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Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

In order to supplement and improve the landscape evaluation system of traditional villages and play a positive guiding role in the specific protection and development of village landscape, this paper proposes the ecological landscape environment evaluation of traditional villages in Guanzhong from the perspective of rural revitalization. First of all, the relevant national and provincial evaluation standards are deeply studied, and the comprehensive evaluation system of the traditional village landscape in the Guanzhong region is constructed by using expert scoring and an analytic hierarchy process, which includes 6 criteria and 25 indicators. Three typical villages of different types and different development stages, namely, village A, village B, and Village C, were selected for landscape investigation and comprehensive evaluation. The results show that the weight of village location and landscape pattern is the largest, that is, the most important. The second is architectural landscape, with a weight of 0.236, accounting for a high proportion. Then, it is the natural landscape and street landscape, with a weight of 0.1-0.2. Finally, it is the intangible cultural landscape and landscape style protection, with a weight of less than 0.1. The alpha value of the comprehensive evaluation questionnaire of the village A is 0.984. The alpha value of the comprehensive evaluation questionnaire of village B is 0.941. The alpha value of the comprehensive evaluation questionnaire for the landscape of village C is 0.986, which is greater than 0.8. Conclusion. This study makes a comprehensive evaluation of the landscape of typical traditional villages. [ABSTRACT FROM AUTHOR]

The sustainable development of smart community is the key to China's grassroots governance and also the general trend of China's urban modernization. In the supervision of the smart community, the optimization of the behavior of the regulatory subject cannot be separated. Previous studies have focused more on how subjects participate in supervision and less on the behavior of stakeholders in the game. This paper analyzes the game behavior of regulatory participants in the process of sustainable development of smart community and studies the optimization strategy of regulatory behavior according to the game behavior logic among participants. The results show the following. (i) Government behavior plays a leading role in supervision. (ii) When the government invests resources in the screening of third-party evaluation agencies and service purchase and mainly adopts policy punishment methods for stakeholders with rent-seeking behavior, the probability of regulatory participation stakeholders' positive behavior is the greatest. (iii) The improvements should be made from the aspects of information network construction, the refinement of reward and punishment measures, and the improvement of evaluation party access rules. This not only helps to enhance the good supervision situation of the supervision enthusiasm of the participants but also can realize the self-discipline operation of the smart community and enhance the responsibility consciousness of the evaluation institutions. [ABSTRACT FROM AUTHOR]

Social determinants of public health have gained increasing attention. This paper studied whether social support from online communities related to maternal mental health. We focused on online maternity communities that group users with a similar prenatal status to facilitate their exchange of personal experiences and knowledge about maternal caring during pregnancy. Such online maternity communities are getting increasingly popular and can be found across countries and societies. We invited users—currently pregnant and gave birth within 1 year at the time of the study—from one such community in China to participate in a survey. The survey measured their perceived social support (PSS) exclusively from the peer group in the online community, their mental health and newborns' birth outcomes (N = 500). Users reported high score in PSS from the online peer group which was comparable to the ones from family, significant other and friends in other studies. We used linear regression models to examine the effects of PSS on mental health and birth outcomes. We found that a one‐point increase in the PSS score was associated with a 0.19‐point (p < 0.1) decrease in the prenatal depression and a 0.26‐point (p < 0.01) decrease in the postnatal depression, which was equivalent to 3% and 4.5% of the average respectively. Moreover, a one‐point increase in the PSS score was associated with a 14.49‐gram increase in a newborn's weight (p < 0.01). [ABSTRACT FROM AUTHOR]

The role of formal volunteering in mental health promotion among older adults in China has been widely discussed during recent decades. However, the relationship connecting mental health with cross‐level interaction (i.e., average levels of participation in the community vs. individual participation) is still unclear. This paper examined the effects of cross‐level formal volunteering on depressive symptoms among older adults living in China. Using two waves of the China Longitudinal Aging Social Survey, a sample of 3128 Chinese older adults was surveyed in 2014 and 2016. Depressive symptoms were measured using the abbreviated CES‐D‐9. Individual fixed‐effects ordinary least squares regression models assessed the associations between individual‐ and community‐level formal volunteering and depressive symptoms in urban and rural areas separately. We found that in the urban sample, formal volunteering activities were negatively associated with depressive symptoms at the individual level (β = −0.49, SE = 0.22, p < 0.05). Higher community‐level formal volunteering was positively associated with depressive symptoms (β = 2.82, SE = 1.42, p < 0.05). When adding interactions between individual and community levels, engagement in individual‐level formal volunteering was associated with lower rates of depressive symptoms as community volunteering participation levels increased (β = −3.07, SE = 1.07, p < 0.01). High community‐level volunteering participation was detrimental for non‐volunteers. In rural areas, neither community‐ nor individual‐level formal volunteering was associated with changes in depressive symptoms. The current findings demonstrate formal volunteering may not always benefit mental health for all. The effects may depend on the community context and individual choices. Social policies aimed to promote mental health through formal volunteering need to be tailored according to the specific community social environment. [ABSTRACT FROM AUTHOR]

Objective. As part of the efforts to build a practical, effective, and diversified medical insurance payment method, it is crucial for China to deepen the reform of ambulatory patient groups (APGs). This study was aimed to explore the mechanism and effect of this policy from three dimensions, including medical expenses, medical insurance funds, and medical services. Methods. In 2020, China's pilot reform of APG was initiated in Jinhua City, Zhejiang Province. Descriptive statistics, correlation analysis, and OLS regression analysis were utilized to evaluate the effect of the APG reform in Jinhua. Results. The implementation of the reform can contribute significantly to establishing a comprehensive medical service governance mechanism of classified settlement and coordinated promotion. It also plays a critical role in safeguarding people's lives and health by promoting the high-level development of medical insurance systems and public hospitals, optimizing the quality of medical services, and improving the efficiency of medical insurance funds. Conclusion. Through the lens of policy evaluation, our findings can provide useful experience for the implementation of the outpatient medical insurance payment method in developing countries. [ABSTRACT FROM AUTHOR]

Chinese government promoted a family physician contract service system in order to establish a tiered healthcare system in June 2016, but there was little evidence to assess the policy performance. This study aimed to examine the association of family physician contract services with the healthcare utilization of community residents in urban China. A cross-sectional face-to-face survey was conducted from July to September, 2019, in four advanced and exemplary cities for family physician contract services in China. A multistage cluster random sampling method was adopted to recruit residents aged 18 and above, and a total of 1508 participants were included in this study. The count model and logit regression were adopted to examine the associations between family physician contract service and healthcare utilization, and the potential bias was addressed using the propensity score matching (PSM) method. There was an increase in number of monthly primary care visits and annual referrals for contracted residents compared to noncontracted residents. Participants who had contracted with a family physician were more likely to choose a primary healthcare facility after illness than those who had not. However, no significant change was found in the number of annual hospital admissions between contracted and noncontracted residents. Family physician contract services may effectively strengthen the use of primary care facilities by community residents and promote the formation of a tiered healthcare system in China. [ABSTRACT FROM AUTHOR]

Taking care of people with dementia is stressful for informal caregivers. Respite care can provide a break for them. But it is often underused, and its acceptability can be low in China. One reason is that it fails to meet their needs. This study aimed to explore the preference of caregivers of people with dementia for respite care services. A discrete choice experiment was used. Attributes and levels of respite care were informed by a literature review and expert consultations. A fractional factorial design was used to reduce the number of choice sets. A questionnaire survey was conducted in Tianjin, China. A mixed logit model was used to compute coefficients for attributes and levels. Respite care packages differed in five attributes, which were content, provider, duration, frequency, and cost. 322 caregivers completed valid discrete choice experiment questionnaires. All five attributes were statistically significant. Two most preferred attributes were "providers" (coefficient 1.297, p < 0.001) and "frequency" (coefficient 1.169, p < 0.001). Caregivers prefer highly qualified service providers and frequent respite care. The desirable respite care for caregivers would be assistance with personal care for people with dementia which was provided by an experienced worker with attitudes of understanding and respect towards people with dementia more than 3 times per week regularly and more than 4 h every time with a lower cost. This study offered new information on Chinese dementia caregivers' preferences for respite care. Policymakers should pay attention to the frequency and quality of providers when designing respite care to improve service uptake and ultimately lighten the burden on caregivers of people with dementia. [ABSTRACT FROM AUTHOR]

Background. Health science popularization, especially digital health science popularization, is essential for development of the Healthy China Strategy. Current studies have focused on interpreting digital education popularization and confirming its positive function; however, reports regarding the limitations and shortcomings thereof are lacking. We aimed to research the current development of digital health science popularization in China, analyze the existing problems, and explore the methods to resolve these problems. Methods. We conducted a qualitative study by mixing in-depth interviews and grounded theory approaches. Participants were recruited according to the inclusion criteria via a snowballing process. Thirty-nine participants, including doctors, nurses, researchers, officers in government, and project leaders, were recruited from the Yangtze River Delta region. Online in-depth interviews with open questions were conducted, and the data were collected. Results. Our results revealed that digital health science popularization has the advantages of convenience, swiftness, friendliness, and social links. However, obvious deficiencies were also exposed, including low authenticity, limited audiences, a lack of manpower, and fragmentation. Conclusions. Current digital health science popularization needs to emphasize public welfare, promote the dissemination of information with professionalism and authority, cultivate cross-border talent, and develop institutional infrastructure to overcome the deficiencies thereof. This remains important to improve the quality and effectiveness of digital health science popularization. [ABSTRACT FROM AUTHOR]

Object. In order to achieve Healthy China 2030 and an effective and sequential diagnosis and treatment system, family doctor contracting is a crucial strategy for improving graded diagnosis and treatment and achieving universal health. Through the examination of data on community members' medical expenditures, this research investigates the influence of contracting on residents' primary care consultation behavior. Methods. Using a quantitative research approach based on information about residents' medical payment patterns, this study aims to examine the effect of family doctor contracting on residents' medical costs. Therefore, a two-part model and a Heckman two-stage model are used to explore the impact of contracting on residents' medical expenses in the community hospital based on the sample of contracted and noncontracted residents and the basic information and monthly checkout data of the residents provided by a community hospital in Beijing. Conclusion. Specifically, contracting increased residents' healthcare expenditures in community hospitals by increasing the number of departments and the frequency of visits, according to the results, which indicate that contracting significantly increased residents' healthcare costs in community hospitals. The frequency and number of departments in community hospitals for two target groups—the elderly and patients with chronic diseases—have increased significantly as a result of contracting, according to subgroup analysis. This finding suggests that family physicians make it possible for the daily care and treatment of these two priority groups to be met to a greater extent at the primary level. The empirical findings of this study reveal that the family doctor contracting system has a significant impact on how primary care and hierarchical treatment patterns are established. [ABSTRACT FROM AUTHOR]

This study investigated the trajectory patterns of activities of daily living (ADLs) and cognitive function among older urban Chinese adults with disabilities and their influence on their family caregivers' (i.e., spouse and adult children) positive caregiving experiences. Data were derived from the three-wave longitudinal panel study titled "Longitudinal Study on Family Caregivers for Frail Older Adults Aged 75 or Above in Shanghai." A total of 251 older adults and their spouse/adult child caregivers participated in the 2010, 2013, and 2016 waves and were included in the final analytic sample. Growth curve modeling was applied to examine the proposed model. The findings suggest that ADLs and cognitive function trajectories declined over six years. Changes were predicted based on the older adults' age and education levels. In 2016, the change rate of cognitive function trajectory was associated with self-affirmation and life enrichment. Neither the initial status (intercept) nor the change rates (slope) of the ADLs' trajectory were associated with the two dimensions of positive caregiving experiences. This study extended the stress process model by demonstrating the trajectory patterns of stressors and their influence on positive caregiving experiences. Change rates in older adults' cognitive function were key risk factors for positive caregiving experiences. This finding has important implications for family-based care systems in China. [ABSTRACT FROM AUTHOR]

Health education is one of the most effective and efficient ways to achieve the goal of universal health coverage and the sustainable development goals. The equity of access to health services (especially services from community healthcare centers) for internal migrants is an important issue of global concern. However, due to the registration system, long-term residence plan, education level, and other determinants, it is more difficult for internal migrants to enjoy equitable health education compared with local residents. At present, there is no research on signing up with family doctors mainly from community healthcare centers among internal migrants and their impact on access to health education services. In this nationwide cross-sectional study, we used the migrant population dynamic monitoring survey (MDMS) in 2018 to assess the disparities in signing up with a family doctor and its association with health education among internal migrants in China. Among the 151,892 participants, a total of 11.26% migrants had signed up with a family doctor and 81.37% internal migrants had received health education. There was a significant association between signing up with a family doctor and health education in the univariate model (aOR = 1.113; 95% CI: 1.095, 1.132) and the multivariate model (aOR = 1.107, 95% CI: 1.089, 1.126). Meanwhile, age (aORinteraction = 0.996, 95% CI: 0.994, 0.997), migration time (aORinteraction = 0.927, 95% CI: 0.907, 0.948), and migration range (aORinteraction = 0.994, 95% CI: 0.992, 0.997) also had an impact on the relationship between signing up with family doctors and health education. Due to the health education inequalities among internal migrants in China, we need to improve health education access and utilization of internal migrants. As signed up with family doctors was significantly associated with health education among migrants in China, we recommended that the government and healthcare facilities promote health education through family doctors. The number and professional ability of family doctors should also be improved especially in areas with weak healthcare service resources in the future. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effect of the Wuhan lockdown on body mass index (BMI) among Wuhan residents as well as factors including food habits affected and changes in physical activity mediating the association. As a survey of the Wuhan lockdown, a random digit dialing method was used to sample residents aged 18 years and older. A computer-aided telephone interview was applied to survey 11,223 residents in Wuhan City in July 2020. Ordinary least squares (OLS) regression and mediation analysis were used to analyze the influence of the Wuhan lockdown on BMI. Demographic characteristics, lifestyle characteristics, and health status differed statistically significantly between residents living in and those who left Wuhan during the lockdown (mean BMI, 23.05 ± 0.04 kg/m2 and 22.34 ± 0.06 kg/m2, respectively). The mean BMI among residents living in Wuhan was 0.42 kg/m2 higher (P < 0.001) than that of residents who left Wuhan during the lockdown, as determined by multivariate OLS regression analysis. Residents living in Wuhan during the lockdown had higher BMI among those aged 18–29 and 30–44 years (P < 0.001), with no difference among those aged 45+ years. The association between living in Wuhan and increased BMI was the strongest among residents who were overweight/obese. The mediation analysis results showed an indirect effect path with living in Wuhan (through decreased physical activity and increasing BMI) and the direct effect of living in Wuhan during the lockdown. The lack of association between living in Wuhan and increased BMI among residents aged 45+ years was due to the indirect influence of living in Wuhan affecting food habits. The findings indicated that the lockdown in Wuhan city increased residents' BMI, especially among those who were young or overweight/obese, partly because of decreased physical activity. [ABSTRACT FROM AUTHOR]

Currently, the number of empty-nest elders in China is rapidly increasing, and their overall health situation is not optimistic. The Chinese government has developed a series of policies to promote the community medical-nursing combined model to meet the health and pension care needs of elderly individuals. The demand for community medical-nursing combined services among empty-nest elders plays a decisive role in providing these services and must be fully recognized before these services are offered. However, only a few quantitative studies have focused on the demand for community medical-nursing combined services, and these studies failed to capture the complexity and dynamic nature of this demand. To address this research gap, this study innovatively conducted a descriptive and qualitative study to explore the demand for these services. Following the principle of data saturation, 14 empty-nest elders from communities in Wuhan, Hubei Province, were recruited using the purposive sampling method. Semistructured interviews were used to collect qualitative data. The inductive content analysis approach was used to analyze the data. The results revealed that Chinese empty-nesters' demand for community medical-nursing combined services was diverse and specific and comprised three themes (basic elderly care services, medical and nursing services, and psychospiritual support services), with fifteen subthemes. This study provides insights into the unique demand and implementation strategies for community medical-nursing services among empty-nest elders in China. Recommendations to enhance the intelligent elderly care system, infrastructure construction, and elderly care talent in the future provision of services for this particular group of people are provided. [ABSTRACT FROM AUTHOR]

The drifting elderly are an interprovincial floating elderly population that is mainly composed of unemployed older parents in China. They have left their usual residence and relocated to urban areas, facing challenge about social integration. As a neighborhood has played important roles in the floating population's social integration, this study was designed to investigate the influence of neighborhood-based identity and social participation on the social integration of the drifting elderly. Five rounds of data collection and analysis were conducted in a continuous crossover sequence using grounded theory. Twenty-four participants were recruited from three districts in Shanghai, China. The neighborhood was shown to play a prominent role in the drifting elderly's perceptions of social integration. Good neighborhood relations help the drifting elderly establish effective social support networks, interact with inflowing society, get in touch with more human resources, and form social relationships and networks. Neighborhood-based participants and identity were more conducive to eliminating heterogeneity and creating homogeneity for the drifting elderly. Thus, the neighborhood affects the social integration of the drifting elderly, which directly impacts their social feelings, integrations, and networks. Management of social integration among the drifting elderly should be focused on creating general opportunities for them to participate in neighborhood-based social events with a reasonable identity. [ABSTRACT FROM AUTHOR]

Participation by patients with chronic diseases under primary health care requires more attention to achieve effective disease management and better health outcomes. In 2016, China proposed accelerating the establishment of a system of family doctors (FDs) and strengthening doctor-patient communication to better meet residents' health service needs. This study aimed to describe perceived participation in primary health care among patients with chronic diseases in northeastern China and explore the impact of FD contract services and patient's trust on patients' perceived participation. A cross-sectional survey of 847 patients with chronic diseases in 16 primary healthcare institutions was conducted in Jilin Province, China. Among all participants, 453 patients reported signing up for FD contract services (62.93%). The perceived participation of patients with chronic diseases was at a low level (mean = 6.71 and SD = 3.35). After controlling for sociodemographic variables and health-related variables, FD contract services directly and indirectly influenced patients' perceived participation. The patient's trust was a mediator in the relationship between FD contract services and perceived participation. This study confirmed the valuation of family doctor contract services and provided a theoretical basis for the formulation of primary health service policies. Health organizations should continue to enhance the capacity of primary health services and attract more chronic disease patients to contract with FD teams, thereby enhancing doctor-patient trust and increasing patient's participation in primary health care. [ABSTRACT FROM AUTHOR]

Growing populations in developing countries have exacerbated inequality in the spatial distribution of living environments. As a result, whether living environment factors matter to health and well‐being is increasingly attracting policy and scholarly attention. Yet, crucial knowledge gaps remain regarding the implications, consequences and mechanisms of one's living environment on health and well‐being in developing countries. This study examined the association between living environment and psychological distress, self‐rated health and satisfaction with life among Chinese adults. Furthermore, it also explored the moderating role of community cohesion and the mediating role of social support on these factors. Using probability proportionate to size sampling methods, 3765 respondents and 148 community organisers were recruited from 160 communities in Yunnan, China, in 2018. Ordinary least squares regression and structural equation modelling were conducted. The findings indicate that residents who lived in communities with higher levels of environment insecurity had lower levels of subjective health and well‐being (psychological distress: β = 1.088, p < 0.001; self‐rated health: β = −0.104, p < 0.01; satisfaction with life: β = −0.164, p < 0.001). Moreover, community cohesion played a moderating role in the relationship between living environment insecurity and self‐rated health (β = 0.212, p < 0.05) and satisfaction with life (β = 0.183, p < 0.05); however, it had no significant effects on psychological distress. Furthermore, the moderated effects of community cohesion on living environment insecurity were mediated through perceived social support for self‐rated health (proportion of total effect mediated = 11%) and satisfaction with life (proportion of total effect mediated = 29%). The present findings have implications for policy makers and community committees who can work towards social inequality in developing countries. The integrated programmes of improving living conditions and strengthening community capacity are crucial to residents' health and well‐being. [ABSTRACT FROM AUTHOR]

The public long‐term care insurance (LTCI) scheme has been implemented in a few countries. Although the hypotheses of crowding‐out, crowding‐in and specialisation can facilitate our understanding of the relationship between LTCI and informal care use, existing studies may suffer from reverse causality. Employing a quasi‐experimental design, this study examined the policy effect of LTCI on informal care use among community‐dwelling older adults in China. Based on the data from three waves of the Chinese Longitudinal Healthy Longevity Survey, a staggered difference‐in‐differences (DID) with propensity score matching (PSM) approach was used to analyse the impact of LTCI on probability and hours of informal care use. The results showed that, for disabled older adults, LTCI reduced 43.3% of the probability and 82.4% of the weekly hours of informal care. LTCI also exhibited a spillover effect among nondisabled older adults through reducing the probability and weekly hours of informal care by 5.2% and 12.2%, respectively. Therefore, we argue that policymakers can consider rolling out the scheme for the entire country. Meanwhile, measures are needed to avoid a sharp decrease in informal care provision. [ABSTRACT FROM AUTHOR]

Qualitative meta‐synthesis is a coherent approach to answering an overarching research question by synthesising past qualitative studies so as to create new meanings from their results. We conducted a qualitative meta‐synthesis to systematically evaluate and integrate the caregiving experiences of adult children providing care for an elderly parent with cancer. The search was conducted in the databases Web of Science, PubMed, Embase, MEDLINE, Cochrane Library, Grew Literature in the Health Sciences, CNKI, WanFang Data, VIP, SINOMED and China Academic Journals as well as Chinese grey literature databases (China Academic Conference Literature Database/中国学术会议文献数据库, National Science and Technology Library) from inception to June 9, 2021. Thirteen studies were included in the final synthesis. The caregiver experiences they describe are synthesised into three primary themes: care needs, care burden and care gains, with numerous secondary themes. Besides our findings that seem to align with those from studies focused on other cultures, we have highlighted three main discoveries from the synthesis that stand out in the Chinese context: (1) many sub‐themes related to specific caregiving skills; (2) a strong expectation for health professionals to improve their communication skills with family caregivers; (3) the negative and positive influences of filial piety in caregiving experiences. Our findings can help multidisciplinary healthcare teams in China support adult children as caregivers in their emphasis on improving caregiver education and training, ways of making the most of potential care gains, and ways of easing care burdens. [ABSTRACT FROM AUTHOR]

Migration‐related stress is detrimental to children's mental health, yet little is known about the potential mechanisms behind this association. This study examines the mediating role of inflow city identity in the association between migration‐related stress and depression and the moderating role of social participation amongst Chinese migrant children. A sample of 484 migrant children aged 8–17 years is randomly recruited through a cross‐sectional survey in Kunming, China. Inflow city identity partially mediates the association between migration‐related stress and migrant children's depression. Moreover, social participation moderates the above relationship. The direct and indirect effects are significant for migrant children with low social participation but insignificant for migrant children with high social participation. This study deepens the theoretical understanding of the underlying mechanism between migration stress and psychological distress and provides practical implications for preventing mental disorders in Chinese migrant children. [ABSTRACT FROM AUTHOR]

Previous literature suggests that gratitude and mindfulness‐based intervention could effectively abate stressful life events, while the associations with cyberbullying perpetration have not been investigated. Little is known about the mechanisms of this association, especially for children who lack sufficient parental protection. The current study aimed to examine the roles of mindfulness and gratitude in the relationship between cyberbullying perpetration and depression among children and adolescents. This study employed data from a school‐based survey conducted in 2018, in which 1298 students aged 9–16 years were randomly selected from three elementary and middle schools in China. The moderated mediation effects of gratitude and mindfulness on the relationship between cyberbullying perpetration and depression were examined through PROCESS model. Results showed that mindfulness mediated the relationship between cyberbullying perpetration and depression, while gratitude moderated and weakened the relationship. The findings may offer insights into the awareness and intervention programs regarding positive psychological mechanisms to reduce cyberbullying perpetration among children and adolescents in China. [ABSTRACT FROM AUTHOR]

The plethora of pathways leading to health problems of later life has made the causal assessment of widowhood on the health of older adults difficult. This research aimed to assess the short‐term impact of widowhood on the objective health of older adults and to the moderating role of community‐based care (CBC) in improving the health outcomes of older adults. In this study, the activities of daily living (ADLs) and number of hospitalisations of older adults were measured, and PSM‐DID models were conducted. Widowhood had a significant negative impact on the objective health of older adults. Widowed adults had higher ADL scores (B = 0.569, 95 percent CI: 0.295 to 0.844) and more hospitalisations (B = 2.551, 95 percent CI: 1.189 to 3.914) than nonwidowed adults. Meanwhile, CBC in urban areas can significantly reduce ADL scores (B = −0.154, SE = 0.082) and the number of hospitalisations (B = −1.402, SE = 0.348) in older adults, whereas CBC in rural areas can only significantly reduce ADL scores (B = −0.197, SE = 0.087). Taken together, there is an urgent need to focus on the health of widowed and older adults and to provide CBC in both urban and rural areas equally. [ABSTRACT FROM AUTHOR]

Chinese immigrants in Australia are overrepresented among people with chronic hepatitis B virus (PWCHB) but experience poor access to healthcare. Given the historical discriminatory policies against PWCHB in mainland China, this study aimed to explore the lived experiences of stigma and discrimination surrounding hepatitis B virus (HBV) among Chinese immigrants originally from mainland China. Semi‐structured in‐depth interviews were conducted by a researcher with a Chinese background in 2019–2020. Sixteen Chinese immigrants living with HBV were recruited across Sydney and Melbourne through advocacy and support groups. This study is positioned in social constructionism. Data analysis was informed by the Health Stigma and Discrimination Framework that highlights the interaction between layered stigmas. This study revealed the historical, social and cultural construction of HBV‐related stigma among PWCHB and demonstrated how this stigma was manifested across socioecological levels in China and Australia. Findings show that HBV‐related stigma has mostly been driven by knowledge deficits about HBV and fear of HBV infection. HBV‐related stigma was mostly demonstrated around social isolation including isolation imposed by family and the community and employment restrictions in the Chinese workplace. In the Australian context, HBV‐related stigma was related to the ethnic and cultural background of PWCHB, and primarily occurred as anticipated stigma in the community and in employment. The findings provide significant insights for crosscutting research and policy endeavours to develop and test cross‐disciplinary initiatives that more broadly address the complex lived realities of Chinese immigrants living with hepatitis B virus. [ABSTRACT FROM AUTHOR]

This study aims to explore the associations between personality traits and depressive symptoms among Chinese adults and analyse the gender and age differences in the associations. A national representative sample of 28,628 adults aged 18 and above were selected from the 2018 China Family Panel Studies (CFPS) data. The short version of the Big Five Inventory (CBF‐PI‐15) and the Center for Epidemiologic Studies Depression (CES‐D 8) were used to measure personality traits and depressive symptoms respectively. Binary logistic regression models were employed to analyse the associations between personality traits and depressive symptoms in the whole participants, different age groups and genders respectively. After adjustment, higher levels of conscientiousness, extraversion and agreeableness were related to lower level of depressive symptoms, while higher levels of openness and neuroticism were related to higher level of depressive symptoms (p < 0.05). A significant interaction between gender and conscientiousness on depressive symptoms was found (interaction p = 0.005), and the association between conscientiousness and depressive symptoms was stronger in males than females (p < 0.001). Significant interactions between age and conscientiousness (interaction p = 0.007), agreeableness (interaction p = 0.001) on depressive symptoms were found respectively. Moreover, the associations of conscientiousness and agreeableness with depressive symptoms were strongest among old group, followed by middle‐aged group, and then young group (p < 0.05). In conclusion, conscientiousness, extraversion and agreeableness had negative associations with depressive symptoms, while openness and neuroticism had positive associations with depressive symptoms. The negative association between conscientiousness and depressive symptoms was stronger among males than females, and the negative associations of conscientiousness and agreeableness with depressive symptoms were strongest among old group, followed by middle‐aged group, and then young group. [ABSTRACT FROM AUTHOR]

Many studies have disentangled the perceived benefits of vegetation on subjective well‐being (SWB). Yet, scant attention has been paid to the joint effect of vegetation and building density on SWB. This study explores the relationship between streetscape vegetation (SV), building density and SWB in Beijing, China. Our analysis relies on rich measures of street view data to assess SV exposure at the neighbourhood level. Notably, we distinguish between trees (SV‐tree) and grasses (SV‐grass) when evaluating SV metrics. The results suggest that streetscape trees and grasses are positively associated with SWB, though estimated effects are dependent upon tree and grass density exposures. We also find that the effects of streetscape trees and grass are moderated by building density in the neighbourhood. Additional decomposition analysis provides the insight that the well‐being implications of street vegetation and building density are varied significantly by individual sociodemographic characteristics such as sex, age and income. The findings of this study suggest the importance of considering density in SV planning and land use policies to enhance people's quality of life. [ABSTRACT FROM AUTHOR]

This study aimed to examine whether older adults' financial status moderated the association between neighbourhood environment (i.e. physical and social environment) and loneliness among older adults in urban China. A cross‐sectional survey was collected from urban communities of Shanghai in mid‐2020. The final analytic sample was 459 older adults (age range = 60–91 years; proportion of women: 55.8%). Multiple group analysis was applied to test the hypothesised model. A measurement model of community social capital (i.e. cognitive and structural dimensions of social capital), a crucial indicator of neighbourhood social environment, was first established in both high‐income and low‐income groups. Factor loading invariance was established in these two groups. The results show that structural social capital (i.e. organisation memberships, volunteering, social participation and citizenship activities) was negatively associated with loneliness among older respondents from the high‐income group only, whereas better community security was significantly associated with lower levels of loneliness among low‐income older respondents only. The findings imply that both structural social capital and household income should be considered as important indicators in needs assessment among lonely older adults. Future social policies and interventions should pay attention to enhancing the role of both social and physical neighbourhood environment among older adults. [ABSTRACT FROM AUTHOR]

Non‐communicable diseases (NCDs) have become the major contributors to premature death and disability in China. This study used the repeated cross‐sectional datasets of the 2008, 2011, 2014, and 2018 Chinese Longitudinal Healthy Longevity Survey, with a total number of 44,886 observations, to investigate the association between doctor‐diagnosed chronic diseases (DCDs) and socioeconomic status at both individual and province level by multilevel logistic models. Results showed that higher socioeconomic status at both individual and regional level (measured as urbanisation) were associated with higher odds of diagnosed chronic diseases among older people in China. This study also found a "convergent" effect on DCDs between individual income and urbanisation. Meanwhile, older people who can receive adequate medical support and who cannot receive adequate medical support have a "divergent" effect on DCDs by urbanisation. Additionally, older people with different types of public health insurance have a "paralleled" effect on DCDs by urbanisation. The implications of this study may be that chronic disease among older people in lower socioeconomic status was substantially underdiagnosed. Investment in primary health care could be a cost‐effective way to reduce the inequalities of diagnosed chronic diseases. [ABSTRACT FROM AUTHOR]

The purpose of this study is to evaluate the effect of assistive devices on the level of depression among older adults. Using data from the 2015 and 2018 waves of China Health and Retirement Longitudinal Studies (CHARLS), we analysed this effect through the PSM‐DID model and verified the mechanism of the effect through Hayes' mediating effect model. The results showed that assistive devices increased depression levels in older adults. Moreover, there were significant differences among different groups of older adults. The use of assistive devices in developed areas, women, people under 75 years old, and socially active older people had a deeper impact on the level of depression. Differences in the type and number of assistive devices used also affect the level of depression in older people. Furthermore, assistive devices use in older adults increases depression levels by decreasing health satisfaction. This study provides new evidence to explore the relationship between the use of assistive devices and depression levels in older adults. Meanwhile, our research illustrates the importance of developing products and services with age‐friendly technology. [ABSTRACT FROM AUTHOR]

Grandparenting is known to impact psychological health in older people. However, the extent to which the effect is altered by migration‐related and sociodemographic determinants is less clear. Therefore, we conducted this cross‐sectional study to investigate whether the association between grandparenting and psychological distress differs between rural–urban migrants and local older adults from May to September 2019. A total of 373 rural–urban migrants and 602 local older adults involved in grandparenting in Hangzhou completed measurements assessing sociodemographic characteristics, childcare burden and psychological distress. In total, 22.2% of the grandparents reported psychological distress. Rural–urban migrant grandparents had a lower socioeconomic status (SES), a higher childcare burden (23.6 ± 9.2 vs. 20.7 ± 9.5, p < 0.001) and higher levels of psychological distress (29.8% vs. 17.4%, p < 0.001) than local grandparents. Childcare burden and pressure from adult children were the most significant predictors for psychological distress in both groups (ps < 0.05). Psychological distress was also significantly associated with self‐rated health status (β = −0.276, p = 0.033) and willingness to participate in grandparenting (β = −0.659, p = 0.024) in migrant grandparents but associated with female gender (β = 0.346, p = 0.022), caring for children at night (β = 0.424, p = 0.011), conflict with adult children (β = 0.432, p < 0.001) and annual income (β = −0.237, p < 0.001) in local grandparents. Migrant status showed a statistically significant moderating effect between childcare burden and psychological distress. These results may be of assistance in comprehensively understanding the social determinants of mental health of grandparents involved in grandparenting. [ABSTRACT FROM AUTHOR]

We aimed to assess the association between change in social participation and long‐term improved cognitive function among older adults. Data were obtained from 9648 participants aged ≥60 years in the 2011, 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, a national prospective cohort study. Cox regression models were used to calculate adjusted risk ratios (aRRs). Social participation was increased in 20.5% of the participants, decreased in 37.8% of the participants and stable in 41.7% of the participants from the 2011 wave to the 2014–2018 waves. The improved cognitive function rate was 17.9% at follow‐up. Compared to individuals with decreased social participation from the 2011 wave to the 2014–2018 waves, individuals with unchanged total social participation were 59% (aRR = 1.59, 95% CI: 1.35–1.87) more likely to have improved cognitive function in the 2014–2018 waves, and individuals with increased social participation were 61% (aRR = 1.61, 95% CI: 1.43–1.82) more likely to have improved cognitive function, regardless of the baseline social participation status. As for the three forms of social participation, compared with the participants with decreased social participation, those with increased participation in organised social activities, increased participation in group leisure‐time activities, unchanged informal social interactions and increased informal social interactions were 24% (aRR = 1.24, 95% CI: 1.02–1.51), 49% (aRR = 1.49, 95% CI: 1.21–1.84), 55% (aRR = 1.55, 95% CI: 1.37–1.76) and 57% (aRR = 1.57, 95% CI: 1.34–1.84) more likely to have improved cognitive function (all p < 0.05) respectively. The results were stable in the sensitivity analysis. Our findings highlight the importance of promoting social participation from a multidimensional perspective (duration, frequency and forms) to improve cognitive function among older adults, for policy makers and healthcare workers in the community. [ABSTRACT FROM AUTHOR]

Ambiguous perceptions of job roles by service providers may lead to poor service quality. This study sought to examine the relationship between role ambiguity and service impact among disability support workers, and further, to compare the mediating effects of job‐based and collective psychological ownership in the role ambiguity–service impact link. Data were derived from a longitudinal survey conducted in 56 cities in mainland China in 2019. 1153 social workers working in disability and rehabilitation services sectors completed the questionnaire. Structural equation modeling analyses and bootstrapping were applied to test the proposed model. The results revealed that role ambiguity is a risk factor for disability support workers' service impact. Furthermore, psychological ownership serves mediating roles in the relationship between role ambiguity and service impact among disability support workers. Even more, job‐based psychological ownership plays a more critical buffering role than collective psychological ownership does among Chinese disability support workers experiencing role ambiguity. The main findings imply that human service organizations in China face the dilemma of insufficient organizational capacity, with employees tending to resolve problems by relying more on their own resources than organizational resources. Therefore, policymakers and human service organizations should develop the organizational capacity of human service organizations to help employees overcome role ambiguity. [ABSTRACT FROM AUTHOR]

Grandparental care has become an involuntary choice in life for many families, mainly due to parents' unavailability to provide care and the lack of public or affordable private childcare. This phenomenon has raised concerns regarding the effects of grandparental care along the dimensions of child development. This study aims to test the association between grandparental care and child development in three dimensions: subjective wellbeing, behavioural traits and study performance. It used data from the 2018 China Family Panel Studies survey. First, the study outlines the data and the applied method with defined variables, on the basis of which an overview on the current stage of grandparental care is presented. It then examines the association of the impact of grandparental care in different dimensions using the general linear model, along with the other influencing factors. Finally, a cross‐age group comparison is employed. The results of the study illustrate the difficulty of examining an overall picture of grandparental childcare, with its negative or positive associations. However, when evaluated using the features of different age groups of children's development, significant associations between grandparental care and child development are mainly found in the 6–11 age group, but the significant associations weaken or disappear in the 12–16 age group. Attachment theory and peer group theory are used to explain the difference between the two age groups. [ABSTRACT FROM AUTHOR]

This study examines if parental neglect is significantly associated with adolescent cyberbullying perpetration, and whether this relationship is mediated by smartphone addiction. In addition, the moderation of self‐regulation in the direct and indirect effects of parental neglect on cyberbullying perpetration among adolescents is determined. A random sample of 728 Chinese adolescents from Grade 10 to 12 in senior high schools respond to anonymous questionnaires regarding parental neglect, smartphone addiction, self‐regulation and cyberbullying perpetration. The data are then analysed using macro PROCESS. Results reveal that adolescents who are neglected by parents are more likely to engage in cyberbullying perpetration. Smartphone addiction significantly partially mediates the above relationship. Moreover, self‐regulation not only moderates the relationship of cyberbullying perpetration with parental neglect but also its association with smartphone addiction among adolescents. This study contributes to a better understanding of how parental neglect increases the risk of adolescent cyberbullying perpetration, which may be reduced through tailored interventions. [ABSTRACT FROM AUTHOR]

This study explores the moderating influence of perceived and objective community environments on the relationship between older adults' home‐ and community‐based care (HCBC) needs and their actual utilisation of such care. We selected 5,668 older adults in two cities in China and adopted latent class analysis to descriptively explore the patterns of their HCBC need and utilisation. Structural equation modelling was used to determine factors related to the patterns of need and utilisation of HCBC services, and to explore the moderating roles that the perceived and objective community environments had on the effect of long‐term care need on its utilisation. The results descriptively showed that older adults' patterns of HCBC need and utilisation appear to be embedded within two broader latent categories: a high‐need/use group and a low‐need/use group. Among participants who were satisfied with their community or who lived in areas with high accessibility to HCBC services, HCBC need could predict HCBC use. Our integrated conceptual framework proved to be applicable, thus enriching the theoretical models in explaining HCBC‐related behaviours. The results have strong implications for urban planners, policymakers, and programme managers who seek to support older people and provide elderly care services in communities. [ABSTRACT FROM AUTHOR]

Past evidence has revealed the negative effects of children's witnessing of family violence. With our increasingly aging society comes a higher risk of elder abuse, which creates new challenges in the form of the indirect and direct victimisation of children in the home. However, research on the relationship between children's witnessing of elder abuse and their victimisation experiences is limited. This study examines the physical and mental health outcomes of witnessing elder abuse, as well as the relationship between children's witnessing of elder abuse at home and child abuse victimisation. A large‐scale representative sample of 18,504 students aged 14–18 from six major cities in China was analysed to investigate the associations. The results showed that children who had witnessed more than one type of elder abuse were more likely to have depression and poor health than those who had witnessed only one type. Children's witnessing of elder abuse was also significantly associated with child abuse and bullying victimisation. These findings offer implications for policy making and service delivery in family‐based child protection and interventions: Future interventions aimed at addressing indirect child victimisation should be integrated with those focused on direct forms of victimisation in order to effectively identify at‐risk families as a whole. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to investigate the influence of perceived discrimination on children's depression and behavioral problems via the mediator of integration among Chinese migrant children. Rural‐urban differences in the proposed relationships are also examined. Methods: The sample included 484 migrant children (Mean age = 11.65 years; 52.9% girls), which was collected through multi‐stage cluster random sampling in Kunming, Southwest China. Structural equation modelling (SEM) was adopted for data analysis. Results: Results indicate that perceived discrimination reduces the integration of Chinese migrant children, which in turn, leads to their higher levels of depression and more behavioral problems. The multi‐group analysis on rural‐urban differences reveals that the effects of discrimination on depression and behavioral problems are significant among rural‐urban migrants but not among urban–urban ones. Conclusions: This study contributes to current knowledge by revealing the mechanisms among perceived discrimination, integration, depression and behavioral problems of Chinese migrant children. The migration pattern differences in terms of their depression and behavioral problems are also highlighted. [ABSTRACT FROM AUTHOR]

Physical activity plays an essential role in preventing diseases and improving overall health. Promoting physical activity has become an important intervention against low physical fitness and chronic diseases in older adults. This study aimed to determine whether telling older people their predictive physical fitness age prompts physical activity. Two hundred and fifty‐three older Chinese people were assigned single‐blindly to either an intervention group (n = 140) or control group (n = 113) in this quasi‐experimental study. Participants in the intervention group were informed of the predictive physical fitness age and taught the difference from their chronological age while participants in the control group were not. Participants in both groups were encouraged to get more physical activities each day. The primary outcome was physical activity, and the secondary outcome was the change in physical fitness age. Results showed that for older adults with low physical fitness, all physical activity parameters (vigorous physical activity, moderate physical activity, walking, total physical activity and sitting) showed a significant difference between intervention and control groups after 2 and 12 weeks (p < 0.05). Moreover, physical fitness age was improved remarkably after 12 weeks compared to the control group (73.57 ± 5.75 vs. 66.85 ± 6.33 years, p < 0.05). For older adults with normal physical fitness, a remarkable difference was observed in moderate physical activity, total physical activity, and sitting between intervention and control groups after 2 weeks (p < 0.05), but the difference disappeared after 12 weeks. For older adults with high physical fitness, no significant changes were found between groups (p > 0.05). The findings suggest that telling older people their predictive physical fitness age can become a viable motivational tool to promote physical activity especially for those with low physical fitness, thereby improving their physical fitness age and overall health. [ABSTRACT FROM AUTHOR]

Little is known about the pattern, influencing factors of peer relationships, or their interplays amongst community‐dwelling older people. This qualitative study was undertaken to understand and present these issues under the guidance of existing Adams‐Blieszner‐Ueno integrative conceptual framework for friendship in the context of China. Semi‐structured interviews were undertaken with 20 older adults in Chongqing, China. Interview transcripts were then analysed by performing content analysis under the guidance of existing categories of Adams‐Blieszner‐Ueno integrative conceptual framework for friendship and developing separate categories inductively to ensure all data was captured. The results revealed four themes—context, individual characteristics, interactive motifs and peer relationship patterns—and 16 categories. Based on the original Adams‐Blieszner‐Ueno integrative conceptual framework for friendship, the revised framework for peer relationships modified two dimensions (from structural context to social context, friendship patterns to peer relationship patterns) and added two categories (natural context and health status) that emerge from the data. Besides, different dimensions in the modified framework for peer relationships are explicitly interrelated and not completely independent from each other. In conclusion, this study modified the pre‐existing Adams‐Blieszner‐Ueno integrative conceptual framework for friendship, especially identifying two additional categories, natural context and health status, to understand peer relationships amongst the Chinese community‐dwelling older people through careful examination of the data. All domains concerning the modified conceptual framework of peer relationship may serve as possible targets for developing peer‐involved programs and thus improving social health, well‐being and successful ageing of Chinese older people. [ABSTRACT FROM AUTHOR]

Despite a rapid increase in people with Parkinson's disease (PD) in China, studies focusing on caregiver burden remain scarce. Challenges faced by caregivers in other Asian societies are also underexplored in the PD‐related research field. To addresses this gap, this study drew on the theory of resilience and examined the caregiving experiences of Chinese family caregivers for older people with PD. We conducted participant observation and semi‐structured interviews with 15 family caregivers of older people with PD in Shanghai in 2018. We used thematic analysis to identify key patterns of stressors and factors affecting the capacity of caregivers to address burdens. Our analysis shows that stressors faced by Chinese PD caregivers included physical limitations, psychological and emotional problems, reduction in social connections, financial burden and lack of information and knowledge. Three levels of factors—personal, social and structural—played different roles in resilience among Chinese PD caregivers. However, resilience was unevenly developed among PD caregivers across gender, kinship, residential status and generation. Our study provides novel empirical evidence about the burden on Chinese PD caregivers. It can inform policymakers and social workers as they develop a holistic understanding of promoting resilience building in this rapidly growing group. Our study also enriches cross‐cultural knowledge about factors contributing to caregivers' resilience building in Asian societies. [ABSTRACT FROM AUTHOR]

Social participation comprises comprehensive interactions between individual health and relevant environmental characteristics, which play an increasingly important role in promoting older adults' health and quality of life. Although many studies have examined impacts of various factors on the social participation of older adults, some internal mechanisms between health characteristics and environmental characteristics have not been revealed. This study aimed to examine the moderating effects of health characteristics on the relationships among psychological resources, social network support, community support and social participation of Chinese older adults. Based on some key health indicators, this study used the two‐step cluster algorithm to divide the participants aged over 60 years from the Chinese Longitudinal Aging Social Survey in 2016 (N = 8669) into low (47.2%), moderate (33.8%) and high (18%) health risk groups. A multiple‐group structural equation model was then built to examine the effects of psychological resources, social network support and community support on social participation across the three groups. The results suggested that with the increase in health risks, the contributions of psychological resources and community support to social participation decreased from 28.6% to 23.7% and from 61.5% to 50.7%, respectively, while that of social network support increased from 9.9% to 25.6%. These variations suggest that individual health has a significant moderating effect on the psychological and social compensating mechanisms of the social participation among Chinese older adults. [ABSTRACT FROM AUTHOR]

Universal prevention is a practical approach to preventing depressive symptoms in adolescents, but barriers might reduce its effectiveness. This study explored possible barriers to universal prevention of depressive symptoms in Chinese adolescents. We interviewed thirteen adolescents who participated in the program. Thematic analysis was used to analyse the data. The results revealed three categories of barriers. The first category was participants' maladaptive coping strategies and beliefs about negative emotions. They tended to use avoidance coping, did not believe that negative emotions can be regulated, and had an unrealistic wish for a quick fix. The second category originated from the prevention contents. The complexity of the psychological techniques and the lack of proficiency among the participants were important barriers. The third category was the setting of the psychological course. Participants were reluctant to invest cognitive effort in the psychological course. The large‐size class also made it challenging to have an in‐depth exploration into emotions and thoughts. Our study added to the existing literature by providing more knowledge of barriers to universal prevention. Future research and practice need to adequately address these barriers so that universal prevention can be conducted more effectively. [ABSTRACT FROM AUTHOR]

An increasing number of studies have focused on the relationship between neighbourhood environment and depressive symptoms among older people. However, the underlying mechanisms are still unclear. This study examined the association between neighbourhood environment and depressive symptoms among older urban Chinese adults and the mediator role of social capital in this association. Using a quota sampling approach, 472 respondents aged 60 years or older were recruited from 23 urban communities of Shanghai, China, in 2020. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale. Social capital was measured by two latent constructs: cognitive social capital (e.g., trust, reciprocity, belongingness) and structural social capital (e.g., memberships, social participation). Perceived physical neighbourhood environment was assessed in terms of health care, security, and public transportation status. Structural equation modelling was conducted to test the study hypotheses. Health care services in the community had a direct effect on depressive symptoms (β = −0.097, p <.05). Cognitive social capital played a mediator role in the relationship between physical neighbourhood environment and depressive symptoms (community health care: β = −0.124, p <.01; community security: β = −0.284, p <.01). The mediator effect of structural social capital in the relationship between physical neighbourhood environment and depressive symptoms was not significant. The findings highlight the role of physical neighbourhood environment in fostering community‐based social capital and promoting mental health among older adults in urban China. Policy strategies could focus on improving community health care and security to promote mental health. [ABSTRACT FROM AUTHOR]

Currently, very few studies have comprehensively investigated how intergenerational relationship quality (IRQ) between older parents and adult children is related to older adults' activity engagement. To fill this gap, this study endeavoured to examine the associations between IRQ and older adults' activity profiles, not only considering the overall IRQ but also different dimensions of IRQ. We also aimed to reveal the different roles of IRQ with son(s) and with daughter(s). This study made use of survey data collected in Yibin City, Sichuan Province of China in 2018 (N = 4,211). We adopted hierarchical cluster analysis to identify activity profiles, and performed multinomial logistic regressions to assess the association between IRQ and the profiles. We identified five activity profiles among older adults: "caregiving‐oriented", "employment‐oriented", "social withdrawal", "diverse engagement" and "physically active". Those with greater IRQ were more likely to be "caregiving‐oriented" and have "diverse engagement" relative to "social withdrawal". It also showed that structural‐associational solidarity and affectual closeness were more predictive of the activity profiles, compared to consensual‐normative solidarity and intergenerational conflict. Children's gender plays an important role in the relationship between IRQ and activity engagement profiles. Good intergenerational relationships might not narrow down older adults' activity domains, and instead might actually promote their participation in diverse domains. Promoting structural‐associational solidarity and affectual closeness was likely to reduce social withdrawal among older adults in China. [ABSTRACT FROM AUTHOR]

The purpose of this study was to estimate the prevalence of unintentional injuries and to identify factors mediating the risk of unintentional injuries among internal migrant children in southern China using self‐reported data collected between April 2016 and March 2017. Logistic regression models were used to identify significant risk factors for unintentional injuries among the internal migrant children. The prevalence of self‐reported unintentional injuries among internal migrant children in this study was 19.15%. Internal migrant children exhibiting antisocial (antisocial behaviour vs. no behaviour problems, OR = 2.162, 95% CI: 1.194–3.915, p =.011) and neurotic behaviours (neurotic behaviour vs. no behaviour problems, OR = 2.064, 95% CI: 1.098–3.880, p =.024) were more likely to report unintentional injuries. There was a positive correlation between the number of risk behaviours and the prevalence of unintentional injuries among non‐migrant and internal migrant children. Children's behavioural problems were closely related to unintentional injuries and may be useful as predictors of unintentional injuries in children. [ABSTRACT FROM AUTHOR]

Social exclusion is a widely accepted risk factor for child well‐being, but relatively little is known about its dynamics and effect on multiple well‐being domains. This study aims to extend prior research by examining the influencing mechanisms of structural‐economic and socio‐relational exclusion on the physical, psychological, behavioural and educational well‐being of Chinese migrant children. Multi‐stage cluster random sampling is used to recruit a sample of migrant children (N = 484; Mage = 11.65 years; 52.9% girls) in Kunming, China, and structural equation modelling is used for data analysis. Results indicate that a high level of structural‐economic exclusion predicts a high level of socio‐relational exclusion, which, in turn, leads to low levels of physical, psychological, behavioural and educational well‐being among migrant children. This study not only contributes to the understanding of the dynamic effects of social exclusion but also provides practical implications for social policy and interventions to reduce social exclusion and improve the well‐being of Chinese migrant children. [ABSTRACT FROM AUTHOR]

The reduction of diabetes‐related avoidable hospitalisations (AHs) can be achieved via the provision of timely and effective primary healthcare (PHC), which has made diabetes AHs rate a widely adopted indicator for evaluating the performances of PHC systems. This study reported the AHs rate of diabetes and further explored its relationship with PHC resourcing in China. Hospital discharge data of the fourth quarters of 2016 and 2017 in Sichuan Province, China were used. The number of PHC doctors per 10,000 population and the proportion of PHC doctors on all doctors were used as indicators reflective of PHC resourcing. Linear regression models were used to explore the associations between PHC resourcing and AHs of diabetes. Age‐standardised rates of diabetes‐related AHs in Sichuan province, China were found to be 248.102 and 272.368 per 100,000 population in 2016 and 2017, respectively. A 10% increase in the number of PHC doctors per 10,000 population was associated with a reduction of 2.574 per 100,000 population in the age‐standardised AHs rate of diabetes. In addition, 10% increase in the proportion of PHC doctors on all doctors was associated with a reduction of 10.839 diabetes‐related AHs per 100,000 population. Based on subgroup analysis, PHC resourcing demonstrated to have a stronger impact on AHs of diabetes with long‐term complications than on that of uncontrolled diabetes. Our findings reported that the diabetes AHs rates in Sichuan Province were prevalently high. We also found that increased PHC resourcing was associated with decreased diabetes‐related AHs rates. [ABSTRACT FROM AUTHOR]

The fast‐developing Internet is changing the way people interact, this new phenomenon helps people build and accumulate online social capital. However, the influence of online social capital on individual health is controversial. Based on the social capital theory, this study examined the effect of online social capital on health in subgroups with different levels of offline social capital. Data from the China Family Panel Studies of 2016 were used (N = 13,910), and the propensity score matching approach was used to address potential endogeneity problems. The results show that offline social capital had significant positive associations with individual health; although online social capital had few effects on individual health overall, significant health effects of online social capital were observed in subgroups with different offline social capital levels. In subgroups with less general trust and neighborhood social capital, more online social capital was associated with less depression; while in subgroups with more neighborhood social capital, more online social capital was associated with an elevated probability of two‐week morbidity. Our findings further clarify the relationship between online/offline social capital and individual health. Online social capital can be considered as a supplement of offline social capital when it comes to health promotion, and more online contact should be encouraged when offline social capital of individuals or within the community is scarce. [ABSTRACT FROM AUTHOR]

Transgender women sex workers (TGSW), as a highly stigmatised population, are at substantial risk for mental health problems but lack access to mental health care. This study investigated factors of mental health service utilisation (MHSU) behaviour and related behavioural intention among TGSW who were at risk of mental health problems in the past year [subsample 1: scored above the cut‐off for probable depression or probable anxiety or had suicidal ideation (N = 126); subsample 2: perceived needs for mental health services (N = 109)]. A cross‐sectional survey was conducted among TGSW in Shenyang, China during 2017–2018. Data on minority stress, coping, mental health and MHSU were collected. 10.3% of participants in subsample 1 and 14.7% in subsample 2 had sought help from mental health professionals in the last year. Unwillingness to disclose minority identity and gender non‐affirmation were negatively associated with MHSU. Factors for behavioural intention of MHSU included unwillingness to disclose minority identity and social support for both subsamples and adaptive coping for subsample 2. Confidentiality concern, discrimination and cost were the most frequently endorsed barriers to mental health services. Interventions should promote gender affirmation, social support and adaptive coping as well as remove stigma to increase health service access and utilisation among minority populations. [ABSTRACT FROM AUTHOR]

Since the mid‐1990s, information technology, particularly the diffusion of the internet, has brought tremendous changes to communication and social participation for people in China, including older adults. At the same time, modernisation and urbanisation have transformed the way many people in China live. The traditional multigenerational household—older adults living with adult children and grandchildren—is giving way to other living arrangements, such as living alone or with a spouse only. Using wave 1 of the World Health Organization Study on Global AGEing and Adult Health collected between 2007 and 2010, we examined the extent to which home internet access might be associated with cognitive function in older adults aged 50 or over in urban China (N = 5,898), paying attention to the moderating role of living arrangements. We found that home internet access was associated with better cognitive function, and living arrangements played an essential role in such an association for different age groups. Specifically, older adults living alone benefited cognitively from internet access, particularly among those aged 50–64 and 65–74. Those living with a spouse only and those in two‐generation households benefited cognitively from internet access, particularly among those aged 50–64 and 75+. Older adults age 75+ in skip‐generation households benefited cognitively from internet access. Considering the trend of older adults living apart from their children, our research suggests that providing internet access to older adults in urban China, especially those living alone, could help protect their cognitive function. [ABSTRACT FROM AUTHOR]

Cyberbullying is a global and growing phenomenon, which affects the wellbeing of millions of adolescents around the world including Chinese adolescents. However, there is a lack of valid and reliable measures of cyberbullying behaviours in Chinese. To address this research gap, this study aims to adapt and validate a well‐known, reliable and validated instrument: the European Cyberbullying Intervention Project Questionnaire (ECIPQ) among Chinese adolescents. A 14‐item (seven for cyber aggression and seven for cyber victimisation) of the Chinese version of ECIPQ was developed based on its relevance and appropriateness to the Chinese culture. After its cultural and linguistic adaptation, the measure was norm with a sample of Chinese adolescents. A total sample of 452 adolescents was randomly split into two evenly subsamples for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The EFA results indicated that the Chinese version of ECIPQ had a good convergent validity and satisfactory discriminant validity, and a two‐factor model was identified. CFA results showed a good fit of the measurement model in assessing cyber aggression and cyber victimisation. This adapted Chinese version of ECIPQ can be used to facilitate future research on cyberbullying screening, and that research may in turn promote proactive screening and better coordination of community responses for victims as well as perpetrators. Future comparative studies may use the validated scale to assess the prevalence of cyberbullying and the results of interventions to reduce cyberbullying among Chinese adolescents. [ABSTRACT FROM AUTHOR]