With the popularity of the health and wellness trend in recent years, smartphone fitness applications have become more and more popular. Thus, this study explored factors affecting the behavioral intention to use and the actual usage behavior of smartphone fitness apps from technical, health, and social perspectives by integrating the Social Cognitive Theory (SCT) and Unified Theory of Acceptance and Use of Technology (UTAUT). We examined whether perceived usefulness, perceived ease-of-use, social influence, self-efficacy, goal-setting, and self-monitoring predict usage behavior. Based on the survey responses of 1066 smartphone fitness apps users, we revealed that all of the variables, except for self-monitoring, significantly influence usage behavior, while behavioral intention acts as a total mediator between perceived usefulness, perceived ease-of-use and usage behavior. Drawing on the research findings, we suggest that influencing behavioral intention to use a fitness app can be an effective method to increase its adoption. Therefore, app developers need to pay attention to interventions that seek to enhance the usefulness of the app, provide professional counseling, as well as an opportunity for effortless goal setting features.

The proposition that digital innovations can put people in charge of their health has been accompanied by prolific talk of empowerment. In this paper we consider ethical challenges and opportunities of trying to achieve justice and empowerment using digital health initiatives. The language of empowerment can misleadingly suggest that by using technology, people can control their health and take responsibility for health outcomes to a greater degree than is realistic or fair. Also, digital health empowerment often primarily reaches people who already have high technological and health literacy, leaving others behind. We critically investigate whether the concept of health empowerment could be re-engineered to mean something different, namely the process of improving the health literacy and access of those who least possess it, in line with recent proposals for conceptual engineering in the service of justice. We settle on the weaker conclusion that underlying ethical values including justice should be used to interpret the existing concept of empowerment. To conclude, we take a high-level view of various strategies for achieving the ethical value associated with digital health empowerment.

Drawing upon the protective action decision model and the heuristic-systematic model, this study investigated the determinants of parents’ response to the 2016 vaccine crisis in Shandong Province, China. A survey was conducted from Anhui Province (N = 456). The findings showed that both perceived vaccine knowledge and perceptions of risk from the vaccine crisis were vital in predicting parents’ information insufficiency (the perceived discrepancy between actual and desired levels of vaccine knowledge), information seeking, information processing (where parents make a judgement about information validity), and their intentions towards childhood vaccination. In addition, information insufficiency and information seeking also significantly facilitated parents’ information processing. When parents described processing information systematically, they were more likely to accept childhood vaccination. On the other hand, seeking more information about the crisis did not influence reported childhood vaccination practices. Implications and suggestions for health-related crisis communication research are discussed.

Although active aging is widely accepted and applied in various countries, research on active aging has predominantly focused on environmental interventions, often overlooking the autonomy of older people. This study addresses this gap by using group psychological counseling technique to implement growth mindset interventions, aiming to stimulate older people’s autonomy and foster their active aging behaviors. This study employs a randomized controlled trial design with two groups: an autonomous intervention group and a usual control group. Each participant in the autonomous intervention group will be assigned to one fixed group of four to seven people and participate in four structured group psychological counseling-based growth mindset intervention sessions. The usual control group will engage in community activities of equivalent duration. The study will take place in the eastern and western provinces of China. Indicators of active aging and positive psychology orientation, including growth mindset, active learning behaviors, active health behavior, active social participation behaviors, and active self-security behaviors will be evaluated to verify intervention effects at four timepoints (baseline, after the intervention, one month and three months after the intervention). The study will employ the Theoretical Domains Framework (TDF) to conduct qualitative interviews among the participants and community workers who participate in the autonomous intervention group. The Generalized Estimating Equation (GEE) model will be utilized to examine the intervention effect. The study will focus on the autonomy of older people and design a structured, scalable group psychological counseling-based growth mindset intervention program, offering a novel pathway to fostering active aging behaviors and tackling the critical challenges posed by population aging. This is the first study that will validate the effectiveness of the growth mindset theory in behavioral interventions tailored to the older people population. To improve the scalability and replicability of the intervention program, the study will utilize TDF to explore the factors that facilitate or hinder the effectiveness of the growth mindset intervention. Hypotheses were registered on Aspredicted.org (#138686) on July 18, 2023, prospectively registered. The trial was registered on the Chinese Clinical Trial Registry (ChiCTR2500095613) on January 9, 2025, retrospectively registered.

De Proost & Grey criticize Nickel et al.’s article “Justice and empowerment through digital health: ethical challenges and opportunities,” arguing that it should have embraced relational autonomy and capability approaches. We distinguish two variants of this critique, one saying that a view of digital health empowerment should welcome these approaches, and one saying that a view of digital health empowerment should essentially be defined in terms of these approaches. We are somewhat open to the first variant: relational autonomy and the capability approach are promising ways of spelling out the ethical values behind digital health empowerment, even if they are not completely unproblematic and uncontroversial. However, there are reasons to reject the second variant. A view that leaves the exact normative commitments of digital health empowerment open is persuasive to a wider audience, and more amenable to different constructs of autonomy, capability, and empowerment across disciplines.