Background: Adults with chronic conditions such as heart disease, diabetes, or lung disease are more likely to develop complications from a number of vaccine-preventable diseases, including influenza and pneumonia. In this study, we use the data from a chronic disease management information system in Shanghai to estimate vaccination coverage and characterize predictors of seasonal influenza and 23-valent pneumococcal polysaccharide vaccine (PPSV23) vaccination among people with chronic disease in Shanghai. Methods: The Shanghai Centers for Disease Control and Prevention have information systems related to chronic disease management, hospital records, and immunizations. Data from individuals with hypertension, diabetes and chronic obstructive pulmonary disease (COPD) were abstracted during July 2017. The main outcome was coverage of pneumococcal and influenza vaccination. Vaccination coverage was calculated across demographic groups. Significance in bivariate associations was assessed through Pearson’s chi-square tests, and in multivariable models through logistic regression models with a forward stepwise method to select variables. Results: In the sample of 2,531,227 individuals ≥15 years, 22.8% were vaccinated for pneumonia from January 2013 to July 2017, and the vaccination coverage of influenza in the 2016/17 influenza season was 0.4%. Vaccination coverage was highest in those 70–79 and lowest in those younger than 60. Compared to urban areas, uptake in rural areas was higher for pneumonia vaccination (OR: 2.43, 95% CI: 2.41, 2.45), but lower for influenza vaccination (OR: 0.55, 95% CI: 0.51, 0.59). Having a greater number of chronic diseases was associated with higher likelihood of pneumonia vaccination (3 vs 1: OR: 1.68, 95% CI: 1.64, 1.71), but this relationship was not statistically significant for influenza vaccination. Conclusions: We found low levels with of pneumococcal vaccination, and extremely low uptake of influenza vaccination among individuals with high risk conditions in Shanghai who should be priority groups targeted for vaccination. Interventions could be designed to target groups with low uptake – like younger adults, and individuals who have not yet retired.

Background: The benefits of physical activity (PA) have been well documented, and the worksite is a promising setting for PA promotion. The aims of this study were as follows: 1. To evaluate the effect of a group-based worksite intervention on PA and health-related outcomes by using pedometers. 2. To examine the associations between the change in vigorous physical activity (VPA)/moderate physical activity (MPA)/walking and health related outcomes. Methods: A total of 398 participants (221 in the intervention group (IG) and 177 in the control group (CG)) from 17 worksites were recruited for a prospective self-controlled trial of a worksite physical activity intervention program in China. In the IG, a pedometer was utilized to self-monitor the PA, together with group competition, goal setting, and other incentives. No intervention was applied to the CG. Physical activity, sedentary behavior, and health-related outcomes were measured at baseline and immediately after the 100-day period intervention. Results: A total of 262 participants completed the program (68.3% adherence). Adherence in the intervention group was 67.9% (n = 150/221). Improvements between baseline and follow-up among intervention participants were observed in the following parameters: VPA (+ 109.7 METs/week; p < 0.05), walking (+ 209.2 METs/week; p < 0.01), systolic blood pressure (SBP; − 2.1 mmHg; p < 0.01), waist circumference (WC; − 2.3 cm; p < 0.01), body fat percentage (BF); − 1.0%; p < 0.01), and body mass index (BMI; − 0.5 kg/m²; p < 0.01). VPA was related to changes in body fat percentage (p < 0.05) and body mass index (p < 0.05). Conclusion: This integrated group-based intervention program contributed to comprehensive improvement in health-related outcomes. The study was useful for establishing associations between change in VPA/MPA/walking and health-related outcomes in a natural setting. Long-term evaluation is required to examine the potential of such an integrated intervention to promote PA. Registration: This study was prospectively registered in the Chinese Clinical Trial Registry. Trial registration number: ChiCTR-1,800,015,529. Date of registration: April 5, 2018.

Artificial intelligence (AI) telephone is reliable for the follow‐up and management of hypertensives. It takes less time and is equivalent to manual follow‐up to a high degree. We conducted a reliability study to evaluate the efficiency of AI telephone follow‐up in the management of hypertension. During May 18 and June 30, 2020, 350 hypertensives managed by the Pengpu Community Health Service Center in Shanghai were recruited for follow‐up, once by AI and once by a human. The second follow‐up was conducted within 3–7 days (mean 5.5 days). The mean length time of two calls were compared by paired t‐test, and Cohen's Kappa coefficient was used to evaluate the reliability of the results between the two follow‐up visits. The mean length time of AI calls was shorter (4.15 min) than that of manual calls (5.24 min, P < .001). The answers related to the symptoms showed moderate to substantial consistency (κ:.465–.624, P < .001), and those related to the complications showed fair consistency (κ:.349, P < .001). In terms of lifestyle, the answer related to smoking showed a very high consistency (κ:.915, P < .001), while those addressing salt consumption, alcohol consumption, and exercise showed moderate to substantial consistency (κ:.402–.645, P < .001). There was moderate consistency in regular usage of medication (κ:.484, P < .001).

BACKGROUND: The association between season of screening blood pressure (BP) measurement and adverse outcomes has not been examined among populations without prior physician-diagnosed hypertension. We aimed to investigate the association between the season of screening clinic BP measurement and the risk of all-cause mortality. METHODS: This was a prospective cohort study, and data were analyzed from an ongoing community hypertension screening program in Shanghai between 2018 and 2024. In this study, 166 670 participants aged 35 to 89 years who were free of prior physician-diagnosed hypertension were included and had their BP measured with an automated office BP platform in Shanghai community health centers. Participants were categorized into 4 groups by season of screening BP measurement: spring, summer, autumn, and winter. Deaths were ascertained from linkage to the Shanghai Vital Statistics Registry with follow-up until September 30, 2024. Cox regression models were used to examine the association between seasons of BP measurement and risk of all-cause mortality. RESULTS: During a median follow-up of 1.6 years, 1850 (1.1% of participants) all-cause deaths occurred. The incidence rate of all-cause mortality was 5.0 per 1000 person-years and was higher in participants with screening BP measured in summer (5.4 per 1000 person-years) than in other seasons (4.4, 5.3, and 4.9 per 1000 person-years in spring, autumn, and winter, respectively). After adjustment for age, sex, residential region, and systolic and diastolic BP, the hazard ratio for the risk of all-cause mortality in participants with screening BP measured in summer relative to the overall population was 1.14 (95% CI, 1.05–1.24). There was no any significant interaction between the season of screening BP measurement and sex, age, and hypertension status in relation to the risk of all-cause mortality (all P ≥0.05). CONCLUSIONS: Screening for raised BP in summer was associated with significantly higher risks of all-cause mortality, though the mean systolic/diastolic BP was lowest in summer. The findings imply that if only clinic BP is measured for hypertension screening in 4-season countries and regions, repeated BP measurements, preferably in different seasons, might be needed.