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Digital contact-tracing systems have been widely implemented worldwide with different system designs and implementation policies for the purpose of tracking potentially exposed individuals. The use of a digital contact-tracing app in Hong Kong has been mandated for visiting certain premises by legislations. This paper reviewed the regulations promulgated specifically for the prevention and control of COVID-19 and identified those associated with the digital contact-tracing system. A comprehensive search in newspaper databases was performed to explore the enforcement of the mandated use of the digital contact-tracing app. The three facets of regulations in relation to digital contact tracing were examined: duty to disclose information, requirements and directions to businesses, and compulsory testing. The use of digital contact-tracing data for non-public health purposes was also reported. Our analyses showed that prosecution of non-use or the use of fraudulent digital contact-tracing apps was not limited to COVID-19-specific legislations. The flexible approach ensured the enforcement of the use of the digital contact-tracing app, but the judiciary's test must be passed in future cases. [ABSTRACT FROM AUTHOR]

Hong Kong experienced the SARS pandemic in 2003. Seventeen years later, the Covid-19 pandemic now challenges Hong Kong and the world. This study aims to unveil the impact of the pandemic on health social workers. One hundred and sixty-six health care social workers in Hong Kong were recruited to join a cross-sectional online survey from November 2020 to March 2021. This paper includes the analysis of the demographic information, fear of contamination, resilience, perceived social support and physical health only. Irrespective of the demographic background, the level of fear of contamination, resilience, perceived social support and physical health were similar. The mean scores of the two dimensions of fear of contamination (Harm avoidance: m = 7.49, s.d. = 3.25; Disgust avoidance: m = 7.75, s.d. = 2.90) were higher than those of general public and clinical samples with Obsessive-Compulsive Disorder. No moderation effects were found in resilience and perceived social support in the relationship of fear of contamination and physical health. Instead, direct effects were shown.The impact of the pandemic on health social workers was universal. Psychoeducational programs to alleviate the fear of contamination and organizational-level interventions to improve workplace social support are highly needed. [ABSTRACT FROM AUTHOR]

The East Asian experience in tackling COVID-19 has been highly praised, but this high-level generalisation neglects variation in pandemic response measures adopted across countries as well as the socio-political factors that shaped them. This paper compares the early pandemic response in Singapore and Hong Kong, two Asian city-states of similar sizes, a shared history of SARS, and advanced medical systems. Although both were able to contain the virus, they did so using two very different approaches. Drawing upon data from a cross-national, probability sample Internet survey conducted in May 2020 as well as media and mobility data, we argue that the different approaches were the result of the relative strength of civil society vs. the state at the outset of the outbreak. In protest-ridden Hong Kong, low governmental trust bolstered civil society, which focused on self-mobilisation and community mutual-help. In Singapore, a state-led response model that marginalised civil society brought early success but failed to stem an outbreak among its segregated migrant population. Our findings show that an active civil society is pivotal to effective outbreak response and that trust in government may not have been as important as a factor in these contexts. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco use is associated with an increased risk of Coronavirus Disease 2019 (COVID-19) infection, severe COVID-19 outcomes requiring intensive care, and mortality. We investigated the perceived risk of and changes in cigarette, e-cigarette (EC) and heated tobacco product (HTP) use in relation to COVID-19 in Hong Kong adolescent tobacco users. METHODS We conducted semi-structured telephone interviews from January to April 2021 and in February 2022 on 40 adolescents (65% boys, Secondary school grades 2-6) who participated in our previous smoking surveys and were using cigarettes, ECs or HTPs before the first wave of the COVID-19 pandemic in January 2020. RESULTS Adolescents generally perceived higher risks of contracting and having more severe COVID-19 from using cigarettes than ECs/HTPs, but they had limited knowledge of COVID-19 risks from EC/HTP use, particularly. Both increased and reduced consumption were found in tobacco, with EC use being the less affected product. Changes also included switching to ECs for convenience and lower cost and shifting from smoking cigarettes outside to mainly at home or in hidden areas. COVID-related policies, fear of infection, non-COVID-related health concerns, less social opportunities and pocket money, and limited access to tobacco products were barriers to tobacco use. In contrast, greater freedom at home versus school and negative emotions due to social distancing were facilitators. Family/peer influence had mixed impacts. CONCLUSIONS Adolescent tobacco users perceived lower COVID risks associated with HTPs and ECs than cigarettes, and various changes in tobacco use were found amid the pandemic in Hong Kong. COVID-19 and related social changes may both facilitate or deter adolescent tobacco use. [ABSTRACT FROM AUTHOR]

INTRODUCTION Perceived risk of COVID-19 infection is associated with smoking behaviors, but the change in smoking across different settings are uncertain. We examined the associations of perceived increased susceptibility to COVID-19 due to smoking with change in smoking at home and on the streets. METHODS We analyzed data of 1120 current cigarette smokers aged >15 years from a population-based telephone survey in Hong Kong. Perceived increased susceptibility to COVID-19 due to smoking, change in smoking, intention to quit, and tobacco dependence were measured. We used Poisson regression with robust variance to estimate adjusted risk ratio (ARR) for associations, adjusting for sociodemographic characteristics, intention to quit, and time to first cigarette after waking. RESULTS More current smokers reduced smoking on the streets (46.1%; 95% CI: 42.8-50.0) than at home (8.7%; 95% CI: 7.0-10.8). Perceived increased susceptibility to COVID-19 due to smoking was associated with smoking reduction at home (ARR=3.29; 95% CI: 1.80-6.00, p<0.001) but not on the streets (ARR=1.13; 95% CI: 0.98-1.30, p=0.09). More smokers with stronger quit intention and lower tobacco dependence reduced smoking at home but not on the streets in those with high perceived increased susceptibility to COVID-19 due to smoking. CONCLUSIONS This is the first report showing that more cigarette smokers reduced smoking on the streets than at home, and the perceived increased susceptibility to COVID-19 due to smoking was only associated with smoking reduction at home but not on the streets. Improving smokers' awareness of the susceptibility to COVID-19 may be an effective strategy to reduce tobacco consumption and secondhand smoke exposure at home within the context of future respiratory pandemics. [ABSTRACT FROM AUTHOR]

As social inequalities during the COVID-19 pandemic have been recognised, emerging research showed that lesbian, gay and bisexual (LGB) people may be additionally affected during the pandemic. This paper adds to the understanding of the experiences of LGB people during the pandemic with a focus on Hong Kong, where issues of space significantly influence LGB people's lives in this city with high population density. As part of a larger community study of LGB lives in Hong Kong, COVID-19-related impact on 434 Chinese-speaking LGB people was explored. Data collection was conducted from 20 May to 30 June 2020. Inductive thematic analysis of the open-text response survey data found that the LGB participants described both negative and positive impacts brought by COVID-19. Such impacts could be dimensionalised into those related to personal space and privacy, romantic and sexual space, and community space. It was also found that the experiences of COVID-19 among LGB people in Hong Kong were intersectional, along the lines of living arrangement and relationship status. Such findings make unique contributions to the emerging literature. First, there needs to be a more nuanced understanding of sexual minority individuals' experiences during COVID-19 across cultural contexts. Second, COVID-19 was described as having brought positive impact in addition to its widely known negative impact. [ABSTRACT FROM AUTHOR]

INTRODUCTION How changes in smoking routine due to COVID-19 restrictions (e.g. refraining from smoking outdoors and stockpiling tobacco products) influence smoking behaviors remains understudied. We examined the associations of changes in smoking-related practices with quit attempts and smoking consumption in current smokers using a mixed-methods design. METHODS In a community-based telephone survey conducted between the second and third wave of the COVID-19 pandemic in Hong Kong, 659 smokers (87.1% male; 45.2% aged 40--59 years) were asked about quit attempts and changes in cigarette consumption and five smoking-related practices since the COVID-19 outbreak. Logistic regression was used to calculate adjusted odds ratio (AOR), adjusting for sex, age, education level, chronic disease status, heaviness of smoking (HSI), psychological distress (PHQ-4) and perceived danger of COVID-19. A subsample of 34 smokers provided qualitative data through semi-structured interviews for thematic analyses. RESULTS Favorable changes in smoking-related practices, including having avoided smoking on the street (prevalence: 58.9%) and reduced going out to buy cigarettes (33.5%), were associated with a quit attempt (AOR: 2.09 to 2.26; p<0.01) and smoking reduction (AOR: 1.76 to 4.97; p<0.05). Avoiding smoking with other smokers (50.5%) was associated with smoking reduction (AOR=1.76; p<0.05) but not quit attempt (AOR=1.26; p>0.05). Unfavorable changes, including having increased smoking at home (25.0%) and stockpiled tobacco products (19.6%), were associated with increased smoking (AOR: 2.84 to 6.20; p<0.05). Low HSI (0--2) was associated with favorable changes (p<0.01), while high HSI score (3--6) was associated with unfavorable changes (p<0.01). Qualitative interviews revealed a double-edged effect of staying at home on smoking consumption and that pandemic precautionary measures (e.g. mask-wearing) reduced outdoor smoking. CONCLUSIONS Amid the pandemic, favorable changes in smoking-related practices in smokers were mostly associated with quit attempts and smoking reduction, while unfavorable changes were associated with increased smoking. Smokers with higher nicotine dependence were more negatively impacted. [ABSTRACT FROM AUTHOR]

INTRODUCTION Changes in tobacco use since the COVID-19 outbreak differed by countries and little is known about changes in the use of specific tobacco products. METHODS We analyzed data from four cross-sectional telephone/online surveys from April to June 2020 to investigate such changes since the 1st and 2nd wave outbreaks (February to April 2020) in Hong Kong. The respondents were 1595 adults (83.2% male) who used tobacco before the COVID-19 outbreak from our previous intervention study and surveys. We investigated the changes in tobacco use, intention to quit and quit attempts during the outbreak. RESULTS About two-thirds (65.3%) of respondents reported no change in overall tobacco use, while 23.1% used less (including cessation) and 11.6% used more, resulting in a net decrease of 11.5 percentage points. A greater net decrease was observed for cigarettes (14.3% points) than heated tobacco products (HTPs, 3.3% points) and electronic cigarettes (e-cigarettes, 2.5% points). Decreased use was mainly due to the more extended stay at home (63.2%), health considerations (52.6%) and mask-wearing (47.4%), while increased use was for passing time (75.0%) and releasing stress (46.4%). Eight percent of cigarette, HTP and e-cigarette users reported a higher intention to quit since the pandemic outbreak. Nineteen percent of tobacco users (176/948) attempted to quit during the pandemic. Only 2.9% (46/1569) were abstinent at the time of the survey. CONCLUSIONS Overall tobacco use decreased after the first two waves of the COVID-19 outbreak in Hong Kong. A greater proportion of cigarette users decreased use than HTP and e-cigarette users. Given the different methods used in the four surveys, future studies should aim for a large and representative sample. [ABSTRACT FROM AUTHOR]

Summary: Individuals with intellectual disabilities who might have been previously placed into segregated institutions now live independently in the community, supported by the necessary community care services. Nevertheless, social inclusion can be deemed successful only if they can positively interact with the various microsystems of the community. The disruption of social service provision due to the COVID-19 pandemic allowed us to evaluate other systems of support in the community. By adopting a bioecological perspective, qualitative methods are used to examine the interactions between people with intellectual disabilities and their social environment during the pandemic primarily based on focus group sessions with 17 social workers and 12 caregivers. Findings: Three overarching themes are identified through a thematic analysis: (1) limited social ties with the community that could provide support; (2) professional support as the main source of assistance; and (3) limited resources on how to care for people with intellectual disabilities. Applications: The results show that unilateral systems of support with limited participation of other systems lead people with intellectual disabilities to live segregated lives, even though they reside in the community. To fully realize the right of inclusion in society of all people with intellectual disabilities, further efforts are required to promote informal social care for people with intellectual disabilities. There is a need for a shared-care model that provides care in the community by the community through the establishment of neighborly relations and expansion of the social networks of people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

There is evidence showing that the triarchic model of grit and its dimensions (i.e., perseverance of effort, consistency of interests, and adaptability to situations) predict engagement and well-being outcomes in high school and undergraduate students during the COVID-19 pandemic outbreak. However, there has been limited research on how this model of grit relates to engagement and optimal psychological outcomes in primary school students. This research investigates the association of grit's dimensions with academic engagement in math and science as well as well-being outcomes (i.e., positive emotions, negative emotions, and flourishing) in primary school students. Participants were primary school students (Mage = 10.42; SDage = 1.26) from Hong Kong (n = 279) and Macau (n = 124). Results showed that perseverance of effort positively predicted cognitive and behavioral engagement in math as well as positive emotions even after controlling for demographic covariates (i.e., age, gender, setting, and year level), conscientiousness, and achievement goal orientations. Adaptability to situations positively predicted cognitive and social engagement in math and flourishing. Consistency of interests negatively predicted both cognitive engagement in science and negative emotions. Indeed, this study indicates that perseverance and adaptability may facilitate children's positive academic and psychological functioning during the COVID-19 pandemic outbreak. [ABSTRACT FROM AUTHOR]

Background: Globally, the corona virus disease 2019 (COVID-19) pandemic has created an interpersonally threatening context within which other people have become a source of possible threat. This study reports on the development and validation of a self-report measure of pandemic paranoia; that is, heightened levels of suspicion and mistrust towards others due to the COVID-19 pandemic. Methods: An international consortium developed an initial set of 28 items for the Pandemic Paranoia Scale (PPS), which were completed by participants from the UK (n = 512), USA (n = 535), Germany (n = 516), Hong Kong (n = 454) and Australia (n = 502) using stratified quota sampling (for age, sex and educational attainment) through Qualtrics and translated for Germany and Hong Kong. Results: Exploratory factor analysis in the UK sample suggested a 25-item, three-factor solution (persecutory threat; paranoid conspiracy and interpersonal mistrust). Confirmatory factor analysis (CFA) on the remaining combined sample showed sufficient model fit in this independent set of data. Measurement invariance analyses suggested configural and metric invariance, but no scalar invariance across cultures/languages. A second-order factor CFA on the whole sample indicated that the three factors showed large loadings on a common second-order pandemic paranoia factor. Analyses also supported the test–retest reliability and internal and convergent validity. Conclusion: The PPS offers an internationally validated and reliable method for assessing paranoia in the context of a pandemic. The PPS has the potential to enhance our understanding of the impact of the pandemic, the nature of paranoia and to assist in identifying and supporting people affected by pandemic-specific paranoia. [ABSTRACT FROM AUTHOR]

Background: Research has identified that loneliness during COVID-19 is associated with co-residence status, and individuals living alone were more likely to report loneliness. However, it may not apply to sexual minority people as those living with their family may experience different sexual orientation-related stressors. Aims: This study aims to (1) understand the pattern of living arrangement and loneliness among sexual minority people during COVID-19, (2) examine parental acceptance, family conflict and loneliness among sexual minority people with different living arrangements and (3) investigate the association between parental acceptance and loneliness among sexual minority people with different living arrangements during COVID-19. Method: An online survey with 1,457 Hong Kong sexual minority people was conducted. Results: Sexual minority people living with their partner(s) were less likely to report loneliness. Concurrently, those living with their parent(s) showed a similar level of loneliness as those who lived alone. Living with parent(s) during COVID-19 does not necessarily alleviate feelings of loneliness among them, which we argue may be due to parental unacceptance of their sexual orientation. Nearly half of the respondents stated that their parent(s) were unaccepting of their sexual orientation and 41.8% of them indicated an increase in family conflict during COVID-19. For those living with their parent(s), parental unacceptance is related to more family conflict during COVID-19, which in turn is associated with higher levels of loneliness. Conclusions: Not living with unaccepting parents may reduce family conflict and feelings of loneliness, but this has not been the case for many respondents from a city with high population density and cost of living. Social and mental health service providers need to come up with timely and appropriate interventions to address the unique needs faced by sexual minority people during and after the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

During the great life-altering challenges brought by Coronavirus 2019, school closures and lack of access to exercise and social interactions may have increased students' negative emotions. The current research acts as a follow-up study to the development of the EXSEM-SC, using the Repeated Measures Panel Analysis Framework (RMPAF) to examine the stability of the model in revealing the relationship between physical activity, self-compassion, and mental well-being among Hong Kong adolescents. It is also aimed at examining the changes in physical activity, self-compassion, and mental well-being among Hong Kong adolescents between, before, and after the peak of COVID-19 using the EXSEM-SC Model. The RMPAF has involved 572 (60% Female, Mage = 13.63, SD =1.31) Hong Kong secondary school students. Furthermore, using the abductive qualitative approach, a total of 25 (Mage = 14.84, SD = 1.40) students were involved in the in-depth interviews to further investigate the relationships within the EXSEM-SC. The quantitative results showed that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs, as well as satisfying model construct consistency. Moreover, it showed no significant differences in the level of physical activity, self-compassion, and mental well-being during and after the peak of COVID-19. The qualitative results demonstrated two new categories within the EXSEM-SC variables, which are personality traits and injuries experiences. With the stability of the EXSEM-SC model among adolescents, it is expected that the physical activity intervention, which is based on the EXSEM-SC model, could also aim at easing Hong Kong adolescent's mental health issues. In addition, in terms of generating a long-term impact among students, the physical activity and self-compassionate intervention should be promoted among schools. However, the quantitative properties of the two new categories in the qualitative outcomes should be involved in future investigation. [ABSTRACT FROM AUTHOR]