Exploring the Incentive Function of Virtual Academic Degrees in a Chinese Online Smoking Cessation Community: Qualitative Content Analysis.

BACKGROUND: Previous studies on online smoking cessation communities (OSCCs) have shown how such networks contribute to members' health outcomes from behavior influence and social support perspectives. However, these studies rarely considered the incentive function of OSCCs. One of the ways OSCCs motivate smoking cessation behaviors is through digital incentives. OBJECTIVE: This study aims to explore the incentive function of a novel digital incentive in a Chinese OSCC-the awarding of academic degrees-to promote smoking cessation. It specifically focuses on "Smoking Cessation Bar," an OSCC in the popular web-based Chinese forum Baidu Tieba. METHODS: We collected discussions about the virtual academic degrees (N= 1193) from 540 members of the "Smoking Cessation Bar." The time frame of the data set was from November 15, 2012, to November 3, 2021. Drawing upon motivational affordances theory, 2 coders qualitatively coded the data. RESULTS: We identified five key topics of discussion, including members' (1) intention to get virtual academic degrees (n=38, 2.47%), (2) action to apply for the degrees (n=312, 20.27%), (3) feedback on the accomplishment of goals (n=203, 13.19%), (4) interpersonal interaction (n=794, 51.59%), and (5) expression of personal feelings (n=192, 12.48%). Most notably, the results identified underlying social and psychological motivations behind using the forum to discuss obtaining academic degrees for smoking cessation. Specifically, members were found to engage in sharing behavior (n=423, 27.49%) over other forms of interaction such as providing recommendations or encouragement. Moreover, expressions of personal feelings about achieving degrees were generally positive. It was possible that members hid their negative feelings (such as doubt, carelessness, and dislike) in the discussion. CONCLUSIONS: The virtual academic degrees in the OSCC created opportunities for self-presentation for participants. They also improved their self-efficacy to persist in smoking cessation by providing progressive challenges. They served as social bonds connecting different community members, triggering interpersonal interactions, and inducing positive feelings. They also helped realize members' desire to influence or to be influenced by others. Similar nonfinancial rewards could be adopted in various smoking cessation projects to enhance participation and sustainability.

Virtual and In-Person Day Camps for the Craniofacial Community.

ABSTRACT: Children with congenital craniofacial conditions (CFCs) and their families may stand to benefit from day camps offering tailored psychosocial support and resources. Nonprofit ConnectMed International has held virtual and in-person day camps in San Diego for this community since 2018. We administered surveys before and after a series of day camps to understand the needs of this community and benefits perceived programming offered. Although studies have reported the psychosocial benefits of camps for children with rare diseases, few have examined the specific benefit for children with CFCs and their parents. Herein, we present the findings of our survey study as the first article to report a needs assessments and psychosocial benefits of day camps for children with CFCs and their parents.

Influence factors associated with health risk behaviors of middle school students in the poverty area of China: An observational study.

We aim to investigate the status and influence factors of health risk behaviors among middle school students and explore the relationship between social support, family care, and the health risk behaviors. The study was conducted in 3 middle schools in the Fan county located in the Puyang city. Independent measures were applied to assess adolescent health risk behaviors, perceive social support, and family care. Multiple regression analysis was used to analyze the main factors that affect adolescent health risk behaviors. The total scores of health risk behaviors were 53.87 ± 9.97, and all kinds of health risk behaviors were very common. The highest score was health-compromising (2.45 ± 0.43), and the lowest score was unprotected sex behaviors (1.07 ± 0.28). Multiple regression analysis showed that sex (P < .001), grade (P < .001), parent relationships (P < .001), father's occupation (P = .035), mother's education level (P = .011), social support (P < .001), affection (P < .001), and growth (P = .003) were the main factors of health risk behaviors, accounting for 25.3%. The health risk behaviors among middle school students in Fan county should attract the attention of education administration, schools, and parent due to the varied influencing factors. Related interventions should be conducted to reduce the severity and frequency of adolescent health risk behaviors and protect the health and growth of adolescents. In order to better analyze the health risk behaviors of middle school students, we will incorporate more influencing factors and carry out further causal analysis in the future.

Socially-Aware Adaptive Delay Tolerant Network (DTN) routing protocol.

Network partitioning and node disconnectivity results in high latency and frequent link disruption in DTNs. Therefore, routing a message toward a destined node is a challenge in such environment. Several DTN routing schemes have been introduced in this regard. Some, recently proposed DTN routing protocols either use a single or combination of multiple social metrics to identify the suitable forwarder node(s). However, these DTN routing protocols produced results at the expense of community formation cost and over utilization of network resources. To address these issues, we propose Socially-Aware Adaptive DTN (SAAD) routing scheme which exploits a social attribute known as Degree Centrality (DC). In this scheme, each node calculates and shares its DC with other nodes at regular intervals. A forwarder node disseminates message to the most influential node possessing highest DC. The proposed routing scheme works great in situations where someone want to improve the energy efficiency and want to involve only relevant nodes. The simulation results show that SAAD has improved to select the best node and has reduced the hop-count, overhead on the expense of delay as compared to Epidemic, PRoPHET and PRoPHETv2.

(Un)disclosed. Disease disclosure in people living with rheumatic diseases: An exploratory study.

OBJECTIVE: Little is known about disease-related disclosure (DD) in patients with rheumatic musculoskeletal diseases (RMDs). We aim to investigate DD behaviors and to explore which socio-demographic, clinical and psychological factors play a role in this self-disclosure process among patients with RMDs. METHODS: A cross-sectional Italian nationwide study captured DD in RMDs in different contexts (workplace, family, friends, partner, social networks). An ad hoc survey was developed and disseminated by the Patients' Association ALOMAR ODV (Lombard Association for Rheumatic Diseases) between June and July 2020. Patient demographics, clinical data, and questionnaires assessing anxiety, depression, anticipated stigma, patient health engagement, perceived social support, and perceived general health status were collected. RESULTS: There were 376 rheumatic patients who completed the survey. There were 73.9% of the participants who talk to others about their RMD "sometimes"; 18.7% disclose their RMD "always/very often", while 7.4% "never" talk about their RMD. A significant association was detected between DD and both perceived visibility (P = .04) and psychological support (P = .01). Moreover, participants who never/sometimes disclose their RMD reported significantly lower scores in the "Total" Social Support (P < .01) and in the "Friends" subscale (P < .001) compared to others. Psychological support and the "Friends" subscale were the only significant predictors of DD (both P = .002). CONCLUSIONS: The majority of RMD patients disclosed their disease "sometimes". The DD behavior is not associated with any specific demographic or clinical variables. Further research on the subject might help to foster better DD decision-making processes for rheumatic patients in different contexts of daily life.

Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice.

Structured lifestyle interventions through cardiac rehabilitation (CR) are critical to improving the outcome of patients with cardiovascular disease (CVD) and cardiometabolic risk factors. CR programs' variability in real-world practice may impact CR effects. This study evaluates intensive CR (ICR) and standard CR (SCR) programs for improving cardiometabolic, psychosocial, and clinical outcomes in high-risk CVD patients undergoing guideline-based therapies. Both programs provided lifestyle counseling and the same supervised exercise component. ICR additionally included a specialized plant-based diet, stress management, and social support. Changes in body weight (BW), low-density lipoprotein cholesterol (LDL-C), and exercise capacity (EC) were primary outcomes. A total of 314 patients (101 ICR and 213 SCR, aged 66 ± 13 years, 75% overweight/obese, 90% coronary artery disease, 29% heart failure, 54% non-optimal LDL-C, 43% depressive symptoms) were included. Adherence to ICR was 96% vs. 68% for SCR. Only ICR resulted in a decrease in BW (3.4%), LDL-C (11.3%), other atherogenic lipids, glycated hemoglobin, and systolic blood pressure. Both ICR and SCR increased EC (52.2% and 48.7%, respectively) and improved adiposity indices, diastolic blood pressure, cholesterol intake, depression, and quality of life, but more for ICR. Within 12.6 ± 4.8 months post-CR, major adverse cardiac events were less likely in the ICR than SCR group (11% vs. 17%), especially heart failure hospitalizations (2% vs. 8%). A comprehensive ICR enhanced by a plant-based diet and psychosocial management is feasible and effective for improving the outcomes in high-risk CVD patients in real-world practice.

Household visitation during the COVID-19 pandemic.

The COVID-19 pandemic has posed novel risks related to the indoor mixing of individuals from different households and challenged policymakers to adequately regulate this behaviour. While in many cases household visits are necessary for the purpose of social care, they have been linked to broadening community transmission of the virus. In this study we propose a novel, privacy-preserving framework for the measurement of household visitation at national and regional scales, making use of passively collected mobility data. We implement this approach in England from January 2020 to May 2021. The measures expose significant spatial and temporal variation in household visitation patterns, impacted by both national and regional lockdown policies, and the rollout of the vaccination programme. The findings point to complex social processes unfolding differently over space and time, likely informed by variations in policy adherence, vaccine relaxation, and regional interventions.

Insaka: mobile phone support groups for adolescent pregnant women living with HIV.

BACKGROUND: Mobile phone-based interventions have been demonstrated in different settings to overcome barriers to accessing critical psychosocial support. In this study, we aimed to assess the acceptability and feasibility of a phone-based, peer-to-peer support group intervention for adolescent pregnant women aged 15-24 years living with HIV in Zambia. METHODS: Sixty-one consenting participants were recruited from Antenatal Clinics of two large urban communities in Lusaka. They were invited to participate in the mobile phone-based intervention that allowed them to anonymously communicate in a small group led by a facilitator for 4 months. A mixed methods approach was used to assess acceptability and feasibility, including a focus group discussion, pre- and post-intervention interview and analysis of the content of the text message data generated. RESULTS: Participants reported finding the platform "not hard to use" and enjoyed the anonymity of the groups. Seventy-one percent of participants (n = 43) participated in the groups, meaning they sent text messages to their groups. Approximately 12,000 text messages were sent by participants (an average of 169 messages/user and 6 mentors in 6 groups. Topics discussed were related to social support and relationships, stigma, HIV knowledge and medication adherence. CONCLUSION: The study showed that the intervention was acceptable and feasible, and highlighted the potential of the model for overcoming existing barriers to provision of psychosocial support to this population.

Implementing supportive exercise interventions in the colorectal cancer care pathway: a process evaluation of the PREPARE-ABC randomised controlled trial.

BACKGROUND: A colorectal resection is standard treatment for patients with colorectal cancer (CRC). However, the procedure results in significant post-operative mortality and reduced quality of life. Maximising pre-operative cardiopulmonary fitness could improve post-surgical outcomes. PREPARE-ABC is a multi-centre, three-armed, randomised controlled trial investigating the effects of exercise interventions, with motivational support on short and longer-term recovery outcomes in CRC patients undergoing major lower-gastrointestinal surgery. The trial included an internal pilot phase with parallel process evaluation. The aim of the process evaluation was to optimise intervention implementation for the main trial. METHODS: Mixed methods process evaluation conducted in 14 UK hospitals between November 2016 and March 2018. Data included a site profile questionnaire and telephone scoping interview with hospital staff, 34 qualitative observations of standard care and 14 observations of intervention delivery, 13 semi-structured interviews with healthcare professionals (HCPs) and 28 semi-structured interviews with patients. Data analysis focused on describing intervention delivery within each arm, assessing fidelity, acceptability and how variation in delivery was linked to contextual characteristics. RESULTS: Standard care exercise advice was typically limited to maintaining current activity levels, and with lead-in time to surgery affecting whether any exercise advice was provided. Variation in HCP capacity affected the ability of colorectal units to deploy staff to deliver the intervention. Patients' exercise history and motivation prior to surgery influenced HCP perceptions and delivery of the motivational components. Observations indicated a high level of fidelity to delivery of the exercise interventions. All but one of the 28 interviewed patients reported increasing exercise levels as a result of receiving the intervention, with most finding them motivational and greatly valuing the enhanced level of social support (versus standard care) provided by staff. CONCLUSION: Hospital-supervised and home-based exercise interventions were highly acceptable for most patients undergoing surgery for CRC. Delivery of pre- and post-operative exercise within the CRC care pathway is feasible but systematic planning of capacity and resources is required to optimise implementation.

A peer intervention reduces loneliness and improves social well-being in low-income older adults: A mixed-methods study.

BACKGROUND: Evidence-based interventions addressing loneliness and social isolation are needed, including among low-income, community-dwelling older adults of diverse racial and ethnic backgrounds. Our objective was to assess the effect of a peer intervention in addressing loneliness, isolation, and behavioral health needs in this population. METHODS: We conducted a mixed-method, two-year longitudinal study of a peer-outreach intervention in 74 low-income older adults recruited via an urban senior center in San Francisco. Structured participant surveys were conducted at baseline and every 6 months for up to 2 years. Outcomes included loneliness (3-item UCLA loneliness scale), social interaction (10-item Duke index), self-perceived socializing barriers (range: 0-10), and depression (PHQ-2 screen). Data were analyzed using mixed-effects linear and logistic regression adjusted for age and gender. Qualitative, semi-structured interviews with participants (N = 15) and peers (N = 6) were conducted in English and Spanish and analyzed thematically. RESULTS: Participants were on average 71 years old (range: 59-96 years), with 58% male, 15% LGBT, 18% African American, 19% Latinx, 8% Asian, 86% living alone, and 36% with an ADL impairment. On average, 43 contact visits (IQR: 31-97 visits) between participants and peers occurred over the first year. Loneliness scores decreased by, on average, 0.8 points over 24 months (p = 0.015). Participants reported reduced depression (38%-16%, p < 0.001) and fewer barriers to socializing (1.5 fewer, p < 0.001). Because of the longitudinal relationship and matching of characteristics of peers to participants, participants reported strong feelings of kinship, motivations to reach out in other areas of life, and improved mood. CONCLUSION: Diverse older adults in an urban setting participating in a longitudinal peer program experienced reduced loneliness, depression, and barriers to socializing. Matching by shared backgrounds facilitated rapport and bonding between participants and peers.

Moving beyond 'don't ask, don't tell': Mental health needs of adults with type 1 diabetes in rural and remote regions of British Columbia.

AIMS: To investigate the mental health needs of adults with type 1 diabetes living in rural and remote regions of Interior, British Columbia (BC) and identify factors associated with accessing support. We also explored perspectives around using peer support and digital health strategies for delivering mental health support. METHODS: This study recruited 38 adults with type 1 diabetes to complete a self-report survey and participate in focus groups. We conducted six 90-min focus groups that addressed the following: current and past mental health needs, social media use for type 1 diabetes support, peer supporter recruitment and training, and support delivery features for virtual care platforms. Focus groups were recorded, transcribed, quality checked, coded and analysed to develop themes and subthemes. RESULTS: Four core themes emerged: (1) emotional challenges linked to type 1 diabetes management, (2) unique type 1 diabetes-related concerns in rural and remote communities, (3) previous support experiences and future support needs and (4) diabetes-related mental health support interventions involving peer support and digital health strategies. Existing support services are inadequate in meeting the needs of type 1 diabetes adults in Interior BC. Some have turned towards social media as a way to connect with the type 1 diabetes community for support. CONCLUSIONS: Though type 1 diabetes adults living in rural and remote settings experience distress associated with the ongoing burdens, frustrations and fears of managing a complex chronic condition, many have not been offered support and do not know how to seek services in the present/future. Peer support and digital health strategies are two potential solutions to address this care gap.

Exploring the role of social support and social media for lifestyle interventions to prevent weight gain with young adults: Focus group findings.

BACKGROUND: Young adults gain more weight annually than other adults and may be destined for future obesity. Effective interventions are needed, and social support may be a key element for success. The present study explores how best to leverage social media to support young adults with their health goals in a healthy lifestyle programme. METHOD: Young adults aged 18-25 years were recruited from the community to a series of four focus groups led by an experienced facilitator who used a discussion guide developed a priori. The discussion explored their opinions regarding which social media platforms were appropriate for providing social support, the types of support that were relevant (family and friends versus strangers) and factors that would encourage peer-to-peer communication in a healthy lifestyle intervention. Sessions were audio-taped, transcribed and analysed using the qualitative software, nvivo, version 11 (QSR International Pty Ltd., Melbourne, VIC, Australia). Themes were generated using an inductive approach informed by the Theory of Social Identity and Social Influence Model of Consumer Participation. RESULTS: Thirty-three people (12 male) participated. Facebook was the most popular platform for facilitating social support as a result of its private group capabilities and already being embedded into their daily routines. The preference was to be grouped with strangers who shared similar goals in smaller groups of participants. The discussions highlighted the integral role of a credible and relatable health coach to serve as a mentor, mediator and role model. CONCLUSIONS: The learnings from this research will be applied to optimise engagement within social media support groups in lifestyle interventions.