Family e-chat group use was associated with family well-being and personal happiness in Hong Kong adults amidst the COVID-19 pandemic: a population-based cross-sectional study (Preprint)

BACKGROUND Family e-chat groups are commonly used, but little is known about its associations with family and individual well-being amidst the COVID-19 pandemic. OBJECTIVE Under the Hong Kong Jockey Club SMART Family-Link project, we examined the associations of family e-chat group use amidst the COVID-19 pandemic with family well-being and personal happiness, and the mediating effects of family communication quality on these associations. METHODS A territory-wide self-administered online survey was conducted in May 2020 on Chinese adults in Hong Kong. Respondents reported the number of family e-chat groups (0, 1, 2, ≥3), the instant messaging (IM) functions used (receiving/sending text messages, photos/pictures, short videos, voice messages, making voice calls and video calls), and the average numbers of IM messages sent and received daily (<1, 1-2, 3-10, 11-20, >20) in family e-chat groups. Prevalence was weighted by sex, age, and education of the general population. Adjusted prevalence ratios (aPRs) for IM function use by demographics were calculated. Adjusted β for family well-being (health, harmony, and happiness), and personal happiness (all scale 0-10, higher scores indicate better outcomes) by number of family e-chat groups and IM function use were calculated, and the mediation effect of family communication quality on these associations examined. RESULTS Of 4890 respondents, 4046 (82.7%) had ≥1 family e-chat group. Sending/receiving text messages was most commonly used (weighted prevalence: 78.4%), followed by receiving/sending photos/pictures (76.5%), making voice calls (46.2%), receiving/sending short videos (37.2%) and voice messages (13.8%), and making video calls (8.2%). Women and older age were associated with having more groups (aPRs: 1.04-1.22, all P≤.03) and non-text function use (aPRs: 1.10-3.10, P≤.02). Better family well-being was associated with having more groups (β: 0.23-0.77), receiving/sending photos/pictures (β: 0.33), voice calls (β: 0.18), video calls (β: 0.45), more IM functions used (β: 0.43-0.51), and more IM messages received/sent daily (β: 0.38-0.54) (all P≤.01). Higher personal happiness was associated with having more groups (β: 0.30-0.72), receiving/sending photos/pictures (β: 0.30), video calls (β: 0.32), more IM functions use (β: 0.36-0.42) and more IM messages received/sent daily (β: 0.42-0.67) (all P≤.01). Family communication quality mediated the associations of more groups and more IM functions used with family well-being (mediated proportions: 75.5% and 69.5%, respectively) and personal happiness (mediated proportions: 66.4% and 46.2%, respectively). CONCLUSIONS This is the first study showing that, amidst the COVID-19 pandemic, having more family e-chat groups and using more IM functions including sending/receiving photos/pictures and making video calls in family e-chat groups, were associated with better family well-being and personal happiness, and about half to three-quarters of these associations were mediated by family communication quality. Prospective studies are needed to confirm the associations. People without or with low use of family e-chat groups would need more attention and assistance.