the health of long COVID cases, healthy lifestyles including mental decompression should be considered as the core strategy of primary prevention when the epidemic of COVID-19 is still at a low level.

How urban versus rural population relates to COVID-19 booster vaccine hesitancy: A propensity score matching design study.

During the COVID-19 pandemic, the vaccine hesitancy has significantly affected the vaccination. To evaluate the booster vaccine hesitancy and its influencing factors among urban and rural residents, as well as to estimate the net difference of booster vaccine hesitancy between urban and rural residents. We conducted a nationwide, cross-sectional Internet survey on 1-8 February 2023, and employed stratified random sampling technique to select participants (≥18 years old) from urban and rural areas. Multivariate logistic regression was used to determine the factors impacting booster vaccine hesitancy. Propensity Score Matching was used to estimate the net difference of COVID-19 booster vaccine hesitancy between urban and rural residents. The overall COVID-19 booster vaccine hesitancy rate of residents was 28.43%. The COVID-19 booster vaccine hesitancy rate among urban residents was found to be 34.70%, among rural residents was 20.25%. Chronic diseases, infection status, vaccination benefits, and trust in vaccine developers were associated with booster vaccine hesitancy among urban residents. Barriers of vaccination were associated with booster vaccine hesitancy among rural residents. PSM analysis showed that the urban residents have a higher booster vaccine hesitancy rate than rural residents, with a net difference of 6.20%. The vaccine hesitancy rate increased significantly, and the urban residents have a higher COVID-19 booster vaccine hesitancy than rural residents. It becomes crucial to enhance the dissemination of information regarding the advantages of vaccination and foster greater trust among urban residents toward the healthcare system.

Quantifying the benefits of healthy lifestyle behaviors and emotional expressivity in lowering the risk of COVID-19 infection: a national survey of Chinese population.

BACKGROUND: COVID-19 is still prevalent in most countries around the world at the low level. Residents' lifestyle behaviors and emotions are critical to prevent COVID-19 and keep healthy, but there is lacking of confirmative evidence on how residents' lifestyle behaviors and emotional expressivity affected COVID-19 infection. METHODS: Baseline study was conducted in August 2022 and follow-up study was conducted in February 2023. Baseline survey collected information on residents' basic information, as well as their lifestyle behaviors and emotions. Follow-up study was carried out to gather data on COVID-19 infection condition. Binary logistic regression was utilized to identify factors that may influence COVID-19 infection. Attributable risk (AR) was computed to determine the proportion of unhealthy lifestyle behaviors and emotional factors that could be attributed to COVID-19 infection. Sensitivity analysis was performed to test the robustness of the results. RESULTS: A total of 5776 participants (46.57% males) were included in this study, yielding an overall COVID-19 infection rate of 54.8% (95%CI: 53.5 - 56.0%). The findings revealed that higher stress levels [aOR = 1.027 (95%CI; 1.005-1.050)] and lower frequency in wearing masks, washing hands, and keeping distance [aOR = 1.615 (95%CI; 1.087-2.401)], were positively associated with an increased likelihood of COVID-19 infection (all P < 0.05). If these associations were causal, 8.1% of COVID-19 infection would have been prevented if all participants had normal stress levels [Attributable Risk Percentage: 8.1% (95%CI: 5.9-10.3%)]. A significant interaction effect between stress and the frequency in wearing masks, washing hands, and keeping distance on COVID-19 infection was observed (ß = 0.006, P < 0.001), which also was independent factor of COVID-19 infection. CONCLUSIONS: The overall COVID-19 infection rate among residents is at a medium level. Residents' increasing stress and decreasing frequency in wearing masks and washing hands and keeping distance contribute to increasing risk of infection, residents should increase the frequency of mask-wearing, practice hand hygiene, keep safe distance from others, ensure stable emotional state, minimize psychological stress, providing evidence support for future responses to emerging infectious diseases.

Association between lifestyle and COVID-19 vaccination: A national cross-sectional study.

Objective: To assess lifestyles, COVID-19 vaccination coverage rates, and the relationships between lifestyles and COVID-19 vaccination among Chinese population. Methods: We collected data on sociodemographics, perception of the COVID-19 pandemic, lifestyles, and self-reported COVID-19 vaccination via an online survey in China. The chi-square goodness-of-fit test was used to monitor sample saturation throughout the formal online survey. The binary logistic regression analyses were conducted to examine the association between COVID-19 vaccination rate and lifestyle score. We assigned values to 12 lifestyles ranging from positive to negative, with positive lifestyles receiving a higher score and negative lifestyles receiving a lower score, ranging from 1 to 5. For each participant, the total lifestyle scored from 12 to 56. Restricted cubic spline (RCS) was used to visualize the trends and correlations between lifestyle score and COVID-19 vaccination coverage. Propensity score matching (PSM) was used to explore the association between specific lifestyles and COVID-19 vaccination. Results: A total of 29,925 participants (51.4% females) responded. The lifestyle score of the sample was 44.60 ± 6.13 (scoring range: 12-56). COVID-19 vaccination rate was found to be 89.4% (89.1-89.8%). Female participants reported a higher vaccination rate than male participants (91.5 vs. 87.1%). Compared to Q1, COVID-19 vaccination coverage rates increased with lifestyle total scores [OR Q2 = 1.901 (1.718-2.103), P < 0.001; OR Q3 = 2.373 (2.099-2.684), P < 0.001; and OR Q4 = 3.765 (3.209-4.417), P < 0.001]. After applying PSM, it was determined that all the 12 specific healthy lifestyles analyzed, including maintaining a healthy body weight, a healthy diet, regular physical exercises, adequate sleep, regular physical examination, and others, were found to be positive factors for COVID-19 vaccination. Conclusion: The majority of mainland Chinese lived a healthy lifestyle throughout the COVID-19 pandemic, and the rate of COVID-19 vaccination was high. Specific healthy lifestyles contributed to COVID-19 vaccination coverage rates significantly. According to the study's findings, global efforts to achieve herd immunity should be prioritized by continually promoting healthy lifestyles and improving public perception of COVID-19 vaccines.

The Psychological Experience of COVID-19 Vaccination and Its Impact on the Willingness to Receive Booster Vaccines among the Chinese Population: Evidence from a National Cross-Sectional Study.

The purpose of this study was to assess the psychological experience of COVID-19 basic vaccination, the willingness to receive booster vaccines, and to determine their relationships among Chinese people. Between 6 August 2021 and 9 August 2021, a research firm performed a national cross-sectional online survey among Chinese individuals (aged over 18), using the snowball sampling approach, with 26,755 participants. Factor analysis and binary logistic regression were used to evaluate the existing associations. The overall COVID-19 vaccination psychological experience score of the participants was 25.83 (25.78~25.89; scores ranged from 7-35). A total of 93.83% (95%CI = 93.54~94.12) of respondents indicated a willingness to receive booster vaccines. After classifying psychological experiences associated with COVID-19 vaccination into positive and negative experiences and adjusting for confounding factors, for the former, the willingness to receive booster vaccines for participants with the highest scores of 13-15 was 3.933 times higher (OR = 3.933, 95%CI = 3.176~4.871) than participants who obtained scores of 3-9, and for the latter, the willingness to receive booster vaccines for participants with the highest scores of 19-20 was 8.871 times higher (OR = 8.871, 95%CI = 6.240~12.612) than participants who obtained scores of 4-13. Our study suggests that a good psychological experience with vaccination is positively associated with an increased willingness to receive booster vaccines.