WeChat: An applicable and flexible social app software for mobile teaching

Analysis of "Dr Ding Xiang" on WeChat in China to Determine Factors Influencing Readership on Medical Social Media: Observational Study

BACKGROUND

With the rapid expansion of social media platforms, the demand for health information has increased substantially, leading to innovative approaches and new opportunities in health education.

OBJECTIVE

This study aims to analyze the characteristics of articles published on the "Dr Ding Xiang" WeChat official account (WOA), one of the most popular institutional accounts on the WeChat platform, to identify factors influencing readership engagement and to propose strategies for enhancing the effectiveness of health information dissemination.

METHODS

A total of 5286 articles published on the "Dr Ding Xiang" WOA from January 2021 to December 2021 were collected and analyzed. Additionally, a random sample of 324 articles was selected for detailed text analysis. Univariate analysis was conducted using the chi-square test, and multivariate analysis was performed using multivariable logistic regression.

RESULTS

In 2021, the total number of reads for "Dr Ding Xiang" articles reached 323,479,841, with an average of 61,196 reads per article. Articles exceeding 100,000 reads accounted for 33.90% of the total. Most articles were published during the time slots of 8:00-10:00 AM, 11:30 AM to 1:30 PM, and 8:30-10:30 PM. Analysis indicated that the order of publication, style of the title sentence, number of likes, number of in-views, total likes on comments, and number of replies to comments were significantly associated with an article's number of reads. Text analysis further revealed that the article's reasoning approaches and concluding methods also had a significant impact on readership.

CONCLUSIONS

To enhance readership and the effectiveness of health communication, health-focused WOAs should consider key factors such as optimal publication timing, engaging title design, and effective content structuring. Attention to these elements can improve user engagement and support the broader dissemination of health information.

WeChat mini program in laboratory biosafety education among medical students at Guangzhou Medical University: a mixed method study of feasibility and usability

BACKGROUND

Laboratory biosafety should be a priority in all healthcare institutions. In traditional laboratory safety teaching students typically receive knowledge passively from their teachers without active involvement. The combination of experiential learning and mobile learning may provide students with greater engagement, retention, and application of knowledge. To address this issue, we developed and conducted a convergent mixed methods study to assess the feasibility and usability of a WeChat mini program (WMP) named WeMed for laboratory biosafety education for medical laboratory students at Guangzhou Medical University (GMU).

METHODS

The study was conducted between November 2022 and October 2023 among second-year undergraduate students at GMU. It involved the concurrent collection, analysis, and interpretation of both qualitative and quantitative data to assess feasibility and usability. In the quantitative strand, two evaluations were conducted via online surveys from students (n = 67) after a four-week study period. The System Usability Scale (SUS) was used to evaluate usability, while self-developed questions were used to assess feasibility. Additionally, a knowledge test was administered 6 months after the program completion. In the qualitative strand, fourteen semi-structured interviews were conducted, whereby a reflexive thematic analysis was utilized to analyze the interview data.

RESULTS

The overall SUS score is adequate (M = 68.17, SD = 14.39). The acceptability of the WeMed program is in the marginal high range. Most students agreed that WeMed was useful for learning biosafety knowledge and skills (13/14, 93%), while 79% (11/14) agreed it was easy to use and they intended to continue using it. After 6 months, a significant difference in the knowledge test scores was observed between the WeMed group (n = 67; 2nd year students) and the traditional training group (n = 90; 3rd year students). However, the results should be interpreted cautiously due to the absence of a pretest.

CONCLUSION

The combination of experiential learning and mobile learning with WMP is a feasible tool for providing laboratory biosafety knowledge and skills. Ongoing improvements should be made in order to increase long-term acceptance.

Effects of Wuxi CDC WeChat official account article features on user engagement in health promotion

OBJECTIVE

To identify the characteristics of subscribers to assess users' needs and analyze the features of articles published on Wuxi CDC WeChat official account (WOA) to evaluate the effectiveness of health education dissemination and guide future communication strategies.

METHODS

Collect data from the WeChat official account (WOA) of the Wuxi Center for Disease Control and Prevention (CDC) to identify factors affecting the effectiveness of health education dissemination as measured by shares and 100% reading completion rate between January 1, 2022, and December 31, 2022. Multivariate logistic regression analysis was utilized to identify influencing features of articles associated with health education dissemination.

RESULTS

By the end of 2022, our account had accumulated 891,170 subscribers, of which, 523,576 were females (58.75%), 349,856 were males (39.3%), mainly located in third-tier cities (82.59%). Age distribution peaked in the 26-35 and 36-45 age groups (43.63% and 30.6%, respectively). A total of 170 articles were included in the analysis. Multivariate logistic regression analysis revealed that articles with a lower word count (OR = 0.999, 95% CI = 0.998 ~ 1), lower picture count (OR = 0.892, 95% CI = 0.828 ~ 0.962), dominated headlines (OR = 2.454, 95% CI = 1.234 ~ 4.879) and thematically focused on Nutrition and food-borne diseases (OR = 5.728, 95% CI = 1.778 ~ 18.458) demonstrated higher engagement, as measured by shares and 100% completion rates.

CONCLUSIONS

Our findings suggest that future content should prioritize conciseness, optimize images, and align with subscriber interests, particularly in nutrition and food hygiene. Additionally, maintaining informative yet engaging content formats remains crucial for maximizing reach and impact.

Development of the WeChat Public Account I Love Parasitology and its Preliminary Application in the Teaching of Human Parasitology

OBJECTIVE

To better construct teaching resources, enhance real-time interaction and feedback between teachers and students in and out of class, and improve the teaching quality of parasitology, our team set up a WeChat public account I love Parasitology.

METHODS

The data sources were mainly from original pictures and multimedia materials of different parasites collected and produced by our team, as well as related materials collected from traditional publications and digital media. With the instant interactive platform, course schedules and corresponding teaching contents were sent by push notifications, case-based learning was carried out, and 2-way communication between students and teachers was achieved. Teaching effectiveness was assessed using a self-evaluation questionnaire.

RESULTS

A WeChat public account suitable for our daily teaching of parasitology was established. The second recursion and implementation of the learning resources allowed students to conduct in-depth reading and get unrestricted access to high-quality resources through the public account. In addition, all contents were in digital forms and made the original resources reborn, which would make up for our current and future shortage of physical teaching specimens. Moreover, the results from the questionnaire indicated that all these actions encouraged students to master theoretical knowledge, improved their abilities of case analysis and communication, and increased their knowledge of academic progress.

CONCLUSION

Our WeChat public account can provide excellent learning materials for students and is a good supplement to the routine education of human parasitology.

Computer-aided drug design course for pharmacy major students in Shenyang Pharmaceutical University following the COVID-19 pandemic: Challenges and opportunities

The computer-aided drug design (CADD) course that spans biochemistry, computational chemistry, medicinal chemistry, and other cutting-edge sciences is considered an important course by pharmaceutical universities in China. The course teaches students how drugs bind to protein targets and exert their biological activities using computer tools, and covers the basic principles of drug development and optimization. Due to the lockdown and social distancing measures adopted during the coronavirus disease 2019 (COVID-19) pandemic, the CADD course in Shenyang Pharmaceutical University was briefly suspended. Thereafter, it was taught in the online mode by adopting a novel blended teaching method. Through a questionnaire survey and final report assessment, we found that blended teaching might provide an opportunity to stimulate greater motivation and interest in students as well as improve teaching effectiveness and learning outcomes of the course. This study describes how we conducted the CADD course during the COVID-19 period with the intention of providing a reference for other teachers to conduct similar courses.

Research on the application and effect of flipped-classroom combined with TBL teaching model in WeChat-platform-based biochemical teaching under the trend of COVID-19

BACKGROUND

Biochemistry is a core subject in clinical medical education. The traditional classroom teaching model led by teachers is often limited to the knowledge transfer of teachers and the passive acceptance of students. It lacks interactive and efficient teaching methods and is not enough to meet the learning needs and educational goals of modern students. The combination of WeChat public platform, flipped classroom and TBL teaching model is closer to the needs of real life and workplace, helping students to cultivate comprehensive literacy and the ability to solve practical problems. At the same time, this teaching model has yet to be used in biochemistry courses.

OBJECTIVE

To explore the influence of the mixed teaching model of flipped classroom and combining TBL based on WeChat public platform upon undergraduates in biochemistry.

METHODS

Using the mixed research method of quasi-experimental research design and descriptive qualitative research, 68 students were selected into the traditional and the blended teaching groups. Among them, the blended teaching group adopts the blended teaching model of flipped classroom combined with TBL based on the WeChat platform to learn biochemical courses. In this study, an independent sample t-test was intended to analyze the differences in final scores, a chi-square test was served to analyze the differences in satisfaction questionnaires, and thematic analysis was used to analyze semi-structured interview data.

RESULTS

Compared with the traditional teaching model, the mixed teaching model significantly improved students' final exam scores (P < 0.05). The teaching satisfaction of the mixed teaching group was also higher than that of the traditional teaching group with statistical significance (P < 0.05). The results of the interviews with eight students were summarized into three topics: (1) Stimulating interest in learning; (2) Improving the ability of autonomous learning; (3) Recommendations for improvement.

CONCLUSIONS

The combination of the WeChat platform and flipped classroom with TBL has a positive effect on improving medical students' autonomous learning ability and problem-solving ability. The research shows that the teaching mode of flipped classroom combined with TBL based on the WeChat platform is effective and feasible.

WeChat as a platform for blending problem/case-based learning and paper review methods in undergraduate paediatric orthopaedics internships: a feasibility and effectiveness study

BACKGROUND

Paediatric orthopaedics is a significant and difficult for undergraduate students to master. During the COVID-19 pandemic, we used the WeChat platform to combine the advantages offered by problem-based learning (PBL), case-based learning (CBL) and paper review teaching methods to establish a new blended online teaching model and demonstrated its feasibility and effectiveness.

OBJECTIVE

This study aims to demonstrate the feasibility and effectiveness of a new blended pedagogical method that uses the WeChat platform and combines PBL, CBL and paper review.

METHODS

We enrolled 22 students participating in the Department of Paediatric Orthopaedics. They participated in the WeChat blended pedagogy mode. Their departmental rotation examination scores were compared with those of 23 students who participated in the traditional teaching method. Moreover, an anonymous questionnaire was used to evaluate students' perceptions and experiences.

RESULTS

The total average scores of students who participated in the WeChat blended pedagogy mode and the traditional teaching method were 47.27 and 44.52, respectively. There were no statistically significant differences between the online teaching mode and the traditional teaching method in terms of possessing professional accomplishment, gaining knowledge and promoting interpersonal skills (P = 0.07, P = 0.12 and P = 0.65, respectively). In terms of independent clinical thinking, self-improving capability and improving clinical skills, the scores associated with the WeChat blended pedagogy mode were 8.00, 8.00 and 6.00, whereas those associated with the traditional teaching method were 6.70, 6.87 and 7.48. The overall satisfaction with the WeChat blended pedagogy mode reached 100%. A total of 64%, 86%, 68%, 64% and 59% of students chose very large or large in response to the items concerning professional accomplishment, knowledge absorption, independent clinical thinking skills, English reading and literature exploring capacity, as well as interpersonal skills, respectively. Fifteen participants claimed that the WeChat blended pedagogy mode was less helpful to them with regard to promoting the improvement of their clinical skills. Nine students claimed that the WeChat blended pedagogy mode was time-consuming.

CONCLUSIONS

Our study verified the feasibility and effectiveness of the WeChat blended pedagogy mode for undergraduate paediatric orthopaedics internships.

TRIAL REGISTRATION

Retrospectively registered.

WeChat app combined CBL in oral medicine clinical training: A review

Hotly used in student-centered medical education worldwide, case based learning (CBL) is worthen with WeChat, the most popular communication app and is widely used in all walks of life. We have practiced several years combining WeChat and CBL in the clinical training of oral medicine for young doctors, promoting outcomes over traditional bedside training. This article's objective is demonstrating the acceptability and merits of WeChat CBL in the clinical training of oral medicine for young doctor. A total of eighty young doctors and 2 tutors participated in this study for interns of a every 2-month training during January 2018 to 2020. The control group used clinical bedside mode; the experimental group used bedside plus WeChat CBL mode. The evaluations included participation passion, daily routine and final test. Ten clerkships and thirty residents were in same number respectively of experiment and control groups. The participants in the experimental group produced a higher degree of participation in discussions. The twice and above Q&A action percentage is 40% in experimental group rather than 25% in control group. Daily assessment and final examination scores in the experimental group were significantly higher than those in the control group (P < .001). WeChat CBL mode has a positive effect on students' learning enthusiasm, assessments and evaluations in clinical training of oral medicine.

High-Tech Classroom Management: Effects of the Use of an App on Disruptive and On-Task Classroom Behaviours for Students with Emotional and Behavioural Disorder

Students with emotional behavioural disorders may exhibit extremely challenging behaviour that interferes with their academic achievement and social relationships. Failure at school frequently leads to a succession of poor life outcomes including increased rates of unemployment or underemployment. Increasing on-task behaviours and decreasing disruptive classroom behaviours is of crucial importance. If successful, this may promote positive experiences and outcomes in terms of effective learning, and, ultimately, greater opportunities in life. This study evaluated a high-tech approach to classroom management using an App* that offers elements of choice and predictability to students. Teachers were provided with two hours of training on how to upload lesson plans to their smartphone and how to broadcast onto screens in classrooms. A multiple-baseline design across four participants was used and the data suggested that the use of the App resulted in both increases in on-task behaviour and a reduction in disruptive classroom behaviour for all participants.

Development and application of an online learning platform for nursing ethics: A teaching practice research

BACKGROUND

It is crucial to diversify the methods for clinical nurses to continue learning nursing ethics in that ethical decision-making ability in nursing is regarded as one of the core competencies in nursing practice.

OBJECTIVE

In response to nurses' learning needs for nursing ethics, this study built an online learning platform for the pertinent topic, and tested its effect on improving nurses' ethical decision-making ability and critical thinking ability.

DESIGN

A qualitative method was adopted to develop interventions, which were designed as a teaching practice research consisting of a study group and a control group.

PARTICIPANTS

A total of 93 nurses, including 20 interviewees and 30 in the study group and 43 in the control group.

METHOD

Qualitative methods were employed to understand the learning needs of nurses. The judgment about nursing decisions and the critical thinking disposition inventory, learning effectiveness questionnaire and learning software quality evaluation scale were used as research tools in this teaching practice research. The SPSS 25.0 was adopted to analyze data by paired sample t-test and independent sample t-test.

RESULTS

In the measurement of the judgment about nursing decisions scale, the study group scored higher than the control group. The critical thinking disposition inventory scale identified a similar result in the total score incorporating the four dimensions, including analyticity, systematicity, critical thinking self-confidence, inquisitiveness. There is a correlation between learning software quality and learning effect, with a correlation coefficient of 0.640.

CONCLUSION

The online learning platform of nursing ethics built in this study has positive learning effects, and it demonstrates effectiveness to improve nurses' abilities in nursing ethics, decision-making and critical thinking. It is expected to be a viable way to improve the continuity of nurses' study of ethics.

Application of WeChat-based flipped classroom on root canal filling teaching in a preclinical endodontic course

BACKGROUND

This study was aimed to evaluate the application of WeChat-based flipped classroom in root canal filling teaching in a preclinical endodontic course.

METHODS

A two-group comparative study was designed. The pre-class test, on-site quiz, and root canal filling on extracted premolars were performed by students from a lecture-based classroom group (LG, n = 30) and a WeChat-based flipped classroom group (WFG, n = 30). Results of the Pre-class test and on-site quiz were analyzed by independent samples t-test. Post-filling radiographs were taken and evaluated by a specialist in oral radiology who was blinded to grouping. Results of root canal fillings were analyzed by the Pearson chi-square test. Student responses in questionnaires were analyzed by Fisher's exact test.

RESULTS

The students in WFG could get significantly higher scores in the on-site test and make better performances in root canal filling than those in LG. In terms of questionnaires, students from WFG were perceived to be more motivated to learn, better to understand the knowledge, better to improve communication and clinical skills, easier to perform root canal filling but spending more time.

CONCLUSION

The WeChat-based flipped classroom teaching can have a better effect than lecture-based teaching on root canal filling learning for students with limited endodontic experiences.

Advances in Research on Technological, Pedagogical, Didactical, and Social Competencies of Preservice TCFL Teachers

With the development of China, learning the Chinese language has received more and more attention from international students. Teaching Chinese as a foreign language (TCFL) is crucial for spreading Chinese culture and promoting cultural exchanges. In recent years it has become the focus of attention of many scholars, and the heterogeneous cultural backgrounds and diverse language needs of learners determine that TCFL should promote the development of students’ intercultural communication competence in language practice with the use of educational technology. In this study, 82 preservice teachers as an experiment group and 64 preservice teachers as a control group participated in this study; this research aims to improve the quality and level of TCFL, using innovative teaching tools as a means to target preservice TCFL teachers and create a teaching–learning design strategy based on the smart teaching tools Moso Teach (MT) and Rain Classroom (RC). The findings from this research show the importance of the use of smart teaching tools and the improvement of preservice teachers during the experiment compared to preservice teachers with traditional methods. This paper answers the following questions: (1) How to improve preservice TCFL teachers’ competencies by integrating smart teaching tools into their learning process? (2) How to integrate technological, pedagogical, didactic, and social competencies into preservice teachers’ daily teaching CFL?

The Application of a Case-Based Social Media-Assisted Teaching Method in Cariology Education：Comparative Study

Background

Current cariology education based on the traditional teaching method faces a lot of challenges. Meanwhile, the COVID-19 pandemic caused an unprecedented disruption in medical education and health care systems worldwide. Innovation in the teaching mode of cariology education is required to change the situation.

Objective

The goal of the research was to evaluate the application effects of a case-based social media–assisted teaching method in cariology education.

Methods

Dental students of class 2019 were enrolled into the experimental group, while students of class 2018 served as control. A case-based social media–assisted teaching method was used in the experimental group, which included preclass activity via social media, additional discussion and practice process record in class, and questions and answers on the platform after class. The traditional teaching method, which consisted of conventional preparation before class, traditional lectures and demonstrations followed by students practice in class, and questions and answers step after class, was used in the control group. The teaching materials were the same in both groups. At the end of the program, students from both groups took cavity preparation skill evaluation tests. Questionnaires were tested on the case-based social media–assisted teaching group students anonymously. All data were analyzed using SPSS statistical software (version 22.0, IBM Corp).

Results

The mean student cavity preparation skill evaluation scores was 82.51 (SD 6.82) in the experimental group and 77.19 (SD 5.98) in the control group (P<.05). The questionnaire response rate was 100%. Of those, 94.3% (100/106) of the students recommended the case-based social media–assisted teaching method in cariology education. The majority of the participants agreed that it helped them memorize the theoretical knowledge of cariology, facilitated in-depth discussion, improved their enthusiasm and initiative in learning, and enhanced the relationship between teachers and students (104/106, 98.1%). They also recognized that the classroom atmosphere was active (94/106, 88.7%).

Conclusions

The case-based social media–assisted teaching method was beneficial in terms of learning, as demonstrated by the statistically significant improvement of the cavity preparation skill evaluation scores and satisfaction from attending students. This method could be used to supplement the teaching of cariology.

Influencing Factors on Health Information to Improve Public Health Literacy in the Official WeChat Account of Guangzhou CDC

Background: Social media is used as a new channel for health information. In China, the official WeChat account is becoming the most popular platform for health information dissemination, which has created a good opportunity for the Centers for Disease Control and Prevention to facilitate health information online to improve emergency public health literacy. Methods: Data were collected from the Guangzhou CDC i-Health official WeChat account between April 1, 2018 and April 30, 2019. Descriptive analysis was performed for basic information about the followers and posts of the official WeChat account. Multiple logistic regression analysis was used to analyze the association among various factors of posts on engagement of followers of the official WeChat account. Results: Among 187,033 followers, the total numbers of post views, shares, likes, add to favorites, and comments for 213 posts were 1,147,308, 8,4671, and 5,535, respectively. Engagement of followers peaked on the dissemination date and gradually declined. The main post topics were health education posts and original posts. In the multiple logistic regression model, the number of post views was found to be significantly associated with infectious disease posts (AOR: 3.20, 95% CI: 1.16-8.81), original posts (AOR: 10.20, 95% CI: 1.17-89.28), and posts with title-reflected content (AOR: 2.93, 95% CI: 1.16-8.81). Conclusion: Our findings facilitate the government to formulate better strategies and improve the effectiveness of public information dissemination.

WeChat as a Platform for Problem-Based Learning Among Hematological Postgraduates: Feasibility and Acceptability Study

Background

Hematological medicine is a practical discipline that is difficult to study. Problem-based learning (PBL) is an innovative student-centered teaching method wherein students define their own learning objectives from clinically based problems. Considering that WeChat is the most popular communication app in China, we selected it as a new platform for online PBL to reduce the limitations of traditional PBL in hematology teaching.

Objective

This study aims to explore a new pedagogical method called WeChat-PBL, which is based on real micro clinical cases for postgraduates majoring in hematology and to demonstrate its feasibility and acceptability.

Methods

A total of 48 hematological postgraduates and 7 tutors participated in this study. We divided the participants into 7 groups where students can learn theoretical knowledge. After each course, the members of each group were required to complete in-class quizzes. Moreover, the students and tutors were required to fill out periodic (after each class) and overall (after each semester) evaluations.

Results

A total of 8 micro clinical cases were presented in WeChat-PBL. The average quiz score for acute myelogenous leukemia, chronic myeloid leukemia, multiple myeloma, acute promyelocytic leukemia, and lymphoma were 89.0%, 86.0%, 83.4%, 88.8%, and 77.5%, respectively. Periodic evaluations showed that both students and tutors were satisfied with the process of WeChat-PBL. The overall evaluation results showed that WeChat-PBL was able to positively impact the learning experiences of hematological postgraduates.

Conclusions

Our results indicate the feasibility and acceptability of the WeChat-PBL teaching method for postgraduates majoring in hematology.

Improvement in outpatient services using the WeChat calling system in the Shanghai Children's Hospital

Objectives:

We explored the utility of WeChat applet as part of the Outpatient Department (OPD) to provide patients with timely queuing information and compared it with the traditional calling system.

Methods:

Data for the WeChat calling system was extracted for the period of May 2018 to September 2018. Data for the traditional system was extracted for the same period from the year 2017. We compared the effective patient waiting time and nurse idle time i.e. nonproductive time spent on factors outside of employees’ control with the two systems. We also analyzed the relationship between the length of waiting time and conflicts between doctors and patients.

Results:

The mean wait time for the traditional calling system was 126 minutes, while the average idle time for nurses was 96 minutes/day. On the other hand, the mean wait time for the WeChat calling system was 33 minutes, and the average idle time for nurses was 72 minutes/day. The incremental profit (cost of traditional calling system – cost of WeChat calling system) achieved from switching systems was 13,879 yuan/month. Behavioral observations showed that wait time (OR=2.745, 95%CI 1.936~3.892 P<0.0001) was a risk factor for staff-patient conflict.

Conclusion:

The cost of the WeChat calling system was significantly lower than the traditional system. Also, the traditional calling system was time-consuming. Longer waiting time was the main factor affecting OPD quality and caused conflicts between doctors and patients.

Gender differences of depression and anxiety among social media users during the COVID-19 outbreak in China:a cross-sectional study

Background

Studies have shown that the outbreak of infectious diseases would result in mental health problems. Females are in greater risk for psychological problems than males. The present study investigated gender differences of depression and anxiety and explored associated factors during the COVID-19 epidemic among Chinese social media users.

Methods

We recruited 3088 participants through social media cross China. Participants completed sociodemographic and the COVID-19 epidemic related questions, the 2-item Patient Health Questionnaire (PHQ-2), and the 2-item Generalized Anxiety Disorder Scale (GAD-2), the Chinese version of the 10-item Connor-Davidson Resilience Scale. We applied Chi-square test and ANOVA for data description and linear regression analysis for exploring factors associated with depression and anxiety.

Results

Of 3063 participants eligible for analysis, the total prevalence of depression and anxiety was 14.14 and 13.25%. Females were experiencing more severe stress and anxiety symptoms, while males showed better resilience to stress. The severity of depression symptoms would decrease with the increase of age resilience, and it would increase if being unemployed, feeling less adapted, being more stressed. The severity of anxiety symptoms would decrease with higher education and better resilience, and it would increase if being female, spending over 60 min on COVID-19 related information, less adapted, and being more stressed.

Conclusion

The findings show the increased prevalence of depression and anxiety in Chinese population during the COVID-19 epidemic, and females are experiencing more severe anxiety symptoms than males. As social media is the current main resource of information related to COVID-19, interventions should be implemented to help users to limit the time they spend on social media and to get key information related to the epidemic from authoritative and authentic resource to avoid infodemic and prevent mental health problems.

Assessing a WeChat-Based Integrative Family Intervention (WIFI) for Schizophrenia: Protocol for a Stepped-Wedge Cluster Randomized Trial

BACKGROUND

Schizophrenia is a persistent and debilitating mental illness, and its prognosis depends largely on supportive care and systematic treatment. In developing countries like China, families constitute the major caregiving force for schizophrenia and are faced with many challenges, such as lack of knowledge, skills, and resources. The approach to support family caregiving in an accessible, affordable, feasible, and cost-effective way remains unclear. The wide-spread use of WeChat provides a promising and cost-effective medium for support.

OBJECTIVE

We aim to present a protocol for assessing a WeChat-based integrative family intervention (WIFI) to support family caregiving for schizophrenia.

METHODS

We will develop a WIFI program that includes the following three core components: (1) psychoeducation (WeChat official account), (2) peer support (WeChat chat group), and (3) professional support (WeChat video chat). A rigorous stepped-wedge cluster randomized trial will be used to evaluate the implementation, effectiveness, and cost of the WIFI program. The WIFI program will be implemented in 12 communities affiliated with Changsha Psychiatric Hospital through the free medicine delivery process in the 686 Program. The 12 communities will be randomized to one of four fixed sequences every 2 months during an 8-month intervention period in four clusters of three communities each. Outcomes will be assessed for both family caregivers and people with schizophrenia. Family caregivers will be assessed for their knowledge and skills about caregiving, social support, coping, perceived stigma, caregiver burden, family functioning, positive feelings, and psychological distress. People with schizophrenia will be assessed for their symptoms, functioning, quality of life, recovery, and rehospitalization. Cost data, such as intervention costs, health care utilization costs, and costs associated with lost productivity, will be collected. Moreover, we will collect process data, including fidelity and quality of program implementation, as well as user attitude data. Treatment effects will be estimated using generalized linear maximum likelihood mixed modeling with clusters as a random effect and time as a fixed effect. Cost-effectiveness analysis will be performed from the societal perspective using incremental cost-effectiveness ratios. Qualitative analysis will use the grounded theory approach and immersion-crystallization process.

RESULTS

The study was funded in August 2018 and approved by the institutional review board on January 15, 2019. Preliminary baseline data collection was conducted in May 2019 and completed in September 2019. The WIFI program is expected to start in September 2020.

CONCLUSIONS

This is the first study to assess a WeChat-based mHealth intervention to support family caregiving for schizophrenia in China. The innovative study will contribute to the development of a more cost-effective and evidence-based family management model in the community for people with schizophrenia, and the approach could potentially be integrated into national policy and adapted for use in other populations.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04393896; https://clinicaltrials.gov/ct2/show/NCT04393896.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/18538.

The Prevalence of Smartphones and WeChat Use Among Older Adults With Chronic Disease in a Western China

Telemedicine is a promising way to deliver patient education and health services, but access to information technology among potential patients is a prerequisite. This study surveyed the prevalence of smartphone use and the use of the Chinese social networking platform WeChat and Wi-Fi access in the homes of older adults in a western area of China. A convenience sample of 225 older adults with chronic diseases in two tertiary hospitals was interviewed regarding smartphone ownership, WeChat use, and access to Wi-Fi at home. Participant ability in performing the activities of daily living was also assessed. Logistic regressions were used to analyze the independently associated factors of smartphone ownership, WeChat use, and Wi-Fi access at home. The results show that the prevalence of smartphone use was 19.6%, only 8.9% of those surveyed used WeChat, but 39.6% had access to Wi-Fi at home. Education level was the only factor significantly associated with the three dependent variables. Ability in performing activities of daily living was positively correlated with access to Wi-Fi at home (odds ratio, 2.549; P = .011). It will be difficult to implement telemedicine through smartphones in such relatively poor areas of China. Better-educated older adults who are less dependent in performing activities of daily living are potential users of telemedicine.

Information and Communications Technologies (ICTs) in Education for Sustainable Development: A Bibliographic Review

In recent years, technological advances have played a very important role in our society, as well as in different educational contexts, including Education for Sustainable Development. Information and Communication Technologies (ICTs), which have made it possible to improve the quality of life of many people. The aim of this study is to review the scientific evidence on the use of ICTs for Sustainable Development. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines, a bibliographic search was carried out using the Web of Science and Scopus bibliographic repositories, with a total of 19 articles comprising the final sample for review. The results show that the most preeminent strategies used are mobile learning and distance education, which are related to the achievement of the sustainable development goals. Included among the conclusions of this study is the need to investigate the different strategies that are being carried out, with ICTs in school aimed at developing a more sustainable environment standing out.