Search

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. [ABSTRACT FROM AUTHOR]

Health education is one of the most effective and efficient ways to achieve the goal of universal health coverage and the sustainable development goals. The equity of access to health services (especially services from community healthcare centers) for internal migrants is an important issue of global concern. However, due to the registration system, long-term residence plan, education level, and other determinants, it is more difficult for internal migrants to enjoy equitable health education compared with local residents. At present, there is no research on signing up with family doctors mainly from community healthcare centers among internal migrants and their impact on access to health education services. In this nationwide cross-sectional study, we used the migrant population dynamic monitoring survey (MDMS) in 2018 to assess the disparities in signing up with a family doctor and its association with health education among internal migrants in China. Among the 151,892 participants, a total of 11.26% migrants had signed up with a family doctor and 81.37% internal migrants had received health education. There was a significant association between signing up with a family doctor and health education in the univariate model (aOR = 1.113; 95% CI: 1.095, 1.132) and the multivariate model (aOR = 1.107, 95% CI: 1.089, 1.126). Meanwhile, age (aORinteraction = 0.996, 95% CI: 0.994, 0.997), migration time (aORinteraction = 0.927, 95% CI: 0.907, 0.948), and migration range (aORinteraction = 0.994, 95% CI: 0.992, 0.997) also had an impact on the relationship between signing up with family doctors and health education. Due to the health education inequalities among internal migrants in China, we need to improve health education access and utilization of internal migrants. As signed up with family doctors was significantly associated with health education among migrants in China, we recommended that the government and healthcare facilities promote health education through family doctors. The number and professional ability of family doctors should also be improved especially in areas with weak healthcare service resources in the future. [ABSTRACT FROM AUTHOR]

Participation by patients with chronic diseases under primary health care requires more attention to achieve effective disease management and better health outcomes. In 2016, China proposed accelerating the establishment of a system of family doctors (FDs) and strengthening doctor-patient communication to better meet residents' health service needs. This study aimed to describe perceived participation in primary health care among patients with chronic diseases in northeastern China and explore the impact of FD contract services and patient's trust on patients' perceived participation. A cross-sectional survey of 847 patients with chronic diseases in 16 primary healthcare institutions was conducted in Jilin Province, China. Among all participants, 453 patients reported signing up for FD contract services (62.93%). The perceived participation of patients with chronic diseases was at a low level (mean = 6.71 and SD = 3.35). After controlling for sociodemographic variables and health-related variables, FD contract services directly and indirectly influenced patients' perceived participation. The patient's trust was a mediator in the relationship between FD contract services and perceived participation. This study confirmed the valuation of family doctor contract services and provided a theoretical basis for the formulation of primary health service policies. Health organizations should continue to enhance the capacity of primary health services and attract more chronic disease patients to contract with FD teams, thereby enhancing doctor-patient trust and increasing patient's participation in primary health care. [ABSTRACT FROM AUTHOR]

Migration‐related stress is detrimental to children's mental health, yet little is known about the potential mechanisms behind this association. This study examines the mediating role of inflow city identity in the association between migration‐related stress and depression and the moderating role of social participation amongst Chinese migrant children. A sample of 484 migrant children aged 8–17 years is randomly recruited through a cross‐sectional survey in Kunming, China. Inflow city identity partially mediates the association between migration‐related stress and migrant children's depression. Moreover, social participation moderates the above relationship. The direct and indirect effects are significant for migrant children with low social participation but insignificant for migrant children with high social participation. This study deepens the theoretical understanding of the underlying mechanism between migration stress and psychological distress and provides practical implications for preventing mental disorders in Chinese migrant children. [ABSTRACT FROM AUTHOR]

The plethora of pathways leading to health problems of later life has made the causal assessment of widowhood on the health of older adults difficult. This research aimed to assess the short‐term impact of widowhood on the objective health of older adults and to the moderating role of community‐based care (CBC) in improving the health outcomes of older adults. In this study, the activities of daily living (ADLs) and number of hospitalisations of older adults were measured, and PSM‐DID models were conducted. Widowhood had a significant negative impact on the objective health of older adults. Widowed adults had higher ADL scores (B = 0.569, 95 percent CI: 0.295 to 0.844) and more hospitalisations (B = 2.551, 95 percent CI: 1.189 to 3.914) than nonwidowed adults. Meanwhile, CBC in urban areas can significantly reduce ADL scores (B = −0.154, SE = 0.082) and the number of hospitalisations (B = −1.402, SE = 0.348) in older adults, whereas CBC in rural areas can only significantly reduce ADL scores (B = −0.197, SE = 0.087). Taken together, there is an urgent need to focus on the health of widowed and older adults and to provide CBC in both urban and rural areas equally. [ABSTRACT FROM AUTHOR]

This study aims to explore the associations between personality traits and depressive symptoms among Chinese adults and analyse the gender and age differences in the associations. A national representative sample of 28,628 adults aged 18 and above were selected from the 2018 China Family Panel Studies (CFPS) data. The short version of the Big Five Inventory (CBF‐PI‐15) and the Center for Epidemiologic Studies Depression (CES‐D 8) were used to measure personality traits and depressive symptoms respectively. Binary logistic regression models were employed to analyse the associations between personality traits and depressive symptoms in the whole participants, different age groups and genders respectively. After adjustment, higher levels of conscientiousness, extraversion and agreeableness were related to lower level of depressive symptoms, while higher levels of openness and neuroticism were related to higher level of depressive symptoms (p < 0.05). A significant interaction between gender and conscientiousness on depressive symptoms was found (interaction p = 0.005), and the association between conscientiousness and depressive symptoms was stronger in males than females (p < 0.001). Significant interactions between age and conscientiousness (interaction p = 0.007), agreeableness (interaction p = 0.001) on depressive symptoms were found respectively. Moreover, the associations of conscientiousness and agreeableness with depressive symptoms were strongest among old group, followed by middle‐aged group, and then young group (p < 0.05). In conclusion, conscientiousness, extraversion and agreeableness had negative associations with depressive symptoms, while openness and neuroticism had positive associations with depressive symptoms. The negative association between conscientiousness and depressive symptoms was stronger among males than females, and the negative associations of conscientiousness and agreeableness with depressive symptoms were strongest among old group, followed by middle‐aged group, and then young group. [ABSTRACT FROM AUTHOR]

Many studies have disentangled the perceived benefits of vegetation on subjective well‐being (SWB). Yet, scant attention has been paid to the joint effect of vegetation and building density on SWB. This study explores the relationship between streetscape vegetation (SV), building density and SWB in Beijing, China. Our analysis relies on rich measures of street view data to assess SV exposure at the neighbourhood level. Notably, we distinguish between trees (SV‐tree) and grasses (SV‐grass) when evaluating SV metrics. The results suggest that streetscape trees and grasses are positively associated with SWB, though estimated effects are dependent upon tree and grass density exposures. We also find that the effects of streetscape trees and grass are moderated by building density in the neighbourhood. Additional decomposition analysis provides the insight that the well‐being implications of street vegetation and building density are varied significantly by individual sociodemographic characteristics such as sex, age and income. The findings of this study suggest the importance of considering density in SV planning and land use policies to enhance people's quality of life. [ABSTRACT FROM AUTHOR]

We aimed to assess the association between change in social participation and long‐term improved cognitive function among older adults. Data were obtained from 9648 participants aged ≥60 years in the 2011, 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, a national prospective cohort study. Cox regression models were used to calculate adjusted risk ratios (aRRs). Social participation was increased in 20.5% of the participants, decreased in 37.8% of the participants and stable in 41.7% of the participants from the 2011 wave to the 2014–2018 waves. The improved cognitive function rate was 17.9% at follow‐up. Compared to individuals with decreased social participation from the 2011 wave to the 2014–2018 waves, individuals with unchanged total social participation were 59% (aRR = 1.59, 95% CI: 1.35–1.87) more likely to have improved cognitive function in the 2014–2018 waves, and individuals with increased social participation were 61% (aRR = 1.61, 95% CI: 1.43–1.82) more likely to have improved cognitive function, regardless of the baseline social participation status. As for the three forms of social participation, compared with the participants with decreased social participation, those with increased participation in organised social activities, increased participation in group leisure‐time activities, unchanged informal social interactions and increased informal social interactions were 24% (aRR = 1.24, 95% CI: 1.02–1.51), 49% (aRR = 1.49, 95% CI: 1.21–1.84), 55% (aRR = 1.55, 95% CI: 1.37–1.76) and 57% (aRR = 1.57, 95% CI: 1.34–1.84) more likely to have improved cognitive function (all p < 0.05) respectively. The results were stable in the sensitivity analysis. Our findings highlight the importance of promoting social participation from a multidimensional perspective (duration, frequency and forms) to improve cognitive function among older adults, for policy makers and healthcare workers in the community. [ABSTRACT FROM AUTHOR]

This study examines if parental neglect is significantly associated with adolescent cyberbullying perpetration, and whether this relationship is mediated by smartphone addiction. In addition, the moderation of self‐regulation in the direct and indirect effects of parental neglect on cyberbullying perpetration among adolescents is determined. A random sample of 728 Chinese adolescents from Grade 10 to 12 in senior high schools respond to anonymous questionnaires regarding parental neglect, smartphone addiction, self‐regulation and cyberbullying perpetration. The data are then analysed using macro PROCESS. Results reveal that adolescents who are neglected by parents are more likely to engage in cyberbullying perpetration. Smartphone addiction significantly partially mediates the above relationship. Moreover, self‐regulation not only moderates the relationship of cyberbullying perpetration with parental neglect but also its association with smartphone addiction among adolescents. This study contributes to a better understanding of how parental neglect increases the risk of adolescent cyberbullying perpetration, which may be reduced through tailored interventions. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to investigate the influence of perceived discrimination on children's depression and behavioral problems via the mediator of integration among Chinese migrant children. Rural‐urban differences in the proposed relationships are also examined. Methods: The sample included 484 migrant children (Mean age = 11.65 years; 52.9% girls), which was collected through multi‐stage cluster random sampling in Kunming, Southwest China. Structural equation modelling (SEM) was adopted for data analysis. Results: Results indicate that perceived discrimination reduces the integration of Chinese migrant children, which in turn, leads to their higher levels of depression and more behavioral problems. The multi‐group analysis on rural‐urban differences reveals that the effects of discrimination on depression and behavioral problems are significant among rural‐urban migrants but not among urban–urban ones. Conclusions: This study contributes to current knowledge by revealing the mechanisms among perceived discrimination, integration, depression and behavioral problems of Chinese migrant children. The migration pattern differences in terms of their depression and behavioral problems are also highlighted. [ABSTRACT FROM AUTHOR]

The purpose of this study was to estimate the prevalence of unintentional injuries and to identify factors mediating the risk of unintentional injuries among internal migrant children in southern China using self‐reported data collected between April 2016 and March 2017. Logistic regression models were used to identify significant risk factors for unintentional injuries among the internal migrant children. The prevalence of self‐reported unintentional injuries among internal migrant children in this study was 19.15%. Internal migrant children exhibiting antisocial (antisocial behaviour vs. no behaviour problems, OR = 2.162, 95% CI: 1.194–3.915, p =.011) and neurotic behaviours (neurotic behaviour vs. no behaviour problems, OR = 2.064, 95% CI: 1.098–3.880, p =.024) were more likely to report unintentional injuries. There was a positive correlation between the number of risk behaviours and the prevalence of unintentional injuries among non‐migrant and internal migrant children. Children's behavioural problems were closely related to unintentional injuries and may be useful as predictors of unintentional injuries in children. [ABSTRACT FROM AUTHOR]

Social exclusion is a widely accepted risk factor for child well‐being, but relatively little is known about its dynamics and effect on multiple well‐being domains. This study aims to extend prior research by examining the influencing mechanisms of structural‐economic and socio‐relational exclusion on the physical, psychological, behavioural and educational well‐being of Chinese migrant children. Multi‐stage cluster random sampling is used to recruit a sample of migrant children (N = 484; Mage = 11.65 years; 52.9% girls) in Kunming, China, and structural equation modelling is used for data analysis. Results indicate that a high level of structural‐economic exclusion predicts a high level of socio‐relational exclusion, which, in turn, leads to low levels of physical, psychological, behavioural and educational well‐being among migrant children. This study not only contributes to the understanding of the dynamic effects of social exclusion but also provides practical implications for social policy and interventions to reduce social exclusion and improve the well‐being of Chinese migrant children. [ABSTRACT FROM AUTHOR]

Transgender women sex workers (TGSW), as a highly stigmatised population, are at substantial risk for mental health problems but lack access to mental health care. This study investigated factors of mental health service utilisation (MHSU) behaviour and related behavioural intention among TGSW who were at risk of mental health problems in the past year [subsample 1: scored above the cut‐off for probable depression or probable anxiety or had suicidal ideation (N = 126); subsample 2: perceived needs for mental health services (N = 109)]. A cross‐sectional survey was conducted among TGSW in Shenyang, China during 2017–2018. Data on minority stress, coping, mental health and MHSU were collected. 10.3% of participants in subsample 1 and 14.7% in subsample 2 had sought help from mental health professionals in the last year. Unwillingness to disclose minority identity and gender non‐affirmation were negatively associated with MHSU. Factors for behavioural intention of MHSU included unwillingness to disclose minority identity and social support for both subsamples and adaptive coping for subsample 2. Confidentiality concern, discrimination and cost were the most frequently endorsed barriers to mental health services. Interventions should promote gender affirmation, social support and adaptive coping as well as remove stigma to increase health service access and utilisation among minority populations. [ABSTRACT FROM AUTHOR]

The fast‐developing Internet is changing the way people interact, this new phenomenon helps people build and accumulate online social capital. However, the influence of online social capital on individual health is controversial. Based on the social capital theory, this study examined the effect of online social capital on health in subgroups with different levels of offline social capital. Data from the China Family Panel Studies of 2016 were used (N = 13,910), and the propensity score matching approach was used to address potential endogeneity problems. The results show that offline social capital had significant positive associations with individual health; although online social capital had few effects on individual health overall, significant health effects of online social capital were observed in subgroups with different offline social capital levels. In subgroups with less general trust and neighborhood social capital, more online social capital was associated with less depression; while in subgroups with more neighborhood social capital, more online social capital was associated with an elevated probability of two‐week morbidity. Our findings further clarify the relationship between online/offline social capital and individual health. Online social capital can be considered as a supplement of offline social capital when it comes to health promotion, and more online contact should be encouraged when offline social capital of individuals or within the community is scarce. [ABSTRACT FROM AUTHOR]

Coping strategies have the ability to reduce immediate and long‐term stress from cyberbullying experiences. This study compares the perceptions of cyberbullying victims and non‐victims in relation to the coping strategies for different types of cyberbullying victimisation. A group of 1,339 Chinese adolescents from vocational schools in Jiangxi province participated in the study. Effects of demographic factors, cyberbullying victimisation and self‐compassion on coping strategies were computed with logistic regression analysis. Results showed that cyberbullying victims indicated a stronger preference towards doing nothing, or to rely on themselves, instead of seeking help. Both victims and non‐victims indicated 'Asking a parent/family for help' as the first choice across all victimisation types. The effects of self‐compassion on coping with cyberbullying were found to be significant. This study provides evidence that can be used to enhance policy and practice for effectively enabling parents and professionals' involvement in cyberbullying intervention. Cyberbullying prevention programs should therefore arm parents with the knowledge to provide support to, and strengthen self‐compassion of children, to modulate positive coping emotions and cyber behaviour. [ABSTRACT FROM AUTHOR]

Mental health problems are prevalent among migrant workers in China. The present study examined the prevalence of mental health problems (depression, anxiety and suicidal ideation) among migrant workers in China, and identified the work‐related factors associated with their mental health problems based on the Demand‐Control and Effort‐Reward Imbalance Model. A total of 807 migrant workers were recruited from three factories in Shenzhen using stratified randomized sampling. The prevalence of moderate‐to‐severe anxiety, mild‐to‐severe depression and suicidal ideation in the past year was 17.8%, 60.3% and 4.8% respectively. Results from stepwise regression analyses reported that role conflict and effort were risk factors, whereas utilization of job skills and reward were protective factors for anxiety and depression. Social support was also associated with lower level of depression. Effort was the only factor associated with suicidal ideation in the stepwise analysis. Interventions to improve their mental health are warranted and they should work to reduce their role conflict, improve effort–reward balance, promote utilization of skills and increase social support. [ABSTRACT FROM AUTHOR]

Few studies have assessed the impact of home and community‐based services (HCBSs) provision on cognitive function among older adults over time. This study examined the longitudinal association between HCBSs provision and cognitive function in Chinese older adults. The study included 5,134 participants aged 65 years and older in the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014. The Mini‐Mental State Examination (MMSE) was used to evaluate cognitive function over the same time period. Participants were asked what kind of HCBSs were provided in his or her community. However, they were not asked whether services were utilised. The study used the number of HCBSs provided each wave to represent the strength of HCBSs, and used the MMSE score of each wave to represent the older adults' cognitive function status. A latent growth model was used to explore the relationship between HCBSs provision and cognitive function of older adults. The number of HCBSs provided was positively associated with older adults' cognitive function (2008: β = 0.03, p = 0.031; 2011: β = 0.06, p < 0.001; 2014: β = 0.06, p < 0.001) after controlling for gender, age, residence, education, income, medical insurance, activities of daily living disability, instrumental activities of daily living disability, serious illness, living arrangement and marital status. Results provided longitudinal evidence that an increase in HCBSs provision at a national level can result in better cognitive function in Chinese older adults. [ABSTRACT FROM AUTHOR]

This study explored the health effect of perceived built environment on depression of the Chinese elderly people in rural areas. A multifaceted approach in examining perceived built environment was used. A sample of 670 older residents in rural area of China were interviewed, and data were collected mainly for exploratory factor analysis, confirmatory factor analysis and moderation analysis. Results showed a reliable construct of perceived built environment which was developed by this study. A significant moderating role of personal income per month in the significantly negative relationship between perceived built environment and depression was confirmed. That is, the health effect of perceived built environment on depression became weakened among people of higher income levels. This study added evidence for the health effect of perceived built environment on depression among Chinese elderly people. Additionally, individual income was identified as an important influencing factor in such effect. Discussion on the negative relationship between perceived built environment and depression, as well as the moderating effect of personal income in such relationship were presented. [ABSTRACT FROM AUTHOR]

Health care social workers' attitudes towards evidence‐based practice (EBP) are an indispensable precursor of implementing EBP. Using a subset including 405 health care social workers from the first nationally representative survey of social workers in China, this study empirically assesses how transformational leadership (TFL) promotes health care social workers' attitudes towards EBP. The results show that organisational learning capacity (OLC) and professional competence (PC) fully mediate the positive relationship between TFL and EBP attitudes. Furthermore, TFL, OLC and PC explain 56% of the variance in health care social workers' attitudes towards EBP. This result supports the perspective that both organisational factors and individual factors may facilitate social workers' positive attitudes towards EBP, but organisational factors are more important. Therefore, to adopt, use and sustain EBP in health care social work, learning and innovation in the organisation should be increased. Furthermore, it is important to help social workers improve their PC. [ABSTRACT FROM AUTHOR]

The prevalence of depressive symptoms in older Chinese adults has increased recently. Intergenerational relationships play an important role in the mental health conditions of older adults, especially in Chinese culture. Therefore, this study aims to unravel the complex connection between intergenerational relationships and depression, and to explore the potential mediating roles of loneliness and nighttime insomnia symptoms within that connection. A cross‐sectional household survey was conducted in China with 2038 participants aged 65 years or above. Variables were measured using the Center for Epidemiologic Studies Short Depression Scale, the Intergenerational Relationship Quality Scale for Aging Chinese Parents (IRQS‐AP), three nighttime insomnia symptoms extracted from the Insomnia Severity Index and the De Jong Gierveld Six‐Item Loneliness Scale. The IRQS‐AP includes four subdimensions: consensual‐normative solidarity, structural‐associational solidarity, affectual closeness and intergenerational conflicts. Path analyses were performed in Mplus to investigate regression coefficients and mediating effects. Results showed that three general intergenerational relationships (consensual‐normative solidarity, affectual closeness and intergenerational conflicts) were significantly correlated with all mental health outcomes, including their symptoms of loneliness, insomnia and depression. A serial mediation model suggested that loneliness mediated the connection between those constructs of intergenerational relationships and depression, with an independent path to insomnia symptoms via loneliness. The proposed mediators fully mediated the effects of affectual closeness on depression. Nighttime insomnia symptoms alone mediated only the relationship between intergenerational conflicts and depression independently from paths involving depression. Removal of sleep item from CES‐D did not affect the results of paths. Our findings highlight the importance of intergenerational relationships for mental health, especially for the mediating effects of loneliness and nighttime insomnia symptoms on the relationship between intergenerational relationships and depression. Effective mental health services for older adults can address their feelings of loneliness and sleep problems, especially for those who have a poor relationship with their adult children. [ABSTRACT FROM AUTHOR]

Maternal HIV disclosure to children has numerous benefits for both mothers and children. However, the prevalence of maternal HIV disclosure to children remains low in many countries. The present study examined factors associated with intention to disclose maternal HIV status to children among Chinese HIV+ women who have not disclosed their HIV status to their child. Factors from the Theory of Planned Behavior and various norms (injunctive, descriptive and moral norm) were examined. Findings from 179 HIV+ women revealed that only 16.8% intended to disclose their HIV status to their child in the future. Adjusted for significant background variables, all factors from the TPB and various norms (i.e. attitude, injunctive norm, descriptive norm, moral norm, perceived behavioural control) were associated with intention to disclose HIV status (adjusted odds ratios ranged from 3.22, 15.85). Stepwise logistic regression showed that attitude (ORm = 6.96) and injunctive norm (ORm = 6.81) were associated with intention to disclose HIV status. Interventions to promote maternal HIV disclosure were warranted to promote attitude, perceived behavioural control, and various norms associated with HIV disclosure. [ABSTRACT FROM AUTHOR]

While emotional and behaviorial problems increase risks to youth development, resilience helps youth adapt and overcome adversity. Research has discussed factors related to youth resilience, emotional problems, and behaviorial problems; however, existing literature excludes non‐western sociocultural contexts and has not explored the potential relations among mindfulness and life skills. This study examines the effects of mindfulness and life skills on resilience, emotional problems, and behaviorial problems of adolescents in China. Our data come from a group‐administered survey among 60 adolescents from a school for behaviourally delinquent students in Beijing, China, in 2017. The regression results indicate that mindfulness is associated with reduced adolescent emotional and behaviorial problems, whereas life skills are associated with increased resilience. The findings suggest the importance of adolescent interventions that incorporate concepts from both mindfulness and life skills training. [ABSTRACT FROM AUTHOR]

The family is the key for survival and success of the 4.6 million older immigrants in the United States. It is also an overlooked context to understand older immigrants' health service utilisation. Most prior studies on this topic either focus on individual or institutional factors that affect how older immigrants use formal health services. Using data from 2011 Population Study of Chinese Elderly in Chicago (N = 3,159), this study examined potential linkages between family relationships and health service utilisation among US Chinese elderly. Negative binomial and logistic regressions were carried out to investigate whether health service use of these older immigrants are related to positive family relations, negative family relations, and health‐related communications among family members. The findings showed that positive spousal or family relations were not associated with either physician visits or hospital stays. However, respondents with more negative family relations had more doctor visits (β = 0.065, p < 0.05) and were marginally more likely to use inpatient services (OR = 1.15, CI: 0.88–1.04, p = 0.08). Respondents who talked to their spouse for medical concerns were less likely to use inpatient services (OR = 0.68, CI: 0.46–0.99, p < 0.05). The findings showed that family relations play a role in Chinese older immigrants' health service use. In addition, family conflict seems to be more influential than close family relations in predicting service use. Practitioners need to thoroughly assess family dynamics to fully understand the resources and barriers for health service utilisation among the older immigrant populations. [ABSTRACT FROM AUTHOR]

Many communities provide older people with various opportunities to participate in the society. The 2010 Chinese census reveals that the majority of the older adults in China are still healthy, but research shows that older adults have relatively low levels of community participation. This study aims to determine the factors that affect the community participation of older adults in China using data collected from the 2011 China Health and Retirement Longitudinal Study ( CHARLS). The CHARLS survey used a multistage sampling strategy to select respondents from 450 resident or village communities in China. A total of 17,000 persons from 10,000 families participated in the survey. The sample for this study includes 4283 individuals aged 60 years and above who have been invited to answer the survey based on their participation in entertainment and volunteer activities within the past month; 1009 were from urban areas and 3247 were from rural areas. Using logistic regression, this study identifies several variables that can predict the community participation of older adults. These variables included educational background, residence status, self-rated living standard and health status, number of available community facilities, expected social support, family care responsibility and involvement/non-involvement in old-age insurance schemes. In addition, an urban-rural difference was observed in the participation of these adults in entertainment activities, and the differences between older adults residing in urban and rural areas were insignificant in terms of their participation in volunteer work. These findings imply that the Chinese government should consider these predictors and the urban-rural differences when making policies regarding the community participation of older adults. [ABSTRACT FROM AUTHOR]

Food security has been identified as an important issue for elderly people's quality of life and ageing in place. A food security index composed of three indicators (food intake, food quality and food affordability) was developed to measure the food security status of community-living elderly people. Food security was then examined among community-living elderly in the central urban districts of Beijing, China. Data were collected by a questionnaire survey in the summer of 2013 and the response rate was 78.5%. Descriptive statistics and binary logistic regression were applied to analyse food security and the associations between food security and demographic and socioeconomic factors. The results showed that 54.2% of the surveyed elderly experienced food security. Participants with better education ( OR = 1.68) and better health ( OR = 1.47) were more likely to experience food security. The young-old were less likely to experience food security than the older old ( OR = 0.94). Elderly people who lived with their children were less likely to experience food security than those who lived alone ( OR = 0.43). The results of impact factors on food security highlight both similarities with studies from more developed countries and the unique challenges faced in a rapidly changing China with its unique social, cultural and political systems. The food security index we developed in this study is a simple and effective measure of food security status, which can be used in surveys for evaluating the food security status of elderly people in the future. [ABSTRACT FROM AUTHOR]

Healthcare settings provide a major arena for administering smoking cessation interventions. However, few studies have reported differences in the frequency of practice in healthcare professionals by gender and smoking status. This might also be influenced by a difference in smoking prevalence by gender, especially in China and other developing countries. This study examined factors associated with the frequency of cessation intervention practices by smoking status among Chinese physicians in men and women. A cross-sectional survey was conducted in 2006 in physicians with direct patient contact from nine hospitals in Guangzhou with a response rate of 60.8%. Significantly more female physicians who were non-smokers (79.7%) reported 'initiation and/or advice' smoking cessation interventions than male physicians who were smokers (71.2%) and non-smokers (71.6%). Factors significantly associated with 'initiation and/or advice' were prior smoking cessation training (OR = 4.2, 95% CI 1.8-9.6) and lack of knowledge to help patients to quit (OR = 0.4, 95% CI 0.2-0.9) among male physicians who smoked; and organisational support (OR = 1.7, 95% CI 1.3-2.2) and successful past experience (OR = 0.4, 95% CI 0.2-1.0) among male physicians who did not smoke. Among female physicians who did not smoke, significant factors were agreeing that quitting smoking is the most cost-effective way to prevent chronic disease and cancer (OR = 3.0, 95% CI 1.4-6.1), helping patients stop smoking is part of expected role and responsibility (OR = 2.0, 95% CI 1.0-3.7), lack of knowledge to help patients to quit (OR = 0.5, 95% CI 0.2-1.0) and organisational support (OR = 1.3, 95% CI 1.0-1.6) for non-smoking female physicians. This study is the first to show that male physicians were less likely to provide smoking cessation counselling regardless of their smoking status while non-smoking female physicians were more active in advising patients on quitting. The findings highlight the need for developing tailored smoking cessation training programmes for physicians according to their smoking status and gender in China. [ABSTRACT FROM AUTHOR]