BackgroundBoth face-to-face and instant messaging (IM) communication are important for families, but face-to-face communication has reduced amidst the COVID-19 pandemic. We examined the use and contents of both communication methods amidst the pandemic, their associations with family wellbeing and personal happiness, and the mediation effects of communication quality in Hong Kong Chinese adults.MethodsThis population-based online survey enrolled 4,921 respondents in May 2020, who reported (i) any face-to-face or IM family communication when the pandemic was severe; (ii) communication contents being classified as neutral, positive, supportive, and negative; and (iii) communication quality, family wellbeing and personal happiness (score 0–10). Associations of family wellbeing and personal happiness with communication methods and contents (no communication excluded) were examined using linear regressions (β), adjusting for each other, sex, age, socioeconomic status, and the number of cohabitants. Mediating effects of communication quality on these associations were examined. Prevalence estimates were weighted by sex, age, and education of the general population. Interactions of methods and contents were examined.ResultsOf 4,891 included respondents (female: 52.9%, 45–54 years: 37.7%, ≥65 years: 21.3%), 7.1% reported no communication, 12.7% face-to-face communication only, 26.7% IM only, and 53.4% both methods. More males and those at younger ages, had lower socioeconomic status, or fewer cohabitants showed no family communication or face-to-face only. More respondents reported neutral (83.1–99.3%) than positive (42.1–62.2%), supportive (37.5–54.8%), and negative (10.9–34.5%) contents despite communication methods. Communication quality was higher with both methods than IM only, face-to-face only, and no communication (scores: 6.7 vs. 4.5–6.6, all P ≤ 0.02). Better family wellbeing and personal happiness were associated with using IM only (adjusted βs: 0.37 and 0.48) and both methods (0.37 and 0.42) than face-to-face only, and positive (0.62 and 0.74) or supportive (0.45 and 0.46) contents (all P ≤ 0.001). Communication quality mediated 35.2–93.5% of these associations. Stronger associations between positive contents and family wellbeing showed in both methods and face-to-face only than IM only (P for interaction = 0.006).ConclusionsWe have first shown that, amidst the COVID-19 pandemic, family IM communication and positive and supportive contents may promote family wellbeing and personal happiness. People with no family communication may need assistance.

BACKGROUND Family e-chat groups are commonly used, but little is known about its associations with family and individual well-being amidst the COVID-19 pandemic. OBJECTIVE Under the Hong Kong Jockey Club SMART Family-Link project, we examined the associations of family e-chat group use amidst the COVID-19 pandemic with family well-being and personal happiness, and the mediating effects of family communication quality on these associations. METHODS A territory-wide self-administered online survey was conducted in May 2020 on Chinese adults in Hong Kong. Respondents reported the number of family e-chat groups (0, 1, 2, ≥3), the instant messaging (IM) functions used (receiving/sending text messages, photos/pictures, short videos, voice messages, making voice calls and video calls), and the average numbers of IM messages sent and received daily (<1, 1-2, 3-10, 11-20, >20) in family e-chat groups. Prevalence was weighted by sex, age, and education of the general population. Adjusted prevalence ratios (aPRs) for IM function use by demographics were calculated. Adjusted β for family well-being (health, harmony, and happiness), and personal happiness (all scale 0-10, higher scores indicate better outcomes) by number of family e-chat groups and IM function use were calculated, and the mediation effect of family communication quality on these associations examined. RESULTS Of 4890 respondents, 4046 (82.7%) had ≥1 family e-chat group. Sending/receiving text messages was most commonly used (weighted prevalence: 78.4%), followed by receiving/sending photos/pictures (76.5%), making voice calls (46.2%), receiving/sending short videos (37.2%) and voice messages (13.8%), and making video calls (8.2%). Women and older age were associated with having more groups (aPRs: 1.04-1.22, all P≤.03) and non-text function use (aPRs: 1.10-3.10, P≤.02). Better family well-being was associated with having more groups (β: 0.23-0.77), receiving/sending photos/pictures (β: 0.33), voice calls (β: 0.18), video calls (β: 0.45), more IM functions used (β: 0.43-0.51), and more IM messages received/sent daily (β: 0.38-0.54) (all P≤.01). Higher personal happiness was associated with having more groups (β: 0.30-0.72), receiving/sending photos/pictures (β: 0.30), video calls (β: 0.32), more IM functions use (β: 0.36-0.42) and more IM messages received/sent daily (β: 0.42-0.67) (all P≤.01). Family communication quality mediated the associations of more groups and more IM functions used with family well-being (mediated proportions: 75.5% and 69.5%, respectively) and personal happiness (mediated proportions: 66.4% and 46.2%, respectively). CONCLUSIONS This is the first study showing that, amidst the COVID-19 pandemic, having more family e-chat groups and using more IM functions including sending/receiving photos/pictures and making video calls in family e-chat groups, were associated with better family well-being and personal happiness, and about half to three-quarters of these associations were mediated by family communication quality. Prospective studies are needed to confirm the associations. People without or with low use of family e-chat groups would need more attention and assistance.