In this digital era, young children spend a considerable amount of time looking at telephone, tablet, computer and television screens. However, preventative eye health behavior education could help avoid and relieve asthenopia. The effects of parental influence on their children’s eye health behavior through the preschool eye health education intervention program were examined. The Health Belief Model was used to develop parental involvement strategy and eye health curriculum. The study was conducted in a large public preschool with five branches in Beijing, China. A total of 248 parent–child pairs participated in the baseline and follow-up surveys, of which 129 were in the intervention group and 119 were in the comparison group. The generalized estimating equation analysis results indicated that parental involvement in preschool-based eye health intervention on screen uses had positive influence on parents’ eye health knowledge, cues to action, and parenting efficacy. The intervention program also had positive effects on the increasing level of children’s eye health knowledge, beliefs, cues to action, self-efficacy, and behaviors. The results supported the implementation of a preschool-based eye health intervention program with parental involvement, which could potentially enhance children’s and parents’ eye health beliefs and practices.

Introduction: Although there is evidence linking the relationships between smartphone usage with health, stress, and academic performance, there is still inadequate knowledge about the influence on pro-environmental behaviors. This study seeks to bridge this gap by adapting the theory of attribution framework to examine the effects of personal norms, social norms, perceived behavioral control on pro-environmental behavior of smartphone usage in children.Methods: A total of 225 children aged between 11 to 12 from eight selected public primary schools at the Hsinchu Science and Industrial Park in Taiwan were surveyed. Two distinct groups (excessive versus moderate usage) were purposefully selected for comparison, of which 96 participants were excessive smartphone users while the remaining 129 were moderate smartphone users.Results: Findings revealed significant differences between excessive and moderate smartphone usage children groups in personal norms (p < 0.001), social norms (p = 0.002), perceived behavioral control (p = 0.001), and pro-environmental behavior (p = 0.001). Findings for excessive smartphone usage children showed that social norms (β = 0.428,t = 4.096***,p < 0.001) had a direct predictive impact on pro-environmental behavior. In contrast, while there was no direct path established between personal norms and pro-environmental behavior (β = 0.177,t = 1.580,p > 0.05), as well as social norms and pro-environmental behavior for moderate smartphone usage children (β = 0.181,t = 1.924,p > 0.05), but such a relationship could be developed through the mediating effect of perceived behavioral control (β = 0.497,t = 4.471***,p < 0.001).Discussion: The results suggested that excessive smartphone usage children lack positive perceived behavioral control, and their pro-environmental behavior could only be predicted through explicit social norms, whereas pro-environmental behavior of moderate smartphone usage children was implicitly influenced by personal norms through perceived behavioral control.

The outbreak of the coronavirus disease in 2019 (COVID-19) has greatly impacted the life and mental health of many people globally. The objective of this study was to investigate the factors associated with preventive behaviors and mental health among Chinese adults during their home quarantine in the COVID-19 period. An online questionnaire survey was administered in March 2020. The study participants were adults aged between 18 and 70 years old from 31 provinces in China. Of the 3878 participants, 1314 reported moderate levels of anxiety, and the remaining participants reported moderate to severe levels of anxiety. Findings revealed that females aged between 18 and 30 years old who had higher educational qualifications, greater levels of preventive knowledge, trust in the government, and resided in urban and medium-risk areas (R² = 0.100, F = 27.97, p < 0.001) were more likely to exhibit preventive behaviors. In contrast, a higher negative emotional response was generally seen in males who had low levels of preventive knowledge and behaviors, higher risk perception of infection, lower trust in the government, and unhealthy lifestyles (R² = 0.127, F = 32.33, p < 0.001). In addition, the high-risk perception of infection was positively associated with high odds of anxiety (AOR = 1.17, 95% CI: 1.10–1.24), whereas a greater level of preventive knowledge (AOR = 0.36, 95% CI: 0.19–0.70) and behaviors (AOR = 0.69, 95% CI: 0.57–0.84), higher trust in the government’s COVID-19 pandemic mitigation measures (AOR = 0.77, 95% CI: 0.71–0.83), and a healthier lifestyle (AOR = 0.89, 95% CI: 0.79–0.99) were negatively associated with high odds of anxiety. Results showed that a lower level of anxiety and negative emotional response were associated with better preventive behaviors against COVID-19, which were influenced by preventive knowledge, risk perception, trust in the government’s COVID-19 pandemic mitigation measures, and healthy lifestyle. Findings in this study could help formulate health interventions for vulnerable groups related to gendered vulnerabilities in the COVID-19 environment to improve their mental health and preventive behaviors, especially during the period of a pandemic.

The aim was to investigate the efficacy of binoculus orthokeratology with different optical zone designs in myopic children and adolescents, analyze influencing factors, and establish a dynamic follow-up model. This retrospective cohort study randomly selected 110 myopic patients (220 eyes), aged 8 to 13 years, who underwent orthokeratology correction at the Affiliated Hospital of Hangzhou Normal University from March 2022 to March 2024. Participants were divided into 2 groups: the 5.0 group (110 eyes) with a 5.0 mm optical zone and the 6.0 group (110 eyes) with a 6.0 mm optical zone. After 1 year, the differences in visual acuity, refractive error progression, and axial length control between the groups were assessed. Patients were classified into favorable (axial length change ≤ 0.20 mm) and unfavorable (axial length change > 0.20 mm) groups. Baseline characteristics were analyzed, and logistic regression was used to identify influencing factors. A nomogram-based risk prediction model was constructed and evaluated using receiver operating characteristic curves and area under the curve. A 1-year dynamic follow-up model was also established. The 5.0 group showed better visual acuity, less refractive error progression, and less axial length growth compared to the 6.0 group (all P < .05). Axial length growth > 0.20 mm was observed in 21.00% (42/200) of eyes (unfavorable group), while 89.00% (178/200) showed ≤ 0.20 mm growth (favorable group). Significant baseline differences were found in age, spherical power, cylindrical power, spherical equivalent, axial length, optical zone diameter, and mesopic pupil diameter (all P < .05). Logistic regression identified higher spherical power, cylindrical power, spherical equivalent, axial length, and optical zone diameter as risk factors for unfavorable outcomes, while older age and larger mesopic pupil diameter were protective factors. The nomogram model showed excellent predictive performance with an area under the curve of 0.958 (95% confidence interval: 0.922–0.993). Orthokeratology lenses with a 5.0 mm optical zone demonstrated superior efficacy compared to 6.0 mm lenses. Baseline factors such as age, spherical power, cylindrical power, spherical equivalent, axial length, optical zone diameter, and mesopic pupil diameter influenced treatment outcomes. Continuous dynamic follow-up is essential for optimizing efficacy.

Background: Although there are evidences linking the relationships between smartphone usage with health, stress, and academic performance; however, there is still inadequate knowledge about the influence on pro-environmental behaviors. This study seeks to bridge this gap by adapting the theory of attribution framework to examine the effects of personal norms, social norms, perceived behavioral control on pro-environmental behavior of smartphone usage in children. Methods: A total of 225 children aged between 11 to 12 from eight selected public primary schools at the Hsinchu Science and Industrial Park in Taiwan were surveyed. Two distinct groups (excessive versus moderate usage) were purposefully selected for comparison, and of which 96 (42.7%) participants were regarded as excessive smartphone users while the remaining 129 (57.3%) were moderate smartphone users. Results: Findings revealed significant differences between excessive smartphone usage children and moderate smartphone usage children in personal norms ( p < 0.001), social norms ( p = 0.002), perceived behavioral control ( p = 0.001), and pro-environmental behavior ( p = 0.001), where moderate smartphone usage children’s responses were considerably higher than those of excessive smartphone usage children. Path analysis suggested that the two smartphone usage groups had different pro-environmental behavior paths. For excessive smartphone usage children, findings showed that social norms ( β = 0.428, t = 4.096***, p 0.05), as well as social norms and pro-environmental behavior for moderate smartphone usage children ( β = 0.181, t = 1.924, p >0.05), but such a relationship could be developed through the mediating effect of perceived behavioral control ( β = 0.497, t = 4.471***, p < 0.001). Conclusions: In conclusion, findings suggested that excessive smartphone usage children lack positive perceived behavioral control, and their pro-environmental behavior could only be predicted through explicit social norms. Whereas, pro-environmental behavior of moderate smartphone usage children were implicitly influenced by personal norms through perceived behavioral control.