Long-term Improvement of Air Quality Associated with Lung Function Benefits in Chinese Young Adults: A Quasi-experiment Cohort Study

Background: Long-term exposure to air pollution is associated with lung function impairment. However, whether long-term improvements in air quality could improve lung function is unclear.<br />Methods: We conducted a prospective quasi-experiment cohort study with 1731 college students in Shandong, China from September 2019 to September 2020, covering COVID-19 lockdown period. Data on PM2.5, PM10, NO2 and SO2 concentrations were obtained from China Environmental Monitoring Station. The concentration of O3 was obtained from Tracking Air Pollution in China. Lung function indicators included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and forced expiratory flow at 50% of FVC (FEF50%). Linear mixed-effects model was used to examine the associations between the change of air pollutants’ concentrations and the change of lung functions. We also conducted stratified analysis by sex.<br />Results: Compared with 2019, the mean FVC, FEV1 and FEF50% were elevated by 414.4ml, 321.5ml, and 28.4ml respectively in 2020. Every 5μg/m3 decrease in annual average PM2.5 concentrations was associated with 36.0ml [95% confidence interval (CI):6.0, 66.0ml], 46.1ml (95% CI:16.7, 75.5ml), and 124.2ml/s (95% CI:69.5, 178.9ml/s) increment in the FVC, FEV1, and FEF50%, respectively. Similar associations were found for PM10. There was no significant effect difference between male and female.<br />Conclusions: Long-term improvement of air quality can improve lung function among young adults. Stricter policies on improving air quality are needed to protect human health.<br />Funding: Taishan Scholar Program

A Feasibility Study of the WHO Digital Mental Health Intervention Step-by-Step to Address Depression Among Chinese Young Adults

Background: Chinese young adults experience barriers to mental health treatment, including the lack of treatment providers and stigma around treatment seeking. Evidence-based digital mental health interventions are promising and scalable alternatives to face-to-face treatment for this population, but lack rigorous evidence to support scale-up in China.Aim: The study was a feasibility study for a large-scale RCT of Step-by-Step, a behavioral activation-based, mental health intervention to address depression and anxiety symptoms in Chinese young adults. It sought to assess feasibility of recruitment and of delivery of Step-by-Step in a University setting, to assess acceptability of the intervention, and to examine potential effectiveness.Method: An uncontrolled, feasibility trial was conducted to assess the feasibility and acceptability of Chinese Step-by-Step for Chinese University students with elevated depressive symptoms (PHQ-9 scores at or above 10) in Macao, China. Data was collected at two different time points (i.e., baseline and 8-weeks after baseline), administered via questionnaires embedded in an interventional mobile application. Participation rate and dropout rate were measured. Depressive and anxiety symptom severity, well-being, and self-defined stress were assessed. Satisfaction with the program was assessed using qualitative interviews.Results: A total of 173 students were screened, 22.0% (n = 38) were eligible, and 63.2% of them (n = 24) started the intervention. The dropout rate by post-test was 45.8%. Results from completers showed that Step-by-Step was potentially effective in reducing depressive and anxiety symptom severity, and self-defined stress. Students were generally satisfied with the program, but also offered suggestions for continued improvement. Qualitative feedback was reported within the RE-AIM framework, covering recruitment, effectiveness, adoption, implementation, and maintenance. Amendments to the program were made according to the feedback (e.g., adding notification for new session, modify the time zone).Conclusion: A minimally guided Step-by-Step protocol and the study procedure were successfully pilot tested for use for Chinese University students. The intervention was acceptable and no adverse events were reported. The results support the potential effectiveness and feasibility of a large-scale evaluation of the program.

Cloud-Based Commensality: Enjoy the Company of Co-diners Without Social Facilitation of Eating

Previous research has associated frequently enforced solo dining with negative consequences on psychological well-being, but the problem of having to eat alone may be solved by seeking mealtime companions in the digital space by watching an eating broadcast (i.e., Mukbang) or videoconferencing with others (i.e., cloud-based commensality). We conducted the present study to compare the consequences of Mukbang-based, cloud-based, and in-person commensality. Ninety-five healthy Chinese young adults were instructed to rate images of eating scenarios and foods. The results revealed that they expected loneliness to be reduced by Mukbang-based or in-person commensality, but they were also aware of the risks of enhancing food intake and/or being shifted toward less healthy food choices in these two scenarios. By contrast, the participants expected cloud-based commensality to provide the benefits of reducing loneliness without the health-compromising risks of increasing food intake or unhealthy eating. Collectively, these findings suggest the beliefs of the participants that cloud-based commensality can provide an “alone but together” context to balance the need for social interactions with the strategic avoidance of a social context facilitating unhealthy eating. The findings also provide some novel insights into how the application of technologies for eating behavior can be used to integrate social factors and food pleasure, and shed light on the promising future of cloud-based commensality as a combination of the strengths of solitary and commensal eating.

Changes in Physical Activity and Sedentary Behavior in Chinese Young Adults during the COVID-19 Pandemic: A Repeated-Measure Study throughout One Year

Though we know physical activity (PA) decreased while sedentary behavior (SB) increased compared to that before the COVID-19 pandemic, little is known about subsequent changes in PA and SB throughout one year in the post-pandemic era. This study aimed to examine the changes in PA and SB in a sample of Chinese young adults using a four-wave repeated-measure design during the pandemic. A total of 411 participants provided self-reported data of sociodemographic characteristics (e.g., sex, age), PA, and SB. Nonparametric tests and generalized estimating equations were conducted. Results revealed significant changes in moderate to vigorous PA (MVPA), light PA (LPA), and SB. The MVPA of Wave 1, 2, and 3 was significantly less than that of Wave 4 (p < 0.001); the LPA of Wave 1 and 2 was significantly less than that of Wave 4; the SB of Wave 1 was significantly more than that of Wave 4 (p < 0.05). Being female was the only predictor of changes in MVPA (Beta = −0.311, p< 0.001). Being female (Beta = 0.115, p = 0.003) and perceived family affluence (Beta = −0.059, p< 0.001) were predictors of changes in SB. As such, PA was less, while SB was more during the early stages of the pandemic. With the progress of the pandemic stages, health behaviors in young adults have been gradually improved. Sex and perceived family affluence were two important factors in predicting health behaviors. Our results can inform efficient policies or interventions in the COVID-19 era and future similar public health events.

Self-compassion in Chinese Young Adults: Specific Features of the Construct from a Cultural Perspective

Objectives Recent research has suggested that Chinese individuals from a collectivist culture may have a different understanding of self-compassion, which could differentially contribute to mental health. This study aimed to obtain an in-depth insight into Chinese adults’ understanding of self-compassion. Methods Four online focus groups in Chinese undergraduates discussed the construct of self-compassion based on self-kindness, self-judgment, common humanity, isolation, mindfulness, and over-identification. Thematic analysis was used to analyse the data. Results Chinese participants valued benign self-criticism and self-reflection when contemplating their understanding of self-compassion. Similarly, participants’ view of self-compassion dimensions can be described as dialectical in that they reflected both negative and positive perceptions in each factor rather than suggesting separate and purely negative or purely positive dimensions. There was also an overlap in the interpretation of the negative dimensions (self-judgment, isolation, and over-identification). Conclusions The findings highlight particularities in the understanding of self-compassion in these Chinese students, which may be influenced by philosophical traditions promoting dialecticism and the dual focus on the transformation of the self and social participation. This suggests the importance of a cultural perspective when studying self-compassion and interpreting relevant research findings.