To develop a scale measuring parents’ attitudes towards their children’s dietary health and to test its reliability and validity. This study aims to provide a scientific tool for assessing parents’ attitudes towards their children’s dietary health.

According to the Health Belief Model, an initial item pool was created for the scale. A research team was assembled, and through processes such as consulting with experts, the preliminary version of the scale was established. A staged cluster sampling method was employed to select a total of 40 classes from grades 4 to 8 in primary and secondary schools in Chengdu’s Xindu District between May and October 2023. Initially, an item analysis was conducted using all 2 651 collected samples. Then, the entire sample set was randomly split into two subsets: Sample 1 (n=2 091) was subjected to exploratory factor analysis first, and Sample 2 (n=560) was subjected to confirmatory factor analysis. Finally, the total sample was used for internal consistency testing. Two weeks after the survey, parents in a random class were randomly selected to refill the questionnaire to obtain the test-retest reliability of the scale.

The final version of the scale included 24 items. EFA extracted six common factors (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action), with a cumulative variance contribution rate of 82.433%. CFA results showed: χ²/df=2.641, RMSEA=0.055,GFI=0.913, AGFI=0.890, TLI=0.964, IFI=0.969, and CFI=0.969. The overall Cronbach’s α coefficient was 0.934, the split-half reliability was 0.813, and the test-retest reliability was 0.641. Children’s dietary behavior was significantly associated with parents’ attitudes scores (P<0.05).

The scale developed in this study demonstrates good reliability and validity, and is suitable for assessing parents’ attitudes towards the dietary health of school-aged children in community family settings.

To examine whether adverse childhood experiences(ACEs) predict frailty in middle-aged and elderly Chinese adults, and whether social participation or education level moderates this association.

Four waves (2011—2018) of the China Health and Retirement Longitudinal Study were combined with the 2014 life-history module to construct panel data. Based on the Hausman test(χ²=261.490, P<0.001), a fixed-effects model was applied to examine the association between ACEs and frailty, with particular attention to social participation and educational attainment and potential moderating effects.

A total of 9 354 individuals were retained, 61.71% had experienced two or more ACEs, and the prevalence of frailty was 15.01%. A significant positive correlation was observed between ACEs and frailty, with the effect intensifying as the number of ACEs increased (ACEs=2: β=1.45, 95% CI: 0.64~-2.26; ACEs=3: β=2.90, 95% CI: 2.00-3.86; ACEs=4: β=3.52,95% CI: 2.48-4.56). Social participation (β=-0.50, 95% CI: -0.63-0.30) and high school or vocational education (β=-1.71, 95% CI: -2.62-0.80) were cross-sectionally associated with lower frailty. However, neither social participation nor education level significantly moderated the relationship between ACEs and frailty (P>0.05).

Within the middle-aged and elderly population in China, ACEs had been identified as a significant risk factor for the development of frailty. Although both social participation and high school or vocational education were negatively associated with frailty, neither of these factors significantly moderated the relationship between ACEs and frailty.

To investigate the association between Li ethnicity and the risk of delivering small for gestational age(SGA).

Based on data from 1 472 940 live births recorded in the Hainan Provincial Birth Certificate System between 2010 and 2021, generalized linear models were employed to analyze the associations between different combinations of Han and Li parental ethnicity and the risk of SGA and its subtypes. Statistical interactions were assessed to examine the influence of demographic characteristics and perinatal factors on these associations.

The SGA rate among Li parents was 22.99%,followed by Li father/Han mother (17.96%) and Han father/Li mother pairs (16.22%), all significantly higher than that of Han pairs (15.05%, P<0.001). The patterns for different SGA subtypes were generally consistent with the overall trend. Adjusted models showed a graded increase in SGA risk relative to Han pairs: Han father/Li mother (RR=1.041, 95% CI: 1.026-1.057), Li father/Han mother (RR=1.115, 95% CI: 1.094-1.136) and Li pairs (RR=1.385, 95% CI: 1.371-1.400). Multiplicative interaction models showed the association was significantly modified by parental age, multiplicity, residence, neonatal sex, and delivery hospital (P<0.05).

Our findings suggest that Li ethnicity may be an independent risk factor for SGA.Targeted interventions and optimized perinatal care tailored to the Li population are needed to improve maternal and infant health outcomes.

This study aimed to investigate the effects of childhood trauma, classmate support and school connectedness on psychological distress, thereby providing an empirical basis for developing preventive interventions for mental health problems in adolescents.

A questionnaire survey was conducted among 2 500 middle school students. Multiple linear regression analysis was employed to examine the effects of childhood trauma, classmate support, and school connectedness on psychological distress, and their interactive effects.

The total detection rate of psychological distress was 43.9%, with moderate, and severe cases accounting for 13.5%, and 5.0%, respectively. Childhood trauma positively predicted psychological distress (β=0.271, P<0.05), while classmate support (β=-0.089, P<0.05) and school connectedness (β=-0.260, P<0.05) negatively predicted psychological distress. After including the three-way interaction term (childhood trauma × classmate support × school connectedness), the model’s explanatory power for psychological distress increased by 0.4%(△R²=0.004, P<0.05). Childhood trauma remained a positive predictor of psychological distress(β=0.289, P<0.05), whereas classmate support (β=-0.105, P<0.05), school connectedness (β=-0.282, P<0.05), and the three-way interaction term (β=-0.103, P<0.05) negatively predicted psychological distress. Results of the simple slope analysis showed that there were significant differences between Slope 1 and Slope 3, as well as between Slope 3 and Slope 4(both P<0.05).

The occurrence of psychological distress in middle school students is associated with childhood trauma,classmate support, and school connectedness. Notably, these three factors demonstrate significant interactive effects on students’ psychological distress. Moving forward, greater emphasis should be placed on screening adolescents for childhood trauma experiences while simultaneously addressing peer relationships and school culture.

To investigate the impact of parent-child relationship on adolescent smoking frequency and to analyze the chain mediating effect of life satisfaction and social support seeking.

Based on the survey data from the Adolescent Health Database for the 2020—2021 academic year, Spearman correlation analysis was used to explore the correlations among parent-child relationship, life satisfaction, social support seeking, and smoking behavior. The chain mediation model was constructed using the PROCESS 4.1 program, Model 6.

A total of 22 345 samples were included in the study. Parent-child relationship positively influenced adolescents’ life satisfaction and social support seeking (β=0.604, P<0.001; β=0.258, P<0.001). Life satisfaction also positively influenced social support seeking (β=0.306, P<0.001). Parent-child relationship, life satisfaction, and social support seeking were all significantly associated with lower adolescent smoking frequency (β=-0.212, P<0.001; β=-0.039, P<0.001; β=-0.080, P<0.001). The chain mediating effect of life satisfaction and social support seeking between parent-child relationship and smoking frequency was significant (β=-0.015, 95% CI: -0.018~-0.011).

Life satisfaction and social support seeking play a significant chain mediating role between parent-child relationship and adolescent smoking frequency. Parents should create a positive family atmosphere, establish a harmonious parent-child relationship, and promptly correct adolescents’ misconceptions to reduce the occurrence of smoking behavior.

This study aimed to analyze the current status of sleep quality and its impact on the quality of life among rural residents in Fumin County, Yunnan Province.

A multi-stage stratified random sampling method was adopted to select 2 503 rural permanent residents aged 35 and above in Fumin County for face-to-face questionnaire surveys. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), while the short form 36 (SF-36) scale was used to assess quality of life (QOL) scores.

The prevalence of sleep disorders in the surveyed population was 19.70%, and was higher in females than in males (24.40% and 14.70%, P<0.001). Prevalence of sleep disorders increased progressively with age (P<0.001). Individuals with lower levels of education had higher prevalence of sleep disorders (P<0.001). Multiple linear regression analysis showed that individuals with sleep disorders had significantly lower scores in domains of Physical Component Summary(PCS) and Mental Component Summary (MCS) than their counterparts (P<0.001).

The prevalence of sleep disorders among rural residents in Fumin County of Yunnan Province is relatively high. Health education regarding sleep-related knowledge should be enhanced, particularly targeting females, the elderly, and individuals with lower educational levels.Furthermore, taking measures to reduce the occurrence of sleep disorders could help improve their QOL.

To understand the public’s preferences and willingness to pay for digital therapeutics (DTx) products for chronic disease management.

Based on a discrete choice experiment, an online questionnaire survey was administered via Wenjuanxing in February to March 2025, targeting the adult working population with independent spending capacity across the country. The preference outcomes were analyzed using a mixed logit model.

Higher product accuracy (β=1.006), greater ease of use (β=0.349), superior product efficacy (β=0.569), higher product risk (β=-2.104),significant long-term health benefits (β=0.670), and inclusion in the medical insurance reimbursement list (β=1.458)demonstrated substantial influence on respondents’ preferences (P<0.001). Specifically, compared with low-risk products,respondents’ willingness to pay for high-risk products decreased by 7 891 yuan, and coverage by the medical insurance reimbursement list increased willingness to pay by 5 466 yuan compared with no coverage.

It is necessary to improve the regulatory system for DTx, establish a multi-payment pattern with medical insurance payment as the core and a climate of paying for health value, enhance the usability of products, and ultimately promote the improvement of chronic disease management levels and the promotion of DTx.

To explore the relationship between health literacy and quality of life of rural residents in Changzhou City, and to examine the mediating effect of health protective behavior.

A multi-stage random sampling method was employed to select 605 rural residents in Changzhou for the survey. The questionnaire comprised sections on general information, short-form health literacy scale, health protective behavior scale, and the EQ-5D-5L scale. Descriptive statistics and correlation analysis were performed using SPSS software. A structural equation model was constructed using Amos software, and the mediating effect of health protective behavior was examined through bootstrap analysis (with 5 000 resamples).

The score of the health literacy index for rural residents in Changzhou City was 35.77±7.42, the average utility score was 0.95±0.09, and the average EQ-VAS score was 83.88±12.13. A positive correlation was observed between health literacy and health protective behavior among rural residents in Changzhou (β=0.463, P<0.001). Similarly, health protective behavior was positively correlated with quality of life (β=0.244, P=0.006), and health literacy also showed a positive correlation with quality of life (β=0.157, P=0.037). Mediating effect analysis revealed that the direct effect of health literacy on quality of life among rural residents in Changzhou was 0.157, with an indirect effect of 0.113, resulting in a total effect of 0.270. The confidence interval for the path of health literacy → health protective behavior → quality of life was [0.038, 0.201]. The mediating effect of health protective behavior between health literacy and quality of life accounted for 41.85% (P=0.004).

Efforts should be continuously made to enhance the health literacy of rural residents, facilitating the transformation of their health knowledge and beliefs into health protective behaviors, so as to further improve the quality of life among rural residents.

To evaluate the fairness and efficiency of health supervisor allocation in Yunnan Province from 2020 to 2024,providing a basis for optimizing human resource allocation and enhancing the effectiveness of the health supervision system.

Based on relevant statistical and supervision data of Yunnan Province from 2020 to 2024, the allocation of health supervisor resources was assessed from three dimensions of current status, fairness, and efficiency, utilizing comprehensive quality scores of health supervisors, the Gini coefficient, and Data Envelopment Analysis (DEA) efficiency scores.

The number of health supervisors in Yunnan Province decreased from 1 762 in 2020 to 1 688 in 2024, while the supervised entities per supervisor increased from 189.78 to 257.25. The comprehensive quality score improved from 6.34 to 6.47, whereas the professional title score decreased by 13.1%. The Gini coefficients for the quantity of health supervisors, calculated based on the permanent resident population and the number of supervised entities, remained below 0.18, indicating a high level of equity. In contrast, the corresponding Gini coefficient for quality was close to the 0.4 warning line. The comprehensive efficiency score decreased initially and then increased over the five years, reaching its lowest point 0.797 in 2022. Scale efficiency was lower than pure technical efficiency each year. Prefectures(cities) exhibited regional differentiation in efficiency, characterized as highly efficient and stable, medium efficiency with fluctuation, or low efficiency with fluctuation, and these patterns were primarily influenced by scale efficiency.

The number of health supervisors in Yunnan Province has decreased, leading to a heavier workload, although their overall quality has improved. The fairness of quantity allocation is good, but the fairness of quality allocation requires improvement. Efficiency fluctuations are mainly attributable to scale efficiency. It is recommended to reform the professional title evaluation system, implement differentiated regional allocation strategies, and strengthen technical empowerment to enhance the overall efficiency and fairness of human resource allocation.

To explore the underlying mechanisms among mental health variables, including perceived stress, psychological resilience, depression, anxiety, and insomnia, within the medical staff population.

Between November 1 and December 31,2023, a convenience sampling method was used to survey healthcare workers in Beijing via an electronic questionnaire. We used internationally validated scales to measure stress perception and psychological resilience. Hypothesized relationships between the variables were tested using a structural equation model (SEM) developed based on existing literature.

A total of 2 014 valid questionnaires were collected from 83 medical and health institutions. The scores of the mental health scales were as follows: PSS 16.00 (10.00, 18.00), CD-RISC 63.00 (48.00, 77.00), PHQ-9 3.00 (0.00, 7.25), GAD-7 1.00 (0.00, 6.00), and ISI 5.00 (1.00, 9.00).Psychological resilience showed a potential mediating effect of 5.5%-9.3% on the associations between perceived stress and each psychological symptom. In addition, anxiety symptoms played a stronger mediating role in the pathways from perceived stress to depressive symptoms and insomnia symptoms, accounting for 55.0% and 79.4% of the total effects, respectively. The direct effect of perceived stress on anxiety symptoms was the most prominent (94.5%). The structural equation model demonstrated good overall fit (χ²/df=2.829, RMSEA=0.030), and the hypothesized interrelationships among the variables were supported by the data.

This study demonstrates that psychological resilience and anxiety symptoms are key mediators in the impact of stress perception on mental health, suggesting that optimizing mental health management in healthcare professionals requires integrated strategies focusing on stressor control, early identification of anxiety, and resilience enhancement.