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.

Background: The study burnout of medical students is more and more serious, which directly affects the study style of university and the learning quality of students. This has aroused the high attention of researchers and universities. This study aimed to explore the mechanism of the influence of school climate on academic burnout among medical students in Chinese cultural context.Methods: 2411 medical students (50.52% female; mean age = 19.55,SD = 1.41, rang = 17–24 years) were investigated with psychological environment questionnaire, collective self-esteem scale, psychological capital scale and academic burnout scale. The data were analyzed by using a moderated mediation model with SPSS and the Process 4.0 macro.Results: The results revealed that: (1) school climate had a significant negative predictive effect on academic burnout among medical students controlling for gender, grade and age (B= -0.40,p < 0.001). (2) Collective self-esteem played a partial mediating role in school climate and academic burnout (indirect effect = -0.28, 95% CI = [-0.32,-0.25], accounting for 52.83%). (3) The first and second half of the indirect effect of school climate on medical students’ academic burnout were moderated by psychological capital (B = 0.03,p < 0.01;B= -0.09,p < 0.001).High level of psychological capital can enhance the link between school climate and collective self-esteem as well as the link between self-esteem and academic burnout.Conclusion: Creating a good school atmosphere and improving the level of collective self-esteem and psychological capital are beneficial to improve the academic burnout of medical students.

Background: Schizophrenia is a neurodevelopmental disorder with high heritability. Widespread cortical thinning has been identified in schizophrenia, suggesting that it is a result of cortical development deficit. However, the findings of other cortical morphological indexes of patients are inconsistent, and the research on their relationship with genetic risk factors for schizophrenia is rare. Methods: In order to investigate cortical morphology deficits and their disease-related genetic liability in schizophrenia, we analyzed a sample of 33 patients with schizophrenia, 60 biological parents of the patients, as well as 30 young controls for patients and 28 elderly controls for parents with age, sex and education level being well-matched. We calculated vertex-wise measurements of cortical thickness, surface area, local gyrification index, sulcal depth, and their correlation with the clinical and cognitive characteristics. Results: Widespread cortical thinning of the fronto-temporo-parietal region, sulcal flattening of the insula and gyrification reduction of the frontal cortex were observed in schizophrenia patients. Conjunction analysis revealed that patients with schizophrenia and their parents shared significant cortical thinning of bilateral prefrontal and insula, left lateral occipital and fusiform regions (Monte Carlo correction, P<0.05), as well as a trend-level sulcal depth reduction mainly in bilateral insula and occipital cortex. We observed comprehensive cognitive deficits in patients and similar impairment in the speed of processing of their unaffected parents. Significant associations between lower processing speed and thinning of the frontal cortex and flattening of the parahippocampal gyrus were found in patients and their parents, respectively. However, no significant correlation between abnormal measurements of cortical morphology and clinical characteristics was found. Conclusion: The results suggest that cortical morphology may be susceptible to a genetic risk of schizophrenia and could underlie the cognitive dysfunction in patients and their unaffected relatives. The abnormalities shared with unaffected parents allow us to better understand the disease-specific genetic effect on cortical development.

Background: With advances in science and technology and improvements in health literacy, more studies have focused on frailty prevention by promoting medication adherence, emphasizing the role of eHealth literacy. However, the association between eHealth literacy and medication adherence in frail older adults has not been well studied, and it is unknown whether urban-rural differences exist in this relationship. Objective: This study aims to examine the relationship between eHealth literacy and medication adherence in older people with different frailty statuses, emphasizing variations between rural and urban areas. Methods: Between November and December 2020, a total of 4218 urban and rural community members (aged ≥60 years) in China were recruited as participants using a multistage random sampling method. A face-to-face structured questionnaire survey was conducted to collect information on demographic characteristics, eHealth literacy (consisting of application, evaluation, and decision dimensions), and medication adherence. eHealth literacy was assessed using the Chinese version of the eHealth Literacy Scale developed by Norman and Skinner, and medication adherence was measured using the 4-item Morisky scale. We used a general descriptive analysis and stratified logistic regression models to examine how eHealth literacy is linked to medication adherence and urban-rural differences. Results: There were 4218 respondents, of which 2316 (54.9%) lived in urban areas and 1902 (45.1%) in rural areas, respectively. After adjusting for potential confounders, among participants with prefrailty, eHealth literacy was associated with medication adherence in urban areas in terms of less application (adjusted odds ratio [AOR] 1.16, 95% CI 0.82‐1.63), less evaluation (AOR 1.29, 95% CI 0.92‐1.81), and less decision ability (AOR 1.20, 95% CI 0.86‐1.68); eHealth literacy was linked with medication adherence in the rural areas in terms of less application (AOR 1.10, 95% CI 0.56‐2.13), less evaluation (AOR 1.05, 95% CI 0.61‐1.79), and less decision ability (AOR 1.10, 95% CI 0.64‐1.90). Among frail participants, less eHealth literacy (AOR 0.85, 95% CI 0.48‐1.51), along with its dimensions, including less application (AOR 0.85, 95% CI 0.47‐1.54), evaluation (AOR 0.89, 95% CI 0.50‐1.57), and decision ability (AOR 0.99, 95% CI 0.55‐1.76), were associated with medication adherence in urban areas; less eHealth literacy (AOR 0.89, 95% CI 0.48‐1.65), along with its dimensions, including less application (AOR 1.23, 95% CI 0.62‐2.44), evaluation (AOR 0.98, 95% CI 0.53‐1.82), and decision ability (AOR 0.90, 95% CI 0.49‐1.67), were associated with medication adherence in rural areas. Conclusions: The results of this study suggest that there is an association between eHealth literacy and medication adherence among older people with frailty and prefrailty. To promote medication adherence, eHealth literacy can be helpful in tailoring interventions.

Interpersonal communication is beneficial in promoting individuals’ tendency to accept health-campaign-targeted behavior. Based on the protective action decision model, this study investigated the key factors underlying individual’s interpersonal communication on the Gongkuai campaign, which was carried out during Coronavirus disease 2019 (COVID-19). The main goal of the Gongkuai campaign was to change traditional communal eating habits and reduce public health risks. An online questionnaire survey involving 618 respondents was conducted in China after the 2020 Gongkuai campaign propagated, and the data were analyzed by using the structural equation modeling technique. The results indicated that health campaign exposure is a critical determinant of perceived campaign-related knowledge and health risk perception, which are significant predictors of interpersonal communication. Meanwhile, campaign-related knowledge can elicit risk perception. Furthermore, campaign exposure influenced interpersonal communication in ways that traditional diet culture did not predict. Risk perception was also unaffected by traditional diet culture. It is worth noting that individuals’ agreement with traditional diet culture does not hinder health campaign-generated interpersonal communication in the context of public health crisis. Based on the findings, theoretical and policy implications for motivating interpersonal communication were discussed, and research limitations were pointed out.