Global Changes and Factors of Increase in Caloric/Salty Food Intake, Screen Use, and Substance Use During the Early COVID-19 Containment Phase in the General Population in France: Survey Study

BACKGROUND

The international outbreak of coronavirus disease (COVID-19) has led many countries to enforce drastic containment measures. It has been suggested that this abrupt lockdown of populations will foster addiction-related habits such as caloric/salty food intake, screen use, and substance use.

OBJECTIVE

Our aim was to assess the global changes and factors of increase in addiction-related habits during the early COVID-19 containment phase in France.

METHODS

A web-based survey was provided from day 8 to day 13 of the containment and was completed by 11,391 participants. The questions explored sociodemographic features, psychiatric/addiction history, material conditions of lockdown, general stress, mental well-being, and reported changes in several addiction-related behaviors. Global changes were described and factors of increase were explored using population-weighted and adjusted logistic regression models, providing adjusted odds ratios (aORs) and their 95% confidence intervals.

RESULTS

Overall, the respondents reported more increases in addiction-related habits than decreases, specifically 28.4% (caloric/salty food intake), 64.6% (screen use), 35.6% (tobacco use), 24.8% (alcohol use), and 31.2% (cannabis use). Reduced well-being scores and increased stress scores were general factors of increase in addiction-related habits (P<.001 for all habits). Factors of increase in caloric/salty food intake (n=10,771) were female gender (aOR 1.62, 95% CI 1.48-1.77), age less than 29 years (P<.001), having a partner (aOR 1.19, 95% CI 1.06-1.35), being locked down in a more confined space (per 1 square meter/person decrease: aOR 1.02, 95% CI 1.01-1.03), being locked down alone (aOR 1.29, 95% CI 1.11-1.49), and reporting current (aOR 1.94, 95% CI 1.62-2.31) or past (aOR 1.27, 95% CI 1.09-1.47) psychiatric treatment. Factors of increase in screen use (n=11,267) were female gender (aOR 1.31, 95% CI 1.21-1.43), age less than 29 years (P<.001), having no partner (aOR 1.18, 95% CI 1.06-1.32), being employed (P<.001), intermediate/high education level (P<.001), being locked down with no access to an outdoor space (aOR 1.16, 95% CI 1.05-1.29), being locked down alone (aOR 1.15, 95% CI 1.01-1.32), living in an urban environment (P<.01), and not working (P<.001). Factors of increase in tobacco use (n=2787) were female gender (aOR 1.31, 95% CI 1.11-1.55), having no partner (aOR 1.30, 95% CI 1.06-1.59), intermediate/low education level (P<.01), and still working in the workplace (aOR 1.47, 95% CI 1.17-1.86). Factors of increase in alcohol use (n=7108) were age 30-49 years (P<.05), a high level of education (P<.001), and current psychiatric treatment (aOR 1.44, 95% CI 1.10-1.88). The only significant factor of increase in cannabis use (n=620) was intermediate/low level of education (P<.001).

CONCLUSIONS

The early phase of COVID-19 containment in France led to widespread increases in addiction-related habits in the general population. Reduced well-being and increased stress were universal factors of increase. More specific factors were associated with increases in each of the explored habits.

Online professionalism and the mirror of social media

The rise of social media--content created by Internet users and hosted by popular sites such as Facebook, Twitter, YouTube, and Wikipedia, and blogs--has brought several new hazards for medical professionalism. First, many physicians may find applying principles for medical professionalism to the online environment challenging in certain contexts. Second, physicians may not consider the potential impact of their online content on their patients and the public. Third, a momentary lapse in judgment by an individual physician to create unprofessional content online can reflect poorly on the entire profession. To overcome these challenges, we encourage individual physicians to realize that as they "tread" through the World Wide Web, they leave behind a "footprint" that may have unintended negative consequences for them and for the profession at large. We also recommend that institutions take a proactive approach to engage users of social media in setting consensus-based standards for "online professionalism." Finally, given that professionalism encompasses more than the avoidance of negative behaviors, we conclude with examples of more positive applications for this technology. Much like a mirror, social media can reflect the best and worst aspects of the content placed before it for all to see.

Relationship between health service use and health information technology use among older adults: analysis of the US National Health Interview Survey

BACKGROUND

Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults' use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services.

OBJECTIVE

This study examined the relationship between US older adults' use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use.

METHODS

The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates.

RESULTS

The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were significantly associated with HIT use only for older women, while having seen or talked to a mental health professional only marginally increased the odds of HIT use only for older men. Having visited or talked to a chiropractor and having had overnight hospitalization, surgery, and/or homecare services were not associated with the odds of HIT use for either gender.

CONCLUSIONS

Older-adult users of general health services were more likely to use HIT than nonusers of general health services, while older-adult users of specialized health services were not different from nonusers of specialized health services in their odds of HIT use. The findings have implications for narrowing the age-related and socioeconomic status-related gaps in HIT use. The access gaps among racial/ethnic minority older adults and poorly educated and/or low-income older adults are especially striking and call for concerted efforts to facilitate Internet access and HIT use among these disadvantaged older adults.

A targeted review of the neurobiology and genetics of behavioural addictions: an emerging area of research

This review summarizes neurobiological and genetic findings in behavioural addictions, draws parallels with findings pertaining to substance use disorders, and offers suggestions for future research. Articles concerning brain function, neurotransmitter activity, and family history and (or) genetic findings for behavioural addictions involving gambling, Internet use, video game playing, shopping, kleptomania, and sexual activity were reviewed. Behavioural addictions involve dysfunction in several brain regions, particularly the frontal cortex and striatum. Findings from imaging studies incorporating cognitive tasks have arguably been more consistent than cue-induction studies. Early results suggest white and grey matter differences. Neurochemical findings suggest roles for dopaminergic and serotonergic systems, but results from clinical trials seem more equivocal. While limited, family history and genetic data support heritability for pathological gambling and that people with behavioural addictions are more likely to have a close family member with some form of psychopathology. Parallels exist between neurobiological and genetic and family history findings in substance and nonsubstance addictions, suggesting that compulsive engagement in these behaviours may constitute addictions. To date, findings are limited, particularly for shopping, kleptomania, and sexual behaviour. Genetic understandings are at an early stage. Future research directions are offered.

Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland

The present study aimed to assess various stressful situations and the psychological impact of the first COVID-19 pandemic lockdown among youths in Switzerland. We included samples of 1627 young adults aged 19–24 from the Swiss Youth Epidemiological Study on Mental Health and 1146 children and adolescents aged 12–17 years and their parents. We assessed symptoms of various mental health problems, internet use, and perceived stress during the first COVID-19 lockdown. In the analyses, data were weighted to be representative of the Swiss population. During the first lockdown in Switzerland, the most common sources of perceived stress were the disruption of social life and important activities, uncertainty about how long the state of affairs would last, and the pandemic itself. In addition, around one-fifth of the young adults met the criteria for at least one of the mental health problems (attention deficit hyperactivity disorder, depression, generalized anxiety disorder), while one-third of children/adolescents screened positive for at least one of the mental health problems (attention deficit hyperactivity disorder, oppositional defiant disorder, depression, anxiety). Moreover, 30.1% of children and 21.3% of young adults met the criteria for problematic internet use. The study showed considerable stress perceived by young adults and symptoms of mental health problems, especially among females, during the first COVID-19 lockdown in Switzerland.

Digital Inequality During a Pandemic: Quantitative Study of Differences in COVID-19-Related Internet Uses and Outcomes Among the General Population

Background

The World Health Organization considers coronavirus disease (COVID-19) to be a public emergency threatening global health. During the crisis, the public’s need for web-based information and communication is a subject of focus. Digital inequality research has shown that internet access is not evenly distributed among the general population.

Objective

The aim of this study was to provide a timely understanding of how different people use the internet to meet their information and communication needs and the outcomes they gain from their internet use in relation to the COVID-19 pandemic. We also sought to reveal the extent to which gender, age, personality, health, literacy, education, economic and social resources, internet attitude, material access, internet access, and internet skills remain important factors in obtaining internet outcomes after people engage in the corresponding uses.

Methods

We used a web-based survey to draw upon a sample collected in the Netherlands. We obtained a dataset with 1733 respondents older than 18 years.

Results

Men are more likely to engage in COVID-19–related communication uses. Age is positively related to COVID-19–related information uses and negatively related to information and communication outcomes. Agreeableness is negatively related to both outcomes and to information uses. Neuroticism is positively related to both uses and to communication outcomes. Conscientiousness is not related to any of the uses or outcomes. Introversion is negatively related to communication outcomes. Finally, openness relates positively to all information uses and to both outcomes. Physical health has negative relationships with both outcomes. Health perception contributes positively to information uses and both outcomes. Traditional literacy has a positive relationship with information uses and both outcomes. Education has a positive relationship with information and communication uses. Economic and social resources played no roles. Internet attitude is positively related to information uses and outcomes but negatively related to communication uses and outcomes. Material access and internet access contributed to all uses and outcomes. Finally, several of the indicators and outcomes became insignificant after accounting for engagement in internet uses.

Conclusions

Digital inequality is a major concern among national and international scholars and policy makers. This contribution aimed to provide a broader understanding in the case of a major health pandemic by using the ongoing COVID-19 crisis as a context for empirical work. Several groups of people were identified as vulnerable, such as older people, less educated people, and people with physical health problems, low literacy levels, or low levels of internet skills. Generally, people who are already relatively advantaged are more likely to use the information and communication opportunities provided by the internet to their benefit in a health pandemic, while less advantaged individuals are less likely to benefit. Therefore, the COVID-19 crisis is also enforcing existing inequalities.

Social and Demographic Patterns of Health-Related Internet Use Among Adults in the United States: A Secondary Data Analysis of the Health Information National Trends Survey

National surveys of U.S. adults have observed significant increases in health-related internet use (HRIU), but there are documented disparities. The study aims to identify social and demographic patterns of health-related internet use among U.S. adults. Using data from the Health Information National Trends Survey (HINTS) 4 cycle 3 and HINTS 5 cycle 1, we examined HRIU across healthcare, health information seeking, and participation on social media. Primary predictors were gender, race/ethnicity, age, education, income, and nativity with adjustments for smoking and survey year. We used multivariable logistic regression with survey weights to identify independent predictors of HRIU. Of the 4817 respondents, 43% had used the internet to find a doctor; 80% had looked online for health information. Only 20% had used social media for a health issue; 7% participated in an online health support group. In multivariable models, older and low SES participants were significantly less likely to use the internet to look for a provider, use the internet to look for health information for themselves or someone else, and less likely to use social media for health issues. Use of the internet for health-related purposes is vast but varies significantly by demographics and intended use.

Internet use among primary care patients with type 2 diabetes: the generation and education gap

BACKGROUND

The Internet represents a promising tool to improve diabetes care.

OBJECTIVE

To assess differences in demographics, self-care behaviors, and diabetes-related risk factor control by frequency of Internet use.

DESIGN AND PARTICIPANTS

We surveyed 909 patients with type 2 diabetes attending primary care clinics.

MEASUREMENTS

Frequency of Internet use, socioeconomic status, and responses to the Problem Areas in Diabetes (PAID), Summary of Diabetes Self-care Activities (SDSCA), and Health Utilities Index (HUI) scales. Survey responses were linked to last measured hemoglobin A1c, cholesterol, and blood pressure results. Comorbidities and current medications were obtained from the medical record.

RESULTS

Internet "never-users" (n=588, 66%) were significantly older (70.0+/-11.2 vs 59.0+/-11.3 years; P<.001) and less educated (26% vs 71% with>high school; P<.001) than Internet users (n=308, 34%). There were few significant differences in PAID or SDSCA scores or in diabetes metabolic control despite longer diabetes duration (10.3+/-8.2 vs 8.3+/-6.7 years; P<.001) and greater prevalence of coronary disease (40% vs 24%; P<.001) in nonusers. Less than 10% of current nonusers would use the Internet for secure health-related communication.

CONCLUSIONS

Older and less educated diabetes patients are less likely to use the Internet. Despite greater comorbidity, nonusers engaged in primary care had equal or better risk factor control compared to users.

The Impact of COVID-19 on Mental Health: The Role of Locus on Control and Internet Use

The true extent of the mental health implications of the COVID-19 pandemic are unclear, but early evidence suggests poorer mental health among those exposed to the pandemic. The Internet may have differential effects, by both connecting people with resources, or reinforce the constant checking of negative information. Moreover, locus of control becomes important in an uncontrollable pandemic. The current study aimed to examine whether exposure to COVID-19 would relate to greater symptoms of depression, anxiety and stress, and to examine the role of internet use and locus of control. Adults in the United States and five European countries (N = 1723) answered an online survey through the website Mturk. Results show elevated psychological symptoms among those who have become infected with COVID-19 or perceive themselves to be at high risk if infected. Experience using the Internet relates to fewer symptoms, but information seeking is associated with more symptoms. Internet social capital relates to fewer symptoms of depression. Having an external locus of control relates to greater symptoms. These findings suggest that public health officials need to focus on the mental health effects of the pandemic, and that internet use and locus of control could be targets to improve mental health in the population.

Phenomenology and treatment of behavioural addictions

Behavioural addictions are characterized by an inability to resist an urge or drive resulting in actions that are harmful to oneself or others. Behavioural addictions share characteristics with substance and alcohol abuse, and in areas such as natural history, phenomenology, and adverse consequences. Behavioural addictions include pathological gambling, kleptomania, pyromania, compulsive buying, compulsive sexual behaviour, Internet addiction, and binge eating disorder. Few studies have examined the efficacy of pharmacological and psychological treatment for the various behavioural addictions, and therefore, currently, no treatment recommendations can be made.

Racial and ethnic disparities in internet use for seeking health information among young women

To examine the influence of race/ethnicity on seeking health information from the Internet among women aged 16-24 years, the authors conducted a self-administered survey on 3,181 women regarding their Internet use and obtaining information on reproductive health (menstruation, contraception, pregnancy, sexually transmitted infections) and general health from the Internet. The authors performed multivariate logistic regression to examine the association between race/ethnicity and online health-related information seeking after adjusting for covariates. Racial/ethnic disparities were noted in overall Internet use and its use to locate health information. Overall, more White (92.7%) and Black (92.9%) women used the Internet than did Hispanics (67.5%). More White women (79.2%) used it to find health information than did Blacks and Hispanics (70.3% and 74.3%, respectively). Compared with White women, Blacks and Hispanics were less likely to seek information on contraception [(OR 0.73, 95% CI 0.58-0.91) and (OR 0.75, 95% CI 0.61-0.92)] and more likely to seek information on pregnancy tests [(OR 1.67, 95% CI 1.28-2.18) and (OR 1.40, 95% CI 1.09-1.81] and sexually transmitted infections [(OR 1.39, 95% CI 1.11-1.73) and (OR 1.25, 95% CI 1.01-1.54)], respectively. With regard to general health issues-such as how to quit smoking, how to lose weight, alcohol/drug use, mood disorders, and skin disorders-Blacks, but not Hispanics, were significantly less likely to seek online information than were Whites. Disparities in the way that women from different backgrounds use the Internet for health-related information could be associated with overall health awareness.

Digital divide: variation in internet and cellular phone use among women attending an urban sexually transmitted infections clinic

We sought to describe: (1) the prevalence of internet, cellular phone, and text message use among women attending an urban sexually transmitted infections (STI) clinic, (2) the acceptability of health advice by each mode of information and communication technology (ICT), and (3) demographic characteristics associated with ICT use. This study is a cross-sectional survey of 200 English-speaking women presenting to a Baltimore City STI clinic with STI complaints. Participants completed a self-administered survey querying ICT use and demographic characteristics. Three separate questions asked about interest in receiving health advice delivered by the three modalities: internet, cellular phone, and text message. We performed logistic regression to examine how demographic factors (age, race, and education) are associated with likelihood of using each modality. The median age of respondents was 27 years; 87% were African American, and 71% had a high school diploma. The rate of any internet use was 80%; 31% reported daily use; 16% reported weekly use; and 32% reported less frequent use. Almost all respondents (93%) reported cellular phone use, and 79% used text messaging. Acceptability of health advice by each of the three modalities was about 60%. In multivariate analysis, higher education and younger age were associated with internet use, text messaging, and cellular phone use. Overall rate of internet use was high, but there was an educational disparity in internet use. Cellular phone use was almost universal in this sample. All three modalities were equally acceptable forms of health communication. Describing baseline ICT access and the acceptability of health advice via ICT, as we have done, is one step toward determining the feasibility of ICT-delivered health interventions in urban populations.

Internet Use in Old Age: Results of a German Population-Representative Survey

Background

The internet has the potential to foster healthy lifestyles and to support chronic disease management. Older adults could benefit from using the internet and other information and communication technology to access health-related information and interventions available online.

Objective

The aim of this study was to investigate factors influencing internet use in older and oldest age groups and to determine the frequency of internet use for health-related purposes.

Methods

Using data from a nationally representative telephone survey of older adults aged 75 years and over, a sample of 999 people was assessed using structured clinical interviews. Descriptive and binary logistic regression analyses were performed.

Results

Overall, 42.6% (418/999) of participants used the internet. Among those, 55.7% (233/417) searched the internet for health-related information. Regression analyses revealed that internet use was significantly associated with younger age (odds ratio [OR] 0.89, 95% CI 0.85-0.92; P<.001), male gender (OR 2.84, 95% CI 2.02-4.00; P<.001), higher education levels (OR 6.69, 95% CI 4.48-9.99; P<.001), a wider social network (OR 1.04, 95% CI 1.01-1.07; P=.01), higher health-related quality of life (OR 1.02, 95% CI 1.00-1.03; P=.006), lower levels of depressive symptoms (OR 0.89, 95% CI 0.80-0.99; P=.04), and higher rates of chronic illness (OR 1.12, 95% CI 1.04-1.21; P<.004).

Conclusions

This study provides population-representative data on internet use in old age in Germany. People in the older and oldest age groups participate in online activities. Understanding the factors that are associated with older adults internet use can contribute to developing tailored interventions and eHealth (electronic health) services to improve well-being in older adults.

Impact of frequency of internet use on development of brain structures and verbal intelligence: Longitudinal analyses

Excessive internet use is shown to be cross sectionally associated with lower cognitive functioning and reduced volume of several brain areas. However, the effects of daily internet use on the development of verbal intelligence and brain structures have not been investigated. Here, we cross sectionally examined the effects of the frequency of internet use on regional gray/white matter volume (rGMV/rWMV) and verbal intelligence as well as their longitudinal changes after 3.0 ± 0.3 (standard deviation) years in a large sample of children recruited from the general population (mean age, 11.2 ± 3.1 years; range, 5.7-18.4 years). Although there were no significant associations in cross sectional analyses, a higher frequency of internet use was found to be associated with decrease of verbal intelligence and smaller increase in rGMV and rWMV of widespread brain areas after a few years in longitudinal analyses. These areas involve areas related to language processing, attention and executive functions, emotion, and reward. In conclusion, frequent internet use is directly or indirectly associated with decrease of verbal intelligence and development to smaller gray matter volume at later stages.

Does the Internet Use Improve the Mental Health of Chinese Older Adults?

Purpose: The Internet has become an important part of daily life. However, older adults in China remain digital refugees amid the rapid development of digital information technology. This study attempts to scientifically answer how Internet use affects the subjective welfare of older adults.

Method: Using data from the 2014 and 2016 China Longitudinal Aging Social Survey (CLASS), a combination of ordinary least squares, ordered logit regression models, and propensity score matching (PSM) models were used to analyze the effects of Internet use on the mental health of Chinese older adults.

Results: Our findings suggest that Internet use affects the mental health of older adults and increases the incidence of their depressive symptoms. These findings are robust to changing the key indicators, research method, and sample. Further heterogeneity analysis reveals that the negative effects on mental health are more evident for specific groups of older adults, such as those who are women, younger and middle-aged, high-income, non-rural Hukou, less educated, and living with others.

Conclusions: Cultivating the ability of older adults to use the Internet and maintain a rational attitude while doing so can prevent its negative impact on their life satisfaction. Moreover, it can improve their attitudes toward using the technology and reduce their anxiety.

Can Online Communication Prevent Depression Among Older People? A Longitudinal Analysis

Evidence on the association between internet usage and incidence of depression remains mixed. We examined the associations between different categories of internet usage and developing clinical depression. We used data from the 2013 and 2016 waves of the Japan Gerontological Evaluation Study (JAGES) comprising 12,333 physically and cognitively independent adults aged ≥65 years. Participants were engaged in seven categories of internet usage: communication with friends/family, social media, information collection about health/medicine, searching for medical facilities, purchase of drugs and vitamins, shopping, and banking. We found that internet use for communication had a protective influence on the probability of developing clinical depression defined as the Geriatric Depression Scale scores ≥5 or self-reported diagnosed depression. Our findings support the role of online communication with friends/family in preventing clinical depression among older people. Online communication could be particularly useful in the COVID-19 crisis because many families are geographically dispersed and/or socially distanced.

Internet Use, Life Satisfaction, and Subjective Well-Being Among the Elderly: Evidence From 2017 China General Social Survey

Purpose: The research objectives of this study are to test the scientific propositions of whether Internet use promotes life satisfaction among the elderly, whether there is variability in the effect of Internet use on the well-being of the elderly, and through what channels Internet use affects the elderly's life satisfaction. Method: Using data from the 2017 Chinese General Social Survey (CGSS), this paper employed linear regression, ordered logit model, and the propensity score matching (PSM) approach to investigate the association of Internet use with life satisfaction among the elderly in China. Results: The results show that Internet use was significantly and negatively associated with the life satisfaction of the Chinese elderly. Further analysis on group heterogeneity demonstrates that the negative association was more prominent among the participants who were males, at a lower age, had lower income and education, non-agricultural registered, and relatively healthy. Finally, the mediating effect indicates that Internet use may affect life satisfaction among the elderly through the channel of reducing their perceptions of social justice. Conclusions: In order to avoid the negative effects of using the Internet, the following policy suggestions are put forward: Improve the elderly's attitudes toward Internet use; pay attention to the sense of fairness of the elderly to improve life satisfaction; guide the elderly to reduce the time of using the Internet.

Reframing video gaming and internet use addiction: empirical cross-national comparison of heavy use over time and addiction scales among young users

BACKGROUND AND AIMS

Evidence-based and reliable measures of addictive disorders are needed in general population-based assessments. One study suggested that heavy use over time (UOT) should be used instead of self-reported addiction scales (AS). This study compared UOT and AS regarding video gaming and internet use empirically, using associations with comorbid factors.

DESIGN

Cross-sectional data from the 2011 French Survey on Health and Consumption on Call-up and Preparation for Defence-Day (ESCAPAD), cross-sectional data from the 2012 Swiss ado@internet.ch study and two waves of longitudinal data (2010-13) of the Swiss Longitudinal Cohort Study on Substance Use Risk Factors (C-SURF).

SETTING

Three representative samples from the general population of French and Swiss adolescents and young Swiss men, aged approximately 17, 14 and 20 years, respectively.

PARTICIPANTS

ESCAPAD: n =22 945 (47.4% men); ado@internet.ch: n =3049 (50% men); C-SURF: n =4813 (baseline + follow-up, 100% men).

MEASUREMENTS

We assessed video gaming/internet UOT ESCAPAD and ado@internet.ch: number of hours spent online per week, C-SURF: latent score of time spent gaming/using internet] and AS (ESCAPAD: Problematic Internet Use Questionnaire, ado@internet.ch: Internet Addiction Test, C-SURF: Gaming AS). Comorbidities were assessed with health outcomes (ESCAPAD: physical health evaluation with a single item, suicidal thoughts, and appointment with a psychiatrist; ado@internet.ch: WHO-5 and somatic health problems; C-SURF: Short Form 12 (SF-12 Health Survey) and Major Depression Inventory (MDI).

FINDINGS

UOT and AS were correlated moderately (ESCAPAD: r = 0.40, ado@internet.ch: r = 0.53 and C-SURF: r = 0.51). Associations of AS with comorbidity factors were higher than those of UOT in cross-sectional (AS: .005 ≤ |b| ≤ 2.500, UOT: 0.001 ≤ |b| ≤ 1.000) and longitudinal analyses (AS: 0.093 ≤ |b| ≤ 1.079, UOT: 0.020 ≤ |b| ≤ 0.329). The results were similar across gender in ESCAPAD and ado@internet.ch (men: AS: 0.006 ≤ |b| ≤ 0.211, UOT: 0.001 ≤ |b| ≤ 0.061; women: AS: 0.004 ≤ |b| ≤ 0.155, UOT: 0.001 ≤ |b| ≤ 0.094).

CONCLUSIONS

The measurement of heavy use over time captures part of addictive video gaming/internet use without overlapping to a large extent with the results of measuring by self-reported addiction scales (AS). Measuring addictive video gaming/internet use via self-reported addiction scales relates more strongly to comorbidity factors than heavy use over time.

Screenomics: A Framework to Capture and Analyze Personal Life Experiences and the Ways that Technology Shapes Them

Digital experiences capture an increasingly large part of life, making them a preferred, if not required, method to describe and theorize about human behavior. Digital media also shape behavior by enabling people to switch between different content easily, and create unique threads of experiences that pass quickly through numerous information categories. Current methods of recording digital experiences provide only partial reconstructions of digital lives that weave - often within seconds - among multiple applications, locations, functions and media. We describe an end-to-end system for capturing and analyzing the "screenome" of life in media, i.e., the record of individual experiences represented as a sequence of screens that people view and interact with over time. The system includes software that collects screenshots, extracts text and images, and allows searching of a screenshot database. We discuss how the system can be used to elaborate current theories about psychological processing of technology, and suggest new theoretical questions that are enabled by multiple time scale analyses. Capabilities of the system are highlighted with eight research examples that analyze screens from adults who have generated data within the system. We end with a discussion of future uses, limitations, theory and privacy.

Internet use and self-rated health among Chinese older adults: The mediating role of social capital

AIM

This study aimed to examine the relationship between Internet use and self-rated health among older adults in China, with a particular focus on the mediating role of social capital.

METHODS

The data used in this study was obtained from the 2018 wave of China Family Panel Studies, including 7193 older adults aged between 60 and 95 years in urban and rural areas. Furthermore, a binary logit regression model was used to explore the association between Internet use and self-rated health among older adults. Moreover, we investigated the mediating effect of social capital on the relationship between Internet use and self-rated health among older adults.

RESULTS

The overall regression results show that Internet use was significantly associated with a higher possibility of being healthy for older adults. In addition, social capital plays a mediating role in the relationship between Internet use and self-rated health among the older adults.

CONCLUSIONS

This study shows that Internet use was positively related to self-rated health for the older adults. In addition, this study finds that social capital mediates the relationship between Internet use and self-rated health among the older adults. Geriatr Gerontol Int 2021; 21: 34-38.

Health Information-Seeking Behaviors of Family Caregivers: Analysis of the Health Information National Trends Survey

BACKGROUND

The growing population of aging adults relies on informal caregivers to help meet their health care needs, get help with decision making, and gather health information.

OBJECTIVE

The objective of this study was to examine health information-seeking behaviors among caregivers and to identify caregiver characteristics that contribute to difficulty in seeking health information.

METHODS

Data from the Health Information National Trends Survey 5, Cycle 1 (N=3181) were used to compare health information seeking of caregivers (n=391) with noncaregivers (n=2790).

RESULTS

Caregivers sought health information for themselves and others using computers, smartphones, or other electronic means more frequently than noncaregivers. Caregivers born outside of the United States reported greater difficulty seeking health information (beta=.42; P=.02). Nonwhite caregivers (beta =-.33; P=.03), those with less education (beta =-.35; P=.02), those with private insurance (beta =-.37; P=.01), and those without a regular health care provider (beta =-.35; P=.01) had less confidence seeking health information. Caregivers with higher income had more confidence (beta =.12; P≤.001) seeking health information.

CONCLUSIONS

This study highlights the prevalence of electronic means to find health information among caregivers. Notable differences in difficulty and confidence in health information seeking exist between caregivers, indicating the need for more attention to the socioeconomic status and caregivers born outside of the United States. Findings can guide efforts to optimize caregivers' health information-seeking experiences.

Socioeconomic and geographic disparities in health information seeking and Internet use in Puerto Rico

BACKGROUND

Geographically isolated Hispanic populations, such as those living in Puerto Rico, may face unique barriers to health information access. However, little is known about health information access and health information-seeking behaviors of this population.

OBJECTIVE

To examine differences in health and cancer information seeking among survey respondents who ever used the Internet and those who did not, and to explore sociodemographic and geographic trends.

METHODS

Data for our analyses were from a special implementation of the Health Information National Trends Survey conducted in Puerto Rico in 2009. We collected data through random digit dialing, computer-assisted telephone interviews (N = 639). The sample was drawn from the eight geographic regions of the Puerto Rico Department of Health. To account for complex survey design and perform weighted analyses to obtain population estimates, we analyzed the data using SUDAAN. Frequencies, cross-tabulation with chi-square, and logistic regression analyses were conducted. Geographic information system maps were developed to examine geographic distributions of Internet use and information seeking.

RESULTS

Of 639 participants, 142 (weighted percentage 32.7%) indicated that they had ever gone online to access the Internet or World Wide Web; this proportion was substantially lower than that of US mainland Hispanics who reported using the Internet (49%). While 101 of 142 (weighted percentage 59.6%) respondents who used the Web had ever sought health information, only 118 of 497 (weighted percentage 20.0%) of those who did not use the Web had sought health information. The pattern was similar for cancer information: 76 of 142 respondents (weighted percentage 47.2%) who used the Web had ever sought cancer information compared with 105 of 497 (weighted percentage 18.8%) of those who had not used the Web. These results were slightly lower but generally consistent with US mainland Hispanics' health (50.9%) and cancer (26.4%) information seeking. Results of separate logistic regression models controlling for sociodemographic characteristics demonstrated that, compared with individuals who did not seek health or cancer information, those who did were over 5 times as likely to have used the Internet (odds ratio 5.11, P < .001). Those who sought cancer information were over twice as likely to have used the Internet (odds ratio 2.5, P < .05). The frequency of Internet use and health and cancer information seeking was higher in the San Juan metro region than in more rural areas.

CONCLUSIONS

Our results contribute to the evidence base for health and cancer communication planning for Puerto Rico, and suggest that health education and outreach efforts should explore the use of available and trusted methods of dissemination such as radio and television, as well as community-based health care providers and organizations, to supplement and encourage use of the Internet as a source of health information.

Multidimensional Internet Use, Social Participation, and Depression Among Middle-Aged and Elderly Chinese Individuals: Nationwide Cross-Sectional Study

BACKGROUND

There is growing evidence that the internet has beneficial effects on the mental health of middle-aged and older people (≥45 years), but the evidence is inconclusive, and the underlying mechanisms are less known.

OBJECTIVE

This study aims to explore the relationship between multidimensional (devices, frequency, and purpose) internet use and depression in middle-aged and elderly Chinese, as well as the mediating effect of social participation. Moreover, this study will explore the moderating effect of the regional informatization development level (RIDL) on the relationships between individual internet use, social participation, and depression.

METHODS

Data on 17,676 participants aged 45 years or older were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2018 data set. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to identify the presence of depression. Logistic regression was used to explore the relationship between each dimension of internet use and depression. Multiple linear regression was used to explore the mediating effect of social participation and the moderating effect of the RIDL.

RESULTS

The results showed that 28.33% (5008/17,676) of the total population had depression. In terms of regional subgroups, respondents living in the western region exhibited the highest proportion of depression (2041/5884, 34.69%). Internet use was negatively associated with depression (odds ratio 0.613, 95% CI 0.542-0.692; P<.001). Various dimensions of internet use positively contributed to individual social participation and reduced individual depression (devices: β=-.170, 95% CI -0.209 to -0.127; frequency: β=-.065, 95% CI -0.081 to -0.047; and purpose: β=-.043, 95% CI -0.053 to -0.031). In addition, the RIDL weakened the relationship between individual-level internet use and social participation (internet use: F74.12,9.82=7.55, P<.001; devices: F51.65/9.88=5.23, P=.005; frequency: F66.74/10.08=6.62, P=.001; and purpose: F66.52/9.78=6.80, P=.001), and negatively moderated the relationship between the frequency of internet use and depression (frequency: F662.67/188.79=3.51, P=.03).

CONCLUSIONS

This study found that different dimensions of internet use are associated with lower levels of depression. Social participation partially mediates the association between multidimensional internet use and depression in the eastern, central, and western regions, respectively. Additionally, the RIDL helps individuals further their internet use and social participation, reducing the impact of depression. However, this effect weakens sequentially from the western region to the central region and then to the eastern region.

Migration Status, Internet Use, and Social Participation among Middle-Aged and Older Adults in China: Consequences for Depression

This study aimed to examine the underlying relationship between migration status and depressive symptoms among middle-aged and older adults in China. Data were derived from three waves of panel data (2011, 2013, and 2015) from the China Health and Retirement Longitudinal Study. Two-level regression models and generalized structural equation modeling were run to fit the data. The results showed that migration status of the respondents could ameliorate their depression (β = -0.02, p < 0.01), so did internet use (β = -0.02, p < 0.001), and social participation (β = -0.06, p < 0.001). The indirect effects of migration status on depression through internet use and of internet use on depression through social participation existed. The effects of migration status, internet use, and social participation in decreasing depression were discussed. Provided the associations among migration status, internet use, social participation, and depression, attention should be paid on increasing protective aspects of migration among middle-aged and older adults, such as internet use and social participation, to enhance their mental health.