Fear of COVID-19 is associated with public health compliance but also with negative well-being; however, no articles have reported associations of such fear with perceived benefits and harms. We assessed the level of fear of COVID-19 in Hong Kong adults and its associations with sociodemographic factors and perceived benefits and harms of COVID-19. In a 6-day population-based cross-sectional online survey in May 2020, 4,890 adults provided data on fear and perceived benefits and harms, personal happiness and family well-being, and sociodemographic characteristics. Linear regression was used to analyze associations. The level of fear was moderate (mean score 6.3/10). Fewer respondents reported perceived benefits (10.6%–21.7%) than harms (13.4%–43.5%). Females, younger age groups, and respondents with lower education or more cohabitants had greater fear. Fear was associated with perceived personal (increased knowledge of personal epidemic prevention) and family benefits (improved family hygiene), both with a very small effect size (Cohen’s d = 0.03). Fear was also associated with lower personal happiness and perceived personal (increased negative emotions, feeling depressed and anxious, decreased income, and decreased work efficiency) and family harms (increased conflicts and negative emotions among family members), with small effect sizes (0.08–0.37). We have first shown sociodemographic differences in the fear of COVID-19 and such fear was associated with both perceived personal and family benefits and harms of COVID-19. Our findings may guide the management of fear to reduce sociodemographic differences, and maximize benefits and minimize harms.

Family support through the sharing of information helps to shape and regulate the health and behaviours of family members, but little is known about how families are sharing COVID-19-related information, or about its associations with family communication quality and well-being. We examined the associations of COVID-19 information sharing methods with sociodemographic characteristics, the perceived benefits of information communication and technology (ICT) methods, and family communication quality and well-being in Hong Kong. Of 4852 respondents (53.2% female, 41.1% aged over 55 years), the most common sharing method was instant messaging (82.3%), followed by face-to-face communication (65.7%), phone (25.5%) and social media (15.8%). Female sex (adjusted prevalence ratio (aPR) 1.09), older age (aPRs 1.14–1.22) and higher household income (aPR 1.06) (all p ≤ 0.04) were associated with instant messaging use, while post-secondary education was associated with face-to-face (aPR 1.10), video call (aPR 1.79), and email (aPR 2.76) communications (all p ≤ 0.03). Each ICT sharing method used was associated with a higher likelihood of both reported benefits (aPRs 1.26 and 1.52), better family communication quality and family well-being (adjusted βs 0.43 and 0.30) (all p ≤ 0.001). We have first shown that COVID-19 information sharing in families using both traditional methods and ICTs, and using more types of methods, was associated with perceived benefits and better family communication quality and well-being amidst the pandemic. Sociodemographic differences in COVID-19 information sharing using ICTs were observed. Digital training may help enhance social connections and promote family well-being.

Mindfulness-based art therapy has shown to improve psychological well-being. Zentangle is an easy-to-learn, mindfulness-based art therapy suitable for everyone. We reported the transition from face-to-face to online Zentangle workshops in family social services during COVID-19. We explored feedback from face-to-face workshops and the acceptability of an online approach utilizing information communication technology (ICT) to achieve greater service reach, satisfaction, and knowledge and related outcomes. Under the Hong Kong Jockey Club SMART Family-Link Project and in collaboration with Caritas Integrated Family Service Centre—Aberdeen, this study was conducted in two phases: a four-session, face-to-face workshop (phase one) and eleven online single-session workshops (phase two) from September 2019 to September 2020. A total of 305 participants joined the workshops. Phase one participants (n = 11) reported high satisfaction (4.7 out of 5), increases in knowledge (4.2/5) and confidence (3.9/5) towards managing stress, increases in knowledge (4.1/5) and confidence (3.9/5) in showing support and care towards family members, and an increase in knowledge towards strengthening family relationships (4.0/5). Phase two participants (n = 294) also reported high satisfaction (4.7/5) and strongly agreed that ICT helped with learning Zentangle more conveniently, that they had increased knowledge and interest in Zentangle (all 4.7/5), and would definitely join the workshop again (4.8/5). The qualitative data supported the quantitative findings. We are the first to report on the utilization of ICT in an exploratory trial of brief, online Zentangle art workshops targeting the general public, with high satisfaction and positive participant experiences with ICT integration, learning Zentangle, and enhanced psychological and family well-being. This study provided preliminary evidence on the use of ICT to successfully transition face-to-face to online workshops and reach a wider audience.

The COVID-19 pandemic caused different types of harms and benefits, but the combined patterns of perceived harms and benefits are unclear. We aimed to identify the patterns of perceived harms and benefits of the COVID-19 outbreak and to examine their associations with socio-demographic characteristics, happiness, and changes in smoking and drinking. A population-based cross-sectional online survey was conducted in May 2020 on Hong Kong adults (N = 4520). Patterns of perceived harms and benefits of COVID-19 were identified using latent profile analysis. Their associations with socio-demographic characteristics, happiness, and changes in smoking and drinking were examined using multinomial logistic regression. We identified three distinct patterns: indifferent (66.37%), harm (13.28%), and benefit (20.35%). Compared with the indifferent subgroup, the harm subgroup was younger, less happy, and had increased drinking, and hence might be at higher risk, whereas the benefit subgroup was more likely to be female, live with one or more cohabitants, have postsecondary education, be happier, and have decreased drinking, and could be more adaptive. Future studies can target the harm subgroup to facilitate their positive adjustments.

BACKGROUND The mental health of international students studying abroad has been neglected during the COVID-19 pandemic. OBJECTIVE This mixed-method study examined perceived public attitudes, personal beliefs, practice and stress toward facemask wearing as a preventive measure against COVID-19 among international university students from Hong Kong studying in the United Kingdom (UK) in the early stage (January – March 2020) of the pandemic. METHODS Our study included 2 parts: (i) an exponential, non-discriminative snowball sampling strategy was used to recruit 91 Chinese students studying in the UK to complete an online questionnaire survey, and (ii) online Zoom focus group interviews were conducted with 16 students to gain an in-depth understanding on their experiences and coping methods during the pandemic. RESULTS Of the 91 students, 92.3% reported the UK public did not view facemask wearing as a preventive measure. 98.9% believed facemask wearing was an effective preventive measure, but 56% wore facemasks more than half of the time when out in public. 50.5% of them had internal conflicts of feeling stressed both when wearing facemasks and not wearing facemasks, which was more common in females than males [(62.5% versus 31.5%, P=0.004, Relative Risk (RR): 1.99 (1.17, 3.38)]. 61.5% reported public prejudiced attitudes against facemask wearing, also more females than males (71.4% versus 45.7%, P=0.02, RR: 1.56 (1.05, 2.32). Qualitative findings showed feeling of conflicts between personal beliefs and social norms, feeling stressed about wearing facemasks as a preventive measure, and experience of prejudice. Peer and family support helped students face such difficulties. Positive thinking and being adaptable were effective methods of stress management. Qualitative findings corroborated the quantitative results. CONCLUSIONS Prejudiced attitudes and behaviours from others, and differences in public attitudes toward facemask wearing resulted in much stress in students’ stress. Clear and accurate public health messaging regarding facemask wearing is needed to change public attitudes and mitigate prejudice. Owing to the ongoing pandemic and rising xenophobia, specifically Sinophobia, academic institutions and public health professionals should take initiative in reaching out to urgently address the needs of international students and provide support in managing their ongoing stress and enhance mental wellbeing. CLINICALTRIAL Ethics approval was granted by the Institutional Review Board of The University of Hong Kong / Hospital Authority Hong Kong West Cluster (reference number: UW20-298). The study was registered with the National Institutes of Health (identifier number: NCT04365361).

Exercise benefits individuals, but research about exercising with family members (EFM) and personal and family well-being is scarce. We investigated the associations of home-based individual exercise (IE) and EFM with personal and family well-being amid the COVID-19 pandemic. A population-based cross-sectional survey on Hong Kong Chinese adults was conducted from February to March 2021, when COVID-19 was under control (N = 5825). Respondents reported the number of days IE and EFM occurred at home in the past 7 days (0, 1–2, 3–4, 5–6, 7), respectively. Family well-being, personal happiness, and personal/family adversity coping capability (ACC/FACC) were each measured with an 11-point scale (range 0–10). Psychological distress was measured using the four-item Patient Health Questionnaire (range 0–12). Associations were assessed using multiple linear regressions. Of 1911 respondents, 9.2% reported having ≥3 days of EFM. After adjusting for each other and sociodemographic characteristics, more frequent IE or EFM (≥3 vs. 0–2 days) was associated with greater family well-being, FACC, personal happiness, and lower psychological distress. Our findings suggest that home-based EFM or IE may promote personal/family well-being and highlight the potential for incorporating home-based exercise into public health strategies to enhance overall well-being.