Background Healthy lifestyles are crucial for preventing chronic diseases. Nonetheless, approximately 90% of Chinese community residents regularly engage in at least one unhealthy lifestyle. Mobile smart devices-based health interventions (mHealth) that incorporate theoretical frameworks regarding behavioral change in interaction with the environment may provide an appealing and cost-effective approach for promoting sustainable adaptations of healthier lifestyles. We designed a randomized controlled trial (RCT) to evaluate the effectiveness of a socioecological model-guided, smart device-based, and self-management-oriented lifestyles (3SLIFE) intervention, to promote healthy lifestyles among Chinese community residents. Methods This two-arm, parallel, cluster-RCT with a 6-month intervention and 6-month follow-up period foresees to randomize a total of 20 communities/villages from 4 townships in a 1:1 ratio to either intervention or control. Within these communities, a total of at least 256 community residents will be enrolled. The experimental group will receive a multi-level intervention based on the socioecological model supplemented with a multi-dimensional empowerment approach. The control group will receive information only. The primary outcome is the reduction of modifiable unhealthy lifestyles at six months, including smoking, excess alcohol consumption, physical inactivity, unbalanced diet, and overweight/obesity. A reduction by one unhealthy behavior measured with the Healthy Lifestyle Index Score (HLIS) will be considered favorable. Secondary outcomes include reduction of specific unhealthy lifestyles at 3 months, 9 months, and 12 months, and mental health outcomes such as depression measured with PHQ-9, social outcomes such as social support measured with the modified Multidimensional Scale of Perceived Social Support, clinical outcomes such as obesity, and biomedical outcomes such as the development of gut microbiota. Data will be analyzed with mixed effects generalized linear models with family and link function determined by outcome distribution and accounting for clustering of participants in communities. Discussion This study will provide evidence concerning the effect of a mHealth intervention that incorporates a behavioral change theoretical framework on cultivating and maintaining healthy lifestyles in community residents. The study will provide insights into research on and application of similar mHealth intervention strategies to promote healthy lifestyles in community populations and settings. Trial registration number ChiCTR2300070575. Date of registration: April 17, 2023. https://www.chictr.org.cn/index.aspx .

Depression is a common issue among illicit drug users. However, the interaction between addiction memory, family functioning, and depressive symptoms remains insufficiently examined. This study investigates the relationship between addiction memory, family functioning, and depressive symptoms, with self-esteem serving as a mediator. A random sample of 600 illicit drug users from Hubei, China, was evaluated using the Addiction Memory Intensity Scale (AMIS), Family APGAR Index, Patient Health Questionnaire (PHQ-9), and Rosenberg Self-Esteem Scale (RSES). A factorial algorithm was used to parcel the AMIS, PHQ-9, and RSES items, and structural equation modeling was applied to examine the mediation effect. The model fit the data well (χ2/df = 2.248, CFI = 0.956, NNFI = 0.966, RMSEA = 0.046, SRMR = 0.040), with significant path coefficients (p < 0.05). Addiction memory was positively correlated with depression (β = 0.195, p < 0.001), while family functioning negatively correlated with depression (β = −0.113, p = 0.008). Both addiction memory and family functioning indirectly influenced depression through self-esteem, with mediating effects equal to 1.154 (95% CI: 0.106 to 0.209) and −0.097 (95% CI: −0.154 to −0.047). These findings suggest that interventions targeting addiction memory and family functioning may alleviate depressive symptoms by improving self-esteem among illicit drug users.

Background: Internet addiction (IA) is one of the most prevalent mental health problems among adolescents. Several studies have reported that the prevalence of IA among adolescents has increased during the COVID-19 pandemic. However, with China’s ongoing regular epidemic prevention and control, it is unclear whether the prevalence among adolescents is still at such high levels in China during the COVID-19 pandemic. Therefore, we conducted a cross-sectional study from December 2020 to January 2021 that aims to understand the prevalence and related factors of IA among adolescents in Nanchang, China, during the pandemic. Methodology: The cross-sectional survey was conducted in seven secondary schools in Nanchang. Participants completed a questionnaire comprising Young’s Diagnostic Questionnaire for internet addiction (YDQ), International Physical Activity Questionnaire Short Form, and questions regarding demographic characteristics, outdoor activity time, and sleep quality. Results: A total of 6,553 secondary school students participated in the survey. Of the total, 14.4% (946/6553) were classified as addicted internet users (YDQ ≥5). The risk of IA was higher among students of older age (OR=1.17) and with poorer subjective sleep quality (OR=1.27-2.56). Urban household registration (OR=0.80), high level of physical activity (OR=0.68), 1-2 hours of outdoor activity per day (OR=0.69), long sleep duration (OR = 0.60), and normal sleep duration (OR = 0.74) were protective factors of IA. Conclusions: During the COVID-19 pandemic, adolescents in China reported some risks for IA. Age, household registration, outdoor activity time, level of physical activity, subjective sleep quality, and sleep duration were the key factors affecting IA. Therefore, extended school and family support should be provided for vulnerable adolescents in this extraordinary period.

目的 分析家庭关怀度指数问卷(family APGAR index,APGAR)在评估毒品滥用者家庭功能方面的适用性,为毒品滥用者家庭功能测量工具选择提供参考.方法 采用分层随机抽样方法,随机抽取600名毒品滥用者为研究对象.采用决断值和题总相关系数进行条目分析,采用因子分析和Pearson相关系数检验APGAR的效度,采用Cronbachα系数检验APGAR的信度.结果 APGAR呈单因子结构.经因子分析交叉验证,APGAR的单因子结构模型拟合良好(x2/df=2.011,CFI=0.986,NNFI=0.971,SRMR=0.029,RMSEA=0.059,AIC=30.053),但删除"适应度"条目后的单因子结构模型更优(AIC=21.364).APGAR总分与Rosenberg自尊量表和戒毒信心量表得分之间的Pearson相关系数均具有统计学意义(P＜0.001).5个条目的APGAR的Cronbach α系数为0.78,删除"适应度"条目后的APGAR的Cronbach α系数为0.79.结论 APGAR在毒品滥用者中的信效度较好,但在评估该群体家庭功能时需注意"适应度"这一条目的适用性.

Outpatient satisfaction is important in evaluating the performance of tertiary public hospitals in China. However, only a few studies have examined the interaction between outpatient satisfaction and its related factors. This study aimed to explore the relationship between patient satisfaction and its related factors in provincial tertiary hospitals. Six hundred outpatients in three provincial tertiary hospitals in Nanchang, China, were randomly selected. Structural equation modeling was used to analyze the relationship of the factors associated with outpatient satisfaction. The conceptual model fitted the data well (χ2/df = 4.367, CFI = 0.951, TLI = 0.937, SRMR = 0.055, RMSEA = 0.075), with all the path coefficients being statistically significant (p < 0.001). The environment and facilities showed the most significant influence on outpatient satisfaction (standardized total effect = 0.389), followed by the quality of diagnosis and treatment (standardized total effect = 0.235). The waiting time for medical services showed a partial mediation effect of 0.077 between the environment and facilities and outpatient satisfaction. The study indicates that targeted measures should be taken to improve the amenities of hospitals and shorten the waiting time for medical services, thus further improving outpatients’ medical experience.

目的 调查武汉市甲基苯丙胺依赖患者操守自我效能状况及其相关因素.方法 抽取武汉市479名甲基苯丙胺依赖患者,采用戒毒信心量表评价其操守自我效能,采用多元线性回归模型分析操守自我效能的相关因素.结果 武汉市甲基苯丙胺依赖患者的操守自我效能得分为(74.5±12.4)分;多元线性回归分析结果显示,甲基苯丙胺依赖患者操守自我效能与其文化程度呈正相关,与其毒品使用时长呈负相关.结论 文化程度与毒品使用时长是甲基苯丙胺依赖患者操守自我效能的相关因素,提示在今后的复吸预防工作对于文化程度较低、吸毒时间较长的患者应予以关注,以帮助其提高自我效能.

Background. This study aims to investigate the prevalence of glaucoma and its related factors among residents aged 40 and over in Jiangxi Province, China, and provide a scientific basis for the prevention and control of glaucoma. Methods. The cluster sampling method was used to randomly select six townships. Similarly, eight villages were randomly selected from each sample township. A total of 5385 rural residents from 48 villages were collected for a questionnaire survey. A logistic regression model was used to explore the personal behavioral factors related to glaucoma. Results. Among the 5385 participants, the prevalence rate of glaucoma was 1.4%. The logistic regression model found that alcohol consumption, vegetable consumption, physical exercise, daily reading time, and frequent reading environment were related to glaucoma. Conclusion. To prevent the occurrence of glaucoma, it is important for rural residents to reduce the frequency of alcohol consumption, increase the frequency of vegetable consumption and physical exercise, control the length of daily reading, and read in a moderately lit environment.

目的 探讨简易应对方式问卷(SCSQ)在麻风病受累群体中的信效度.方法 采用多阶段抽样方法随机抽取江西省麻风病受累者288例,采用题总相关系数对SCSQ进行项目分析,采用因子分析和相关分析检验量表的结构效度与效标关联效度,采用Cronbach α系数进行信度分析.结果 经修订的SCSQ分为积极应对(1～12条)和消极应对(13～19条)二个维度共计19个条目,该二因子结构模型拟合良好(x2/v = 1.845,CFI = 0.920,NNFI = 0.902,SRMR = 0.086,RMSEA = 0.077).修订后的SCSQ总分与病人健康问卷抑郁量表及焦虑自评量表得分呈负相关(r = 0.312,P＜0.001;r =0.304,P＜0.001),与社会支持评定量表得分呈正相关(r = 0.239,P＜0.001).修订后的SCSQ在麻风病受累者中的Cronbach α系数为0.910,积极应对和消极应对因子的Cronbach α系数分别为0.910和0.841.结论 修订后的简易应对方式问卷是评估麻风病受累群体应对方式的良好工具,量表信效度高.

目的:调查武汉市甲基苯丙胺依赖患者的戒毒意向,并分析其相关因素.方法:在武汉市2所强制隔离戒毒所中随机抽取甲基苯丙胺依赖患者488例,采用自编一般资料问卷、戒毒意向标尺、渴求视觉模拟评分、成瘾记忆强度量表和激惹-抑郁-焦虑量表进行调查,采用多元线性回归模型分析患者戒毒意向的相关因素.结果:甲基苯丙胺依赖患者的戒毒意向标尺得分为(6.2±2.1)分.多元线性回归分析结果显示,甲基苯丙胺依赖患者的戒毒意向标尺得分与其就业状况呈正相关,全职就业者的戒毒意向标尺得分高于无业者(β=0.60,P=0.013);其与渴求视觉模拟评分之间则呈负相关(β=-0.49,P=0.010).结论:甲基苯丙胺依赖患者的戒毒意向与其就业状况和渴求程度相关,在戒毒矫治工作中应对患者的就业帮扶问题予以关注,并积极采用相关干预策略帮助患者降低毒品渴求,以提高其戒毒意向.

目的 探讨江西省麻风病受累者社会支持现状及其相关因素,为提高麻风病受累者社会支持水平提供参考依据.方法 2018-2019年随机抽取288例麻风病受累者,对其社会支持与患病情况进行调查,采用多元线性回归分析.结果 288例麻风病受累者的社会支持评定量表总分为(32.27±8.56)分,其中主观支持维度(19.50±5.49)分,客观支持维度(6.05±2.55)分,支持利用度维度(6.72±2.23)分.江西省麻风病受累者社会支持水平的相关因素包括:年龄≥60岁(β=4.72,95％CI:2.43～ 7.01),文化程度小学(β=9.18,95％CI:6.89～ 11.46)、初中及以上(β=12.37,95％CI:8.95～ 15.79),居住方式集体宿舍(β=13.68,95％CI:11.02～ 16.35)、与亲属同住(β=22.51,95％CI:19.94～ 25.08),畸残等级1级(β=6.52,95％Ct:3.30～9.73)、2级(β=4.01,95％CI:1.41～ 6.61)、其他畸残(β=6.35,95％CI:3.14～9.56),治疗期时长＞2年(β=5.04,95％CI..2.88～7.20).结论 江西省麻风病受累者的社会支持水平偏低,建议政府、社区、家庭增加物质支持,加强心理疏导,重点关注文化程度低、独居、2级畸残者,保障其身心健康,促进全民健康.

目的 编制评估新型冠状病毒个人防护信念的量表工具,检测其信度与效度.方法 以保护动机理论为基础设计量表,通过网络调查平台问卷星对国内18岁以上社区居民进行调查,回收有效问卷613份.结果 成功编制《新型冠状病毒个人防护信念量表》;该量表有19个条目,包括"威胁感知""回报感知""效能评价""反应代价"和"恐惧"5个因子;五因子结构模型解释了总变异的71.93％,拟合情况更好(CFI=0.950,NNFI=0.937,SRMR=0.056,RMSEA=0.070);总量表Cronbachα系数为0.883,五因子系数介于0.512～0.966.结论 基于保护动机理论编制的《新型冠状病毒个人防护信念量表》有较高的信度和效度,有助于评估社区居民对于新型冠状病毒的个人防护信念.

[目的]基于自回归移动平均(ARIMA)模型,构建江西省渝水区居民心血管疾病死亡时间序列模型,为该地区心血管疾病防治工作提供数学模型支撑.[方法]基于江西省渝水区居民2014-2018年心血管疾病死亡的时序资料,使用Econometrics View 9.0软件构建ARIMA季节调整模型预测该地区居民2019-2021年心血管疾病死亡情况.[结果]江西省渝水区居民2014-2018年心血管疾病月度死亡数呈现长期上升趋势,季节规律明显,每年春季和冬季为心血管病死亡高峰期.将原始序列N1经一阶差分及一阶季节性差分后,序列n1表现出良好平稳性(P＜0.05).列出所有的理论模型并分别计算其模型参数,经统计学检验后,筛选出7个ARIMA季节调整备选模型,其中ARIMA(1,1,1)(1,1,1)12为最优模型,R2=0.749,调整R2=0.724,赤池信息准则(AIC)=8.454,施瓦兹准则(SC)=8.633,汉南-奎因准则(HQ)=8.515.ARIMA(1,1,1)(1,1,1)12模型的残差序列通过白噪声检验(P＞0.05),预测效果良好.[结论]ARIMA(1,1,1)(1,1,1)12模型可以较准确地模拟江西省渝水区心血管疾病死亡的长期趋势及季节规律,并对其年度变化趋势及月度分布做出科学的预测.

Cerebrovascular disease (CVD) is the leading cause of death in many countries including China. Early diagnosis and risk assessment represent one of effective approaches to reduce the CVD-related mortality. The purpose of this study was to understand the prevalence and influencing factors of cerebrovascular disease among community residents in Qingyunpu District, Nanchang City, Jiangxi Province, and to construct a model of cerebrovascular disease risk index suitable for local community residents. A stratified cluster sampling method was used to sample 2147 community residents aged 40 and above, and the prevalence of cerebrovascular diseases and possible risk factors were investigated. It was found that the prevalence of cerebrovascular disease among local residents was 4.5%. Poisson regression analysis found that old age, lack of exercise, hypertension, diabetes, smoking, and family history of cerebrovascular disease are the main risk factors for local cerebrovascular disease. The relative risk ORs were 3.284, 2.306, 2.510, 3.194, 1.949, 2.315, respectively. For these six selected risk factors, a cerebrovascular disease risk prediction model was established using the Harvard Cancer Index method. The R value of the risk prediction model was 1.80 (sensitivity 81.8%, specificity 47.0%), which was able to well predict the risk of cerebrovascular disease among local residents. This provides a scientific basis for the further development of local cerebrovascular disease prevention and control work.

目的 了解南昌市西湖区老年人的体质指数(BMI)、腰高比的现状,分析其与高血压患病的相关性,为制定城市社区老年人高血压防治策略提供依据.方法 采用多阶段分层整群随机抽样法,随机抽取6个社区,共计2111名60岁以上居民进行问卷调查和体格检查.采用χ2检验、Pearson相关、Logistic回归分析BMI和腰高比与高血压的关系.结果 2111名老年人中,高血压总患病率为37.52％,其中,男性患病率高于女性患病率(38.78％比36.14％,χ2=5.571,P<0.05).高血压患病率随年龄增长而显著升高(χ2=7.743,P<0.05).模型在调整有无高血压家族史、性别、年龄混杂因素后,均发现超重、肥胖和腰高比过大是高血压的危险因素.结论 体质指数、腰高比的升高会增加高血压患病风险.建议相关部门推出与健康中国相适应的居民保持健康体重计划措施,防止超重与肥胖,尤其是中心性肥胖,从而降低患高血压的风险.

目的:探讨“五步脱敏疗法”对成瘾患者渴求、线索敏感及成瘾记忆的影响.方法:在湖北省武汉市3所自愿戒毒医院中招募39名甲基苯丙胺依赖患者,随机分配入干预组和对照组.干预组接受连续5天,每天90分钟的“五步脱敏”治疗,在此期间对照组不干预.分别采用“渴求视觉模拟标尺”(VAS)、“线索敏感问卷”(CSQ)和“成瘾记忆强度量表”(AMIS)对患者的渴求、毒品相关线索敏感性及成瘾记忆强度进行测试.结果:研究对象的VAS得分变化存在组别和时间的交互效应(P=0.005),CSQ和AMIS得分变化均存在组别效应(P＜0.05).接受干预后,干预组各测量指标得分均低于对照组.结论:“五步脱敏”治疗可有效降低成瘾患者的渴求水平、对毒品相关线索的敏感程度及其成瘾记忆强度.

The New Chinese Diabetes Risk Score (NCDRS) is one of the recommended tools for screening undiagnosed type 2 diabetes in China. However, its performance in detecting undiagnosed diabetes needs to be verified in different community populations. Also, it is unknown whether NCDRS can be used in detecting prediabetes. In the present study, we aimed to evaluate the performance of NCDRS in detecting undiagnosed diabetes and prediabetes among the community residents in eastern China. We applied NCDRS in 7675 community residents aged 18-65 years old in Jiangsu Province. The results showed that the participants with undiagnosed diabetes reported the highest NCDRS value, followed by those with prediabetes (P<0.001). The best cut-off points of NCDRS for detecting undiagnosed diabetes and prediabetes were 27 (with a sensitivity of 78.0% and a specificity of 57.7%) and 27 (with a sensitivity of 66.0% and a specificity of 62.9%). The AUCs of NCDRS for identifying undiagnosed diabetes and prediabetes were 0.749 (95% CI: 0.739~0.759) and 0.694 (95% CI: 0.683~0.705). These results demonstrate the excellent performance of NCDRS in screening undiagnosed diabetes in the community population in eastern China and further provide evidence for using NCDRS in detecting prediabetes.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:探讨融眼动脱敏与再加工（EMDR）、内观、催眠、神经语言程式（NLP）及正面信念植入为一体的综合心理疗法-五步脱敏疗法对甲基苯丙胺依赖患者成瘾记忆及自尊水平的影响。方法:采用随机对照试验设计,选取5所强制戒毒机构内甲基苯丙胺依赖患者128例,随机分为脱敏组（n=65）和常规对照组（n=63）。对照组只接受常规戒毒康复训练,脱敏组在此基础上接受连续5天,每天90分钟的五步脱敏治疗。采用成瘾记忆强度量表（AMIS）和Rosenberg自尊量表（RSES）进行测评。结果:纳入分析的有效样本共116例。其中,脱敏组57例,对照组59例。脱敏组的AMIS得分下降水平优于对照组（P&lt;0.001,Cohen’s d=0.67）,RSES得分升高水平优于对照组（P&lt;0.05,Cohen’s d=0.41）。结论:五步脱敏疗法能有效降低甲基苯丙胺依赖患者的成瘾记忆强度,提高其自尊水平。</span>

目的:编制适用于新型毒品依赖患者的社会适应量表,并检验其信效度.方法:从个体、家庭、社会三个层面进行量表构念设计.以武汉市强制隔离戒毒机构中的新型毒品依赖患者作为量表施测对象,分别进行量表初测(n=82)和正式施测(n=288).采用初测样本数据进行条目分析,采用正式施测样本数据进行探索性因子分析、验证性因子分析、相关分析和信度分析.结果:修订形成的新型毒品依赖患者社会适应评估量表共有17个条目,包括“个体心理适应”、“对家庭环境的适应”、“对社会环境的适应”3个因子,累计解释总方差的57.59％.量表的三因子结构模型拟合良好(x2/df=1.331,CFI=0.962,NNFI=0.952,SRMR=0.078,RMSEA=0.048).量表及各因子得分与成功戒毒信心量表得分、心理韧性量表得分之间均呈正相关,相关系数均有统计学意义(P＜0.05).总量表的Cronbachα系数为0.848,重测信度系数为0.841;各因子的Cronbach α系数为0.644～0.856,重测信度系数为0.702～0.784.结论:新型毒品依赖患者社会适应评估量表具有良好的信效度,可用于测量新型毒品依赖患者的社会适应水平.

To strengthen rural health services, the Chinese government has launched a series of policies to promote health workforce development. This study aims to understand the current status of village doctors and to explore the factors associated with village doctors' job satisfaction in western China. It also attempts to provide references for further building capacities of village doctors and promoting the development of rural health service policy.A multistage stratified sampling method was used to obtain data from a cross-sectional survey on village doctors across 2 provinces of western China during 2012 to 2013. Quantitative data were collected from village doctors face-to-face, through a self-administered questionnaire.Among the 370 respondents, 225 (60.8%) aged 25 to 44 years, and 268 (72.4%) were covered by health insurance. Their income and working time calculated by workloads were higher than their self-report results. Being healthy, working fewer years, and having government funding and facilities were the positive factors toward their job satisfaction. Village doctors working with government-funded village clinics or facilities were more likely to feel satisfied.Problems identified previously such as low income and lack of insurance, heavy workload and aging were not detected in our study. Instead, village doctors were better-paid and better-covered by social insurance than other local rural residents, with increased job satisfaction. Government policies should pay more attention to improving the quality of rural health services and the income and security system of village doctors, to maintain and increase their job satisfaction and work enthusiasm. Further experimental study could evaluate effects of government input to improve rural health human resources and system development.

目的:编制《戒毒患者主观家庭支持量表》,并对其信效度进行检验.方法:通过查阅文献、专家咨询等方法构建条目池,形成《戒毒患者主观家庭支持量表》初稿.以武汉市314名戒毒患者为量表初测对象,对获取数据进行条目分析和筛选.以武汉市和中山市共931名戒毒患者为量表正式施测对象,对获取数据进行量表效度和信度检验.结果:经过条目筛选形成的《戒毒患者主观家庭支持量表》为单维度结构,共有11个条目,方差贡献率为68.56％.量表得分与家庭关怀度指数问卷得分呈正相关(r=0.523,P＜0.001).不同人口学与毒品使用特征的研究对象的量表得分差异均有统计学意义(P＜0.05).量表的Cronbach α系数为0.954,重测信度为0.772.结论:《戒毒患者主观家庭支持量表》具有良好的信效度,符合心理测量学要求,可作为测量戒毒患者主观家庭支持程度的有效工具.