Cuiping Liu

Enhancing accessibility and equity in basic public health services for older migrants constitutes a pivotal objective within global healthcare systems. Pre

Background: The internet has emerged as a critical avenue for the public to access health information resources. As online health information is a key resource for older adults, the factors influencing their online health information–seeking behaviors (OHISBs) are crucial. Objective: This study aims to examine the trajectories and influencing factors of OHISB among community-dwelling older adults and to explore their attitudes toward this information in daily contexts. Methods: A longitudinal mixed methods study was conducted involving 346 older adults from three communities in Shandong Province, China. In the quantitative phase, data were collected at three time points: baseline (T1), 6 months postbaseline (T2), and 12 months postbaseline (T3). Latent class growth modeling and logistic regression identified trajectories and predictors of OHISB, while a cross-lagged panel model analyzed longitudinal relationships among digital health literacy (DHL), technology anxiety (TA), and OHISB. Subsequently, we conducted semistructured, in-depth interviews with 16 older adults from different OHISB trajectory subgroups using a descriptive phenomenological approach. Quantitative and qualitative results were integrated via triangulation. Results: Latent class growth modeling identified three OHISB trajectories: low-level declining group (92/346, 26.6%), medium-level stable group (187/346, 54%), and high-level declining group (67/346, 19.4%). Multivariate logistic regression identified household registration, education, income, chronic disease status, internet frequency and duration, online health information attitude and experience, DHL, and TA as significant predictors of OHISB trajectory. TA mediated the relationship between DHL and OHISB, with an effect size of 0.04 (SE 0.014, 95% CI 0.0123–0.068). Qualitative interviews with 16 participants revealed four themes: personal cognition, emotional experience, external environment, and behavioral choices. The quantitative study elucidated the pathway between DHL, TA, and OHISB, providing a data-driven foundation for the qualitative inquiry. In a complementary manner, the qualitative study revealed themes not captured quantitatively—particularly how personal factors influence behavior through attitudes—and elaborated on sources of social support and the role of the medical environment. Together, both methods convergently demonstrate that older adults’ information behavior is not static but shaped by individual and environmental factors, resulting in distinct behavioral patterns. Conclusions: Both quantitative and qualitative findings clarified the developmental process of OHISB among older adults in communities and the important effects of DHL, TA, and risk perception on OHISB. Although self-efficacy, health anxiety, self-perceived aging, social support, and health care environment were not addressed in the quantitative study, they emerged as important factors shaping older adults’ OHISB in qualitative interviews. Personalized intervention measures should target various OHISB trajectory characteristics and their influencing factors to enhance the health conditions of community-dwelling older adults.

Previous studies have shown that diet is closely related to the subjective well-being, but the interaction between dietary diversity and subjective well-being over time has not been reported. This study is designed to provide fresh insights into the relationship between dietary diversity and subjective well-being within a cohort of older Chinese adults. Data were sourced from the China Longitudinal Survey of Health and Longevity conducted in three waves: 2008–2009 (T1), 2011–2012 (T2), and 2014 (T3). Dietary diversity was determined by the frequency of consumption across various food groups. Subjective well-being was evaluated based on life satisfaction, positive emotions, and negative emotions. The random intercept cross-lagged panel model and linear regression model were employed to analyze the associations between dietary diversity and subjective well-being. The study found that older adults with a higher dietary diversity among 3,680 older participants reported higher subjective well-being. Dietary diversity was positively correlated with subjective well-being across all three waves (rs = 0.143–0.266, ps < 0.01; βs = 0.23–0.40, ps < 0.001). The association remains significant at the between-person level (β = 0.166, p < 0.001) and within-person level (βs = 0.174–0.242, p < 0.001). The random intercept cross-lagged model also indicated an increase in T1 subjective well-being predicted an increase in T2 dietary diversity (β = 0.017, p < 0.05) and an increase in T2 dietary diversity predicted an increase in T3 subjective well-being (β = 0.039, p < 0.05). Sensitivity analyses indicated that the association between dietary diversity and subjective well-being was robust. A longitudinal, reciprocal relationship exists between dietary diversity and subjective well-being in Chinese older adults. The findings underscore the significance of a diversified diet in enhancing the subjective well-being of older adults.

In China, most colorectal cancer patients aged 65 years and above often suffer from poor psychological states, including high levels of anxiety and depression, as well as low resilience, due to the disease and its related symptoms. Analyzing the heterogeneity of anxiety, depression, and resilience in these patients can help intervene timely to improve their psychological well-being and prognosis. It was a cross-sectional study, and participants were recruited at the Affiliated Hospital of Qingdao University. Latent profile analysis (LPA) was used to determine the optimal latent profile model, one-way analysis of variance (ANOVA) was conducted to compare the differences across each latent profile, multinomial logistic regression was employed to analyze the influencing factors. 221 older colorectal cancer patients were identified and classified as low negative emotions and high resilience (49.8%), medium negative emotions, low and unstable resilience (30.8%) and high negative emotions and medium resilience (19.4%). There were significant differences in the scores of anxiety, depression, resilience and social support among these patients. Multinomial logistic regression showed that age, gender, marital status, employment, tumor size, positive lymph nodes, degree of differentiation, and social support were influential in these three profiles. Three heterogeneous subgroups of anxiety, depression, and resilience were identified among older patients with colorectal cancer.

Background: This study sought to identify sleep patterns in older adults residing in rural regions, as well as investigate the potential influence of dietary nutrient intake on these patterns.Methods: Data were collected from a cross-sectional sample of Qingdao Town, Shandong Province, China. The study investigated 1,167 elderly participants using a general questionnaire, the Pittsburgh Sleep Quality Index, the simplified Food Frequency Questionnaire, and 24-h dietary recall methods. Latent profile analysis and binary logistic regression were applied for data analysis.Results: Two sleep categories were identified as “Quick falling asleep, long time, high efficiency group,” Class 1(89.1%) and “Difficult falling asleep, short time, low efficiency group,” Class 2(10.9%). In comparison to Class 1, individuals in Class 2 exhibited a higher likelihood of experiencing difficulties in falling asleep quickly and having poor sleep efficiency when consuming less than 50 g/d of potatoes (OR = 1.863, p = 0.034). Conversely, a daily protein intake of 60 g or more (OR = 0.367, p = 0.007), a daily intake of retinol of 700 equivalents or more (OR = 0.212, p = 0.002), and a daily milk intake of 300 g or more (OR = 0.295, p = 0.035) were associated with a greater probability of falling asleep quickly, having longer sleep duration, and experiencing higher sleep efficiency.Conclusion: Our analysis identified two distinct sleep quality patterns among elderly individuals in rural areas. The sleep quality of rural elderly individuals is influenced by their dietary habits. The findings demonstrated a positive association between enhanced sleep quality and higher intake of dairy products, potatoes, and foods containing retinol and protein. Therefore, we propose increased consumption of these nutritional sources for the elderly population.

Background: The older adult migrant population in China is on the rise, which presents challenges for the national public health service system. However, the heterogeneity of public health service utilization and its relationship with social integration among the older adult migrant population remains unclear. This study aims to explore the heterogeneity the public health service utilization and how it relates to their social integration.Methods: A total of 6,178 older adult migrants from the China Migrants Dynamic Survey (CMDS) in 2017 were included in this study. Exploratory factor analysis was used to categorize social integration into four dimensions. Latent class analysis (LCA) was used to identify different sub-groups of public health service utilization. ANOVA and multivariate logistic regression were used to determine the characteristics of different sub-groups.Results: Three potential classes of public health service utilization were identified: low utilization of basic public health services class (N = 3,264,52.756%), medium utilization of basic public health services class (N = 1,743,28.172%), and high utilization of basic public health services class (N = 1,180,19.072%). Gender, education, extent of mobility, and move alone or not, flow time were all predictors of the class of public health service utilization. There were significant differences in social integration across potential categories (p<0.0001).Conclusion: The utilization of public health services of the older adult migrants is affected by many aspects. Social integration deserves attention as a significant influencing factor in the utilization of public health services. The government should pay attention to the characteristics of the older adult migrants and formulate relevant policies in a targeted manner in order to improve the utilization of public health services of the older adult migrants.

Background: As China rapidly ages, it has now become a deeply aging society with the largest number of older individuals in the world. The issue is particularly severe in rural areas. With the aging population growing and the older population expanding, health problems are becoming more prevalent among older individuals, particularly frailty and cognitive impairments. This study aimed to identify the profiles of physical frailty, social frailty, and cognitive impairment among older adults and explore the influencing factors.Methods: In this cross-sectional study, participants were recruited from six villages in four cities in Shandong Province, China from July to October 2023 through cluster random sampling. Latent profile analysis was used to determine the profiles of physical frailty, social frailty, and cognitive impairment. Chi-square tests and Mann–Whitney U tests were used for univariate analysis, while binary logistic regression was used to analyze the related factors.Results: Seven hundred and sixty-nine older adult care in rural areas showed two profiles: the “high cognitive function and low frailty” group (73.7%, n = 567) and the “low cognitive function and high frailty” group (26.3%, n = 202). A binary logistic regression found that older people were more likely to be aged 80 or older (OR = 2.253, p = 0.029), have a low income level (OR = 1.051, p = 0.007), have one or two (OR = 2.287, p = 0.004), or more than three chronic diseases (OR = 3.092, p = 0.002), and report moderate (OR = 3.406, p = 0.024) or poor health status (OR = 9.085, p < 0.001) in the “low cognitive function and high frailty” group. Meanwhile, older adults who have completed high school (OR = 0.428, p = 0.005) or junior college and above (OR = 0.208, p = 0.009), and engage in adequate physical activity (OR = 0.319, p < 0.001) were more likely to be in the “high cognitive function and low frailty” group.Conclusion: In the future, medical professors should increasingly prioritize promptly identifying and intervening in cognitive decline and frailty status in older individuals without delay.

Background: In a world of rapid digital technology development, the lack of digital health literacy (DHL) among older people cannot be ignored. DHL is becoming an essential competency that can facilitate the health status and health management of older adults. DHL interventions that are feasible and appropriate can be implemented on a large scale through the health care system for older people. Objective: The purpose of this meta-analysis was to assess the effectiveness of DHL interventions for older adults. Methods: English publications in PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to November 20, 2022. Two reviewers independently completed the data extraction and quality assessment. Review Manager (version 5.4; Cochrane Informatics & Technology Services) software was used for all meta-analyses. Results: A total of 7 studies, including 2 randomized controlled trials and 5 quasi-experimental studies, involving 710 older adults were considered eligible. The main outcome was scores on the eHealth Literacy Scale, and secondary outcomes were knowledge, self-efficacy, and skills. Quasi-experimental studies compared baseline and postintervention outcomes, while randomized controlled trials compared pre- and postintervention outcomes in the intervention group. Of the 7 studies, 3 used face-to-face instruction, while 4 adopted web-based interventions. Among them, 4 of the interventions were conducted using theoretical guidance, while 3 were not. Intervention duration varied from 2 to 8 weeks. In addition, the studies included were all conducted in developed countries, mainly in the United States. Pooled analysis presented that DHL interventions had positive effects on eHealth literacy efficacy (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001). Subgroup analysis revealed that DHL interventions that chose face-to-face teaching (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), were guided by a conceptual framework (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), and were sustained over 4 weeks (standardized mean difference 1.1, 95% CI 0.46 to 1.84; P=.001) had a more significant effect. Moreover, the outcomes showed considerable gains in knowledge (standardized mean difference 0.93, 95% CI 0.54 to 1.31; P<.001) and self-efficacy (standardized mean difference 0.96, 95% CI 0.16 to 1.77; P=.02). No statistically significant effect was found for skills (standardized mean difference 0.77, 95% CI –0.30 to 1.85; P=.16). The small number of studies, variable study quality, and heterogeneity are some limitations of this review. Conclusions: DHL interventions have positive effects on the health status and health management of older adults. Practical and effective DHL interventions are crucial for the use of modern digital information technology in managing the health of older people. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42023410204; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=410204

BACKGROUND In a world of rapid digital technology development, the lack of digital health literacy (DHL) among older people cannot be ignored. DHL is becoming an essential competency that can facilitate the health status and health management of older adults. DHL interventions that are feasible and appropriate can be implemented on a large scale through the health care system for older people. OBJECTIVE The purpose of this meta-analysis was to assess the effectiveness of DHL interventions for older adults. METHODS English publications in PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to November 20, 2022. Two reviewers independently completed the data extraction and quality assessment. Review Manager (version 5.4; Cochrane Informatics & Technology Services) software was used for all meta-analyses. RESULTS A total of 7 studies, including 2 randomized controlled trials and 5 quasi-experimental studies, involving 710 older adults were considered eligible. The main outcome was scores on the eHealth Literacy Scale, and secondary outcomes were knowledge, self-efficacy, and skills. Quasi-experimental studies compared baseline and postintervention outcomes, while randomized controlled trials compared pre- and postintervention outcomes in the intervention group. Of the 7 studies, 3 used face-to-face instruction, while 4 adopted web-based interventions. Among them, 4 of the interventions were conducted using theoretical guidance, while 3 were not. Intervention duration varied from 2 to 8 weeks. In addition, the studies included were all conducted in developed countries, mainly in the United States. Pooled analysis presented that DHL interventions had positive effects on eHealth literacy efficacy (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001). Subgroup analysis revealed that DHL interventions that chose face-to-face teaching (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), were guided by a conceptual framework (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), and were sustained over 4 weeks (standardized mean difference 1.1, 95% CI 0.46 to 1.84; P=.001) had a more significant effect. Moreover, the outcomes showed considerable gains in knowledge (standardized mean difference 0.93, 95% CI 0.54 to 1.31; P<.001) and self-efficacy (standardized mean difference 0.96, 95% CI 0.16 to 1.77; P=.02). No statistically significant effect was found for skills (standardized mean difference 0.77, 95% CI –0.30 to 1.85; P=.16). The small number of studies, variable study quality, and heterogeneity are some limitations of this review. CONCLUSIONS DHL interventions have positive effects on the health status and health management of older adults. Practical and effective DHL interventions are crucial for the use of modern digital information technology in managing the health of older people. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42023410204; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=410204