ORCID Profile
0000-0002-6271-1858
Current Organisations
The Chinese University of Hong Kong Faculty of Medicine
,
University of New South Wales
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Publisher: JMIR Publications Inc.
Date: 16-05-2023
DOI: 10.2196/44051
Abstract: With COVID-19 being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs). This systematic review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries as documented in the published literature. A systematic search was conducted on the Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed methods studies) conducted in Africa and published in the English language were included. The screening process and data extraction were performed according to a preregistered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Thematic analysis was used to systematically summarize the studies into 4 predefined domains: knowledge and perception of PPMs, mask use, social and physical distancing, and handwashing and hand hygiene, including their respective levels and associated factors. A total of 58 studies across 12 African countries were included, published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with the lack of personal protective equipment (mainly face masks) and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing and hand hygiene were particularly noted in several African countries, especially among low-income urban and slum dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), sociodemographic, and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities at the regional level, with East Africa contributing 36% (21/58) of the studies, West Africa contributing 21% (12/58), North Africa contributing 17% (10/58), Southern Africa contributing 7% (4/58), and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good as they satisfied most of the quality assessment criteria. There is a need to enhance local capacity to produce and supply personal protective equipment. Consideration of various cognitive, demographic, and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa. PROSPERO International Prospective Register of Systematic Reviews CRD42022355101 www.crd.york.ac.uk rospero/display_record.php?ID=CRD42022355101
Publisher: JMIR Publications Inc.
Date: 19-08-2022
DOI: 10.2196/32968
Abstract: Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV. This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity. A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to s le HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills). As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P .05). HIV infection was associated with higher depressive symptoms (P .001) and lower level of physical activity (P .001). Depressive symptoms and physical activity were negatively correlated (P .001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed). Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV.
Publisher: JMIR Publications Inc.
Date: 16-08-2022
Abstract: ancer patients have higher risk of contracting COVID-19 and are more vulnerable to severe consequences of COVID-19 infection. COVID-19 vaccination is effective for cancer patients without safety concerns. However, COVID-19 vaccination hesitancy is common among cancer patients. his study investigated the prevalence of completing primary COVID-19 vaccination series among cancer patients in China. We examined the effects of sociodemographic data, characteristics of cancer and treatment, and factors at in idual level (perceptions) and interpersonal level (media influence). multicentre cross-sectional study was conducted in four Chinese cities (Changzhi, Hohhot, Urumqi, and Shenzhen) in different geographic regions between May and June 2022. Medical staff of the collaborative hospitals invited all cancer inpatients aged 18 years or above without lymphoma or leukaemia to complete a face-to-face survey. A total of 893 provided written informed consent and completed the study. Logistic regression models were fitted. mong the participants, 58.8% completed the primary COVID-19 vaccination series. Among vaccinated participants, 13.8% reported some side effects. The most common side effect was pain in the injection site (9.3%) no severe side effects were reported. After adjusting for significant background characteristics, perceived higher risk of COVID-19 infection comparing to people without cancers (adjusted odds ratios [AOR]: 0.46, 95%CI: 0.24, 0.88), perceived a high chance of having severe consequences of COVID-19 infection (AOR: 0.68, 95%CI: 0.51, 0.91), and concerns about interactions between COVID-19 vaccination and cancers/cancer treatments (AOR: 0.97, 95%CI: 0.94, 0.99) were associated with lower completion of primary vaccination series. Being suggested by significant others (AOR: 1.32, 95%CI: 1.23, 1.41) and perceived higher self-efficacy to receive COVID-19 vaccination (AOR: 1.48, 95%CI: 1.31, 1.67) were positively associated with the dependent variable. ompletion rate of primary COVID-19 vaccination series was low among Chinese cancer patients. Given the large population size and their vulnerability, there is an urgent need to increase COVID-19 vaccination coverage in this group. Removing concerns about interactions between COVID-19 vaccination and cancers/cancer treatments, using fear appeal approach, involving significant others, and facilitating patients to make a plan to receive COVID-19 vaccination might be useful strategies.
Publisher: Informa UK Limited
Date: 14-06-2023
Publisher: MDPI AG
Date: 06-09-2022
Abstract: China started to implement COVID-19 vaccination programs for children in July 2021. This study investigated the changes in parents’ COVID-19 vaccine hesitancy for children before and after the vaccination program rollout. Repeated cross-sectional online surveys among full-time adult factory workers were conducted in Shenzhen, China. This analysis was based on 844 (first round) and 1213 parents (second round) who had at least one child aged 3–17 years. The prevalence of vaccine hesitancy for children aged 3–11 years dropped from 25.9% (first round) to 17.4% (second round), while such a prevalence for children aged 12–17 years dropped from 26.0% (first round) to 3.5% (second round) (p 0.001). Positive attitudes, a perceived subjective norm, and perceived behavioral control related to children’s COVID-19 vaccination were associated with lower vaccine hesitancy in both rounds. In the second round and among parents with children aged 3–11 years, negative attitudes and exposure to information on SARS-CoV-2 infection after receiving a primary vaccine series were associated with higher vaccine hesitancy, while exposure to experiences shared by vaccine recipients and infectiousness of variants of concern were associated with lower vaccine hesitancy. Regular monitoring of vaccine hesitancy and its associated factors among parents should be conducted to guide health promotion.
Publisher: MDPI AG
Date: 13-08-2023
Abstract: This systematic review and meta-analysis summarises the literature on parental acceptance, parental hesitancy, uptake, and the associated factors of seasonal influenza vaccination (SIV) among children aged 6–59 months. Studies were sourced from the following platforms: PubMed, Web of Science, MEDLINE, and EMBASE databases. A random-effects model was used to evaluate the prevalence and 95% confidence intervals (CI) of parental acceptance, parental hesitancy, and SIV uptake in the last flu season and lifetime among children. A total of 36 studies were included for analysis. The overall prevalence was 64% for parental acceptance (95% CI: 51–75%), 34% for parental hesitancy (95% CI: 22–48%), 41% for SIV uptake in the last flu season (95% CI: 33–50%), and 46% for SIV uptake in a lifetime (95% CI: 20–74%). Associated factors of parental acceptance/hesitancy and uptake included the age of the children or parents, parental education level, household income level, ethnicity, and other modifiable factors, including perceived benefits, perceived barriers, perceived severity, perceived susceptibility, and cues to action related to SIV. Meta-regression analyses revealed regional differences in parental acceptance (Americas: 79% vs. Asia: 60%). The results provided implications informing us of the development of intervention programs targeting parents to improve SIV coverage among young children.
Publisher: MDPI AG
Date: 02-09-2022
Abstract: A significant decline in pediatric vaccination uptake due to the COVID-19 pandemic has been documented. Little is known about the parental willingness and associated factors of pediatric vaccination during the COVID-19 pandemic. An extensive literature search in the databases of PubMed, Scopus, Web of Science, and EBSCOhost were conducted. A total of 20 eligible studies published from 2020–2022 were included for systematic summary by a thematic analysis, among which 12 studies were included in a meta-analysis conducted with R-4.2.1. The prevalence of parental willingness to childhood/routine vaccination and seasonal influenza vaccination was 58.6% (95%CI 2.8–98.6%) and 47.3% (95%CI 25.3–70.5%). Moreover, there is no sufficient evidence of significant change in parental willingness to childhood/routine vaccination, human papillomavirus vaccination, or pneumococcal conjugate vaccination during the pandemic. However, a significant increase in parental willingness to vaccinate their children against seasonal influenza was found. In addition to the factors of parental vaccination willingness/hesitancy that are well-studied in literature, children arents’ history of COVID-19 and children’s perceived vulnerability to COVID-19 were associated with parental willingness. Developing synergetic strategies to promote COVID-19 vaccination together with other pediatric vaccination is warranted during the pandemic. This may help to improve and/or catch up the vaccine uptake of children during and/or after the COVID-19 pandemic.
Publisher: MDPI AG
Date: 22-06-2022
Abstract: The health of people with chronic diabetes mellitus (DM) complications will worsen following coronavirus disease 2019 (COVID-19) infection. This cross-sectional study compared perceptions and factors related to COVID-19 vaccination uptake between subgroups of DM inpatients with and without chronic complications in China. A multivariate logistic regression model was used for data analysis. Of the 645 participants, those without any complications reported significantly higher uptake of at least one dose of COVID-19 vaccination (43.2% versus 11.2%, p 0.001). For people with chronic DM complications, a perception of higher risk and severer consequences of COVID-19 infection, a belief that doctors would suggest they receive COVID-19 vaccination, and a belief that relatives’ vaccination uptake would influence their own decision to receive a COVID-19 vaccination were all associated with higher COVID-19 vaccination uptake. For their counterparts without chronic complications, a perception of severer consequences of COVID-19 infection, a belief that receiving COVID-19 vaccination could reduce the risk of infection, and a belief that relatives’ vaccination uptake would influence their own decision to receive a COVID-19 vaccination were all associated with higher COVID-19 vaccination uptake. Concerns about the safety and the side effects of vaccination were negatively associated with COVID-19 vaccination uptake in both groups of DM patients. Different strategies might be applied to promote COVID-19 vaccination uptake in DM patients with and without chronic complications.
Publisher: MDPI AG
Date: 22-08-2023
Abstract: This study aimed to investigate the associations between COVID-19 vaccination status and self-reported SARS-CoV-2 infection among children and adolescents aged 3–17 years during a massive COVID-19 outbreak after China changed its zero COVID policy. A cross-sectional online survey was conducted between 1 and 9 March 2023. Participants were the parents of children studying in kindergartens, primary schools, or secondary schools in Shenzhen. Convenient s ling was used. All kindergartens, primary schools, and secondary schools in the Longhua District of Shenzhen invited the parents of children and adolescents attending the schools. Interested parents completed an online survey. Multivariate logistic regression was fitted. Among 8538 participants, 40.9% self-reported that their children had SARS-CoV-2 infection after 7 December 2022, where 92.9% of them received two doses of the COVID-19 vaccines, and 74.6% received their second dose for more than six months. In multivariate analysis, children who received their second dose of the COVID-19 vaccination for no more than three months had a lower SARS-CoV-2 infection rate compared to unvaccinated children ( month: AOR: 0.17, 95% CI: 0.07, 0.44 1–3 months: AOR: 0.54, 95% CI: 0.41, 0.75). The duration of protection conferred by the primary COVID-19 vaccination series was relatively short among children. A booster dose should be considered for children.
Publisher: Springer Science and Business Media LLC
Date: 07-06-2023
Publisher: Elsevier BV
Date: 2022
DOI: 10.2139/SSRN.4298130
Publisher: MDPI AG
Date: 14-02-2023
Abstract: Vaccination against COVID-19 remains one of the ultimate solutions to the ongoing pandemic. This study examined and compared the completion of primary COVID-19 vaccination series and associated factors in the slum and estate communities of Uganda. This was a cross-sectional survey conducted among 1025 slum and estate residents. Logistic regression models were fitted. Of the 1025 participants, 511 were slum residents and 514 were estate residents. Completion of COVID-19 vaccination was 43.8% in the slum community and 39.9% in the estate community (p = 0.03). Having more knowledge about COVID-19 was positively associated with completing COVID-19 vaccination in both communities. Perceived benefits and cues to action also had a positive association, but only among the slum residents. However, perceiving people infected with COVID-19 as having a high death rate, perceived barriers such as serious side effects and long distances, and depressive symptoms had negative associations with vaccine uptake among the slum community, but not in the estate community. Addressing barriers to vaccination, strengthening and utilizing the various cues to action, engagement of religious and cultural leaders, and continued community education and sensitization tailored to the needs of each community are potentially vital strategies in raising vaccination rates. Consideration of socioeconomic impact-alleviation strategies, especially among the urban poor, would also be beneficial.
Publisher: Frontiers Media SA
Date: 03-08-2023
DOI: 10.3389/FPUBH.2023.1092018
Abstract: Assessing the likelihood of engaging in high-risk sexual behavior can assist in delivering tailored educational interventions. The objective of this study was to identify the most effective algorithm and assess high-risk sexual behaviors within the last six months through the utilization of machine-learning models. The survey conducted in the Longhua District CDC, Shenzhen, involved 2023 participants who were employees of 16 different factories. The data was collected through questionnaires administered between October 2019 and November 2019. We evaluated the model's overall predictive classification performance using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. All analyses were performed using the open-source Python version 3.9.12. About a quarter of the factory workers had engaged in risky sexual behavior in the past 6 months. Most of them were Han Chinese (84.53%), hukou in foreign provinces (85.12%), or rural areas (83.19%), with junior high school education (55.37%), personal monthly income between RMB3,000 (US$417.54) and RMB4,999 (US$695.76 64.71%), and were workers (80.67%). The random forest model (RF) outperformed all other models in assessing risky sexual behavior in the past 6 months and provided acceptable performance (accuracy 78% sensitivity 11% specificity 98% PPV 63% ROC 84%). Machine learning has aided in evaluating risky sexual behavior within the last six months. Our assessment models can be integrated into government or public health departments to guide sexual health promotion and follow-up services.
Publisher: Frontiers Media SA
Date: 09-06-2022
Abstract: The Coronavirus Diseases 2019 (COVID-19) directly affects HIV prevention and sexual health services utilization among men who have sex with men (MSM). This study investigated changes in human immunodeficiency virus (HIV) testing utilization among MSM before and after the COVID-19 pandemic received initial control in Shenzhen, China. This study was a sub-analysis of a prospective observational cohort study conducted among MSM in Shenzhen, China between August 2020 and May 2021. Participants were recruited through outreaching in gay venues, online recruitment, and peer referral. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. This study was based on 412 MSM who reported to be HIV-negative/unknown sero-status at baseline, 297 (72.1%) of them completed the follow-up online survey. Multilevel logistic regression models (level 1: sources of recruitment level 2: in idual participants) were fitted. When comparing follow-up data with baseline data, a significant increase was observed in the uptake of any type of HIV testing (77.9% at Month 6 vs. 59.2% at baseline, p & 0.001). After adjusting for age group, education level, current employment status and monthly personal income, two predisposing factors were associated with higher uptake of HIV testing during the follow-up period. They were: (1) condomless anal intercourse with male non-regular male sex partners at follow-up only (AOR: 5.29, 95%CI: 1.27, 22.01) and (2) sanitizing before and after sex at baseline (AOR: 1.26, 95%CI: 1.02, 1.47). Regarding enabling factors, utilization of HIV testing (AOR: 3.90, 95%CI: 2.27, 6.69) and STI testing (AOR: 2.43, 95%CI: 1.20, 4.93) 6 months prior to the baseline survey was associated with higher uptake of HIV testing during the follow-up period. Having the experience that HIV testing service providers reduced service hours during the follow-up period was also positively associated with the dependent variable (AOR: 3.45, 95%CI: 1.26, 9.41). HIV testing utilization among MSM might rebound to the level before the COVID-19 outbreak after the pandemic received initial control in China. This study offered a comprehensive overview to identify potential reasons that can influence the uptake of HIV testing among Chinese MSM.
Publisher: JMIR Publications Inc.
Date: 04-11-2022
Abstract: ith COVID-19 being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs). his systematic review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries as documented in the published literature. systematic search was conducted on the Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed methods studies) conducted in Africa and published in the English language were included. The screening process and data extraction were performed according to a preregistered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Thematic analysis was used to systematically summarize the studies into 4 predefined domains: knowledge and perception of PPMs, mask use, social and physical distancing, and handwashing and hand hygiene, including their respective levels and associated factors. total of 58 studies across 12 African countries were included, published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with the lack of personal protective equipment (mainly face masks) and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing and hand hygiene were particularly noted in several African countries, especially among low-income urban and slum dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), sociodemographic, and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities at the regional level, with East Africa contributing 36% (21/58) of the studies, West Africa contributing 21% (12/58), North Africa contributing 17% (10/58), Southern Africa contributing 7% (4/58), and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good as they satisfied most of the quality assessment criteria. here is a need to enhance local capacity to produce and supply personal protective equipment. Consideration of various cognitive, demographic, and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa. ROSPERO International Prospective Register of Systematic Reviews CRD42022355101 www.crd.york.ac.uk rospero/display_record.php?ID=CRD42022355101
Publisher: Frontiers Media SA
Date: 11-03-2022
Abstract: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected sexual minorities including men who have sex with men (MSM). This study investigated factors associated with the uptake of COVID-19 vaccination among MSM in China. Inclusion criteria were: (1) born biologically male, (2) had oral or anal sex with men in the past year, (3) aged at least 18 years, and (4) lived in Shenzhen, China. Prospective participants were recruited through outreach in gay bars and saunas, online recruitment, and peer referrals. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. Logistic regression models were fitted for data analysis. Among 420 participants who completed the baseline survey, 303 completed the follow-up survey. Among participants being followed up, 113 (37%) received at least one dose of COVID-19 vaccination during the study period. After adjusting for significant sociodemographic characteristics, five baseline predisposing factors predicted COVID-19 vaccination uptake during the follow-up period, including asking whether their partners had COVID-19 symptoms [adjusted odds ratio (AOR): 1.17, 95% confidence interval (CI): 1.00–1.38], washing hands before and after sex (AOR: 1.23, 95% CI: 1.03–1.46), sanitizing before and after sex (AOR: 1.17, 95% CI: 1.00–1.37), perceived higher risk of COVID-19 transmission through sexual behaviors (AOR: 1.28, 95% CI: 1.04–1.58), and panic about COVID-19 (AOR: 1.48, 95% CI: 1.16–1.89). Regarding enabling factors, receiving testing for sexually transmitted infections (STI) (AOR: 2.19, 95% CI: 1.25–3.85) and other prevention measures for human immunodeficiency virus (HIV)/STI (AOR: 2.61, 95% CI: 1.56–4.37) 6 months prior to the baseline survey were associated with higher uptake of COVID-19 vaccination. MSM’s uptake rate of COVID-19 vaccination was comparable to that of the general population in Shenzhen, China. This study offered an overview for us to identify tapping points that can encourage COVID-19 vaccination uptake among Chinese MSM.
Publisher: MDPI AG
Date: 23-04-2023
Abstract: This systematic review summarises the literature on Coronavirus Disease 2019 (COVID-19) vaccination, including acceptance, uptake, hesitancy, attitude and perceptions among slum and underserved communities. Relevant studies were searched from PubMed, Scopus, Web of Science and Google Scholar, following a pre-registered protocol in PROSPERO (CRD42022355101) and PRISMA guidelines. We extracted data, used random-effects models to combine the vaccine acceptance, hesitancy and uptake rates categorically, and performed meta-regression by R software (version 4.2.1). Twenty-four studies with 30,323 participants met the inclusion criteria. The overall prevalence was 58% (95% CI: 49–67%) for vaccine acceptance, 23% (95% CI: 13–39%) for uptake and 29% (95% CI: 18–43%) for hesitancy. Acceptance and uptake were positively associated with various sociodemographic factors, including older age, higher education level, male gender, ethnicity/race (e.g., Whites vs African Americans), more knowledge and a higher level of awareness of vaccines, but some studies reported inconsistent results. Safety and efficacy concerns, low-risk perception, long distance to vaccination centres and unfavourable vaccination schedules were prominent reasons for hesitancy. Moreover, varying levels of attitudes and perceptions regarding COVID-19 vaccination were reported with existing misconceptions and negative beliefs, and these were strong predictors of vaccination. Infodemic management and continuous vaccine education are needed to address existing misconceptions and negative beliefs, and this should target young, less-educated women and ethnic minorities. Considering mobile vaccination units to vaccinate people at home or workplaces would be a useful strategy in addressing access barriers and increasing vaccine uptake.
Publisher: MDPI AG
Date: 30-11-2022
Abstract: With a stratified multi-stage s ling approach, 1361 male factory workers in the Longhua district of the Shenzhen Municipality of China were selected to investigate the multifaceted determinants of sexual intercourse with non-regular female sex partners (NRP) and female sex workers (FSW) among them. The results showed that 24.5% and 21.2% of participants had sexual intercourse with NRP and FSW in the past 6 months, respectively. More specifically, at the in idual level, perceived higher job stress and maladaptive coping styles were linked with a higher likelihood of having sexual intercourse with NRP and FSW (adjusted odds ratios [AOR] ranged from 1.06 to 1.17). At the interpersonal level, those who had higher exposure to information related to sexual intercourse with NRP or FSW were more likely to have sex with these female sex partners (AOR: 1.08 & 1.11). At the social structural level, perceived social norms supporting multiple sex partnerships were linked with a higher likelihood of having sexual intercourse with NRP and FSW (AOR: 1.10 & 1.11). No interaction effects were found between the variables at different levels. Providing pre-employment training to clarify roles and job duties, introducing adaptive coping strategies, and addressing misconceptions of social norms are useful strategies to reduce sexual intercourse with NRP or FSW.
Publisher: JMIR Publications Inc.
Date: 30-06-2023
DOI: 10.2196/48447
Abstract: Counseling support for HIV self-testing (HIVST) users is essential to ensure support and linkage to care among men who have sex with men (MSM). An HIVST service with web-based real-time instruction, pretest, and posttest counseling provided by trained administrators (HIVST-OIC) was developed by previous projects. Although the HIVST-OIC was highly effective in increasing HIVST uptake and the proportion of HIVST users receiving counseling along with testing, it required intensive resources to implement and sustain. The service capacity of HIVST-OIC cannot meet the increasing demands of HIVST. This randomized controlled trial primarily aims to establish whether HIVST-chatbot, an innovative HIVST service with web-based real-time instruction and counseling provided by a fully automated chatbot, would produce effects that are similar to HIVST-OIC in increasing HIVST uptake and the proportion of HIVST users receiving counseling alongside testing among MSM within a 6-month follow-up period. A parallel-group, noninferiority randomized controlled trial will be conducted with Chinese-speaking MSM aged ≥18 years with access to live-chat applications. A total of 528 participants will be recruited through multiple sources, including outreach in gay venues, web-based advertisement, and peer referral. After completing the baseline telephone survey, participants will be randomized evenly into the intervention or control groups. Intervention group participants will watch a web-based video promoting HIVST-chatbot and receive a free HIVST kit. The chatbot will contact the participant to implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through WhatsApp. Control group participants will watch a web-based video promoting HIVST-OIC and receive a free HIVST kit in the same manner. Upon appointment, a trained testing administrator will implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through live-chat applications. All participants will complete a telephone follow-up survey 6 months after the baseline. The primary outcomes are HIVST uptake and the proportion of HIVST users receiving counseling support along with testing in the past 6 months, measured at month 6. Secondary outcomes include sexual risk behaviors and uptake of HIV testing other than HIVST during the follow-up period. Intention-to-treat analysis will be used. Recruitment and enrollment of participants started in April 2023. This study will generate important research and policy implications regarding chatbot use in HIVST services. If HIVST-chatbot is proven noninferior to HIVST-OIC, it can be easily integrated into existing HIVST services in Hong Kong, given its relatively low resource requirements for implementation and maintenance. HIVST-chatbot can potentially overcome the barriers to using HIVST. Therefore, the coverage of HIV testing, the level of support, and the linkage to care for MSM HIVST users will be increased. ClinicalTrial.gov NCT05796622 t2/show/NCT05796622 PRR1-10.2196/48447
Publisher: Chinese Center for Disease Control and Prevention
Date: 2023
Publisher: MDPI AG
Date: 12-01-2023
Abstract: China is considering to offer COVID-19 vaccination for children aged 6–35 months. This study investigated the changes in COVID-19 vaccine acceptability and associated factors among parents with children aged 6–35 months in 2020 and 2021. Two rounds of cross-sectional online surveys were conducted among adult factory workers in Shenzhen, China. A subset of 208 (first round) and 229 (second round) parents with at least one child aged 6–35 months was included in the study. Parental acceptability of COVID-19 vaccination increased significantly from 66.8% in the first round to 79.5% in the second round (p = 0.01). Positive attitudes, perceived subjective norm, and perceived behavioral control were associated with higher parental acceptability in both rounds of surveys (p values ranged from .001 to 0.003). A negative association of negative attitudes with parental acceptability was observed in the second round (p = 0.02). No significant associations of exposure to information related to COVID-19 vaccination on social media with parental acceptability was found in either round of survey. Expanding the existing COVID-19 vaccination programs to cover children aged 6–35 months is necessary in China. Future programs should focus on modifying perceptions among parents to promote COVID-19 vaccination for children in this age group.
Publisher: MDPI AG
Date: 06-05-2022
Abstract: COVID-19 vaccination is proven to be effective and safe for older adults. This study investigated the impacts of incentives and health promotional materials provided by the government on the completion of the primary COVID-19 vaccination series among older adults in Hong Kong. Participants were Chinese-speaking community-dwelling adults aged ≥65 years. Telephone numbers were randomly selected from up-to-date Hong Kong telephone directories. A total of 440 participants completed the telephone interview. Logistic regression models were fitted. Among the participants, 58.4% had completed the primary COVID-19 vaccination series. Most participants believed that incentives provided by the government had almost no impact on increasing their motivation to receive COVID-19 vaccination, and less than half thought that vaccination promotional materials produced by the government could address their concerns and help them make decisions. After adjustment for significant background characteristics, we found perceived higher impacts of the incentives and belief that vaccination promotional materials produced by the government could address their concern and were helpful for them to make decisions to be associated with a higher rate of completion of primary COVID-19 vaccination series. Perceptions supporting COVID-19 vaccination and less decisional conflict regarding the choice of vaccine were also positively associated with the dependent variable. Government should develop incentives and health promotional materials tailored to the needs of older adults.
Publisher: MDPI AG
Date: 06-07-2023
Abstract: During the Coronavirus Disease 2019 (COVID-19) pandemic, seasonal influenza remained a significant health threat for older adults. Seasonal influenza vaccination (SIV) is highly effective and safe for older adults. This study investigated the associations of COVID-19 vaccination, perceptions related to COVID-19 and SIV, with the behavioural intention to receive SIV among older adults in Hong Kong, China. A random telephone survey was conducted among 440 community-dwelling Hong Kong residents aged 65 years or above, between November 2021 and January 2022. Among the participants, 55.7% intended to receive SIV in the next year. After adjustment for significant background characteristics, concern about whether SIV and COVID-19 vaccination would negatively affect each other was associated with a lower intention to receive SIV, while a perceived higher risk of co-infection with COVID-19 and seasonal influenza was positively associated with the dependent variable. In addition, the perceived severe consequences of seasonal influenza, perceived benefits of SIV, received cues to action from doctors and participants’ family members or friends, and the perception that more older people would receive SIV was associated with a higher behavioural intention. Future programmes promoting SIV among older adults should modify perceptions related to COVID-19 vaccination and SIV at the same time.
Publisher: JMIR Publications Inc.
Date: 24-04-2023
Abstract: ounseling support for HIV self-testing (HIVST) users is essential to ensure support and linkage to care among men who have sex with men (MSM). An HIVST service with web-based real-time instruction, pretest, and posttest counseling provided by trained administrators (HIVST-OIC) was developed by previous projects. Although the HIVST-OIC was highly effective in increasing HIVST uptake and the proportion of HIVST users receiving counseling along with testing, it required intensive resources to implement and sustain. The service capacity of HIVST-OIC cannot meet the increasing demands of HIVST. his randomized controlled trial primarily aims to establish whether HIVST-chatbot, an innovative HIVST service with web-based real-time instruction and counseling provided by a fully automated chatbot, would produce effects that are similar to HIVST-OIC in increasing HIVST uptake and the proportion of HIVST users receiving counseling alongside testing among MSM within a 6-month follow-up period. parallel-group, noninferiority randomized controlled trial will be conducted with Chinese-speaking MSM aged ≥18 years with access to live-chat applications. A total of 528 participants will be recruited through multiple sources, including outreach in gay venues, web-based advertisement, and peer referral. After completing the baseline telephone survey, participants will be randomized evenly into the intervention or control groups. Intervention group participants will watch a web-based video promoting HIVST-chatbot and receive a free HIVST kit. The chatbot will contact the participant to implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through WhatsApp. Control group participants will watch a web-based video promoting HIVST-OIC and receive a free HIVST kit in the same manner. Upon appointment, a trained testing administrator will implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through live-chat applications. All participants will complete a telephone follow-up survey 6 months after the baseline. The primary outcomes are HIVST uptake and the proportion of HIVST users receiving counseling support along with testing in the past 6 months, measured at month 6. Secondary outcomes include sexual risk behaviors and uptake of HIV testing other than HIVST during the follow-up period. Intention-to-treat analysis will be used. ecruitment and enrollment of participants started in April 2023. his study will generate important research and policy implications regarding chatbot use in HIVST services. If HIVST-chatbot is proven noninferior to HIVST-OIC, it can be easily integrated into existing HIVST services in Hong Kong, given its relatively low resource requirements for implementation and maintenance. HIVST-chatbot can potentially overcome the barriers to using HIVST. Therefore, the coverage of HIV testing, the level of support, and the linkage to care for MSM HIVST users will be increased. linicalTrial.gov NCT05796622 t2/show/NCT05796622 RR1-10.2196/48447
Publisher: MDPI AG
Date: 17-06-2022
Abstract: A COVID-19 vaccine booster dose is effective and safe for older adults. This study investigated facilitators and barriers to take up a COVID-19 vaccine booster dose among older adults in Hong Kong. Participants were Chinese-speaking community-dwelling adults aged ≥65 years. Telephone numbers were randomly selected from up-to-date telephone directories. A total of 395 participants completed the telephone interview. Logistic regression models were fitted. Among the participants, 31.6% received a COVID-19 vaccine booster dose. After adjustment for significant background characteristics, positive attitudes toward the booster dose, perceiving significant others would support them to receive the booster dose, and less uncertainty regarding the choice of the booster dose was associated with higher uptake of a COVID-19 vaccine booster dose. Concerns about poorer responses to the booster dose due to older age and the presence of chronic conditions were negatively associated with the dependent variable. In addition, the belief that governmental promotional materials could address their concern and were helpful for them to make decisions was associated with a higher COVID-19 vaccine booster dose uptake. Improving booster dose health promotion materials, modifying perceptions, involving significant others and reducing uncertainty are potentially useful strategies to improve COVID-19 vaccine booster dose uptake among older adults.
Publisher: MDPI AG
Date: 08-02-2023
Abstract: A second COVID-19 vaccine booster dose is effective and safe for older adults. This study investigated hesitancy to take up a second COVID-19 vaccine booster dose and its determinants among older adults in Hong Kong. Participants were Chinese-speaking community-dwelling adults aged 65 years or above. Telephone numbers were randomly selected from up-to-date telephone directories. A total of 370 participants completed the telephone survey. Logistic regression models were fitted for data analysis. Among the participants, half (52.4%) were hesitant to receive the second COVID-19 vaccine booster dose. After adjustment for significant background characteristics, perceived benefits (AOR: 0.50, 95%CI: 0.42, 0.60), cues to action (AOR: 0.39, 95%CI: 0.30, 0.52), and perceived self-efficacy (AOR: 0.37, 95%CI: 0.21, 0.66) of receiving the second booster dose were associated with lower vaccine hesitancy. Perceived barriers (AOR: 1.23, 95%CI: 1.12, 1.34) and vaccine fatigue (tired of receiving repeated COVID-19 vaccination) (AOR: 1.90, 95%CI: 1.52, 2.38) were associated with higher vaccine hesitancy. Level of hesitancy to receive the second booster dose was high among older adults in Hong Kong. Health authorities should address vaccine fatigue and modify perceptions related to the second booster dose.
Location: Hong Kong
No related grants have been discovered for Siyu Chen.