Jianwei Wu

Objective: This study explored the associations between online health information seeking (OHIS), healthcare utilization, and exercise-related self-management behaviors among adults in China during the COVID-19 pandemic, focusing on individuals with long-term conditions (LTCs). It was guided by the biopsychosocial model and the Information-Motivation-Behavioral Skills (IMB) model. Methods: A cross-sectional analysis used observational data from 1,831 respondents in the 2021 China General Social Survey (CGSS). OHIS was defined as the frequency of using the internet to obtain health or medical information in the past 12 months. Healthcare utilization was measured by the frequency of medical visits, including both traditional Chinese and Western medicine. Exercise-related self-management was represented by regular physical exercise. Multinomial logistic regression was applied while controlling for demographic, psychosocial, and health-related factors. Results: OHIS adopters reported on average more frequent medical visits and higher levels of physical exercise than non-adopters. Meanwhile, among individuals with LTCs, OHIS is associated with less frequent medical visits but a higher likelihood of physical exercise, suggesting a potential pathway linking OHIS to exercise-related self-management behavior. Conclusion: OHIS was positively associated with healthcare utilization and exercise-related self-management behaviors during a period of restricted healthcare access in China. These findings suggest that accessible and reliable online health information may complement patients’ exercise-related self-management capacities in developing countries, offering insights for integrating digital health strategies into primary care and LTCs management.

Traditional Chinese medicine (TCM) constitutions are associated with susceptibility to certain diseases. Studying the types of TCM constitutions associated with diseases helps to predict the occurrence, progression, and prognosis of these diseases. This study is the first to explore the correlation between deficiency constitution, excess constitution, and chronic kidney disease-associated pruritus (CKD-aP). This cross-sectional study was conducted between January and June 2023 at Kiang Wu Hospital. Patients undergoing hemodialysis were interviewed using a questionnaire to collect sociodemographic data and assess pruritus and the TCM constitution. The correlation between body constitution and CKD-aP levels was also analyzed. Of 162 patients analyzed, 78 (48.2%) had a balanced constitution, 49 (30.2%) had a deficient constitution, and 35 (21.6%) had an excess constitution. Both deficiency and excess constitutions were statistically significant in the occurrence of CKD-aP. After adjusting for all possible confounding factors, the analysis showed that compared to the balanced constitution, deficiency constitution (OR = 2.22, 95% CI = 1.025–4.806) and excess constitution (OR = 2.695, 95% CI = 1.091–6.658) significantly increased the likelihood of CKD-aP. A deficient constitution mainly affects the duration, degree, disability, and distribution of pruritus, whereas an excess constitution affects the degree and disability. Both deficiency and excess constitutions were correlated with the occurrence of CKD-aP. Different constitution types affect pruritus differently, necessitating further precise analysis of the interaction between constitution types and pruritus occurrence.

Objective: Conventional observational research has indicated a link between dietary factors and prostate cancer (PCa), yet the impact of confounding factors on this association remains uncertain. The aim of this study was to investigate the potential causal relationship between dietary factors and PCa using the Mendelian randomization (MR) approach. Methods: We examined the potential causal association between dietary factors and PCa by employing a two-sample MR approach. In this study, summary statistics from genome-wide association studies (GWAS) on dietary factors and PCa were extracted from the UK Biobank and FinnGen databases. Six different MR analysis methods were employed to explore the correlation between dietary factors and PCa. The main analytical method is the inverse variance weighted (IVW) method. Meanwhile, we used MREgger regression, Cochran's Q test, the MR-Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test, and the leave-one-out method to assess the robustness of the MR results. Results: The results of this study showed that the average weekly beer plus cider intake (OR=3.305, p=0.040) and oily fish intake (OR=1.877, p=0.012) were correlated with an increased likelihood of developing PCa, while green tea intake was negatively associated with the risk of PCa (OR=0.985, p=0.014). There was no significant direct causal relationship between other dietary factors and PCa in this study. Conclusion: This study found that increasing the average weekly beer plus cider intake and oily fish intake may increase the risk of PCa, while increasing green tea intake may reduce the risk of PCa. The results of this study can provide a reference for optimizing dietary intervention measures in the fields of public health and nursing and assist in the prevention of PCa.

Background: As dementia emerges as a critical global health challenge, youth engagement is pivotal for building dementia-friendly communities. However, culturally sensitive dementia education models for Chinese youths remain underdeveloped. This study aims to explore the perceptions and experiences of a hybrid dementia education program among Macao youths. Methods: A qualitative exploratory study was conducted with 39 Macao youths (aged 15–24; 35.9% male) recruited through purposive sampling. Participants engaged in a hybrid education program comprising 2-h theoretical lectures and 2-h experiential learning. Post-intervention, semi-structured focus group interviews were conducted, transcribed, and analyzed using Colaizzi’s seven-step framework in NVivo 11 to identify emergent themes. Results: Three key themes emerged: (1) Motivation for participating in dementia education: Social and family responsibility-driven motivation; (2) Enhanced youths awareness of dementia: Converted stereotype of dementia and improved communication skills; (3) Suggestions for improving future education programs: Extending youth engagement with patients, increasing diversified practical activities, providing guidance for practical activities. Conclusion: The findings provide evidence to guide the design of tailored dementia awareness programs for youths, supporting the sustainable development of dementia-related interventions.

Background: A validated instrument for assessing adolescent attitudes toward dementia in Chinese-speaking communities is currently lacking. This study aims to translate the Brief-AADS into Chinese and examine the psychometric properties of the Brief AADS-C. Methods: The methodological study employed a cross-sectional design with 2 phases. Data was collected in Macao and Shenzhen, China. Results: The scale demonstrated excellent content validity(S-CVI = 0.99) and good internal consistency (Cronbach’s α = 0.814). Test-retest reliability was acceptable (ICC = 0.647). EFA identified a three-factor solution “Perceptions”, “Acceptance”, and “Engagement” with 11items—accounting for 56.07% of the variance. CFA supported this 3-factor structure with acceptable goodness of fit indices (χ ² /df = 3.076, GFI = 0.937, SRMR = 0.0579, RMSEA = 0.077). All factor loadings of the items ranged from 0. 33to 0.82, indicating strong item-factor relationships. Conclusions: The Brief AADS-C is reliable and valid for assessing adolescent attitudes toward dementia in Chinese-speaking regions.

Background: Dementia-friendly community has been promoted in Macao since 2016. There is no study investigating the understanding of nor attitudes towards dementia among public contact staff in Macao. This study aimed to (i) understand the level of knowledge of dementia, (ii) examine the attitudes towards people living with dementia, and (iii) explore the associated factors of the willingness to help people with dementia symptoms among police officers, bank officers, bus drivers, and building superintendents. Methods: A cross-sectional survey was conducted between January and May 2019 using a structured questionnaire. Results: A total of 351 valid questionnaires were received. Building superintendents had more knowledge while police officers and bank officers had more positive attitudes. All practitioners were more willing to help people with dementia symptoms when they were on official duty. Participants who had more knowledge about dementia were associated with a higher willingness to help people with dementia symptoms.

Providing both personal and social benefits, vaccination may be motivated by collective responsibility (CR). Some previous studies have indicated the relationship between CR and vaccination but could not exclude confounding bias and had little knowledge about the boundary conditions. This study aimed to examine the association between CR and COVID-19 vaccine uptake and its boundary conditions in an extended version of the theory of planned behavior. A cross-sectional survey with 608 participants from six tourism satellite industries in Macao was conducted from 28 July 2021 to 20 August of 2021. Respondentss in CR-lower and CR-higher groups were 1:1 paired using propensity score matching (PSM) to control the potential confounding factors. Results showed participants in the CR-higher group reported significantly higher COVID-19 vaccine uptake than those in the CR-lower group (64.7% vs. 49.7%, p = 0.005). Multivariate logistic regression results indicated a positive association between CR and COVID-19 vaccine uptake (p = 0.012, OR = 2.070, 95% CI= 1.174 to 3.650) and its interaction effect with COVID-19 vaccine attitude (p = 0.019, OR = 0.922, 95% CI = 0.861 to 0.987). Spotlight analysis further illustrated that CR was more effective among individuals with a more negative COVID-19 vaccine attitude. These findings may help promote understanding of vaccine hesitancy, and hence optimize vaccination communication strategies during the COVID-19 pandemic.

Based on Construal Level Theory (CLT), the youth and older adults have different psychological distances towards dementia that may lead to different dementia knowledge and attitudes. A cross-sectional survey among 239 youth and 62 older adults using a two-step sampling approach in Macao aimed to examine the hypothesis. Results showed older adults had a higher score of dementia knowledge (F_(1,299) = 45.692, p (1,299) = 161.887, p 2 = 0.178, F = 9.059, p < 0.001) and for dementia attitudes (R² = 0.399, F = 24.233, p < 0.001), which are β = 0.47 and −0.56, respectively. Thus, the hypothesis was supported and revealed an interesting pattern of dementia knowledge and attitudes among the youth and older adults. From the CLT perspective, the study implies that reducing and bridging the psychological distance of dementia would probably be an effective strategy to increase dementia awareness among young people, and intergenerational programs may be a good option to increase community acceptance and support for people with dementia.

Health literacy has been identified as one vital determinant of public health and healthy behaviors, but very few studies regarding infectious disease prevention have been found. This descriptive cross-sectional study aimed to validate the pathway of infectious disease-specific health literacy (IDSHL), COVID-19 (coronavirus disease 2019) preventive behaviors, and their determinants. A sample of 1459 casino workers in Macao was eligible for analysis. The concept model was verified with a comparative fit index of 0.937 and goodness-of-fit index of 0.971. Government responses was a significant determinant of situational factors (helpfulness of health information, resource accessibility, and organizational training adequacy), while situational factors showed a direct effect on COVID-19 preventive behaviors. Education and organization training adequacy was the strongest influencing factor of IDSHL, which should be a key target of intervention programs for COVID-19.