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Aims. To understand what domains of acculturation are experienced by Chinese immigrants with cardiovascular disease (CVD) in Australia and how these domains of acculturation influence their CVD self‐care behaviours. Design. A qualitative descriptive design. Methods. Individual phone interviews were conducted among Chinese immigrants with CVD in Sydney, recruited from Chinese Community associations and social media. Inductive and deductive thematic analysis was employed, guided by the Middle‐Range Theory of Self‐Care of Chronic Illness and the conceptual model of acculturation. Results. Twenty participants, mean age 69.9 years, were interviewed. The domains of acculturation in relation to CVD self‐care behaviours encompassed cultural practices, cultural values, healthcare system navigation, and new living environment. Retaining their Chinese culture and integrating into Australian culture regarding dietary practices, social networks, traditional values and family relationships served as both enablers and barriers of self‐care maintenance through factors such as heart‐healthy diets, physical activity, stress management and medication adherence. Many participants denied encountering difficulties to utilize primary care services, but language barriers deterred them from accessing acute services and heart‐health information from mainstream sources. Some preserved beliefs and practices in Traditional Chinese Medicine may complicate their self‐care maintenance (medication adherence) and self‐care management (responding to acute angina episodes). Conclusion. The influence of acculturation on CVD self‐care behaviours among Chinese immigrants is multifaceted and individualized. Clinicians and community health workers should assess patients' acculturation experiences to enable culturally sensitive practices. The lack of culturally and linguistically appropriate heart health information in the community should be addressed urgently to mitigate the cardiac health disparity. Collaboration with Chinese community associations offers an opportunity for co‐design and dissemination of information about Australian healthcare systems and heart health education to upskill CVD self‐care practices and mitigate the health inequities experienced by Chinese immigrants. [ABSTRACT FROM AUTHOR]

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]

Taking care of people with dementia is stressful for informal caregivers. Respite care can provide a break for them. But it is often underused, and its acceptability can be low in China. One reason is that it fails to meet their needs. This study aimed to explore the preference of caregivers of people with dementia for respite care services. A discrete choice experiment was used. Attributes and levels of respite care were informed by a literature review and expert consultations. A fractional factorial design was used to reduce the number of choice sets. A questionnaire survey was conducted in Tianjin, China. A mixed logit model was used to compute coefficients for attributes and levels. Respite care packages differed in five attributes, which were content, provider, duration, frequency, and cost. 322 caregivers completed valid discrete choice experiment questionnaires. All five attributes were statistically significant. Two most preferred attributes were "providers" (coefficient 1.297, p < 0.001) and "frequency" (coefficient 1.169, p < 0.001). Caregivers prefer highly qualified service providers and frequent respite care. The desirable respite care for caregivers would be assistance with personal care for people with dementia which was provided by an experienced worker with attitudes of understanding and respect towards people with dementia more than 3 times per week regularly and more than 4 h every time with a lower cost. This study offered new information on Chinese dementia caregivers' preferences for respite care. Policymakers should pay attention to the frequency and quality of providers when designing respite care to improve service uptake and ultimately lighten the burden on caregivers of people with dementia. [ABSTRACT FROM AUTHOR]

Background. Health science popularization, especially digital health science popularization, is essential for development of the Healthy China Strategy. Current studies have focused on interpreting digital education popularization and confirming its positive function; however, reports regarding the limitations and shortcomings thereof are lacking. We aimed to research the current development of digital health science popularization in China, analyze the existing problems, and explore the methods to resolve these problems. Methods. We conducted a qualitative study by mixing in-depth interviews and grounded theory approaches. Participants were recruited according to the inclusion criteria via a snowballing process. Thirty-nine participants, including doctors, nurses, researchers, officers in government, and project leaders, were recruited from the Yangtze River Delta region. Online in-depth interviews with open questions were conducted, and the data were collected. Results. Our results revealed that digital health science popularization has the advantages of convenience, swiftness, friendliness, and social links. However, obvious deficiencies were also exposed, including low authenticity, limited audiences, a lack of manpower, and fragmentation. Conclusions. Current digital health science popularization needs to emphasize public welfare, promote the dissemination of information with professionalism and authority, cultivate cross-border talent, and develop institutional infrastructure to overcome the deficiencies thereof. This remains important to improve the quality and effectiveness of digital health science popularization. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effect of the Wuhan lockdown on body mass index (BMI) among Wuhan residents as well as factors including food habits affected and changes in physical activity mediating the association. As a survey of the Wuhan lockdown, a random digit dialing method was used to sample residents aged 18 years and older. A computer-aided telephone interview was applied to survey 11,223 residents in Wuhan City in July 2020. Ordinary least squares (OLS) regression and mediation analysis were used to analyze the influence of the Wuhan lockdown on BMI. Demographic characteristics, lifestyle characteristics, and health status differed statistically significantly between residents living in and those who left Wuhan during the lockdown (mean BMI, 23.05 ± 0.04 kg/m2 and 22.34 ± 0.06 kg/m2, respectively). The mean BMI among residents living in Wuhan was 0.42 kg/m2 higher (P < 0.001) than that of residents who left Wuhan during the lockdown, as determined by multivariate OLS regression analysis. Residents living in Wuhan during the lockdown had higher BMI among those aged 18–29 and 30–44 years (P < 0.001), with no difference among those aged 45+ years. The association between living in Wuhan and increased BMI was the strongest among residents who were overweight/obese. The mediation analysis results showed an indirect effect path with living in Wuhan (through decreased physical activity and increasing BMI) and the direct effect of living in Wuhan during the lockdown. The lack of association between living in Wuhan and increased BMI among residents aged 45+ years was due to the indirect influence of living in Wuhan affecting food habits. The findings indicated that the lockdown in Wuhan city increased residents' BMI, especially among those who were young or overweight/obese, partly because of decreased physical activity. [ABSTRACT FROM AUTHOR]

Currently, the number of empty-nest elders in China is rapidly increasing, and their overall health situation is not optimistic. The Chinese government has developed a series of policies to promote the community medical-nursing combined model to meet the health and pension care needs of elderly individuals. The demand for community medical-nursing combined services among empty-nest elders plays a decisive role in providing these services and must be fully recognized before these services are offered. However, only a few quantitative studies have focused on the demand for community medical-nursing combined services, and these studies failed to capture the complexity and dynamic nature of this demand. To address this research gap, this study innovatively conducted a descriptive and qualitative study to explore the demand for these services. Following the principle of data saturation, 14 empty-nest elders from communities in Wuhan, Hubei Province, were recruited using the purposive sampling method. Semistructured interviews were used to collect qualitative data. The inductive content analysis approach was used to analyze the data. The results revealed that Chinese empty-nesters' demand for community medical-nursing combined services was diverse and specific and comprised three themes (basic elderly care services, medical and nursing services, and psychospiritual support services), with fifteen subthemes. This study provides insights into the unique demand and implementation strategies for community medical-nursing services among empty-nest elders in China. Recommendations to enhance the intelligent elderly care system, infrastructure construction, and elderly care talent in the future provision of services for this particular group of people are provided. [ABSTRACT FROM AUTHOR]

The drifting elderly are an interprovincial floating elderly population that is mainly composed of unemployed older parents in China. They have left their usual residence and relocated to urban areas, facing challenge about social integration. As a neighborhood has played important roles in the floating population's social integration, this study was designed to investigate the influence of neighborhood-based identity and social participation on the social integration of the drifting elderly. Five rounds of data collection and analysis were conducted in a continuous crossover sequence using grounded theory. Twenty-four participants were recruited from three districts in Shanghai, China. The neighborhood was shown to play a prominent role in the drifting elderly's perceptions of social integration. Good neighborhood relations help the drifting elderly establish effective social support networks, interact with inflowing society, get in touch with more human resources, and form social relationships and networks. Neighborhood-based participants and identity were more conducive to eliminating heterogeneity and creating homogeneity for the drifting elderly. Thus, the neighborhood affects the social integration of the drifting elderly, which directly impacts their social feelings, integrations, and networks. Management of social integration among the drifting elderly should be focused on creating general opportunities for them to participate in neighborhood-based social events with a reasonable identity. [ABSTRACT FROM AUTHOR]

Growing populations in developing countries have exacerbated inequality in the spatial distribution of living environments. As a result, whether living environment factors matter to health and well‐being is increasingly attracting policy and scholarly attention. Yet, crucial knowledge gaps remain regarding the implications, consequences and mechanisms of one's living environment on health and well‐being in developing countries. This study examined the association between living environment and psychological distress, self‐rated health and satisfaction with life among Chinese adults. Furthermore, it also explored the moderating role of community cohesion and the mediating role of social support on these factors. Using probability proportionate to size sampling methods, 3765 respondents and 148 community organisers were recruited from 160 communities in Yunnan, China, in 2018. Ordinary least squares regression and structural equation modelling were conducted. The findings indicate that residents who lived in communities with higher levels of environment insecurity had lower levels of subjective health and well‐being (psychological distress: β = 1.088, p < 0.001; self‐rated health: β = −0.104, p < 0.01; satisfaction with life: β = −0.164, p < 0.001). Moreover, community cohesion played a moderating role in the relationship between living environment insecurity and self‐rated health (β = 0.212, p < 0.05) and satisfaction with life (β = 0.183, p < 0.05); however, it had no significant effects on psychological distress. Furthermore, the moderated effects of community cohesion on living environment insecurity were mediated through perceived social support for self‐rated health (proportion of total effect mediated = 11%) and satisfaction with life (proportion of total effect mediated = 29%). The present findings have implications for policy makers and community committees who can work towards social inequality in developing countries. The integrated programmes of improving living conditions and strengthening community capacity are crucial to residents' health and well‐being. [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]

Chinese immigrants in Australia are overrepresented among people with chronic hepatitis B virus (PWCHB) but experience poor access to healthcare. Given the historical discriminatory policies against PWCHB in mainland China, this study aimed to explore the lived experiences of stigma and discrimination surrounding hepatitis B virus (HBV) among Chinese immigrants originally from mainland China. Semi‐structured in‐depth interviews were conducted by a researcher with a Chinese background in 2019–2020. Sixteen Chinese immigrants living with HBV were recruited across Sydney and Melbourne through advocacy and support groups. This study is positioned in social constructionism. Data analysis was informed by the Health Stigma and Discrimination Framework that highlights the interaction between layered stigmas. This study revealed the historical, social and cultural construction of HBV‐related stigma among PWCHB and demonstrated how this stigma was manifested across socioecological levels in China and Australia. Findings show that HBV‐related stigma has mostly been driven by knowledge deficits about HBV and fear of HBV infection. HBV‐related stigma was mostly demonstrated around social isolation including isolation imposed by family and the community and employment restrictions in the Chinese workplace. In the Australian context, HBV‐related stigma was related to the ethnic and cultural background of PWCHB, and primarily occurred as anticipated stigma in the community and in employment. The findings provide significant insights for crosscutting research and policy endeavours to develop and test cross‐disciplinary initiatives that more broadly address the complex lived realities of Chinese immigrants living with hepatitis B virus. [ABSTRACT FROM AUTHOR]

This study explores the moderating influence of perceived and objective community environments on the relationship between older adults' home‐ and community‐based care (HCBC) needs and their actual utilisation of such care. We selected 5,668 older adults in two cities in China and adopted latent class analysis to descriptively explore the patterns of their HCBC need and utilisation. Structural equation modelling was used to determine factors related to the patterns of need and utilisation of HCBC services, and to explore the moderating roles that the perceived and objective community environments had on the effect of long‐term care need on its utilisation. The results descriptively showed that older adults' patterns of HCBC need and utilisation appear to be embedded within two broader latent categories: a high‐need/use group and a low‐need/use group. Among participants who were satisfied with their community or who lived in areas with high accessibility to HCBC services, HCBC need could predict HCBC use. Our integrated conceptual framework proved to be applicable, thus enriching the theoretical models in explaining HCBC‐related behaviours. The results have strong implications for urban planners, policymakers, and programme managers who seek to support older people and provide elderly care services in communities. [ABSTRACT FROM AUTHOR]

Little is known about the pattern, influencing factors of peer relationships, or their interplays amongst community‐dwelling older people. This qualitative study was undertaken to understand and present these issues under the guidance of existing Adams‐Blieszner‐Ueno integrative conceptual framework for friendship in the context of China. Semi‐structured interviews were undertaken with 20 older adults in Chongqing, China. Interview transcripts were then analysed by performing content analysis under the guidance of existing categories of Adams‐Blieszner‐Ueno integrative conceptual framework for friendship and developing separate categories inductively to ensure all data was captured. The results revealed four themes—context, individual characteristics, interactive motifs and peer relationship patterns—and 16 categories. Based on the original Adams‐Blieszner‐Ueno integrative conceptual framework for friendship, the revised framework for peer relationships modified two dimensions (from structural context to social context, friendship patterns to peer relationship patterns) and added two categories (natural context and health status) that emerge from the data. Besides, different dimensions in the modified framework for peer relationships are explicitly interrelated and not completely independent from each other. In conclusion, this study modified the pre‐existing Adams‐Blieszner‐Ueno integrative conceptual framework for friendship, especially identifying two additional categories, natural context and health status, to understand peer relationships amongst the Chinese community‐dwelling older people through careful examination of the data. All domains concerning the modified conceptual framework of peer relationship may serve as possible targets for developing peer‐involved programs and thus improving social health, well‐being and successful ageing of Chinese older people. [ABSTRACT FROM AUTHOR]

Despite a rapid increase in people with Parkinson's disease (PD) in China, studies focusing on caregiver burden remain scarce. Challenges faced by caregivers in other Asian societies are also underexplored in the PD‐related research field. To addresses this gap, this study drew on the theory of resilience and examined the caregiving experiences of Chinese family caregivers for older people with PD. We conducted participant observation and semi‐structured interviews with 15 family caregivers of older people with PD in Shanghai in 2018. We used thematic analysis to identify key patterns of stressors and factors affecting the capacity of caregivers to address burdens. Our analysis shows that stressors faced by Chinese PD caregivers included physical limitations, psychological and emotional problems, reduction in social connections, financial burden and lack of information and knowledge. Three levels of factors—personal, social and structural—played different roles in resilience among Chinese PD caregivers. However, resilience was unevenly developed among PD caregivers across gender, kinship, residential status and generation. Our study provides novel empirical evidence about the burden on Chinese PD caregivers. It can inform policymakers and social workers as they develop a holistic understanding of promoting resilience building in this rapidly growing group. Our study also enriches cross‐cultural knowledge about factors contributing to caregivers' resilience building in Asian societies. [ABSTRACT FROM AUTHOR]

Universal prevention is a practical approach to preventing depressive symptoms in adolescents, but barriers might reduce its effectiveness. This study explored possible barriers to universal prevention of depressive symptoms in Chinese adolescents. We interviewed thirteen adolescents who participated in the program. Thematic analysis was used to analyse the data. The results revealed three categories of barriers. The first category was participants' maladaptive coping strategies and beliefs about negative emotions. They tended to use avoidance coping, did not believe that negative emotions can be regulated, and had an unrealistic wish for a quick fix. The second category originated from the prevention contents. The complexity of the psychological techniques and the lack of proficiency among the participants were important barriers. The third category was the setting of the psychological course. Participants were reluctant to invest cognitive effort in the psychological course. The large‐size class also made it challenging to have an in‐depth exploration into emotions and thoughts. Our study added to the existing literature by providing more knowledge of barriers to universal prevention. Future research and practice need to adequately address these barriers so that universal prevention can be conducted more effectively. [ABSTRACT FROM AUTHOR]

Despite the growing literature on loneliness, little attention has been paid to the impact of broader changes in social structure and environment on individuals' experience of loneliness. Drawing on data from the 2018 Urbanization and Quality of Life Survey (N = 3,229) conducted in 40 localities undergoing rural–urban transition in China, this study investigates how measures of urbanisation (including population density, duration of urban status, neighbourhood transition and housing type) are associated with residents' loneliness. We revised measures of the six‐item De Jong Gierveld Loneliness Scale, differentiated between emotional and social loneliness, estimated multi‐level mixed‐effects regressions and controlled for a number of individual‐level covariates. The results show that emotional loneliness and social loneliness have different patterns of association with multi‐level covariates: urbanisation at county, township and neighbourhood levels is significantly associated with emotional loneliness, whereas residence in temporary housing is a clear risk factor for social loneliness. The analyses further demonstrate that the revised measures of loneliness address concerns about the original scale, offer a clearer sense of the degrees of loneliness and are strongly associated with multi‐level covariates and psychological distress. In addition to showing how urbanisation leads to greater individual loneliness, our research also illustrates how to model locational parameters in analyses of individual well‐being. [ABSTRACT FROM AUTHOR]

Forgiveness has been found one substantial element in the recovery for women survivors from intimate partner violence following the termination of the abusive relationship. To further investigate the details of forgiveness in this specific context, the present study explored the process of forgiveness using grounded theory. In‐depth and semi‐structured interviews were conducted with 25 Chinese women survivors of IPV. The findings suggest that forgiveness is a strength‐based process including empowerment, transformation, and integration phases. In the empowerment phase, survivors obtain strength at the intrapersonal, behavioural, and interpersonal levels. In the transformation phase, survivors complete cognitive transformation for their IPV experiences and emotional transformation towards former partners. In the integration phase, survivors—now freed from the past—reflect upon and apply the changes they have undergone. Two trajectories in the process were found. One trajectory is going through stages sequentially and the other trajectory is experiencing back and forth between empowerment and transformation stages before moving into the integration stage. The study's findings broaden our knowledge of the strength‐based forgiveness process that women survivors of IPV undergo during recovery. Practitioners and policymakers could develop programmes and policies that support forgiveness by holistically facilitating their recovery and empowerment like assistance in dealing with life difficulties and promoting their reconnection with social networks. To improve the transferability and validity of the findings, the forgiveness of survivors of IPV could be explored in a diverse sample (e.g., survivors with low educational background or live in the rural area). [ABSTRACT FROM AUTHOR]

This study investigated the moderating role of income in the relationship between community social capital and cognitive function among community‐dwelling older adults in rural China. Data were derived from a community survey conducted in Dongliao county, Jilin province, China, in 2019. Trained interviewers completed face‐to‐face interviews with 458 respondents. Multiple group analysis was applied to examine the proposed model. The latent constructs of cognitive social capital and structural social capital were established in low‐income and high‐income groups in rural Chinese contexts. Factor loading invariance of social capital constructs was established across the two income groups. The results showed that income has moderating effects on the relationship between social capital constructs and cognitive function. Social capital that was significantly associated with cognitive function was statistically significant in low‐income group only. The findings highlight the important role of income in understanding the mechanism linking social capital to cognitive function in a rural Chinese context. Social policies and interventions should pay particular attention to older adults with low economic status. Policy and intervention implications are discussed. [ABSTRACT FROM AUTHOR]

Caring is an evidence‐supported behaviour or activity which can meet nursing home residents' needs. China has an ever‐increasing number of care‐dependent individuals in nursing homes. It is important to explore the caring behaviours and to understand the factors associated with the caring behaviours perceived by elderly residents in nursing homes. This will contribute to an evidence‐based approach with which to assist healthcare services. This study aims to explore the perceived caring needs, associated behaviours, and their associated factors identified by elderly residents in nursing homes. Fourteen semi‐structured interviews were conducted with elderly residents from five nursing homes in three districts across Zhengzhou City, China. Interviews were transcribed verbatim and analysed using the Colaizzi phenomenological method. Five themes and fourteen sub‐themes were identified. The availability of health services, a livable environment, and social communication were the main caring needs identified. Nursing assistant factors and resident factors were the main influencers. This study provides valuable information on the need to carry out standardised training of nursing assistants and how to adjust the goal of care in nursing home residents. The medical support, psychological counselling, livable environment, recreational and cultural services as well as caring literacy about nursing assistants in the nursing homes, however, need to be further enhanced to meet the residents' diversified caring needs. [ABSTRACT FROM AUTHOR]

A series of policies aimed toward rational resource allocation of long‐term care have being actively discussed since the launch of the social long‐term care insurance in Shanghai, and it is important to take a societal perspective for informed decision‐making. This study aims to explore factors that are associated with well‐being of informal caregivers in Shanghai, and to provide empirical evidence of application of an established well‐being valuation method to monetise informal caregivers' well‐being losses in a developing country. 310 informal caregivers of applicants for social long‐term care insurance in Shanghai were interviewed. Univariate and multivariate analyses were conducted to explore the associated factors with life satisfaction of the caregivers. The monetary values of an additional hour of caregiving with and without specification of care tasks were estimated by the well‐being valuation method. Life satisfaction was consistently associated with monthly income, health status, and caring hours of the caregivers. The money needed to compensate one additional hour of caring per week was 12.58 CNY (0.3% of the monthly income), and 96.95 CNY (2.0% of the monthly income) for activities of daily living (ADL) tasks. Income, health status, and caregiving are significantly associated with well‐being of informal caregivers. Caregivers in relatively poor health condition and/or involved in more ADL tasks should be particularly considered in supporting policies in Shanghai. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) are at risk of contracting the hepatitis C virus (HCV). Previous studies have documented low uptake of sexually transmitted disease (STD) prevention and health services among Chinese MSM. We carried out qualitative research among MSM in Southwest China. By taking the Health Brief Model (HBM) as a framework, we aimed to determine the underlying factors related to use of HCV health intervention services among MSM. From May to July 2018, we conducted in‐depth interviews in Southwest China with 20 participants. Our research revealed that a lack of knowledge about HCV prevention was the main reason why MSM failed to perceive their susceptibility to HCV and had low motivation to seek preventive services. Poor service accessibility and unpleasant experiences seeing doctors also exerted negative influences on health care‐seeking behaviour in MSM. More trust and understanding needs to be built between health providers and MSM. Protection of privacy for MSM should be guaranteed in the delivery of health interventions. In addition, the interviewees showed refusal to engage with health interventions being specifically targeted at MSM, which would create a sense of being 'labelled'. Tailored health interventions may overemphasise their sexuality, segregate them from heterosexuals, and make them feel alienated. Therefore, we speculate that differential treatment may be an obstacle for MSM to become involved in health interventions. [ABSTRACT FROM AUTHOR]

A national comprehensive management pilot project for mental health has been implemented in China to provide integrated care for people with severe mental disorders through strengthened cooperation among government organisations and between government and other relevant social organisations. The promotion of community rehabilitation has been included as a key part of this pilot program. The present study took the AD district of Beijing as a case study to examine interorganisational cooperation and its effects on community rehabilitation in a real‐world setting. Interviews were conducted with 14 frontline workers, including 7 mental health workers from community health centres and 3 staff and 4 social workers working in rehabilitation centres. Five officials from relevant health and social welfare departments and a social work organisation were also interviewed. Experiences in Beijing revealed that interorganisational cooperation helped to build a multiagency workforce furnished with basic mental health knowledge at the community level, which rendered it possible for frontline workers to provide fundamental follow‐up services, pilot the case management model of service provision and increase the provision of psychosocial rehabilitation services within the poorly resourced context of Chinese mental healthcare. Moreover, the engagement of social organisations provided bottom‐up pressure to innovate through the active bringing forward of new ideas concerning cooperation and service delivery. However, differences in professional authority and commitment were observed. Health department officials and health professionals seemed to exercise a dominant role as compared to social welfare department officials and social workers. Future policy making should motivate social welfare department officials to improve social care for people with severe mental disorders. Social workers require training to improve their knowledge of mental health matters, and social organisations need greater latitude to strengthen their influence over the development of community rehabilitation services for people with severe mental disorders. [ABSTRACT FROM AUTHOR]

Asia is ageing fast. To develop more effective health promotion initiatives among older adults, more knowledge of the environmental correlates of physical activity is needed. However, research in this age group is rare, and most existing studies have been conducted within Western contexts. The present study explores the interaction effects of objective neighbourhood environment and satisfaction with neighbourhood environment on leisure‐time physical activity in older adults in Beijing, China. This study follows a cross‐sectional design and involves older adults aged 65 years and over. The questionnaire was collected in 2018 and 2,061 older adults living in Yanshan, Beijing, China were included in the analysis. Linear regression was applied to examine the effects. The findings show that residents who live in places with higher levels of walkability, or those who are more satisfied with neighbourhood environment (either path/road/street condition or recreational resources) spent significantly longer participating in leisure‐time physical activity. However, the objective neighbourhood accessibility of recreational resources was not a significant factor of physical activity. Satisfaction with neighbourhood recreational resources can significantly moderate the relationship between objective neighbourhood accessibility of recreational resources and leisure‐time physical activity respectively. This is the first study conducted in China examining the relationships between objective neighbourhood environment, satisfaction with neighbourhood environment and leisure‐time physical activity among older adults. This study may have implications for urban planning and service provision planning. The design of built environments that considers quality rather than only quantity can play a significant role in improving older adults' leisure‐time physical activity. [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]

Family support is an important protective factor for pregnant women with a foetal abnormality and can prevent adverse psychological outcomes in this population. This study aimed to explore the importance and influencing factors of family support for pregnant women with foetal abnormalities requiring pregnancy termination and then determine the correlation between family support and women's post‐traumatic stress symptoms. A mixed methods study was conducted from March 2016 to September 2017. In all, 214 participants were surveyed using self‐reported questionnaires including the demographic, family and obstetric information questionnaire, the Family Adaptation Partnership Growth Affection and Resolve Index and the Impact of Event Scale‐Revised to collect quantitative data. Semi‐structured in‐depth interviews with 28 participants were conducted to collect qualitative data. Of the pregnant women with foetal abnormalities, 35% had obstacles in family function such that family support was low. The Impact of Event Scale‐Revised score was negatively associated with total score on the Family Adaptation Partnership Growth Affection and Resolve Index as well as the score for each item on this index. In terms of family support, the demographic, family and obstetric variables hierarchically entered into the regression models significantly explained 20.0%, 26.5% and 2.6% of variation, respectively. In addition, three key themes were identified based on qualitative analyses: intensified instrumental support, inadequate emotional support and insufficient informational support. The findings showed that family support plays a protective role in preventing post‐traumatic stress symptoms following termination of pregnancy. At present, family support still needs to be improved, especially in emotional support and informational support. The factors influencing family support may be important to consider for improving family support. [ABSTRACT FROM AUTHOR]

This study aims to enrich the knowledge of the effects of traditional Chinese culture on bereavement outcomes among older Chinese, and to examine the moderating role of occupation in the relationship between traditional culture and bereavement outcomes. A sample of 352 older Chinese in widowhood was interviewed by quota sampling. A scale of faith in traditional Chinese culture was developed and confirmed by factor analysis. Complicated grief (CG) functioned as the outcome variable. Results showed that faith in traditional culture did affect CG among the sample, and previous occupation moderated the effect of traditional culture on CG. That is, the effect of faith in Chinese culture on CG is stronger in the non‐peasant group than the peasant group. The results broaden the knowledge of spousal bereavement in a Chinese context. Services such as death education and occupational therapy were recommended according to this study. [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]

With its huge ageing population, China faces an enormous challenge for its elderly support and care. One of the proposed solutions was to diversify the elderly support systems. Towards this goal, setting up the Elderly Care Departments in the community health service centres is one of such new Chinese endeavour. This qualitative study was conducted among the residents enrolled in existing Elderly Care Departments established at the community health service centres in Chongqing, a Southwestern Chinese city, to evaluate the lived experience of the residents and to find strategies for improvement. Eighteen participants were recruited from the residents of the Elderly Care Departments of three community health service centres in the city. Data were collected through semi-structured in-depth individual interviews and were analysed utilising the Colaizzi's phenomenological method. Five main themes were identified: Safety and trust; Satisfaction and relief; Gratitude and mutual understanding; Complaints and helplessness; and Worries and apprehension. We found that set-up of the Elderly Care Departments at the community health service centres appeared to be consistent with the idea of integrated care and in general, the current running mode was able to provide the elderly with effective medical, nursing and other cares. The psychological and cultural services at these departments, however, need to be further enhanced. [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]

Street-based female sex workers ( SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs in China. [ABSTRACT FROM AUTHOR]

This research examined the effects of group work with survivors of the Wenchuan earthquake. The two groups studied were organised by social workers in a transitional community. One group was composed of older people and the other of women. The research adopted qualitative research methods. Data were collected by focus group meetings and in-depth individual interviews. The 24 research participants were mainly asked to describe their lives before and after joining the groups. The findings indicated that disaster survivors had resilience to loss and trauma and could recover themselves. Group participation facilitated disaster survivors' self recovery and had positive effects on them. Before joining the groups, many members of both groups felt bored and depressed. After joining, they felt better physically and psychologically and enjoyed socialising with each other. Their lives became more meaningful and their social network was broadened and strengthened. The practical and policy implications of the study are noted and further research recommended. It was concluded that group work, in the form of recreational activities, is effective in alleviating disaster survivors' feelings of distress and depression, improving their psychosocial well-being and fostering their self recovery. [ABSTRACT FROM AUTHOR]

Despite government efforts to increase healthcare insurance and access in China, many individuals, regardless of insurance status, continue to engage in high levels of self-medication. To understand the factors influencing common self-medication behaviour in a community of food market vendors in Fuzhou China, a total of 30 market vendors were randomly recruited from six food markets in 2007. In-depth interviews were conducted with each participant at their market stalls by trained interviewers using a semi-structured open-ended interview protocol. Participants were asked broad questions about their health-seeking behaviours as well as their past experiences with self-medication and hospital care. ATLAS. ti was used to manage and analyse the interview data. The results showed that hospital-based healthcare services were perceived as better quality. However, self-medication was viewed as more affordable in terms of money and time. Other factors prompting self-medication, included confidence in understanding the health problem, the easy accessibility of local pharmacies and the influences of friends/peers and advertising. Three broad domains, attitude, cost and effectiveness, were all seen to determine past decisions and experiences with self-medication. Interestingly, the effective management of self-medication via pharmacy resources raised particular concern because of perceived variation in quality. In conclusion, self-medication was found to be an important and common health-seeking behaviour driven by multiple factors. A sound and comprehensive public health system should systematically attend to these behaviours and the pharmacies, where much of the behaviour occurs. [ABSTRACT FROM AUTHOR]