Background: China was the first country in the world to experience a large-scale COVID-19 outbreak. The rapid spread of the disease and enforcement of public health measures has caused distress among vulnerable populations such as pregnant women. With a limited understanding of the novel, emerging infectious disease, pregnant women have sought ways to access timely and trusted health care information. The mental health status of pregnant women during this public health emergency, as well as how they responded to the situation and where and how they obtained antenatal care information, remain to be understood. Objective: This study aimed to evaluate the mental health status of pregnant women during the COVID-19 epidemic in China by measuring their perceived stress, anxiety, and depression levels; explore the approaches used by them to access antenatal health care information; and determine their associations with maternal mental health status. Methods: We conducted a web-based, cross-sectional survey to assess the mental health status of Chinese pregnant women by using the validated, Chinese version of Perceived Stress Scale, Self-Rating Anxiety Scale, and Edinburgh Depression Scale. We also collected information on the various approaches these women used to access antenatal care information during the early stage of the COVID-19 epidemic, from February 5 to 28, 2020. Results: A total of 1873 pregnant women from 22 provinces or regions of China participated in the survey. The prevalence of perceived stress, anxiety, and depression among these participants was 89.1% (1668/1873; 95% CI 87.6%, 90.4%), 18.1% (339/1873; 95% CI 16.4%, 19.9%), and 45.9% (859/1873; 95% CI 43.6%, 48.1%), respectively. Hospitals’ official accounts on the Chinese social media platforms WeChat and Weibo were the most popular channels among these pregnant women to obtain antenatal care information during the COVID-19 outbreak. Access to antenatal care information via the hospitals’ official social media accounts was found to be associated with a significantly lower risk of perceived stress (adjusted odds ratio [aOR] 0.46, 95% CI 0.30-0.72; P=.001), anxiety (aOR 0.53, 95% CI 0.41-0.68; P<.001), and depression (aOR 0.73, 95% CI 0.59-0.91; P=.005). Access to health care information via hospital hotlines or SMS was found to be significantly associated with a lower risk of anxiety only (OR 0.77, 95% CI 0.60-0.98; P=.04). Conclusions: During the COVID-19 outbreak in China, pregnant women experienced high levels of perceived stress, anxiety, and depression. During such public health emergencies, mental health care services should be strengthened to reassure and support pregnant women. Specific information targeted at pregnant women, including information on how to cope in an emergency or major disease outbreak, developed and disseminated by health care institutions via social media platforms could be an effective way to mitigate mental health challenges and ensure epidemic preparedness and response in the future.

Objective: Frailty represents a significant health challenge among older adults, necessitating effective interventions to enhance their overall wellbeing. This study aims to investigate the impact of various types of activity participation on frailty in older adults and to elucidate their intrinsic associations, thereby providing a basis for targeted interventions.Methods: This study constructed a classification of activities based on the framework proposed by the WHO regarding functional ability in healthy aging, innovatively dividing activities into five categories: physical activity, social activity, economic activity, information activity and sleep activity. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS 2020), the research employed multiple linear regression and mediation analysis to explore the effects of these activities on the frailty status of older adults and their underlying mechanisms. Furthermore, propensity score matching was conducted to robustly test the regression results.Results: The study found that physical activity (β = −0.006, p < 0.01), social activity (β = −0.007, p < 0.01), economic activity (β = −0.017, p < 0.01), information activity (β = −0.040, p < 0.01) and sleep activity (β = −0.044, p < 0.01) all had significant positive effects on the frailty status of older adults. Additionally, sleep activity mediated the relationship between physical activity and frailty status, accounting for 4.819%. Social activity mediated the relationship between information activity and frailty status, accounting for 7.692%.Conclusion: Older adults should enhance their participation in various activities to alleviate frailty. This can be further improved through the following three aspects: engaging in moderate physical exercise, fostering and promoting awareness of volunteer services, and popularizing the use of information technology.

With population aging and the weakening of traditional family caregiving, home-based care services are becoming more important in China. However, little is known about residents’ service preferences during the transition from informal to formal care systems in the context of the long-term care insurance system. This study examines the preferences of Chinese residents aged 25 or above for home-based care services, focusing on the relative importance of key service attributes, willingness to pay, and preference heterogeneity across demographic groups. A discrete choice experiment (DCE) was conducted from September 2024 to January 2025, with 680 valid responses from 21 provinces in China we're included for analysis. Five attributes were identified through literature review, expert consultations, and focus group interviews: nursing program, service attitude of nursing staff, professional competence of nursing staff, type of service organization and monthly cost. A mixed logit model analyzed preference patterns and heterogeneity. For respondents, the service attitude of nursing staff (relative importance 29.59%), and the nursing program (29.30%) are of almost equal importance, followed by the monthly cost (20.62%). Respondents showed the highest willingness to pay for a good service attitude. Unmarried individuals, those without children, and non-public sector employees had stronger preferences for service quality and brand reputation, reflecting the role of social support networks and welfare systems in shaping formal care preferences. Findings reveal that home-based care preferences in China are shaped by the dynamic interplay between formal care systems and informal support networks. While the availability of informal support influences individuals’ reliance on formal services, the design, quality, and institutional credibility of formal care options also play a key role in shaping preferences. Together, these factors jointly shape how people evaluate and choose home-based care services during China’s long-term care market transformation. The observed heterogeneity underscores the need for differentiated service models and policy responses tailored to diverse levels of social and institutional support.

Objective: To explore the relationship between intergenerational care and life satisfaction of older adults, and to analyze the chain mediating effect of children’s emotional support and depression in this relationship, so as to provide scientific reference for improving the quality of life of older adults. Methods: In total, 2970 older adults ≥60 years old from the China Health and Retirement Longitudinal Study (CHARLS) were selected as the study subjects. The process plug-in of SPSS was used, and the chain mediating effect test was carried out following the Bootstrap method. Results: Intergenerational care was positively correlated with children’s emotional support and life satisfaction (r = 0.123, 0.141, p < 0.001) and negatively correlated with depression (r = −0.096, p < 0.001). The mediating effects of children’s emotional support and depression were significant between intergenerational care and life satisfaction, with a mediating effect of 0.023 (95% CI: 0.015–0.033), 0.028 (95% CI: 0.014–0.043), and the chained mediating effect of children’s emotional support-depression was also significant, with a mediating effect of 0.006 (95% CI: 0.004–0.008). The total indirect effect of children’s emotional support and depression between intergenerational care and life satisfaction was 0.057, accounting for 26.03% of the total effect. Conclusions: Intergenerational care not only directly affects life satisfaction of older adults, but also indirectly affects life satisfaction through the independent mediating effect of children’s emotional support and depression, as well as the chain mediating effect of children’s emotional support-depression. It is essential to create a positive and inclusive social environment for the intergenerational care of older adults.

Background: Family doctor contract services are essential to primary healthcare and play a significant role in improving the health of older adults. However, contract rates among older adults vary widely. Investigating the factors influencing contract rates is crucial for optimizing policies and increasing participation in family doctor services.Methods: This study used data from Wangying Community Health Service Center, encompassing 5,684 older adults in 2018. To address the endogeneity issue arising from sample selection bias, the study utilized a 1:1 nearest-neighbor matching method for counterfactual testing, balancing potential confounding factors between the contract and non-contract groups. Subsequently, multiple logistic regression analysis was performed on the matched data to explore the impact of gender, age, number of medical visits, and the number of chronic conditions on family doctor contract behavior.Results: Gender did not significantly impact contracting behavior. However, age, the number of medical visits, and the number of chronic diseases significantly influenced family doctor contract (β = 0.457, p < 0.01; β = 0.286, p < 0.05; β = −0.229, p < 0.1). An inverted U-shaped relationship was found between age and contracting behavior (β = −0.003, p < 0.01).Conclusion: The factors influencing older residents’ decisions to sign up for family doctor services are complex and diverse. The conclusion of the study provides valuable reference and guidance for policymakers to further improve the family doctor contracting system and optimize contracting strategies by considering the characteristics of different older adults.