Background HIV/AIDS remains a major global health issue, and young students are a key affected group. Conventional interventions have overlooked students’ psychological and behavioural differences, reducing their impact. This study will identify specific psychosocial factors that drive college students to get HIV testing.Methods We surveyed 4451 college students in various regions in China from December 2022 to March 2023. Analysis occurred in two steps. First, we used partial least squares structural equation modelling (PLS-SEM) to test linear causal relationships among psychosocial constructs. Second, we used fuzzy set qualitative comparative analysis (fsQCA) to pinpoint combinations leading to high willingness for HIV testing.Results In PLS-SEM, lower HIV stigma (β=0.352, 95% CI 0.311 to 0.391) and higher condom-use self-efficacy (β=0.087, 95% CI 0.056 to 0.120) were associated with stronger safe-sex intention, which was associated with higher testing willingness (β=0.067, 95% CI 0.053 to 0.081). FsQCA identified five distinct pathways leading to high HIV testing willingness (coverage=0.788, consistency=0.790). The main types were (1) students with strong condom use intention; (2) students with low HIV stigma and supportive environments; (3) students with high risk perception and preventive actions; (4) students with high self-efficacy and HIV knowledge and (5) students confident in risk management and willing to test despite risk. These findings show there are multiple clear ways students reach a high willingness for HIV testing.Conclusion Using a dual analytic approach, we found that lower HIV stigma and higher condom-use self-efficacy were associated with greater safe-sex intention, which in turn was associated with higher HIV testing willingness. fsQCA further suggested multiple psychosocial configurations linked to high willingness. These findings may inform a combined universal-plus-tailored approach to campus HIV testing promotion, while longitudinal and intervention studies are needed to test causality.

Insufficient physical activity (PA) among children has become a major global public health concern. The family environment plays a crucial role in shaping children’s weekend PA, yet evidence-based interventions in this context remain scarce This study will conduct a three-arm cluster randomised controlled trial, ‘WeekendGo!’ guided by an integrated theoretical framework that encompasses the Social Cognitive Theory, Health Action Process Approach and Family Functioning Theory, aimed at promoting children’s weekend PA. Approximately 555 children and their parents will be recruited and randomised into three groups: a staged intervention group (intervention I), a general intervention group (intervention II) and a control group, for 12 months. The primary outcome will be the children’s weekend moderate-to-vigorous PA. Secondary outcomes will include children’s cognitive factors such as self-efficacy, perceived barriers and resources, motivation and behavioural intention. Generalised linear mixed-effects models will be used for analysis, adhering to the intention-to-treat principle, with missing data handled through multiple imputation. Trial registration number: ChiCTR2500095942.

Background Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease that profoundly impacts patients’ daily lives. While pharmacological therapies continue to advance, less is known about how patients experience the burden of disease across different periods after IPF diagnosis, resulting in a lack of evidence for the development and optimisation of patient-centred intervention strategies. Therefore, this study aimed to explore how individuals with IPF experience the disease and its impact on daily life in China.Methods This multicentre qualitative study was conducted using semistructured interviews with participants from six geographic regions in China between November 2024 and March 2025. Participants were grouped by time since diagnosis to reflect different periods following diagnosis. Data were collected and analysed inductively and iteratively by using practical thematic analysis until thematic saturation was achieved.Results 53 participants were interviewed to explore the patient experience at different periods following IPF diagnosis. Thematic analysis identified that participants commonly reported the influence of IPF on quality of life, including (1) symptom experience, (2) sleep, (3) eating habits, (4) physical activity, (5) social participation, (6) psychological well-being and (7) financial status. Cough and breathlessness were consistently reported as the most troubling symptoms, often accompanied by psychological challenges related to diagnosis and disease progression.Conclusions The findings highlight the experience and need for patient-centred care across China that addresses not only clinical symptoms but also emotional and social dimensions of living with IPF. Enhancing public awareness may also help reduce stigma and social isolation.

Objective:Based on protection motivation theory(PMT),this study aimed to examine the current status of e-cigarette cessation intention and cessation behavior,as well as their associated factors,among adult e-cigarette users in China.Methods:This was a cross-sectional study.The data were de-rived from a nationwide"E-cigarette Use Survey"conducted in 2023,covering 31 provinces(municipali-ty,autonomous region)in China.A total of 550 current e-cigarette users aged 18-44 years were selec-ted as the study population.After adjusting for sociodemographic variables,multiple linear regression models were used to identify factors associated with e-cigarette cessation intention,while binary Logistic regression models were applied to examine factors associated with e-cigarette cessation behavior.In addi-tion,subgroup analyses were conducted according to smoking status to explore potential differences among exclusive e-cigarette users and dual users of e-cigarettes and combustible cigarettes.Results:The mean score of e-cigarette cessation intention was 3.52±0.96,and 31.64％of participants reported having at-tempted to quit e-cigarettes.After adjustment for covariates,cessation intention was associated with both the threat appraisal and coping appraisal pathways within the PMT framework.Specifically,in the threat appraisal pathway,severity(β=0.14)and vulnerability(β=0.12)were positively associated with ces-sation intention,whereas perceived extrinsic rewards(β=-0.12)were negatively associated.In the coping appraisal pathway,both response efficacy(β=0.26)and self-efficacy(β=0.28)were positive-ly associated with cessation intention.Regarding cessation behavior,only severity(OR=1.58)in the threat appraisal pathway was positively associated,and cessation intention was also positively associated with cessation behavior.Subgroup analyses further showed that,regardless of smoking status,cessation intention was positively associated with both the threat appraisal pathway(β=0.20,β=0.31)and the coping appraisal pathway(β=0.23,β=0.21).Conclusion:PMT provides a valuable theoretical framework for understanding e-cigarette cessation among adults.Factors related to the threat appraisal pathway are associated not only with cessation intention but also with actual cessation behavior.More-over,the associations of PMT-related factors vary across different smoking status subgroups.These findings suggest that future e-cigarette control policies and interventions could focus on enhancing risk perception and cognitive awareness,and develop more targeted cessation strategies for specific subgroups.

China launched a major health-care reform in 2009 aimed to provide all citizens with equal access to basic health care with reasonable quality and financial risk protection. Since then, China has made substantial progress toward Universal Health Coverage (UHC). However, the access of UHC among internal migrants might be disadvantaged compared with local residents. This study aimed to provide an assessment of inequalities and trends in internal migrants' access to Universal Health Coverage. Six rounds (2013-2018) of the China Migrants Dynamic Survey were used including 976,430 respondents. Financial protection was measured using the basic medical insurance enrollment proportion (BMIEP) and hospital reimbursement rate (HRB). Essential health services were measured using the standardized health record establishment proportion (SHREP) and standardized health education intervention coverage (SHEIC). The Erreyers Index (EI) and Wagstaff Index (WI) were used to measure socio-economic related UHC inequalities. The process of the Recentered Influence Function (RIF)-Ordinary Least Squares (OLS) method was used to decompose risk factors of the EI and WI. The average coverage rate of SHREP and SHEIC were 24.3% and 75.7%, respectively. The average coverage rate of BMIEP and the percentage of HRB were 87.4% and 58.3% respectively. Regarding inequalities, it was found that for SHREP and SHEIC, the general trends of inequalities raised while for BMIEP, the general trends decreased. Regarding HRB, it was less inequalities in 2018 compared with 2014. RIF-OLS regression showed that both individual factors and regional factors contributed to the inequalities in UHC among China's internal migrants. Progress has been made in financial protection of migrants as the high coverage of BMIEP and its decrease in inequalities as well as lower inequalities in 2014 of HRB compared with 2018. While challenges remained in the lower coverage rate of SHEIC and increasing inequalities of SHREP and SHEIC. Policy efforts on narrowing down both individual and regional inequalities should be put forward.

This cross-sectional study investigated long-acting injectable pre-exposure prophylaxis (LAI-PrEP) perceptions and attitudes among 1,545 Chinese men who have sex with men (MSM) in December 2023. Of participants, 66.5% met PrEP eligibility criteria, 53.7% expressed willingness to use LAI-PrEP within 6 months, and 77.9% were PrEP naïve. Current oral PrEP users showed higher LAI-PrEP willingness (adjusted odds ratio [AOR] = 2.23, 95% CI [1.44, 3.44]) than the PrEP naïve group. Condomless anal intercourse (AOR = 1.32, 95% CI [1.08, 1.61]) and recent sexually transmitted infection diagnosis (AOR = 1.84, 95% CI [1.15, 2.95]) were positively associated with willingness. Structural equation modeling revealed distinct predictors: for PrEP naïve group, LAI-PrEP willingness was influenced by outcome expectancies, HIV risk perception, self-efficacy, and subjective norms (p <.05), while the PrEP-experienced group relied more on outcome expectancies. Tailored interventions addressing group-specific cognitive factors are critical to optimize LAI-PrEP adoption.

With the rapid digitalization of healthcare and an aging population, understanding the factors influencing older adults' sustained adoption of Internet medical services is critical. However, existing research often oversimplifies these factors by relying on linear models. This study integrates Partial Least Squares Structural Equation Modeling (PLS-SEM) and fuzzy-set Qualitative Comparative Analysis (fsQCA) to explore the complex pathways driving continued use. A survey of 1,920 older adults (60–75 years) in China assessed satisfaction, e-health literacy, self-efficacy, social support, social influence, social participation, and willingness to use Internet medical services. PLS-SEM examined the relationships between variables, while fsQCA identified multiple configurations leading to sustained use. PLS-SEM identified satisfaction as the strongest predictor of sustained use (β = 0.281, p < 0.001), acting as both a direct determinant and a mediator for e-health literacy and social participation. Social influence (β = 0.189, p < 0.001) and social support (β = 0.172, p < 0.001) also contributed significantly. FsQCA revealed six distinct configurations, with satisfaction and e-health literacy as core conditions across most pathways. By integrating linear and configurational approaches, this study provides a nuanced understanding of older adults' digital healthcare behaviors. Enhancing satisfaction, digital literacy, and social engagement is key to fostering sustained adoption. Tailored interventions based on distinct configurations can maximize the effectiveness of digital health programs. This research bridges gaps in understanding complex behaviors and provides actionable insights for policymakers and healthcare providers, highlighting the critical role of digital literacy and social support.

PURPOSE:We estimated the association between maternal sexually transmitted diseases (STDs) and the risk of specific birth defects among live singleton births in the United States (US). METHODS:We conducted a population-based study using data from birth certificates for 14,602,822 live singleton births occurring from 2016 to 2019 in the US. We used logistic regression to estimate the associations between three maternal STDs (chlamydia, gonorrhea, and syphilis) and the risk of four specific birth defects (gastroschisis, cleft lip with or without cleft palate, spina bifida, and hypospadias), adjusting for socio-demographic and pregnancy-related factors. RESULTS:Maternal chlamydia infection was associated with a higher risk of gastroschisis (adjusted odds ratio [aOR], 1.23; (95 % CI: 1.03, 1.46), cleft lip with or without cleft palate (aOR, 1.26; 95 % CI: 1.08, 1.47), and hypospadias (aOR, 1.26; 95 % CI: 1.08, 1.47). It was not associated with an increased risk of spina bifida. These associations were consistent across subgroups defined by maternal age, race and ethnicity, education, body mass index, and infant sex. We found no evidence of an association between gonorrhea or syphilis infections and the studied birth defects. CONCLUSIONS:Among live singleton births in the US, maternal chlamydia infection may be associated with increased risks of gastroschisis, cleft lip with or without cleft palate, and hypospadias.

Background: Nicotine dependence, also known as tobacco dependence, is a common chronic disease and a major risk factor for chronic respiratory diseases. The present study was designed to determine the prevalence of nicotine dependence and its changes among smokers aged 40 years and older in China, to analyze the characteristics of nicotine dependence among smokers, and to provide a reference for smoking cessation interventions. Methods: The data were sourced from nationally representative large-sample surveys conducted during 2014-2015 and 2019-2020 in the Chinese population, covering 125 counties (districts) in 31 provinces, autonomous regions and municipalities. Variables related to smoking and nicotine dependence among residents >= 40 years old were collected in face-to-face interviews. A total of 20,062 and 18,975 daily smokers were included in the 2014-2015 and 2019-2020 surveys, respectively. The severity of nicotine dependence was evaluated according to the Fagerstr & ouml;m Test for Nicotine Dependence and Heaviness of Smoking Index. The level and change in nicotine dependence among daily smokers aged >= 40 years were estimated using a complex weighted sampling design, and their influencing factors were analyzed. Results: Levels of nicotine dependence among daily smokers aged >= 40 years in China could be divided into very low, low, medium, high, and very high, accounting for 31.1%, 27.9%, 13.4%, 20.5%, and 7.1% of the total, respectively. The average Fagerstr & ouml;m Test for Nicotine Dependence score was 3.9 (95% confidence interval [CI]: 3.8-4.0), with the prevalence of medium-high nicotine dependence being 41.0% (95% CI: 39.0-42.9%) and that of high and very high nicotine dependence being 27.6% (95% CI: 26.0-29.3%), both of which were significantly higher in men than in women (both P < 0.001). Among daily smokers, those with a low education level, age at smoking initiation < 18 years, and with smoking duration of >= 20 years had a higher degree of nicotine dependence. In terms of geographic region, the level of medium-high nicotine dependence in South China was higher than in other areas, and the decline in the prevalence of high nicotine dependence was the greatest in Northwest China ( P < 0.001). The prevalence of medium-high and high and very high nicotine dependence was significantly higher in men with chronic respiratory symptoms, chronic obstructive pulmonary disease (COPD), and/or chronic respiratory diseases than in men without these conditions (all P < 0.05). The prevalence of high and very high nicotine dependence in women with chronic respiratory symptoms and chronic respiratory diseases was significantly higher than that in women without these conditions (both P < 0.05). Compared with that during 2014-2015, the prevalence of high nicotine dependence among daily smokers decreased during 2019-2020 by 4.5 percentage points in the total population ( P < 0.001) and by 4.8 percentage points in men ( P < 0.001), with no significant change seen in women ( P > 0.05). Additionally, the prevalence of high nicotine dependence in men with chronic respiratory symptoms and COPD decreased by 6.7 and 4.7 percentage points, respectively ( P < 0.05), but showed no significant change in women with these conditions ( P > 0.05). Multivariate logistic regression analysis showed that the risk of medium-high nicotine dependence was higher among daily smokers who were male; 50-59 years old; unmarried/divorced/widowed/separated; engaged in agriculture, forestry, husbandry, fishery and water conservancy; had a low education level; started smoking before the age of 18 years; and smoked for more than 20 years. Conclusions: The past few years have seen a slight decline in the prevalence of high (severe) nicotine depen-dence among smokers aged >= 40 years in China. However, 41.0% of daily smokers had medium-high nicotine dependence, and 27.6% had high or very high nicotine dependence, with notable differences in population and geographic distributions. Development of tailored interventions, optimization of smoking cessation service sys-tems, and integration of smoking cessation into the management of chronic diseases will effectively reduce the burden of nicotine dependence in China.

BACKGROUND:Community volunteering plays a crucial role in strengthening public health emergency response, particularly during respiratory infectious disease outbreaks. However, limited research has examined the extent of resident participation and the factors influencing engagement in such efforts. This study investigated the prevalence and determinants of community volunteering during the COVID-19 pandemic and other respiratory infectious disease outbreaks in China. METHOD:We conducted a cross-sectional online survey and included data from 1,023 residents residing in five provinces in China (Beijing, Guangdong, Heilongjiang, Hubei, and Yunnan) between early 2020 and March 2023. Participants reported their sociodemographic factors, volunteer activities, related motivations and barriers during the pandemic. We used logistic regression models to identify factors associated with volunteering. RESULTS:Of the respondents, 65.9% participated in community volunteering during the pandemic, with the most common roles related to nucleic acid testing. The primary motivation for volunteering was value expression. Main barriers to participation included a lack of time, limited professional skills, and concerns about the risk of infection. Higher odds of participation were observed among respondents who held at least a bachelor's degree (AOR = 2.58, 95% CI: 1.21-5.48), worked in community (AOR = 4.32, 95% CI: 2.56-7.28) or health‑care roles (AOR = 2.48, 95% CI: 1.31-4.67), were Communist Party members (AOR = 1.68, 95% CI: 1.07-2.64), or had volunteered regularly before 2020 (AOR = 3.02, 95% CI: 2.51-3.64), while single/divorced/widowed individuals had lower odds of participation (AOR = 0.60, 95% CI: 0.39-0.94) (all p < 0.05). CONCLUSION:Community volunteering could constitute a substantial auxiliary workforce during respiratory epidemics in China. Integrating volunteers into emergency preparedness may require institutionalized training programs, transparent management structures, as well as legal and policy safeguards that recognize volunteers' contributions and mitigate perceived risks. Such measures are likely to strengthen community resilience in future public‑health emergencies.

Introduction To describe the prevalence of smoking among Chinese women in the workforce and to investigate its potential associated factors from a multilevel perspective.Aims and Methods The study was based on data collected from the "Asia Best Workplace" program in 2021. We obtained a sample of 6260 women in the workforce and collected the data using a self-administered questionnaire, including occupational characteristics, utilization of workplace health services, and mental health status. We employed univariate and multivariate logistic regression analyses to examine the associations between interested variables and the smoking status of women in the workforce.Results The prevalence of smoking among Chinese women in the workforce was 3.4%. After controlling for potential confounders, factors that were associated with smoking included field sales personnel (adjusted odds ratio, AOR = 3.45, 95% confidence interval, CI: 2.29-5.18, reference: white collar), mixed shift workers (AOR = 2.42, 95% CI: 1.66-3.53), working overtime every day (AOR = 2.27, 95% CI: 1.38-3.74, reference: no overtime work), having depressive (AOR = 1.10, 95% CI: 1.07-1.13) or anxiety symptoms (AOR = 1.25, 95% CI: 1.13-1.39), and daily exposure to secondhand smoke (AOR = 12.54, 95% CI: 8.70-18.05). Women with access to infirmaries (AOR = 0.38, 95% CI: 0.18-0.81) and fitness facilities (AOR = 0.60, 95% CI: 0.38-0.96) were less likely to smoke.Conclusions The prevalence of smoking among Chinese women in the workforce was low. Smoking cessation programs for women in the workforce may benefit from taking into account the nature of their work, whether there were night shifts and overtime working.Implications Smoking takes a huge toll on women, and women in the workforce face additional health challenges. Little is known about the specific factors associated with smoking among women in the workforce. Women who were field sales personnel, managers, working night or irregular shifts, and frequent overtime workers should be considered vulnerable subpopulations for smoking. Providing accessible workplace health services and resources is associated with a lower likelihood of smoking. Smoking cessation programs may consider the specific occupational and workplace factors that influence smoking behavior in this population, as well as address mental health needs.

Tooth loss, often considered as an inevitable result of ageing, is one of the most frequently stated problems with older adults worldwide, which entails a negative impact on physical and mental health, as well as quality of life. However, there is urban-rural gap among older adults in both oral health condition and dental service utilization. The study focused on the urban-rural gap in Chinese older population, aiming to describe their tooth loss and denture use status, and explore the associated factors, hoping to provide insights into improving the oral healthcare system in China and other developing countries. This cross-sectional study used data collected from May to September in 2020. A stratified, multi-stage cluster sampling design was used to produce nationally representative samples of 2709 adults aged 60 years and older. The dependent variable was denture use of the participant. Determinants included demographic characteristics, health status, social support, oral health knowledge and health service utilization. Descriptive analysis was conducted to describe the sample characteristics, and Generalized Linear Mixed Model was used to identify independent factors associated with denture use among older adults in rural and urban China respectively. There were significant urban-rural differences in tooth loss, denture use and health service utilization among Chinese older adults. Urban participants’ denture use was associated with oral health knowledge (OR = 1.29, 95

We analyzed the clinical characteristics of outpatients with influenza-B-associated pneumonia during the 2021–2022 influenza season and analyzed the molecular epidemiology and evolution of influenza B virus. The presence of influenza B virus was confirmed by reverse transcription polymerase chain reaction (RT-PCR). Electronic medical records were used to collect and analyze data of outpatients. The HA and NA genes were phylogenetically analyzed using ClustalW 2.10 and MEGA 11.0. Out of 1569 outpatients who tested positive for influenza B virus, 11.7% (184/1569) developed pneumonia, and of these, 19.0% (35/184) had underlying diseases. Fever, cough, and sore throat were the most common symptoms. Among the complications, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and shock accounted for 2.7% (5/184), 4.9% (9/184), and 1.6% (3/184), respectively. Of the outpatients, 2.7% (5/184) were admitted to the hospital, and 0.5% (1/184) of them died. All of the strains from Beijing were identified as belonging to the B/Victoria lineage. The HA and NA gene sequences of 41 influenza B viruses showed high similarity to each other, and all of them belonged to clade 1A.3. Compared with the vaccine strain B/Washington/02/2019, all of the isolates contained N150K, G181E, and S194D mutations. S194D, E195K, and K200R mutations were detected in the 190 helix of the receptor binding region of HA. Co-mutations of H122Q, A127T, P144L, N150K, G181E, S194D, and K200R in HA and D53N, N59S, and G233E in NA were detected in 78.0% (32/41) of the isolates, and 56.3% (18/32) of these were from outpatients with influenza-B-associated pneumonia. Influenza outpatients with underlying diseases were more likely to develop pneumonia. No significant differences were observed in clinical symptoms or laboratory results between outpatients with and without pneumonia, so testing for influenza virus seems to be a good choice. The observed amino acid variations suggest that current vaccines might not provide effective protection.

What is already known about this topic?:The proportion of elderly living alone in China is approximately 10%. Living away from family poses enormous challenges for older adults. What is added by this report?:Compared to those living with family, elderly individuals living alone exhibit a lower registration rate with general practitioners and have less social support. What are the implications for public health practice?:While the current health service system for elderly people living alone is working relatively well, there is a need for additional programs to enhance social support and improve their social well-being.

Abstract Background Childhood obesity is increasingly recognized as a major public health challenge worldwide, and excessive sedentary screen time is emerging as a key risk factor. This study aimed to assess the recreational screen sedentary time of Chinese primary school-aged children and investigate the relationship between screen-related family factors and the outcome variable. Methods Our study used data from a cross-sectional survey collected from fifth-grade students and their parents in Beijing, China, from April to May 2018 (n = 2,373). The questions included basic demographic information, family socioeconomic status, students’ and parents’ sedentary and exercising habits, within-family communicational factors, and health belief patterns. The recreational screen sedentary time of the children was compared across demographic groups. The study employed multivariate linear regression models to examine associations between children’s screen time and various family factors, as well as the moderating effect of overall family communication. Results Our findings revealed an average daily recreational screen sedentary time of 2.4 h among participants. Screen time significantly varied across demographic categories, including children’s sex, age, residence, parents’ education, household income, family size, and primary family member. After adjustment, the proportion of child-owned digital devices (p < 0.01), child’s personal room (p < 0.05), family screen-viewing together (p < 0.01), and parental screen time (p < 0.01) were positively related to children’s recreational sedentary screen time. Parental restrictions on screen time (p < 0.001) and attitudes toward reducing sitting time (p < 0.01) were correlated with a decrease in children’s screen time. The overall family communication environment significantly moderated the effects of parental practice of restricting children’s screen time (p < 0.001), positive reinforcement by parents (p < 0.05), and parents’ recreational sedentary screen time (p < 0.001). Conclusions Our findings underscored the significance of family dynamics, parental practices, and communication in shaping children’s screen time behaviors, providing valuable insights for tailored interventions and strategies to reduce childhood obesity.

Background: Influenza poses a substantial health burden, especially among older adults in China. While vaccination is one of the most effective preventions, influenza vaccine uptake rates among Chinese older adults remain low. This study examines the individual and combined effects of behavioral interventions based on the Information-Motivation-Behavioral Skills (IMB) model and economic incentives in promoting influenza vaccine uptake among older adults living in China. Methods: The study will recruit 640 older adults living in eight communities that have not been covered by the free influenza vaccination policy. These eight communities (as clusters), stratified by urban and rural, will be randomized to four parallel arms, including a usual care arm, an IMB-based behavioral intervention arm, a conditional economic incentive arm, and a combined behavioral-economic arm. The interventions will start from the beginning of the flu season and last for about one month. Specifically, the IMB-based behavioral intervention encompasses health education brochures, healthcare provider-led lectures, interactive quizzes, and personalized consultations. The exact number of economic incentives is conditional on the timing of vaccination (a higher amount for early immunization) and the number of people within a household to be vaccinated at the same appointment (a higher amount for more people). The primary outcome is the influenza vaccination rate. Data will be gathered through vaccination records and questionnaires covering IMB-based vaccination cognitions. Mixed-effects models will be used to analyze the outcome of vaccination rate, reporting difference-in-differences estimates with 95% confidence intervals. Conclusions: The results of this study have the potential to inform influenza vaccination program scaleup among older adults who are not yet covered by the free influenza vaccination policy. Ethics and dissemination: Ethics approval has been granted by the ethics commission of Peking University Health Science Centre (IRB00001052-24090). Participants will be required to sign a written consent form. Findings will be reported in conferences and peer-reviewed publications in accordance with the recommendations of the Consolidated Standards of Reporting Trials. Registration number: This study was registered at the Chinese Clinical Trial Registry (ChiCTR2400090229).

Background During the COVID-19 pandemic, numerous studies focused on mental health, but few considered both positive and negative aspects within the dual-factor model of psychological well-being. In China, a highly populous country, limited evidence exists regarding mental health and its associated factors following the surge and decline of COVID-19 cases after the loosening of COVID-19 control measures. This study aims to investigate the mental health status of Chinese residents in the aftermath of the pandemic and factors influencing positive and negative indicators using the System-Based Model of Stress. Methods A cross-sectional online survey of 1,026 participants was conducted in China from March 2-31, 2023, using quota sampling. Structural equation modeling (SEM) was performed to test the conceptual model, where social support, perceived susceptibility, perceived severity, pandemic-related events, coping style, and concern about COVID-19 were considered as predictors, and psychological distress and subjective well-being as outcomes. Results The results revealed high prevalence rates of psychological distress (23%) with either of anxiety (15%) or depression (20%), and poor subjective well-being (23%) among Chinese residents after the COVID-19 pandemic. Social support was negatively correlated with psychological distress, and negative coping style, pandemic-related events, and concern about COVID-19 were positively correlated with psychological distress. Moreover, social support was positively correlated with subjective well-being, and negative coping style and pandemic-related events were negatively correlated with subjective well-being. Conclusions These findings enhance our understanding of the differing correlates of positive and negative mental health, suggesting targeted psychological interventions for post-pandemic and future public health events.

The high disease burden of type 2 diabetes seriously affects the quality of life of patients, and with the deep integration of the Internet and healthcare, the application of electronic tools and information technology to has become a trend for disease management. The aim of this study was to evaluate the effectiveness of different forms and durations of E-health interventions in achieving glycemic control in type 2 diabetes patients. PubMed, Embase, Cochrane, and Clinical Trials.gov were searched for randomized controlled trials reporting different forms of E-health intervention for glycemic control in type 2 diabetes patients, including comprehensive measures (CM), smartphone applications (SA), phone calls (PC), short message service (SMS), websites (W), wearable devices (WD), and usual care. The inclusion criteria were as follows: (1) adults (age≥18) with type 2 diabetes mellitus; (2) intervention period ≥1 month; (3) outcome HbA1c (%); and (4) randomized control of E-health based approaches. Cochrane tools were used to assess the risk of bias. R 4.1.2 was used to conduct the Bayesian network meta-analysis. A total of 88 studies with 13,972 type 2 diabetes patients were included. Compared to the usual care group, the SMS-based intervention was superior in reducing HbA1c levels (mean difference (MD)-0.56, 95% confidence interval (CI): -0.82 to -0.31), followed by SA (MD-0.45, 95% CI: -0.61 to -0.30), CM (MD-0.41, 95% CI: -0.57 to -0.25), W (MD-0.39, 95% CI: -0.60 to -0.18) and PC (MD-0.32, 95% CI: -0.50 to -0.14) (p < 0.05). Subgroup analysis revealed that intervention durations of ≤6 months were most effective. All type of E-health based approaches can improve glycemic control in patients with type 2 diabetes. SMS is a high-frequency, low-barrier technology that achieves the best effect in lowering HbA1c, with ≤6 months being the optimal intervention duration. Systematic review registration https://www.crd.york.ac.uk/prospero , identifier CRD42022299896.

BACKGROUND:Health behaviors developed in the college years tend to persist in adulthood. However, distinct changing patterns of food choices and physical activity (PA) and their predictors are still less clear among college students. The current study sought to explore changes of food choices and PA, as well as the effects of personal and interpersonal factors. METHOD:Two-wave longitudinal data was collected from a sample of 431 Chinese college students (Mean baseline age = 19.15 ± 0.61 years; 45.7% male). A validated self-reported food frequency questionnaire was used to assess the frequency of food choices. The Chinese revised version of physical activity rating scale was used to assess physical activity. Latent profile analysis, latent transition analysis, and multinomial logistic regression analysis were used to analyze the data. RESULTS:Two profiles of food choices, i.e., Avoiding staples (5.1% at Time 1) and Varied diet (94.9% at Time 1), were identified at both timepoints. 90.9% remained the same profiles over time, 63.6% participants in the Avoiding staples profile shifted to the Varied diet profile, and only 6.3% of those in the Varied diet profile shifted to the Avoiding staples profile. Negative body shape-related belief was related to the translation from the Varied diet profile to the Avoiding staples profile. Further, four profiles of PA, i.e., Inactives (51.0% at Time 1), Low activies (26.0% at Time 1), Moderate activies (15.3% at Time 1), and Activies (7.7% at Time 1), were identified at both timepoints. 50.8% remained the same profiles over time, 38.6% Inactivies shifted to the other profiles, and 48.5% Activies shifted to the other profiles over time. Participants with higher self-efficacy showed an increase in PA over time, and those with lower self-efficacy and lower peer support showed a decrease in PA over time. CONCLUSIONS:Overall, most of college students remained the same food choices profiles, and body shape-related belief contributed to changes in food choices profiles. About half of college students experienced changes in PA, and the predictors of such changes were peer support and self-efficacy. The findings extend the understanding of the personal and interpersonal predictors of health behaviors among college students from a dynamic perspective.

目的 描述北京市流动老年人基本公共卫生服务利用情况,并分析其影响因素.方法 基于2015-2018年"全国流动人口卫生计生动态监测调查数据",抽取在北京市居住的60岁及以上的流动人口为调查对象.采用二元Logistic回归分析影响流动老年人建立健康档案和接受健康教育的因素.结果 以户口类型为农业户口为参照,非农业户口流动老年人的建档率较高,OR值为1.79(95％CI:1.16～2.74);以流动时长0～4年为参照,流动时长≥10年流动老年人的建档率较高,OR值为1.87(95％CI:1.28～2.74);以流动原因为务工经商为参照,由于其他原因流动的流动老年人的建档率较高,OR值为3.69(95％CI:1.75～7.77).以户口类型为农业户口为参照,非农业户口流动老年人接受健康教育服务情况较好,OR值为1.72(95％CI:1.29～2.29);以流动时长0～4年为参照,流动时长5～9年、≥10年的流动老年人接受健康教育服务情况均较好,OR值分别为 1.33(95％CI:1.01～1.74)和 1.50(95％CI:1.14～1.97);以年龄60～69 岁为参照,年龄≥70 岁的流动老年人接受健康教育服务情况较差,OR值为0.75(95％CI:0.57～0.99);以2015年接受调查情况为参照,2017年、2018年接受调查的流动老年人接受健康教育服务情况均较差,OR值分别为0.27(95％CI:0.19～0.38)和0.35(95％CI:0.25～0.50).结论 北京市流动老年人建立健康档案和接受健康教育的人群分布比较均衡,但对于来自农村以及流动时长偏短的流动老年人群,应进一步关注其公共卫生服务利用情况.