Background: The eHealth Literacy Scale (eHEALS) is the most widely used instrument in health studies to measure individual’s electronic health literacy. Nonetheless, despite the rapid development of the online medical industry and increased rural-urban disparities in China, very few studies have examined the characteristics of the eHEALS among Chinese rural people by using modern psychometric methods. This study evaluated the psychometric properties of eHEALS in a Chinese rural population by using both the classical test theory and item response theory methods. Objective: This study aimed to develop a simplified Chinese version of the eHEALS (C-eHEALS) and evaluate its psychometric properties in a rural population. Methods: A cross-sectional survey was conducted with 543 rural internet users in West China. The internal reliability was assessed using the Cronbach alpha coefficient. A one-factor structure of the C-eHEALS was obtained via principal component analysis, and fit indices for this structure were calculated using confirmatory factory analysis. Subsequently, the item discrimination, difficulty, and test information were estimated via the graded response model. Additionally, the criterion validity was confirmed through hypothesis testing. Results: The C-eHEALS has good reliability. Both principal component analysis and confirmatory factory analysis showed that the scale has a one-factor structure. The graded response model revealed that all items of the C-eHEALS have response options that allow for differentiation between latent trait levels and the capture of substantial information regarding participants’ ability. Conclusions: The findings indicate the high reliability and validity of the C-eHEALS and thus recommend its use for measuring eHealth literacy among the Chinese rural population.

Background: This is the first study to investigate the effect of parental psychological abuse on potential psychopathological symptoms in gender minority youth subgroups, including transgender women, transgender men, and gender queer individuals.Methods: Data was analysed from the Chinese National Transgender Survey in 2017; the survey was distributed through community-based organizations to transgender adolescents and adults residing in China, with representation from all 32 provinces and autonomous regions. A total of 1293 youth that self-identified as transgender or gender queer completed the study. Measures covered psychopathological symptoms including depression, anxiety, risk of suicideand self-harm. Parental psychological abuse was assessed in terms of neglect and avoidance, force to change, and verbal insults. Both the edges and centralities were computed via network analysis, and the network properties were then compared among the three gender minority subgroups. In addition, linear regression was adopted to test the predictive ability of node centrality for low self-esteem.Results: Descriptive analysis revealed that among the three subgroups, transgender women had more severe psychopathological symptoms and reported the most psychological abuse. Network analysis revealed that the risk of suicide and self-harm was directly connected with one type of parental psychological abuse (“neglect and avoidance”). Node centrality was significantly associated with the predicting value of the nodes on low self-esteem (r²= 0.25, 0.17, 0.31) among all three gender minority subgroups.Conclusions: The distinctive core psychopathological symptoms, within the networks of the gender minority subgroups, revealed specific symptoms across each group. The significant association between node centrality and low self-esteem indicated the extent of parental psychological abuse. Parental psychological abuse directed towards gender minority youth should be recognized as a form of family cold violence. It is recommended that schools and local communities should support early intervention to improve psychological well-being.

Background and aims: During the COVID-19 lockdown, problematic Internet use (PIU) has become a serious issue among residential college students, who remain physically isolated from off-campus society. This study constructs an integrated model to investigate the influencing mechanisms of internal locus of control (LOC) and objective peer effects.Methods: Residential college students (n = 494) were surveyed from a single department of a Chinese university. An item from the World Value Survey was employed to measure internal LOC, while objective peer effects were assessed via friends’ mutual nominations. Finally, PIU was measured using Young’s Internet Addiction Tests, while a social network analysis and logit regression were combined to estimate various factors’ effects on PIU.Results: In our sample, the prevalence rate of PIU was 30.6%, and while internal LOC was a protective factor for PIU, its protective role was diluted when exposed to a peer environment with high PIU prevalence. Furthermore, indegree performed contrasting roles on PIU under various network conditions. It acted as a protective factor when exposed to a low prevalence of PIU in a peer environment; however, it became a risk factor when PIU peers were prevalent. Lastly, the protective efficacy of betweenness was activated when individuals had more than one PIU friend.Discussion and conclusions: Further intervention studies focusing on individuals with a weak internal LOC are recommended during the lockdown. Additionally, interventions that consider the network structures carefully, may enhance the prevention of PIU.