The potential benefit of social participation (SP) to one's mental health has been widely acknowledged. Nevertheless, the specific type and amount of SP that is associated with improved depressive symptoms in middle- and old-aged Chinese awaits further investigation. This study aimed to understand the patterns of depression and SP by comparing urban vs rural China, and according to which, measure the associations between changes in SP and that in depressive symptoms. A total of 10,988 community residents aged 45 years and above were selected from wave 1 (2011), wave 2 (2013), and wave 4 (2015) of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. The fixed-effects analysis was used to explore the association between the changes in diversity, frequency, and type of SP and the changes in depressive symptoms. The results indicated that rural respondents suffered from a significantly higher risk of depression and took less SP than their urban counterparts. Transitioning from no SP to 1 or more types of SP or to a once a week or higher frequency was associated with a decline in depressive symptoms. For urban respondents, playing mah-jong or cards and joining sports or social clubs predicted a decline in depressive symptoms. For rural residents, interacting with friends regularly was associated with fewer depressive symptoms. In conclusion, more diverse and higher frequency of SP was associated with better mental health, while the social significance of SP varied across different types of SP and between rural and urban areas.

Background: In recent years, China has witnessed a surge in medical disputes, including many widely reported violent riots, attacks, and protests in hospitals. Asymmetric information between patient and physicians is one of the most critical enablers in this phenomenon, but the Web has become the primary resource for Chinese Internet applications to learn about health information and could potentially play a role in this pathway to patient–physician interaction and patient–physician trust. While considerable attention has been paid in some countries, there are few researches about China’s situation for this issue. The purpose of this quantitative study was to examine the influence of online health information and the online guidance of doctors in patient health information literacy on patient–physician interaction and patient–physician trust in China. Methods: A web-based survey was conducted to collect data from online applications with health problems. A structural equation modeling was used to analyze the data to test the hypotheses. A total of 446 participants from the Tongji Hospital in Wuhan and Huazhong University of Science and Technology hospital participated in the study. Results: Our analysis shows that the usefulness of online health information and the online guidance of doctors both significantly influence the trust of the patient toward physicians and interaction with physicians. Furthermore, the patient–physician interaction also has a significant impact on the patient–physician trust. Conclusions: There are many studies on the influence of online health information on the doctor–patient relationship, whereas a little research has examined this relationship between health information online support from doctors and patient–physician interaction by quantitative empirical analysis. This study also explores the online guidance role of doctors and whether doctor–patient communication will affect the trust of doctors and patients. The practical implications of this study include an improved understanding of the function of online health information and potential impacts regarding the interaction with physicians and trust toward physicians that can be used to resolve conflicts between doctors and patients.

Social Participation (SP) is known to benefit cognitive function. However, whether the positive relationship holds across different types of SP and dimensions of cognitive function, and whether the statement stays true in middle- and old-aged Chinese have not been investigated. The present study aimed to understand the current patterns of SP and cognitive function in China’s context, and therefore, explore the associations between cognitive function and SP at different levels from various aspects. A total of 7973 community residents aged 45 years and older were selected from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015). A fixed-effects analysis was used to explore the association between changes in SP (diversity, frequency, and type) and that in cognitive function (memory and mental status) over a four-year period. Changing from no SP to more variety (β = 0.377, 95% confidence interval (CI) = 0.192-0.562 for 1 type, β = 0.703, 95% CI = 0.470-0.937 for ≥2 types) or higher frequency (β = 0.235, 95% CI = 0.007-0.462 for not regularly, β = 0.604, 95% CI = 0.411-0.798) of SP was associated with improvements in cognitive function. Playing mah-jong and using Internet were associated with improved memory but not with mental status. Sports and volunteering were associated with improved mental status but not with memory. The same pattern was observed in men and in women. The study confirmed that more diversity and higher frequency of SP was associated with improved cognitive function, whereas reminded policymakers to consider cultural context when developing target strategies to improve cognitive function.