Background COVID-19 has seriously affected people's mental health and changed their behaviors. Previous studies for mental state and behavior promotion only targeted limited people or were not suitable for daily activity restrictions. Therefore, we decided to explore the effect of health education videos on people’s mental state and health-related behaviors. Methods Based on WeChat, QQ, and other social media, we conducted an online survey by snowball sampling. Spearman’s non-parametric method was used to analyze the correlation related to mental health problems and health-related behaviors. Besides, we used binary logistic regression analyses to examine mental health problems and health-related behaviors' predictors. We performed SPSS macro PROCESS (model 4 and model 6) to analyze mediation relationships between exposure to health education videos and depression/anxiety/health-related behaviors. These models were regarded as exploratory. Results Binary logistic regression analyses indicated that people who watched the health education videos were more likely to wear masks (OR 1.15, p < 0.001), disinfect (OR 1.26, p < 0.001), and take temperature (OR 1.37, p < 0.001). With higher level of posttraumatic growth (PTG) or perceived social support (PSS), people had lower percentage of depression (For PSS, OR 0.98, p < 0.001; For PTG, OR 0.98, p < 0.01) and anxiety (For PSS, OR 0.98, p < 0.001; For PTG, OR 0.98, p = 0.01) and better health behaviors. The serial multiple-mediation model supported the positive indirect effects of exposure to health education videos on the depression and three health-related behaviors through PSS and PTG (Depression: B[SE] =  − 0.0046 [0.0021], 95% CI − 0.0098, − 0.0012; Mask-wearing: B[SE] = 0.0051 [0.0023], 95% CI 0.0015, 0.0010; Disinfection: B[SE] = 0.0059 [0.0024], 95% CI 0.0024, 0.0012; Temperature-taking: B[SE] = 0.0067 [0.0026], 95% CI 0.0023, 0.0013). Conclusion Exposure to health education videos can improve people's self-perceived social support and inner growth and help them cope with the adverse impact of public health emergencies with better mental health and health-related behaviors.

ObjectivesExamine compliance with personal protective measures in communities for the prevention and control of local transmission of the COVID-19, and explore indicators for such behavioural compliance.DesignCross-sectional design with a self-selecting sample. Data collected in February 2020.SettingCommunity dwellers in China.Participants2956 participants aged 16 and above completed the study and were included in the analysis.Outcome measuresNationwide COVID-19 survey. Demographics and self-reported compliance with four personal protective measures—home quarantine, mask-wearing, temperature-taking and hand-sanitising were collected. Outbreak severity and timeliness of personal protection order were obtained from the China Center for Disease Control and Prevention website. Logistic regression models were employed to examine the association between demographic and social indicators and behavioural compliance.ResultsCompliance with home quarantine was only associated with gender (men, OR=0.61 (0.51–0.73), inverse association) but no other indicators. In contrast, men had higher compliance with mask-wearing (OR=1.79 (1.49–2.16)) and temperature-taking (OR=1.27 (1.05–1.53)). Compared with younger adults (≤20 years), the middle-age groups (31–40 and 41–50 years of age) were more compliant with all protective behaviours, except for home quarantine (OR=0.71 (0.54–0.93) and 0.67 (0.46–0.97), respectively).ConclusionMale gender was associated with lower compliance with home quarantine yet higher compliance with mask-wearing and temperature-taking. The middle-age participants (31–50 years) had lower compliance with home quarantine but higher with other measures. These findings may be supported by the economic considerations and the long-inherited Confucian values among Chinese. In light of the ongoing COVID-19 pandemic, public health authorities should tailor policy implementation to disparities in psychosocial indicators.

ObjectivesInternet Addiction (IA) is a growing issue predominate in adolescents and young adults. Although the effects of diverse stressors on IA have been highlighted, there is little consensus about the specific underpinnings of IA. The current study aims to investigate associations between uncertainty stress, life stress and IA among Chinese university medical students.MethodsA cross-sectional survey employing multi-stage sampling was used. Data were collected from 6,061 students from 27 university medical programs across China. Associations between uncertainty stress, life stress, and IA were examined by means of multivariate logistic regression.ResultsThe findings indicated that the overall IA prevalence was 12.6% (95% CI 11.7-13.5), life stress prevalence was 8.1% (95% CI 7.4-8.8), and uncertainty stress prevalence was 19.1% (95% CI 18.1-20.1). Multivariate logistic regression showed that uncertainty stress [adjusted OR 2.60 (95% CI 2.14-3.15), P &lt; 0.001] and life stress [adjusted OR 1.71 (95% CI 1.32-2.23), P &lt; 0.001] were positively associated with IA. Population Attributable Risk (PAR) of uncertainty stress associated with IA was 29%, and that of life stress was 15%.ConclusionsThe contribution of uncertainty stress to IA is significantly higher than that of life stress. High uncertainty stress, being male and born in a region of higher economic status were associated with excessive Internet use and IA.

Aims: The modern medical model has been transformed into a biopsychosocial model. The integration of the biopsychosocial approach in healthcare can help improve the effectiveness of diagnosis and treatment. This study explored the actual application of the biopsychosocial approach in healthcare and provides a basis for targeted interventions to promote the biopsychosocial approach in healthcare.Methods: Study 1 involved one-on-one interviews with 30 medical staff and focus group interviews with 16 recent patients. Study 2 was a cross-sectional survey of 13,105 medical staff in Hangzhou, China that analyzed the status quo implementation of the biopsychosocial approach in healthcare.Results: Study 1 found that medical staff did not welcome patients to report information unrelated to their disease, hoping patients did not express their emotions. In the treatment process, patients believed that medical staff refused to attend to or did not encourage reporting of any information other than the disease, and that patients should have reasonable expectations for medical staff. Study 2 found that medical staff had a 37.5% probability of actively paying attention to the patient's psychosocial status. Female medical staff (38.5%) were actively concerned about the patient's psychosocial status significantly more than male medical staff (34.2%) (P &lt; 0.01). The medical staff in the psychiatric department (58.4%) paid more active attention to the patient's psychosocial status than staff in the non-psychiatric departments (37.2%). Gender, department, hospital level, and professional title were the factors associated with the medical staff's attention to the patient's psychosocial status (P &lt; 0.05). The influence of age on the probability of medical staff actively paying attention to the psychosocial status of patients increased with the number of years of employment. Participants that were 31–40 years old, had an intermediate professional title, and 11–15 years of employment were the least likely to actively pay attention to patients' psychosocial status.Conclusion: Although the biopsychosocial approach has been popularized for many years, it has not been widely used in medical care. Medical staff pay more attention to patients' physical symptoms and less attention to patients' psychosocial status. It is recommended that training will be provided to medical personnel on implementing a biopsychosocial approach with particular attention to the sociodemographic characteristics of medical personnel. Additionally, we propose helping patients set reasonable expectations, and formulating guidelines for implementing the biopsychosocial approach.

Purpose There are few studies on the intervention of the doctor–patient relationship (DPR) from patients’ perspective, because of lacking appropriate measurement instruments for the effect of the patient interveqntion. Understanding the status of patients’ literacy (the ability to initiatively obtain, read, and analyze health-related materials, make appropriate decisions, reduce risks of health-related problems) and developing the patients’ literacy scale (PLS) align with the interests of patients, doctors, and researchers. Patients and Methods This study was conducted in two stages: item building and item refinement. A total of 303 subjects were recruited from the outpatient hall in three hospitals with different levels in Hangzhou city, China. Twenty patients and seven experts determined the face and content validity, respectively. The construct validity, convergent, discriminant validity, and known-group validity of the scale were examined by exploratory and confirmatory factor analysis (EFA and CFA). Internal consistency, including Cronbach’s alpha, McDonald’s ω, split-half reliability, and composite reliability (CR), was also tested. Results The EFA of PLS showed that Kaiser–Meyer–Olkin (KMO) measure of sampling adequacy was 0.787, and Bartlett’s Test of Sphericity showed a significance of p < 0.001. The extracted four-factor (patient activation, knowledge, attitudes, practice) model explained 61.266% of the total variance. For the overall PLS, the Cronbach’s alpha, McDonald’s ω and split-half reliability coefficient were 0.815, 0.838 and 0.720, respectively. The CFA showed the goodness of fit (RMSEA = 0.065, CMIN/DF = 1.635, GFI = 0.900, CFI = 0.905, TLI = 0.909). The CR of each factor in this scale was 0.740, 0.732, 0.630, and 0.749, respectively. Conclusion This study showed that the PLS was valid and reliable to measure the patients’ literacy (PL). The 15-item PLS can help not only measure PL but also be used as a standard and advocacy target for patients’ behavioral model which can further improve the DPR.