Suping Wang

Background: Cyberbullying victimization is a significant risk factor for poor psychological well-being among college students. Existing tools fail to capture the distinct dimensions of victimization in social media contexts. Objective: This study aimed to adapt and validate a Social Media Cyberbullying Victimization Scale (SMCVS) and examine its associations with psychological outcomes among Chinese college students. Methods: In Shanghai, China, 1766 students from multiple universities completed questionnaires including demographic information, the SMCVS, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 scale. The psychometric evaluation of the SMCVS included content validity, construct validity, criterion validity, internal consistency reliability, split-half reliability, and test-retest reliability. Receiver operating characteristic analyses were used to evaluate predictive ability for depression and anxiety. Results: Content validity was satisfactory, and 13 items were retained, with item-level content validity index values ranging from 0.833 to 1 and a scale-level content validity index of 0.949. Exploratory factor analysis identified 2 dimensions—“information harassment” and “reputation and privacy violation”—explaining 82.2% of the total variance. Confirmatory factor analysis supported this structure (goodness-of-fit index=0.943, comparative fit index [CFI]=0.982, normed fit index=0.978, and root mean square error of approximation [RMSEA]=0.075). Multigroup confirmatory factor analysis supported configural and metric invariance across both gender and academic major (ΔCFI≤0.01, ΔRMSEA≤0.015); scalar invariance was achieved for gender but not for academic major. Both dimensions showed significant correlations with depression ( r =0.433‐0.457) and anxiety ( r =0.356‐0.372). Cronbach α, Spearman-Brown coefficient, and test-retest reliability coefficient were 0.959, 0.973, and 0.860, respectively. The SMCVS demonstrated moderate discriminative accuracy for depression (area under the curve [AUC]=0.738; optimal cutoff=19.5) and anxiety (AUC=0.739; optimal cutoff=22.5). Conclusions: The SMCVS demonstrates sound psychometric properties and may be useful for assessing social media cyberbullying victimization among Chinese college students. Its validated 2D structure clarifies distinct patterns of victimization and their psychological correlates, offering implications for targeted prevention and intervention.

Background: The rapid development of digital technologies has intensified concerns about social media addiction, particularly among university students. The perceived parenting styles they experienced may influence this risk, with unmet interpersonal needs acting as potential mediators. Objective: This study aimed to investigate whether perceived burdensomeness and thwarted belongingness mediate the relationship between perceived parenting and social media addiction among university students. Methods: A cross-sectional survey was conducted among 1766 university students from March 2023 to May 2023. Parenting styles were assessed using the short-form Egna Minnen av Barndoms Uppfostran (Swedish for “My memories of upbringing”) for Chinese, unmet interpersonal needs were assessed via the 15-item version of the Interpersonal Needs Questionnaire, and social media addiction was assessed through the Social Network Addiction Tendency Scale. Parenting profiles were identified using latent profile analysis, and mediation models were examined through path analysis. Results: Three perceived parenting profiles were identified: supportive (1094/1766, 61.9%), emotionally distant (192/1766, 10.9%), and controlling-critical (480/1766, 27.2%). Path analyses indicated indirect effects of parenting profile on social media addiction via unmet interpersonal needs. Compared to the supportive group, the emotionally distant (β=0.107 for perceived burdensomeness; β=0.354 for thwarted belongingness) and controlling-critical (β=0.543 for perceived burdensomeness; β=0.457 for thwarted belongingness) groups reported higher unmet interpersonal needs, which in turn were positively associated with social media addiction (β=0.119 for perceived burdensomeness; β=0.158 for thwarted belongingness). Multigroup analyses further showed that perceived burdensomeness was significantly associated with social media addiction among male students (β=0.180; P <.001) but not among female students (β=0.038; P =.30). Conclusions: Unmet interpersonal needs mediate the link between maladaptive parenting and social media addiction. Early interventions that promote emotional warmth and reduce rejecting and controlling behaviors may help prevent digital dependence among young adults, particularly when tailored to specific interpersonal vulnerabilities.

Background: Young and middle-aged adults are vulnerable to poor sleep quality. eHealth literacy, defined as the ability to effectively access and use digital health information, has been linked to improved health behaviors and may promote better sleep outcomes. However, its relationship with sleep quality remains unclear, especially across age groups. Age-related disparities in eHealth literacy may contribute to a digital health divide in sleep outcomes. Objective: This study aimed to examine the relationship between eHealth literacy and sleep quality among adults aged 18 to 59 years in Shanghai, China, as well as explore age-stratified effects. Methods: A cross-sectional study was conducted between October and December 2022 in 3 districts of Shanghai, with 7 community health service centers randomly selected. Participants were recruited through convenience sampling to complete an online survey. eHealth literacy was assessed using the eHealth Literacy Scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index. Covariates included sociodemographic characteristics, health status, and health behaviors. Logistic regression models were applied to examine the relationship between eHealth literacy and sleep quality, with stratified analyses conducted by age (emerging adults [18-29 years], established adults [30-45 years], and middle-aged adults [46-59 years]). Results: A total of 1810 participants completed the survey. The prevalence of poor sleep quality was 37.9% (686/1810). Participants with eHealth literacy scores in the 25th to 75th percentile range (odds ratio [OR] 1.594, 95% CI 1.216-2.089, P <.001) and below the 25th percentile (OR 1.584, 95% CI 1.149-2.182, P =.005) had a significantly higher likelihood of reporting poor sleep quality compared to those with scores above the 75th percentile . Age-stratified analysis indicated that this association was significant only among emerging adults (OR 2.491, 95% CI 1.133-5.479, P =.02 for scores between the 25th and 75th percentiles ; OR 2.975, 95% CI 1.230-7.195, P =.02 for scores below the 25th percentile ) and established adults (OR 1.439, 95% CI 1.001-2.067, P =.049 for scores between the 25th and 75th percentiles ). Conclusions: This study found that eHealth literacy was associated with sleep quality among younger participants but not middle-aged ones, highlighting the digital divide in sleep health. These findings suggest that enhancing eHealth literacy may serve as an effective strategy for improving sleep outcomes. However, to ensure equitable health outcomes, interventions should be tailored to address the age-specific needs and varying levels of digital access across different groups.

This study systematically analyzes the trends in the number of medical-related disciplines from Chinese universities listed in the ShanghaiRanking’s Global Ranking of Academic Subjects (GRAS) over the past five years and their global standing. The GRAS ranking, with its transparent data, clear evaluation index system, and entirely objective metrics, can provide higher education administrators, policy makers, and researchers with effective data on the strengths of disciplines, offering a reference for the future construction of medical disciplines. A retrospective analysis was performed to evaluate the frequency with which medical-related subjects from universities in the mainland of China in the GRAS ranking from 2020 to 2024. The development of Chinese universities in the field of medicine shows a positive trend, but there is still an obvious gap compared to the top level on a global scale in some disciplines. Properly grasping discipline ranking data can provide valuable insights into the underlying dynamics of a university’s discipline development and support the exploration of more scientific methods for discipline evaluation, thereby contributing to the construction of a top-tier discipline ecosystem.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Electronic health literacy (eHL) has been increasingly associated with health-related quality of life (HRQoL). However, the underlying mechanisms, especially in the general population, remain insufficiently explored. Objective: This study aimed to investigate the mediating role of health self-management behaviors (HSMB) in the relationship between eHL and HRQoL. Methods: A cross-sectional study was conducted in Shanghai, China, from October to December 2022. Participants were recruited via convenience sampling from seven community health service centers. Data were collected through an online survey platform Wenjuanxing. Validated scales, including the eHealth Literacy Scale, the Adults Health Self-Management Skill Rating Scale, and the 12-item Short Form Health Survey were utilized to measure eHL, HSMB, and HRQoL, respectively. The HRQoL was summarized into the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Correlation analysis, multivariate linear regression with stepwise backward selection, and mediation analysis were performed to explore the relationships among eHL, HSMB, PCS, and MCS, with adjustments for sociodemographic and health-related covariates. Results: Among the 2,364 participants recruited from urban, peri-urban, and rural areas, eHL scores varied significantly by demographic characteristics. Positive correlations between eHL, HSMB, PCS and MCS were observed, with Spearman correlation coefficients ranging from 0.24 to 0.46 (P<.001). Multivariate analysis showed that eHL was significantly positively associated with PCS (RC=0.14, 95% CI = 0.09-0.18, P<.001) and MCS (RC=0.23, 95% CI = 0.17-0.28, P<.001). Mediation analysis indicated that eHL had a significant direct (PCS: βc = 0.18, 95% CI = 0.13-0.23, P<.001; MCS: βc = 0.32, 95% CI = 0.25-0.38, P<.001) and an indirect effect on HRQoL through HSMB (PCS: βc’ = 0.11, 95% CI = 0.09-0.14, P<.001; MCS: βc’ = 0.14, 95% CI = 0.10-0.17, P<.001). Conclusions: This study demonstrated a positive association between eHL and HRQoL, with HSMB acting as a partial mediator among the general population in Shanghai. Targeted interventions should be implemented to improve eHL and HSMB.

Background: Ensuring adherence guarantees the efficacy of pre-exposure prophylaxis (PrEP). Methods: We conducted a cross-sectional study among 816 sexually transmitted infection (STI) patients in Shanghai. The questionnaire included self-reported demographic characteristics, self-administered items on adherence to free oral PrEP, and PrEP uptake behavior measurement. We conducted item analysis, reliability analysis, validity analysis and receiver operating characteristic (ROC) curve analysis. Results: Not all items were considered acceptable in the item analysis. The questionnaire had a McDonald’s ω coefficient of 0.847. The scale-level content validity index (CVI) was 0.938 and the item-level CVI of each item ranged from 0.750 to 1. In exploratory factor analysis, we introduced a four-factor model accounting for 79.838% of the aggregate variance, which was validated in confirmatory factor analysis. Adding PrEP adherence questionnaire scores contributed to prediction of PrEP uptake behavior (p < 0.001) in regression analysis. The maximum area under the ROC curve was 0.778 (95% IC: 0.739–0.817). Conclusion: The PrEP adherence questionnaire presented psychometric validation among STI patients.

Background The prevalence of depression in sexually transmitted infections (STIs) patients is much higher than general public. However, studies focusing on comprehensive psychosocial effects on depression among STIs patients are limited. This study aimed to examine association of multiple psychosocial syndemic conditions with depression among STIs patients in Shanghai, China. Methods We conducted a cross-sectional study and recruited 910 STIs patients from Shanghai Skin Disease Hospital. Participants self-reported their demographics and themselves completed the scales of depression, self-esteem, loneliness, social support, entrapment, defeat and interpersonal needs. Logistic regressions were performed to detect the possible contributing psychosocial factors for depression and to verify the syndemic conditions of psychosocial problems. Results Of the STIs patient sample, the prevalence of depression was 17.9%. Multivariable analysis showed low-level self-esteem (odds ratio [ORm]: 2.18, 95% CI [1.19–4.00]) and social support (ORm: 2.18, 95% CI [1.37–3.46]), high-level entrapment (ORm: 6.31, 95% CI [3.75–10.62]) and defeat (ORm: 2.60, 95% CI [1.51–4.48]) increased the risk of depression. Psychosocial syndemic conditions magnified effect in fusing depression (adjusted odds ratio [AOR]: 11.94, 95% CI [7.70–18.53]). Participants with more than 4 psychosocial problems were about 22 times more likely to have depression (AOR: 22.12, 95% CI [13.19–37.09]). Conclusions The psychosocial problems syndemic magnifying the risk of depression was confirmed and psychosocial interventions to prevent depression is needed among STIs patients.

The use of social network sites (SNSs) is inevitable in daily life. Everyone is likely to be addicted to SNSs, especially medical students. This study is aimed to assess the degree of SNS addiction and its relation to psychosocial factors such as depression, loneliness and unmet interpersonal needs among Chinese medical students. The cross-section survey was conducted from March to May in 2018 in Shanghai Jiao Tong University School of Medicine. Of the total 1067 participants, 33.18% had an SNS addiction, 87.7% of the participants used SNSs every day during last month and 53.42% of the participants used SNSs for at least an hour per day during the last week. SNS addiction is positively related with depression both directly and indirectly. The mediating roles of loneliness and unmet interpersonal needs on the relationship between SNS addiction and depression are significant. For the well-being of medical students, efforts should be taken to prevent them from becoming addicted to SNSs.

Background: Sexual compulsivity (SC) and its relationship with unprotected intercourse (UI) have long been an intriguing topic, but its existential meaning in the management of public health or, more precisely, sexually transmitted infections (STIs) has rarely been studied to date. This study examines whether SC plays a role in UI among sexually active STI patients. Method: A cross-sectional study was conducted in two sexual transmitted disease (STD) clinicals of Shanghai Skin Diseases Hospital in Shanghai. Totally 664 sexually active STI patients were included. Results: The ages of the 664 participants ranged from 18 to 76 years, with 58.73% between 26 and 40 years old. 449 (191 male and 258 female) reported had UI during the past 6 months. Although the only statistically significant difference (p < 0.01) was in relation to UI with a casual sexual partner, the difference between male/female and regular/casual sexual partners remained evident. Conclusions: SC is evidently a potential predictor of UI with a casual sexual partner in male STI patients, while the use of condoms is more likely to be affected by other factors. In addition to general sexual education, counseling interventions should be provided by health institutions, and specific intervention methods targeting gender and sexual partners should be considered.

Background: High prevalence and strong relationships among suicidal ideation, Internet gaming disorder (IGD), insomnia, and depression have been reported for adolescents worldwide, but the mechanism underlying these psychological problems remains unclear. This cross-sectional study explored the mediating effect of insomnia and depression on the association between IGD and suicidal ideation. Methods: Participants were 1066 adolescents (median age = 13.0 years) with Internet games exposure in the previous 12 months from junior high schools in Shanghai, China. Questionnaire measures of suicidal ideation, IGD, insomnia, depressive symptoms, and background characteristics were obtained. Path analysis was conducted to test the multiple mediating roles of insomnia and depression. Results: Suicidal ideation, IGD, insomnia, and depression prevalence was 27.2, 13.6, 9.2, and 17.0%, respectively. A serial multiple mediation model was generated. The mediation effect of insomnia and depression on the pathway from IGD to suicidal ideation was 45.5% (direct effect: standardized estimate [Std. estimate] = 0.186; total indirect effect: Std. estimate = 0.155). The association between IGD and depression was partially mediated by insomnia (direct effect: Std. estimate = 0.211; indirect effect: Std. estimate = 0.135). The proposed model fit the data well. Conclusions: Insomnia and depression may serially mediate the association between IGD and suicidal ideation. IGD was positively associated with insomnia, then with depression, which in turn positively contributed to suicidal ideation. We suggest greater monitoring of Internet use and prevention of insomnia and depression to mitigate the risk of suicidal ideation among Chinese adolescents.