ORCID Profile
0000-0001-9822-5424
Current Organisation
The Chinese University of Hong Kong
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Publisher: JMIR Publications Inc.
Date: 26-08-2019
Abstract: he disproportionately high prevalence of HIV among men who have sex with men (MSM) is a global concern. Despite the increasing utilization of electronic health (eHealth) technology in the delivery of HIV prevention interventions, few studies have systematically explored its effectiveness and association with various intervention characteristics. his study aimed to conduct a meta-analysis of the effectiveness of eHealth technology–based interventions for promoting HIV-preventive behaviors among MSM and to determine effectiveness predictors within a framework integrating design and implementation features. systematic literature search using terms related to eHealth technology, HIV, the MSM population, and an experimental study design was performed using 5 databases (ie, MEDLINE, PsycINFO, EMBASE, Web of Science, and ProQuest Dissertations & Theses) and other sources (eg, bibliographies of relevant reviews and JMIR Publications). First, primary meta-analyses were conducted to estimate the effectiveness of eHealth interventions ( i d /i sub + /sub ) in changing 3 HIV-preventive behaviors among MSM: unprotected anal intercourse (UAI), HIV testing, and multiple sex partnership (MSP). Moderation analyses were then conducted to examine a priori effectiveness predictors including behavioral treatment components (eg, theory use, tailoring strategy use, navigation style, and treatment duration), eHealth technology components (eg, operation mode and modality type), and intervention adherence. total of 46 studies were included. The overall effect sizes at end point were small but significant for all outcomes (UAI: i d /i sub + /sub =−.21, i P /i & .001 HIV testing: i d /i sub + /sub =.38, i P /i & .001 MSP: i d /i sub + /sub =−.26, i P /i =.02). The intervention effects on UAI were significantly larger when compared with preintervention groups than with concurrent groups. Greater UAI reductions were associated with the increased use of tailoring strategies, provision of feedback, and tunneling navigation in interventions with a concurrent group, whereas reductions were associated with the use of self-paced navigation in interventions with a preintervention group. Greater uptake of HIV testing was associated with longer treatment duration computer-mediated communication and the use of messaging, social media, or a combined technology modality. Higher intervention adherence consistently predicted larger effects on UAI and HIV testing. his study provided empirical evidence for the effectiveness of eHealth interventions in promoting HIV-preventive behaviors among MSM. Features of treatment content and eHealth technology might best predict the intervention effects on UAI and HIV testing, respectively. Most importantly, intervention adherence tended to play an important role in achieving better effectiveness. The findings could help inform the development of efficacious interventions for HIV prevention in the future.
Publisher: Informa UK Limited
Date: 17-06-2018
DOI: 10.1080/09540121.2018.1487916
Abstract: HIV self-stigma in HIV positive men who have sex with men (HIVMSM) has been identified as one of the largest challenges of HIV prevention, and associates with numerous negative outcomes, including depression, decreased social support, and less condom use intentions. In the present study, 321 HIVMSM in Chengdu, China were recruited to examine the prevalence of condom use in the past months and intentions to use condoms in next six months we also identify pathways between HIV self-stigma and intentions to use condoms by the structural equation modeling approach. Results showed that Chinese HIVMSM had the suboptimal prevalence of consistent condom use and low intentions to use condoms consistently. Additionally, depression and decreased social support were significant mediators between HIV self-stigma and condom use intentions. The complex pathways between HIV self-stigma and intentions to use condoms should be taken into account in the HIV prevention and intervention programs.
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: 24-02-2021
Abstract: ocial media has become an important source of health information during the COVID-19 pandemic. Very little is known about the potential mental impact of social media use on pregnant women. his study aims to examine the association between using social media for health information and risk perception for COVID-19, worry due to COVID-19, and depression among pregnant women in China. total of 4580 pregnant women were recruited from various provinces of China. The participants completed a cross-sectional, web-based survey in March 2020. ore than one-third (1794/4580, 39.2%) of the participants reported always using social media for obtaining health information. Results of structural equation modeling showed that the frequency of social media use for health information was positively associated with perceived susceptibility ( i β /i =.05 i P /i & .001) and perceived severity ( i β /i =.12 i P /i & .001) of COVID-19, which, in turn, were positively associated with worry due to COVID-19 ( i β /i =.19 and i β /i =.72, respectively i P& /i .001). Perceived susceptibility ( i β /i =.09 i P /i & .001), perceived severity ( i β /i =.08 i P /i & .001), and worry due to COVID-19 ( i β /i =.15 i P /i & .001) all had a positive association with depression. Bootstrapping analysis showed that the indirect effects of frequency of social media use for health information on both worry due to COVID-19 ( i β /i =.09, 95% CI 0.07-0.12) and depression ( i β /i =.05, 95% CI 0.02-0.07) were statistically significant. his study provides empirical evidence on how social media use for health information might have a negative impact on the mental health of pregnant women. Interventions are needed to equip this population with the skills to use social media properly and with caution.
Publisher: MDPI AG
Date: 03-2023
Abstract: This study investigates how health literacy (HL) and trust in health information affected COVID-19 vaccine hesitancy among Chinese Hong Kong adults. A cross-sectional study was conducted in August 2022. A total of 401 participants completed the study. Participants completed a newly developed Hong Kong HL scale and self-reported their trust levels in health information from different resources. The proportions of early uptake of the first dose and booster dose of COVID-19 vaccine were 69.1% and 71.8%, respectively. The risk of delaying the first dose was higher among participants with inadequate functional HL (OR = 0.58, p = 0.015), adequate levels of two subdomains of critical HL (OR = 1.82, p = 0.013 OR = 1.91, p 0.01), and low-level trust in health information from the government (OR = 0.57, p = 0.019). Respondents with adequate interactive HL (OR = 0.52, p = 0.014) and inadequate level of one subdomain of critical HL (OR =1.71, p = 0.039) were more likely to delay the booster dose. This negative association between critical HL and vaccination was suppressed by trust in health information from the government. This study shows that HL and trust in health information from the government are associated with COVID-19 vaccine hesitancy. Efforts should be directed at providing tailored communication strategies with regard to people’s HL and increasing public confidence in health authorities to decrease vaccine hesitancy.
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: JMIR Publications Inc.
Date: 12-04-2021
DOI: 10.2196/24053
Abstract: COVID-19 is an emerging infectious disease that has created health care challenges worldwide. Pregnant women are particularly affected by this disease. The aims of this study are to assess the levels of perceived threat (susceptibility, severity, impact), negative emotions (fear, worry), and self-efficacy of pregnant women in China related to COVID-19 and to examine their associations with mental health (depression and anxiety) and personal protective behavior (wearing a face mask). A total of 4087 pregnant women from China completed a cross-sectional web-based survey between March 3 and 10, 2020. The prevalence of probable depression and anxiety was 48.7% (1989/4087) and 33.0% (1347/4087), respectively 23.8% participants (974/4087) reported always wearing a face mask when going out. Of the 4087 participants, 32.1% (1313) and 36.4% (1490) perceived themselves or their family members to be susceptible to COVID-19 infection, respectively 3216-3518 (78.7%-86.1%) agreed the disease would have various severe consequences. Additionally, 2275 of the 4087 participants (55.7%) showed self-efficacy in protecting themselves from contracting COVID-19, and 2232 (54.6%) showed efficacy in protecting their family members 1303 (31.9%) reported a high level of fear of the disease, and 2780-3056 (68.0%-74.8%) expressed worry about various aspects of COVID-19. The results of the multivariate multinominal logistic regression analyses showed that perceived severity, perceived impact, fear, and worry were risk factors for probable depression and anxiety, while self-efficacy was a protective factor. The results of the multivariate logistic regression analysis showed that perceived susceptibility was associated with always wearing a face mask. Chinese pregnant women showed high levels of mental distress but low levels of personal protective behavior during the COVID-19 pandemic. Interventions are needed to promote the mental health and health behavior of pregnant women during the pandemic.
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: Informa UK Limited
Date: 13-01-2021
Publisher: JMIR Publications Inc.
Date: 22-01-2021
DOI: 10.2196/24495
Abstract: Although lockdown and mandatory quarantine measures have played crucial roles in the sharp decrease of the number of newly confirmed/suspected COVID-19 cases, concerns have been raised over the threat that these measures pose to mental health, especially the mental health of vulnerable groups, including pregnant women. Few empirical studies have assessed whether and how these control measures may affect mental health, and no study has investigated the prevalence and impacts of the use of eHealth resources among pregnant women during the COVID-19 outbreak. This study investigated (1) the effects of lockdown and mandatory quarantine on mental health problems (ie, anxiety and depressive symptoms), (2) the potential mediation effects of perceived social support and maladaptive cognition, and (3) the moderation effects of eHealth-related factors (ie, using social media to obtain health information and using prenatal care services during the COVID-19 pandemic) on pregnant women in China. An online cross-sectional survey was conducted among 19,515 pregnant women from all 34 Chinese provincial-level administrative regions from February 25 to March 10, 2020. Of the 19,515 participants, 12,209 (62.6%) were subjected to lockdown in their areas of residence, 737 (3.8%) were subjected to mandatory quarantine, 8712 (44.6%) had probable mild to severe depression, 5696 (29.2%) had probable mild to severe anxiety, and 1442 (7.4%) had suicidal ideations. Only 640 (3.3%) participants reported that they used online prenatal care services during the outbreak. Significant sociodemographic/maternal factors of anxiety/depressive symptoms included age, education, occupation, the area of residence, gestational duration, the number of children born, complication during pregnancy, the means of using prenatal care services, and social media use for obtaining health information. Multiple indicators multiple causes modeling (χ214=495.21 P .05 comparative fit index=.99 nonnormed fit index=.98 root mean square error of approximation=.04, 90% CI 0.038-0.045) showed that quarantine was directly and indirectly strongly associated with poor mental health through decreased perceived social support and increased maladaptive cognition (B=.04 β=.02, 95% CI 0.01-0.02 P=.001), while lockdown was indirectly associated with mental health through increased social support and maladaptive cognition among pregnant women (B=.03 β=.03, 95% CI 0.02-0.03 P=.001). Multigroup analyses revealed that the use of social media for obtaining health information and the means of using prenatal care services were significant moderators of the model paths. Our findings provide epidemiological evidence for the importance of integrating mental health care and eHealth into the planning and implementation of control measure policies. The observed social and cognitive mechanisms and moderators in this study are modifiable, and they can inform the design of evidence-based mental health promotion among pregnant women.
Publisher: JMIR Publications Inc.
Date: 11-02-2021
DOI: 10.2196/24162
Abstract: Mental health problems are prevalent among pregnant women, and it is expected that their mental health will worsen during the COVID-19 pandemic. Furthermore, the underutilization of mental health services among pregnant women has been widely documented. We aimed to identify factors that are associated with pregnant women’s intentions to seek mental health services. We specifically assessed pregnant women who were at risk of mental health problems in mainland China. A web-based survey was conducted from February to March, 2020 among 19,515 pregnant women who were recruited from maternal health care centers across various regions of China. A subs le of 6248 pregnant women with probable depression (ie, those with a score of ≥10 on the 9-item Patient Health Questionnaire) or anxiety (ie, those with a score of ≥5 on the 7-item General Anxiety Disorder Scale) was included in our analysis. More than half (3292/6248, 52.7%) of the participants reported that they did not need mental health services. Furthermore, 28.3% (1770/6248) of participants felt that they needed mental health services, but had no intentions of seeking help, and only 19% (1186/6248) felt that they needed mental health services and had intentions of seek help. The results from our multivariate logistic regression analysis showed that age, education level, and gestational age were factors of not seeking help. However, COVID-19–related lockdowns in participants’ cities of residence, social support during the COVID-19 pandemic, and trust in health care providers were protective factors of participants’ intentions to seek help from mental health services. Interventions that promote seeking help for mental health problems among pregnant women should also promote social support from health care providers and trust between pregnant women and their care providers.
Publisher: JMIR Publications Inc.
Date: 13-01-2022
DOI: 10.2196/28183
Abstract: Social media has become an important source of health information during the COVID-19 pandemic. Very little is known about the potential mental impact of social media use on pregnant women. This study aims to examine the association between using social media for health information and risk perception for COVID-19, worry due to COVID-19, and depression among pregnant women in China. A total of 4580 pregnant women were recruited from various provinces of China. The participants completed a cross-sectional, web-based survey in March 2020. More than one-third (1794/4580, 39.2%) of the participants reported always using social media for obtaining health information. Results of structural equation modeling showed that the frequency of social media use for health information was positively associated with perceived susceptibility (β=.05 P .001) and perceived severity (β=.12 P .001) of COVID-19, which, in turn, were positively associated with worry due to COVID-19 (β=.19 and β=.72, respectively P .001). Perceived susceptibility (β=.09 P .001), perceived severity (β=.08 P .001), and worry due to COVID-19 (β=.15 P .001) all had a positive association with depression. Bootstrapping analysis showed that the indirect effects of frequency of social media use for health information on both worry due to COVID-19 (β=.09, 95% CI 0.07-0.12) and depression (β=.05, 95% CI 0.02-0.07) were statistically significant. This study provides empirical evidence on how social media use for health information might have a negative impact on the mental health of pregnant women. Interventions are needed to equip this population with the skills to use social media properly and with caution.
Publisher: JMIR Publications Inc.
Date: 25-05-2020
DOI: 10.2196/15977
Abstract: The disproportionately high prevalence of HIV among men who have sex with men (MSM) is a global concern. Despite the increasing utilization of electronic health (eHealth) technology in the delivery of HIV prevention interventions, few studies have systematically explored its effectiveness and association with various intervention characteristics. This study aimed to conduct a meta-analysis of the effectiveness of eHealth technology–based interventions for promoting HIV-preventive behaviors among MSM and to determine effectiveness predictors within a framework integrating design and implementation features. A systematic literature search using terms related to eHealth technology, HIV, the MSM population, and an experimental study design was performed using 5 databases (ie, MEDLINE, PsycINFO, EMBASE, Web of Science, and ProQuest Dissertations & Theses) and other sources (eg, bibliographies of relevant reviews and JMIR Publications). First, primary meta-analyses were conducted to estimate the effectiveness of eHealth interventions (d+) in changing 3 HIV-preventive behaviors among MSM: unprotected anal intercourse (UAI), HIV testing, and multiple sex partnership (MSP). Moderation analyses were then conducted to examine a priori effectiveness predictors including behavioral treatment components (eg, theory use, tailoring strategy use, navigation style, and treatment duration), eHealth technology components (eg, operation mode and modality type), and intervention adherence. A total of 46 studies were included. The overall effect sizes at end point were small but significant for all outcomes (UAI: d+=−.21, P .001 HIV testing: d+=.38, P .001 MSP: d+=−.26, P=.02). The intervention effects on UAI were significantly larger when compared with preintervention groups than with concurrent groups. Greater UAI reductions were associated with the increased use of tailoring strategies, provision of feedback, and tunneling navigation in interventions with a concurrent group, whereas reductions were associated with the use of self-paced navigation in interventions with a preintervention group. Greater uptake of HIV testing was associated with longer treatment duration computer-mediated communication and the use of messaging, social media, or a combined technology modality. Higher intervention adherence consistently predicted larger effects on UAI and HIV testing. This study provided empirical evidence for the effectiveness of eHealth interventions in promoting HIV-preventive behaviors among MSM. Features of treatment content and eHealth technology might best predict the intervention effects on UAI and HIV testing, respectively. Most importantly, intervention adherence tended to play an important role in achieving better effectiveness. The findings could help inform the development of efficacious interventions for HIV prevention in the future.
Publisher: Wiley
Date: 08-11-2022
DOI: 10.1111/HEX.13651
Abstract: Health literacy (HL) refers to in iduals' abilities to process and use health information to promote health. This study aimed to develop the first HL measurement tool for the Chinese Hong Kong population. A two-phase methodology was adopted. In Phase I, evidence synthesis with a deductive method was conducted to formulate the item list from the literature. In Phase II, a modified e-Delphi survey was conducted among stakeholders (i.e., healthcare providers and healthcare consumers) to confirm the content validity of the item list. The stakeholders were invited to rate the relevance of each draft item on a 4-point scale and provide suggestions for revisions, removal or adding new items. In Phase I, a total of 34 items covering functional, interactive and critical HL were generated. In Phase II, to obtain a balanced view from experts and laypeople, healthcare professionals (n = 12) and consumers (n = 12) were invited to participate in the Delphi panel. The response rates of the three rounds were 100%. After the third round, the consensus was reached for 31 items, and no further comments for adding or revising items were received. All items exhibited excellent content validity (item content validity index: 0.79-1.00 K*: 0.74-1.00). A Health Literacy Scale for Hong Kong was developed. Compared with existing HL scales, the scale fully operationalized the skills involved in functional, interactive and critical HL. The Delphi study shows evidence supporting the high content validity of all items in the scale. In future studies, these items should undergo rigorous testing to examine their psychometric properties in our target population groups. By illuminating the details in the development process, this paper provides a deeper understanding of the scale's scope and limitations for others who are interested in using this tool. Public as healthcare consumers, in addition to healthcare providers, were involved in developing a new HL scale for this study. The input from the public contributed to examining the scale's content validity by judging whether all items reflected the skills that they need to find and use health-related information in their daily life.
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: 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: 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: JMIR Publications Inc.
Date: 07-09-2020
Abstract: ental health problems are prevalent among pregnant women, and it is expected that their mental health will worsen during the COVID-19 pandemic. Furthermore, the underutilization of mental health services among pregnant women has been widely documented. e aimed to identify factors that are associated with pregnant women’s intentions to seek mental health services. We specifically assessed pregnant women who were at risk of mental health problems in mainland China. web-based survey was conducted from February to March, 2020 among 19,515 pregnant women who were recruited from maternal health care centers across various regions of China. A subs le of 6248 pregnant women with probable depression (ie, those with a score of ≥10 on the 9-item Patient Health Questionnaire) or anxiety (ie, those with a score of ≥5 on the 7-item General Anxiety Disorder Scale) was included in our analysis. ore than half (3292/6248, 52.7%) of the participants reported that they did not need mental health services. Furthermore, 28.3% (1770/6248) of participants felt that they needed mental health services, but had no intentions of seeking help, and only 19% (1186/6248) felt that they needed mental health services and had intentions of seek help. The results from our multivariate logistic regression analysis showed that age, education level, and gestational age were factors of not seeking help. However, COVID-19–related lockdowns in participants’ cities of residence, social support during the COVID-19 pandemic, and trust in health care providers were protective factors of participants’ intentions to seek help from mental health services. nterventions that promote seeking help for mental health problems among pregnant women should also promote social support from health care providers and trust between pregnant women and their care providers.
Publisher: JMIR Publications Inc.
Date: 02-09-2020
Abstract: OVID-19 is an emerging infectious disease that has created health care challenges worldwide. Pregnant women are particularly affected by this disease. he aims of this study are to assess the levels of perceived threat (susceptibility, severity, impact), negative emotions (fear, worry), and self-efficacy of pregnant women in China related to COVID-19 and to examine their associations with mental health (depression and anxiety) and personal protective behavior (wearing a face mask). total of 4087 pregnant women from China completed a cross-sectional web-based survey between March 3 and 10, 2020. he prevalence of probable depression and anxiety was 48.7% (1989/4087) and 33.0% (1347/4087), respectively 23.8% participants (974/4087) reported always wearing a face mask when going out. Of the 4087 participants, 32.1% (1313) and 36.4% (1490) perceived themselves or their family members to be susceptible to COVID-19 infection, respectively 3216-3518 (78.7%-86.1%) agreed the disease would have various severe consequences. Additionally, 2275 of the 4087 participants (55.7%) showed self-efficacy in protecting themselves from contracting COVID-19, and 2232 (54.6%) showed efficacy in protecting their family members 1303 (31.9%) reported a high level of fear of the disease, and 2780-3056 (68.0%-74.8%) expressed worry about various aspects of COVID-19. The results of the multivariate multinominal logistic regression analyses showed that perceived severity, perceived impact, fear, and worry were risk factors for probable depression and anxiety, while self-efficacy was a protective factor. The results of the multivariate logistic regression analysis showed that perceived susceptibility was associated with always wearing a face mask. hinese pregnant women showed high levels of mental distress but low levels of personal protective behavior during the COVID-19 pandemic. Interventions are needed to promote the mental health and health behavior of pregnant women during the pandemic.
Publisher: Hindawi Limited
Date: 02-08-2019
DOI: 10.1111/HSC.12825
Abstract: Maternal HIV disclosure to children has numerous benefits for both mothers and children. However, the prevalence of maternal HIV disclosure to children remains low in many countries. The present study examined factors associated with intention to disclose maternal HIV status to children among Chinese HIV+ women who have not disclosed their HIV status to their child. Factors from the Theory of Planned Behavior and various norms (injunctive, descriptive and moral norm) were examined. Findings from 179 HIV+ women revealed that only 16.8% intended to disclose their HIV status to their child in the future. Adjusted for significant background variables, all factors from the TPB and various norms (i.e. attitude, injunctive norm, descriptive norm, moral norm, perceived behavioural control) were associated with intention to disclose HIV status (adjusted odds ratios ranged from 3.22, 15.85). Stepwise logistic regression showed that attitude (ORm = 6.96) and injunctive norm (ORm = 6.81) were associated with intention to disclose HIV status. Interventions to promote maternal HIV disclosure were warranted to promote attitude, perceived behavioural control, and various norms associated with HIV disclosure.
Publisher: JMIR Publications Inc.
Date: 22-09-2020
Abstract: lthough lockdown and mandatory quarantine measures have played crucial roles in the sharp decrease of the number of newly confirmed/suspected COVID-19 cases, concerns have been raised over the threat that these measures pose to mental health, especially the mental health of vulnerable groups, including pregnant women. Few empirical studies have assessed whether and how these control measures may affect mental health, and no study has investigated the prevalence and impacts of the use of eHealth resources among pregnant women during the COVID-19 outbreak. his study investigated (1) the effects of lockdown and mandatory quarantine on mental health problems (ie, anxiety and depressive symptoms), (2) the potential mediation effects of perceived social support and maladaptive cognition, and (3) the moderation effects of eHealth-related factors (ie, using social media to obtain health information and using prenatal care services during the COVID-19 pandemic) on pregnant women in China. n online cross-sectional survey was conducted among 19,515 pregnant women from all 34 Chinese provincial-level administrative regions from February 25 to March 10, 2020. f the 19,515 participants, 12,209 (62.6%) were subjected to lockdown in their areas of residence, 737 (3.8%) were subjected to mandatory quarantine, 8712 (44.6%) had probable mild to severe depression, 5696 (29.2%) had probable mild to severe anxiety, and 1442 (7.4%) had suicidal ideations. Only 640 (3.3%) participants reported that they used online prenatal care services during the outbreak. Significant sociodemographic/maternal factors of anxiety/depressive symptoms included age, education, occupation, the area of residence, gestational duration, the number of children born, complication during pregnancy, the means of using prenatal care services, and social media use for obtaining health information. Multiple indicators multiple causes modeling ( i χ /i sup /sup sub /sub =495.21 i P /i & .05 comparative fit index=.99 nonnormed fit index=.98 root mean square error of approximation=.04, 90% CI 0.038-0.045) showed that quarantine was directly and indirectly strongly associated with poor mental health through decreased perceived social support and increased maladaptive cognition (B=.04 i β /i =.02, 95% CI 0.01-0.02 i P /i =.001), while lockdown was indirectly associated with mental health through increased social support and maladaptive cognition among pregnant women (B=.03 i β /i =.03, 95% CI 0.02-0.03 i P /i =.001). Multigroup analyses revealed that the use of social media for obtaining health information and the means of using prenatal care services were significant moderators of the model paths. ur findings provide epidemiological evidence for the importance of integrating mental health care and eHealth into the planning and implementation of control measure policies. The observed social and cognitive mechanisms and moderators in this study are modifiable, and they can inform the design of evidence-based mental health promotion among pregnant women.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Phoenix Mo.