Gamification and social incentives are promising strategies to increase the effectiveness of web-based physical activity (PA) interventions by improving engagement. In this study, we designed a PA intervention integrating gamification and social incentives based on the most popular social networking service in China, WeChat. A controlled trial involving 52 Chinese undergraduate students was implemented to evaluate the effectiveness of the intervention. Subjects in the intervention group received a 7-week intervention. PA behavior and related social cognitive variables according to the theory of planned behavior were measured at the baseline and after the intervention. Daily physical activity duration was measured during the intervention. The results showed that PA-related subjective norms, perceived behavior control, and intention, as well as self-reported vigorous physical activity and moderate physical activity in the intervention group, were increased after the intervention, compared with the control group (p <0.05). During the intervention, perceived daily physical activity duration in the intervention group was on the rise, while it declined in the control group (p <0.001). The findings indicate that WeChat-based intervention integrating gamification and social incentives could effectively increase subjectively measured PA and related social cognition among Chinese undergraduate students and that it is a promising way to ameliorate the problem of insufficient PA among youths.

ObjectivesGiven the increasing need of long-term care and the low occupancy rate of nursing homes in Shanghai, this study attempts to explore what factors influence older people’s intention to enrol in nursing homes.DesignA cross-sectional observational study based on the theory of reasoned action was conducted. Survey data were collected from subjects during face-to-face interviews. Structural equation modelling was employed for data analysis.SettingThis study was conducted in six community health service centres in Shanghai, China. Two service centres were selected in urban, suburban and rural areas, respectively.ParticipantsA total of 641 Shanghai residents aged over 60 were surveyed.ResultsStructural equation modelling analysis showed that the research model fits the data well (χ2/df=2.948, Comparative Fit Index=0.972 and root mean squared error of approximation =0.055). Attitude (β=0.41, p<0.01), subjective norm (β=0.28, p<0.01) and value-added service (β=0.16, p<0.01) were directly associated with enrolment intention, explaining 32% of variance in intention. Attitude was significantly influenced by loneliness (β=−0.08, p<0.05), self-efficacy (β=0.32, p<0.01) and stigma (β=−0.24, p<0.01), while subjective norm was significantly influenced by life satisfaction (β=−0.15, p<0.01) and stigma (β=−0.43, p<0.01).ConclusionsThis study advances knowledge regarding the influencing factors of older people’s intention to enrol in nursing homes. It suggests that Chinese older persons’ perceived stigma has the strongest indirect effect on their intention to enrol in nursing homes. This is unique to the Chinese context and has practical implications for eldercare in China and other Asian countries with similar sociocultural contexts.

Purpose The purpose of this paper is to investigate how WeChat addiction influences users’ physical, mental, and social health. Design/methodology/approach A national survey was conducted in China. A total of 1,058 responses were collected from 31 regions of China. Findings The regression results show that WeChat addiction is negatively associated with users’ physical, mental, and social health. The negative effects are significant even after adjusting for the effects of the Big Five personality traits, years of using WeChat, and demographic variables such as age, gender, education level, and monthly income. Years of using WeChat is not significantly related to users’ health. It is also found that the influence of WeChat addiction on health outcomes is sensitive to years of WeChat use. The influence is dormant when users have less than three years of WeChat usage, but starts to exhibit itself after three years. Research limitations/implications Addictive use of WeChat is associated with declining overall health among Chinese users. Given the cross-sectional nature of this study, definite causal relationship between WeChat addiction and health deterioration cannot be established. Controlled experiments are needed to further examine the causal effects of WeChat addiction. Originality/value WeChat is the most popular mobile social network service (SNS) in China, but its comprehensive impact on users’ health is rarely studied. This paper extends the extant research on SNS addiction by providing a deepened understanding of how mobile SNS addiction affects personal health in the unique context of WeChat, which provides an important contribution to the interdisciplinary research in public health, psychology, and information systems.

Background Traditional exercise [supervised exercise (SE)] intervention has been proved to be one of the most effective ways to improve metabolic health. However, most exercise interventions were on a high-cost and small scale, moreover lacking of the long-term effect due to low engagement. On the other hand, it was noteworthy that gamification and social incentives were promising strategies to increase engagement and sustain exercise interventions effects; as well as mobile technologies such as WeChat also can provide an appropriate platform to deploy interventions on a broader, low-cost scale. Thus, we aim to develop a novel exercise intervention (‘S&G exercise intervention’) that combines SE intervention with gamification and social incentives design through WeChat, with the aim of improving metabolic health and poor behaviors among overweight and obesity children. Methods We propose a randomized controlled trial of a ‘S&G exercise intervention’ among 420 overweight and obese children who have at least one marker of metabolic syndrome. Children will be randomized to control or intervention group in a 1:1 ratio. The exercise intervention package includes intervention designs based on integrated social incentives and gamification theory, involving targeted essential volume and intensity of activity (skipping rope) as well as monitoring daily information and providing health advice by WeChat. Participants will undertake assessments at baseline, at end of intervention period, in the follow-up time at months 3,6,12. The primary outcome is outcome of metabolic health. Secondary outcomes include behavioral (e.g., diary physical activity, diet) and anthropometric measures (e.g., body fat rate and muscle mass). Discussions This will be the first study to design an exercise intervention model that combines traditional supervised exercise (SE) intervention with gamification and social incentives theory through WeChat. We believed that this study could explore a low-cost, easy-to-popularize, and effective exercise intervention model for improving metabolic health and promote healthy among obese children. Furthermore, it will also provide important evidence for guidelines to prevent and improve metabolic health and health behaviors. Trial registration 10-04-2019;Registration number: ChiCTR1900022396 .

BackgroundIndividuals with high sexual compulsivity are preoccupied with their sexual desire to such an extent that it interferes with their normal daily life and can inhibit self-control. Previous studies have found a close association between sexual compulsivity and condomless sex among different populations; however, no studies have investigated this among unmarried female migrant workers in China. This study aimed to validate the Sexual Compulsivity Scale (SCS) for appropriate use and examine the association between sexual compulsivity and condomless sex in this target population.MethodsIn 2015, we recruited 1325 unmarried female migrant workers in Shanghai, China. Information about sociodemographics, sexual compulsivity, and condomless sex were collected using a structured questionnaire. Exploratory factor analysis and reliability analysis were performed to validate the Chinese version of the SCS. Multiple logistic regression analyses were used to examine the association between sexual compulsivity and condomless sex.ResultsThe prevalence of condomless sex in the previous 6 months was 66.8% among all participants. The SCS was proven internally consistent for the overall scale (Cronbach’s α = 0.89), and two factors, Social Disruptiveness (Cronbach’s α = 0.87) and Perceived Self-Control (Cronbach’s α = 0.84), were extracted. With mean total score of 18.25 (standard deviation = 4.94) after adjusting for significant sociodemographic factors, the SCS total scores (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI] = 1.02–1.07) and two subscale scores (AOR = 1.07, 95% CI = 1.02–1.13; AOR = 1.06, 95% CI = 1.02–1.10) were all related to inconsistent condom use with partners in the previous 6 months.ConclusionsThe Chinese version of the SCS was found to be well adaptable for use among unmarried Chinese female migrant workers and a potential predictor for condomless sex. In addition to safe sex interventions, counselling on managing sexually compulsivity should also be provided in this population.