Rize Jing

The growing prevalence of short video platforms among middle-aged and older adults raises questions about their mental health implications. Using a national survey of 5,039 Chinese adults aged 50 years and above, this study examined how short video use relates to depressive symptoms through competing mechanisms using structural equation modeling. The results showed a dual-path pattern: Short video use was associated with fewer depressive symptoms via more positive attitudes toward aging, but also with increased symptoms via Internet addiction. Moderation analyses indicated that higher levels of Internet addiction were associated with a weaker protective cognitive pathway. Greater diversity in platform use was linked to higher addiction risk and reduced cognitive benefits, suggesting that fragmented engagement may correspond to less favorable psychosocial patterns. Urban–rural differences further indicated that these pathways are context-dependent. Overall, the findings highlight the importance of both behavioral patterns and usage structure in understanding the mental health effects of digital media in later life.

Objective: Despite existing research confirming that eHealth literacy promotes healthy lifestyles and subjective well‐being among adults aged 50 years and older, its connection to depressive symptoms remains unclear. This cross‐sectional study explored the association between eHealth literacy and depressive symptoms among adults aged 50 years and older, and investigated potential mechanisms and moderating effects of the association. Methods: Data were obtained from the China Digital Divide and Digital Inclusion Survey (CDDDIS), which provided a nationally representative sample of 4284 participants aged 50 years and older. Ordinary least squares (OLS) regression was employed to analyze the associations between eHealth literacy and depressive symptoms, adjusting for relevant sociodemographic and health‐related covariates. Bootstrap‐based mediation analysis was conducted to evaluate indirect pathways embedded within the correlation network. Income‐stratified analyses were performed to explore differences in the association across income groups. Results: The results revealed that higher eHealth literacy was significantly correlated with fewer depressive symptoms ( β = −0.029, 95% CI = [−0.052, −0.006], p = 0.012). Bootstrapped mediation analysis revealed that physical activity and perceived stress served as significant indirect pathways mediating the association in this correlational analysis, whereas the indirect pathway via online healthcare services utilization was not statistically significant. Income‐stratified analysis showed that the negative association between eHealth literacy and depressive symptoms was statistically significant among middle‐ and high‐income participants, whereas no significant association was observed for low‐income participants. Conclusions: eHealth literacy constitutes a critical resource for promoting healthy aging and mitigating aging‐related stressors among adults aged 50 years and older. These correlational patterns suggest potential utility for targeted eHealth interventions aimed at reducing depressive symptoms in aging populations.

Background: The rapid development of Internet technology and the swift digitization of public services may expose middle‐aged and older adults to challenges of pressured Internet use. This study aimed to compare the relationships between pressured and voluntary Internet use and mental health among Chinese middle‐aged and older adults, and to explore the mediating role of subjective age. Methods: Based on data from the China Digital Divide and Digital Inclusion Survey (CDDDIS) involving 5231 individuals aged ≥50 years, confirmatory latent class analysis (LCA) was employed to identify pressured and voluntary Internet use patterns. Structural equation modeling, adjusting for covariates, was utilized to examine their differential associations with depressive symptoms and the mediating effects of subjective age. Results: Among middle‐aged and older Internet users, 27% engaged in pressured Internet use. Voluntary Internet use demonstrated significant direct and indirect effects on reducing depressive symptoms via lowering subjective age. Pressured Internet use showed no discernible effect on depressive symptoms compared to nonuse. Conclusion: Voluntary Internet engagement enhances mental health among middle‐aged and older adults by mitigating stereotyped self‐perceptions of aging, whereas unwilling technology interactions fail to yield psychological benefits. Supporting self‐driven digital participation is crucial in addressing well‐being disparities in the context of proliferating Internet services.

Family physician contract service (FPCS) was introduced by the Chinese government in 2016, which entailed the registration of individual patients with a designated family physician in primary healthcare facilities. To assess the yet‐to‐be realized impacts of incentives for family physicians on the performance of the FPCS policy in China, a qualitative semistructured interview was conducted in 2019 with 36 participants, including directors of local health commissions, leaders of primary healthcare facilities, family physicians, and nurses in eight community health centers in four cities deemed to have advanced and effectively implemented FPCS policies. The data analysis was guided by the framework method, which indicated the necessity of implementing a patient‐based capitation system for FPCS and augmenting its financial allocation. The analysis further reveals a divergence in how incentives are perceived based on professional seniority: nonsenior physicians view financial incentives as a matter of livelihood and fairness, while senior physicians approach them strategically, weighing them against other professional activities. The independent distribution method was found to have the potential to enhance the motivation of family physicians in their work. A financing model that relies on health insurance payments may give rise to adverse selection concerns, as it could encourage the selection of healthier patients when making contracts. This issue can be effectively addressed through an innovative modification of the distribution method, whereby higher contract fees are assigned to individuals with more serious medical conditions. The implementation of nonfinancial incentives, including increased authority delegation, closer work relationships, and sufficient self‐identification, has the potential to enhance the performance of the FPCS program. Consequently, it remains important to augment family physicians’ income and enhance their sense of self‐fulfillment in the implementation of the FPCS policy in China.

The decline in the total fertility rate (TFR) is a key driver of population change and has important implications for population health and social development. However, China’s TFR has been a considerable controversy due to a lack of high-quality data. Therefore, this study used the 2020 national population census of China (NPCC) data and reverse survival method to reassess temporal trends in the TFRs and to reexamine rural–urban differences and regional variations in TFRs from 2000 to 2020 in China. Overall, there were significant gaps between the estimated and reported TFRs before 2020, and the estimated TFRs based on the 2020 NPCC data remained higher than the reported TFRs from government statistics. Although TFRs rebounded shortly in the years after the two-child policy, they have shown a wavelike decline since 2010. Additionally, the estimated TFRs fluctuated below 1.5 children per woman in urban areas compared to above 1.8 in rural areas, but the rural–urban differences continued to decrease. Regarding geographic regional variations, the estimated TFRs in all regions displayed a declining trend during 2010–2020, especially in rural areas. Large decreases of over 25% in TFRs occurred in the north, east, central, and northwest regions. In addition to changing the birth policy, the government and society should adopt comprehensive strategies, including reducing the costs of marriage, childbearing, and child education, as well as promoting work-family balance, to encourage and increase fertility levels.

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.

No consensus has been reached on the relationship between retirement and mental health, and limited information is available on retirement and mental health in developing countries. This study investigated the associations between short-term changes in mental health status and labor force transitions (retirement and reemployment) in both the agricultural and nonagricultural sectors in China. This study used nationally representative panel data from three waves (2011, 2015, and 2018) of the China Health and Retirement Longitudinal Study on workers and retirees aged 40-70 years in China. The latent change score (LCS) model was employed. The transition from nonagricultural and agricultural sectors to retirement significantly increased the changes in the Center for Epidemiological Studies-Depression scale (CES-D-10) score. Reentering the nonagricultural sectors significantly decreased the changes in the CES-D-10 score, whereas reentering the agricultural sectors had no impact on the changes in the CES-D-10 score. Stronger associations were identified among male workers, while the associations were weaker and less significant for female workers. Findings are consistent with the resource-based dynamic theory and extends the work in developing country by showing the mental health status worsens after retirement transitions and improves after reentering the workforce, especially for nonagricultural male workers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mass COVID-19 vaccination campaigns have been launched globally, but the translation from vaccination intention to actual vaccine uptake by the public remains unknown, hindering the evaluation of p...

BACKGROUND Previous studies found that general internet use was associated with better mental health. However, there was little evidence about how this relationship would change across multiple subdimensions of internet divides and multiple subpopulations of older adults, particularly in low- and middle-income countries. OBJECTIVE This study examines the associations between multiple subdimensions of internet divides and mental health among older adults, as well as the potential moderating effects of rural/urban hukou status on these associations in China. METHODS We analyzed data from the 2018 China Longitudinal Aging Social Survey (CLASS), which provided a nationally representative sample of 11,418 participants aged 60 years and older. Multivariate linear regression models were used to analyze the associations of general internet use and three successive subdimensions (including access divide, support divide, and usage divide) with depressive symptoms (measured using the CES-D scale). The moderating roles of rural/urban hukou status were tested based on the interaction terms. RESULTS Among Chinese older adults, 18.3% (2,085/11,418) used the internet, with the proportion of rural participants (624/6,528, 9.6%) much lower than that of urban counterparts (1,461/4,890, 29.9%). After controlling for the confounders, older adults who used the internet reported significantly lower depressive symptom levels than non-users in China (β=-1.2; P<0.001). Further, access to internet devices, support for internet use from family, and using the internet for entertainment or as instruments were found to be significantly associated with a lower likelihood of suffering from depressive symptoms (P<0.05). Additionally, the associations between multidimensional internet divides and depressive symptoms were moderated by rural/urban hukou status, with these associations being significantly stronger among rural older people (P<0.1). CONCLUSIONS Lack of internet-enabled device access, technical support for internet use, and internet usage opportunities were the important barriers for Chinese older adults to take advantage of the internet in promoting mental health. Policy interventions targeting the access divide, support divide, and usage divide, respectively, should be taken to empower older adults, especially those with a rural hukou, for active engagement with the internet.