General Structural Equation Model Research Articles

Pre-Gestational Obesity and Gestational Weight Gain as Predictors of Childhood Obesity: PROGRESS Cohort from Mexico City

To evaluate the associations of pre-gestational body mass index (BMI) and gestational weight gain (GWG) with the risks of overweight, obesity, and adiposity in the first seven years of life in the offspring of a cohort of pregnant women. Analysis of 751 mothers and their children participating in the PROGRESS cohort. These women were recruited in Mexico City between 2007 and 2010. Pre-gestational BMI was classified as normal, overweight, and obesity according to the WHO. GWG was calculated as the difference between the last reported pre-pregnancy weight and the pre-gestational weight and categorized as inadequate, adequate, or excessive, according to US IOM recommendations. Children's anthropometry was evaluated at 4-5 and 6-7 years of age. Adiposity was classified into three groups: normal (BMI z-score and waist circumference), overweight (BMI z-score>1), and overweight plus abdominal obesity (OW+AO). A generalized structural equation model (GSEM) was constructed to account for the temporal relationship between variables and to assess direct and indirect effects. A total of 49.3% of the women had excessive (13.8 ± 4.2 kg) and 19.8% inadequate (3.15 ± 3.4 kg) GWG. Women with pre-gestational overweight or obesity were more likely to have excessive GWG (OR 1.9 [95% CI: 1.32, 2.74] and 3.50 [95% CI: 1.83, 6.69], respectively). In the GSEM, excessive GWG was directly associated with OW+AO at 4-5 years. At 6-7 years, pre-gestational obesity was associated with OW+AO. Pre-gestational obesity and excessive GWG were independent predictors of childhood obesity.

Neurodevelopmental outcomes following possible serious bacterial infection in early infancy in Karachi, Pakistan: a prospective cohort study

BackgroundPakistan reports a significant burden of neonatal mortality, with infections as one of the major causes. We aim to assess the long-term impact of early infancy infections on neurodevelopmental outcomes during later childhood.MethodsWe conducted a prospective follow-up study of the cohort enrolled at the Karachi site of the Aetiology of Neonatal Infection in South Asia (ANISA) during 2019–2020. Children with a possible serious bacterial infection (based on the WHO IMCI algorithm) at early infancy were assessed for neurodevelopment at 6–9 years of age and compared with healthy controls. The Ten Questions (TQS) questionnaire, Strengths and Difficulties Questionnaire (SDQ), and Parent’s Evaluation of Developmental Stage Assessment Level (PEDS: DM-AL) neurodevelopmental assessment tools, were administered and scored by the research staff who were blinded to the child’s exposure status. Generalized Structural Equation Modelling (GSEM) was employed to verify relationships and associations among developmental milestones, anthropometry, and sociodemographic variables.ResultsA total of 398 children (241 cases and 157 controls) completed neurodevelopmental and growth assessments. Cases had a significantly higher rate of abnormal TQS scores (54.5% vs. 35.0%, p-value 0.001), greater delays in motor milestones (21.2% vs. 12.1%, p-value 0.02), lower fine motor skills (78.4 ± 1.4 vs. 83.2 ± 1.5, p-value 0.02). The receptive language skills were well-developed in both groups. According to the logistic regression model, exposure to infection during the first 59 days of life was associated with delayed TQS milestones (β = -0.6, 95% CI -1.2,-0.04), TQS hearing domain (β = -0.3, 95% CI: -1.2 to 0.7), PEDS: DM-AL fine motor domain (β = -1.3, 95% CI: -4.4 to 1.7), PEDS: DM-AL receptive language development (β = -1.1, 95% CI: -3.7 to 1.4) and child anthropometric measurements such as weight and height (β = -0.2, 95% CI: -0.4 to 0.01 and β = -0.2, 95% CI: -0.4 to -0.01, respectively). Early pSBI exposure was positively associated with PEDS: DM-AL self-help domain (β = 0.6, 95% CI: -1.2 to 2.4) and SDQ-P overall score (β = 0.02, 95% CI: -0.3 to 0.3).ConclusionChildren exposed to PSBI during early infancy have higher rates of abnormal development, motor delays, and lower fine motor skills during later childhood in Pakistan. Socioeconomic challenges and limited healthcare access contribute to these challenges, highlighting the need for long-term follow-ups with integrated neurodevelopment assessments.

Drinking to Cope With the COVID-19 Pandemic Mediates Pathways From COVID-19 Anxiety to Alcohol Use and Alcohol Myopia Consequences

Objective People may consume alcohol to cope with the stressors and anxieties of the COVID-19 pandemic. The present study applied the self-medication hypothesis, tension reduction hypothesis, and alcohol myopia theory to understand COVID-19 alcohol coping as a mediator of the pathways from COVID-19 anxiety to alcohol use and alcohol consequences. Methods Participants (N = 477) were undergraduate college students. The mean age was 22.14 (SD = 5.66) years. Gender distribution included 73% females, 26% males, and 1% transgender. Racial categories included 70% White, 11% Latino, 5% Black, 5% Asian, and 9% multiracial. They completed the Coronavirus Anxiety Scale, the COVID-19 Alcohol Coping Scale developed and validated in the present study, measures of drinking frequency and drinking quantity, and the Alcohol Myopia Scale to assess alcohol consequences. Results First, confirmatory factor analysis supported the measurement structure of the COVID-19 Alcohol Coping Scale. Second, a general structural equation model containing only latent factors provided evidence for the following pathways: COVID-19 anxiety to COVID-19 alcohol coping to overall alcohol use to alcohol myopia consequences. Third, a specific structural equation model separated the overall alcohol use factor into two measures of drinking frequency and drinking quantity. Results found that COVID-19 alcohol coping uniquely explained drinking frequency (but not drinking quantity), indicating that the pursuit of alcohol to cope with the pandemic was related to more frequent days of alcohol use but not more concentrated use on drinking days. Tests of indirect effects corroborated the mediational pathways in the explanatory models. Conclusions The research offers insights into understanding that the risk connections from COVID-19 anxiety to alcohol behavioral outcomes are mediated by alcohol use to cope with the pandemic.

Hypertension and diabetes, but not leptin and adiponectin, mediate the relationship between body fat and chronic kidney disease

Abstract Purpose Obesity may promote kidney damage through hemodynamic and hormonal effects. We investigated the association between body mass index (BMI), total body fat (TBF) and chronic kidney disease (CKD) and whether hypertension, diabetes, leptin and adiponectin mediated these associations. Methods In this cross-sectional analysis of the Netherlands Epidemiology of Obesity study, 6671 participants (45–65 y) were included. We defined CKD as eGFR <60 ml/min/1.73 m2 and/or moderately increased albuminuria. The percentage of mediation was calculated using general structural equation modeling, adjusted for potential confounding factors age, sex, smoking, ethnicity, physical activity and Dutch healthy diet index. Results At baseline mean (SD) age was 56 (6), BMI 26.3 (4.4), 44% men, and 4% had CKD. Higher BMI and TBF were associated with 1.08 (95%CI 1.05; 1.11) and 1.05-fold (95%CI 1.02; 1.08) increased odds of CKD, respectively. As adiponectin was not associated with any of the outcomes, it was not studied further as a mediating factor. The association between BMI and CKD was 8.5% (95%CI 0.5; 16.5) mediated by diabetes and 22.3% (95%CI 7.5; 37.2) by hypertension. In addition, the association between TBF and CKD was 9.6% (95%CI −0.4; 19.6) mediated by diabetes and 22.4% (95%CI 4.2; 40.6) by hypertension. We could not confirm mediation by leptin in the association between BMI and CKD (35.6% [95%CI −18.8; 90.3]), nor between TBF and CKD (59.7% [95%CI −7.1; 126.6]). Conclusion Our results suggest that the relations between BMI, TBF and CKD are in part mediated by diabetes and hypertension.

Association between early spontaneous abortion and homocysteine metabolism.

The purpose of this study is to explore the effects of homocysteine (HCY) metabolism and related factors on early spontaneous abortion. We conducted a hospital-based case-control study and included a total of 500 cases and 1,000 controls in Shaanxi China. Pregnant women waiting for delivery in the hospital were interviewed to report their characteristics and other relevant information during pregnancy. The unconditional Logisitic regression model was applied to assess the association between early spontaneous abortion and HCY metabolism and related factors. The multiplicative model was applied to assess the effects of interaction of HCY metabolism and related factors on early spontaneous abortion. The logit test method of generalized structural equation model (GSEM) was used to construct the pathway diagram of HCY metabolism and related factors affecting early spontaneous abortion. Folic acid supplementation and adequate folic acid supplementation during periconception were the protective factors of early spontaneous abortion (OR = 0.50, 95% CI: 0.38-0.65; OR = 0.44, 95% CI: 0.35-0.54). The serum folate deficiency, higher plasma HCY in early pregnancy, the women who carried the MTHFR 677TT genotype were the risk factors of early spontaneous abortion (OR = 5.87, 95% CI: 1.53-22.50; OR = 2.94, 95% CI: 1.14-7.57; OR = 2.32, 95% CI: 1.20-4.50). The women's educational level and maternal and child health care utilization affected the occurrence of early spontaneous abortion by influencing the folic acid supplementation during periconception. The folic acid supplementation during periconception affected the occurrence of early spontaneous abortion by influencing the level of serum folate or plasma HCY in early pregnancy. The maternal MTHFR 677 gene polymorphism affected the occurrence of early spontaneous abortion by influencing the level of serum folate in early pregnancy. In terms of the risks for early spontaneous abortion, there was multiplicative interaction between higher plasma HCY in early pregnancy, serum folate deficiency in early pregnancy and maternal MTHFR 677TT genotype (OR = 1.76, 95% CI: 1.17-4.03), and there was multiplicative interaction between higher plasma HCY and serum folate deficiency in early pregnancy (OR = 3.46, 95% CI: 2.49-4.81), and there was multiplicative interaction between serum folate deficiency in early pregnancy and maternal MTHFR 677TT genotype (OR = 3.50, 95% CI: 2.78-5.18). The above interactions are all synergistic. The occurrence risk of early spontaneous abortion was significantly increased if multiple factors existed at the same time. Our study is the first time to construct the pathway of HCY metabolism and related factors affecting early spontaneous abortion, and provides a comprehensively new idea to prevent and reduce the occurrence of spontaneous abortion.

A Technique for Efficient Estimation of Dynamic Structural Equation Models: A Case Study

Dynamic structural equation models (DSEM) are designed for time series analysis of latent structures. Inherent to the application of DSEM is model parameter estimation, which has to be addressed in many applications by a single time series. In this context, however, the methods currently available either lack estimation quality or are computationally inefficient. Given the era of big data, the necessity for a trade-off between these properties may be detrimental to the applicability of DSEM. The paper is aimed at tackling this trade-off by proposing a novel estimator recursioning technique (ER technique) that facilitates the development of computationally efficient raw-data maximum likelihood estimation algorithms through data transformation, covariance matrix block decomposition, likelihood function reduction, and estimator recursioning steps. The ER technique is introduced by applying it to a special case of the general dynamic structural equation model that encompasses a noisy Wiener-process-type structure with input from the factor-analytic model. The resulting algorithm has been verified through a number of numerical experiments as well as implemented in a brand new R package EMLI, which is available on CRAN.

The effect of possible mediators on the association between chewing khat during pregnancy and fetal growth and newborn size at birth in Eastern Ethiopia

IntroductionRestriction in the growth of the fetus is a leading cause of stillbirth, neonatal mortality, and short- and long-term morbidity. Documented existing scientific evidence have shown the effects of maternal drugs use, alcohol drinking, tobacco smoking, cocaine use and heroin use on fetal growth restriction. However, data is lacking on the effects of khat chewing during pregnancy on fetal growth status and newborn size at birth. Therefore, the aim of the present study was to measure the effect of chewing khat during pregnancy on fetal growth and size at birth in eastern Ethiopia.MethodA cohort study was conducted in selected health institutions in eastern Ethiopia. All pregnant women fulfilled the eligibility criteria in the selected health institutions was the source population. The calculated sample size of exposed and unexposed groups included in the study, in total, was 344. Data collection was performed prospectively by interviewers administered questionnaires, and anthropometric, clinical and ultrasound measurements. Data was analyzed using SPSS version 27 and STATA version 16 software. The survival analysis (cox proportional hazards model) and generalized linear model (GLM) for the binomial family analysis were performed to estimate the crude and adjusted relative risk and attributable risk (AR) with corresponding 95% CI of chewing khat on fetal growth restriction. The mediation effect has been examined through Generalized Structural Equation Modeling (GSEM) analysis using the Stata ‘gsem’ command. Statistically significant association was declared at p-value less than 5%.ResultsIn the present study, the incidence of fetal growth restriction (FGR) among the study cohorts was 95 (29.7%); of this, 81 (85.3%) were among khat chewer cohorts. The relative risk of fetal growth restriction among khat chewer cohort mothers was significantly higher (aRR = 4.32; 95%CI 2.62–7.12). Moreover, the incidence of small for gestational age at birth among the present study cohorts was 100 (31.3%); 84 (84%) were from khat chewer cohorts’ deliveries. More importantly, in the present study, 98.95% of the ultrasound-identified fetuses with FGR were found to be SGA at birth. Hence, in the current study, FGR was highly associated with SGA at birth. In additional analysis, the regression coefficient of khat chewing during pregnancy on fetal growth restriction has been decreased in size from path o, β = 0.43, p < 0.001 to path o’, β = 0.32, p < 0.001, after adjusting for gestational hypertension and maternal anemia.ConclusionIn sum, the present study showed khat chewing during pregnancy is not simply affected the mothers, but it also affected the unborn fetuses. Therefore, the health workers as well as the local community and religious leaders should give high emphasis on provision of health education regarding the damage of chewing khat by pregnant mothers, with especial focus of the effects on their fetuses.

Trumpism, climate and COVID: Social bases of the new science rejection.

Although the hazards posed by greenhouse warming and COVID-19 are quite different, diagnosis and mitigation prospects for both depend heavily on science. Unfortunately, the reality of both threats has been subject to politicized science rejection in the US, making these deadly problems less tractable. There are substantial parallels between the two cases of science rejection, including common rhetoric and conservative political leadership. Survey research has reached widely-replicated conclusions regarding the social bases of climate-change perceptions. Corresponding studies of COVID-19 perceptions have found some political commonalities, but less agreement on other details. Here, we address this gap using generalized structural equation modeling (GSEM) and 2021 US survey data to make direct comparisons between the social bases of rejecting the reality of anthropogenic climate change (ACC) and rejecting COVID-19 vaccination. Trumpism, operationalized from approval of ex-president Trump, is viewed as an intervening variable that influences both types of science rejection. Trumpism itself is predicted by age, race, evangelical religion, ideology, and receptivity to seemingly non-political conspiracy beliefs. Considering direct as well as indirect effects (through Trumpism), climate change and vaccine rejection are similarly predicted by white and evangelical identity, conspiracism, and by education×ideology and friends×party interactions. The finding that Trumpism exacerbates science rejection could also apply to other science- and expertise-related topics unrelated to climate and COVID. These results invite broader comparisons across topics, with analogous movements in other countries, and continued tracking as US Trumpism evolves beyond Trump.

The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities.

Information on factors that increase mortality in remote settings is limited. This study aims to estimate the independent and joint role of several factors on mortality risk among older adults living in rural Ecuador. Participants were selected from community-dwelling older adults who were included in previous studies targeting mortality risk factors in the study population. Generalized structural equation modeling (GSEM) was utilized to evaluate prior causal assumptions, to redraw causal links, and to introduce latent variables that may help to explain how the independently significant variables are associated with mortality. The study included 590 individuals (mean age: 67.9 ± 7.3 years; 57% women), followed for a median of 8.2 years. Mortality rate was 3.4 per 100 person-years. Prior work on separate multivariate Poisson and Cox models was used to build a tentative causal construct. A GSEM containing all variables showed that age, symptoms of depression, high social risk, high fasting glucose, a history of overt stroke, and neck circumference were directly associated with mortality. Two latent variables were introduced, 1 representing the impact of biological factors and another, the impact of social factors on mortality. The social variable significantly influenced the biological variable which carried most of the direct effect on mortality. Several factors contributed to mortality risk in the study population, the most significant being biological factors which are highly influenced by social factors. High social risk interact with biological variables and play an important role in mortality risk.

Impact of Limited English Proficiency on Medication-Related Problems and Emergency Room Visits Among Community-Dwelling Older People.

Background Older people have higher risk of experiencing medication-related problems (MRPs), leading to increased morbidity, health care use, and mortality. Few studies have examined the pathway between limited English proficiency (LEP) among older people and health service use through MRPs. Objective This study aimed to explore the association of LEP among Latino older people with MRPs and their relationship to emergency room (ER) visits. Methods Researchers used secondary enrollment data from a community medication program for older people (N = 180). Researchers conducted linear regression to examine the relationship between ethnicity/English proficiency and MRPs, and logistic regression to explore the association between MRPs and ER visits. Generalized structural equation modeling (GSEM) with bootstrapping was used to test the indirect effect between LEP Latino through MRPs to ER visits. Results The sample included 70% non-Latino participants, 12% English-speaking Latinos, and 18% LEP Latinos. Analysis LEP Latinos were associated with having 3.4 more MRPs than non-Latino participants, after controlling for covariates. Additionally, each additional MRP was associated with a 10% increased probability of having an ER visit. The GSEM results illustrated there was a significant indirect effect between LEP through MRPs to ER visits (β = 0.27, 95% CI 0.07-0.61). Conclusion Though LEP was not directly related to increased ER visits, it may have inhibited the ability of Latinos to read and understand medication instructions, contributing to their elevated risk of experiencing MRPs, thus indirectly increasing potential risks of having ER visits.

Association between residential environment and emotional wellbeing among older adults in China: the mediating effect of health lifestyle.

The association between the residential environment and emotional wellbeing (EWB) in older adults has received extensive attention from gerontologists, especially during the COVID-19 pandemic; however, the mediating mechanism of how residential environment affects emotional wellbeing has not been fully explored. This study examined the effects of the residential environment on EWB and the mediating role of health lifestyle. This study analyzed the survey data of 493 rural and 515 urban older adults from 2021 Chinese General Social Survey. General linear regression and structural equation models were used to examine the effects of residential environment and health lifestyle. Urban participants exhibited clear advantages in EWB, residential environment, and physical activity. Residential environment significantly affected the EWB of older adults, and health lifestyle played a mediating role in this relationship. The residential environment and health lifestyle did not significantly affect EWB in rural participants. This study revealed differences in the effects of health lifestyles and residential environments on EWB among older adults in rural and urban settings in China. This study provided empirical evidence of mental health disparities between older rural and urban Chinese residents.

Green signals: The impact of environmental protection support policies on firms' green innovation

AbstractThe importance of government environmental financial incentives in stimulating firms' green innovation has long been recognized. However, researchers have yet to fully determine how a small amount of financial incentives can be used to promote expensive green innovation. Unlike prior studies based on the investigation of direct effects, this study provides a new perspective by employing signaling theory. Focusing on environmental protection support policy (EPSP) in China, it employs ordinary least squares (OLS) regression and generalized structural equation modeling (GSEM) to analyze a sample of panel data from China's A‐share listed companies from 2003 to 2020. The results suggest that EPSP funding can serve as a green signal that helps firms acquire external resources for green innovation. The results of this study enhance our understanding of the role that government financial incentives play in firms' green innovation and inform policymakers on how to formulate effective environmental policies.

Spousal religious difference, marital satisfaction, and psychological well‐being of Chinese older adults

AbstractObjectivesThis study aims to explore the associations between spousal religious difference (one religious and one nonreligious), marital satisfaction, and the psychological well‐being of middle‐aged and older Chinese adults.BackgroundBoth religion and marital relationships are critical in coping with aging‐related challenges.MethodWe adopted the China Health and Retirement Longitudinal Study (CHARLS) data, which collected a nationally representative sample of Chinese people over 45 years old. The sample included 1,285 adults (714 men and 571 women). Descriptive statistics, multiple regression models, and a path analysis based on generalized structural equation modeling (GSEM) were adopted.ResultsWives' marital satisfaction mediated spousal religious difference and psychological well‐being, including depression and life satisfaction. Marital satisfaction was associated with depression and life satisfaction for both genders, and wives' marital satisfaction had a stronger association with life satisfaction than husbands'.ConclusionsSpousal religious difference has significant negative associations with marital satisfaction and psychological well‐being among middle‐aged and older people in China, especially among women.ImplicationBased on the results of this study, further research is needed to focus on the individual and interpersonal outcomes of religiosity in middle‐aged and older adults. In family therapy involving couples with different religious affiliations, counselors should pay attention to gender differences and prioritize addressing wives' marital satisfaction. Additionally, policies and services should also recognize the significant role of wives' marital satisfaction in the well‐being of such couples.

Can Knowledge, Responsibility and Environmentalism Explain Preference Heterogeneity? A Latent-Class Probit Model Analysis for Plastic Pollution Abatement

This study explores the impact of prior experiences, environmental concern and awareness levels on pro-environmental behavior in the context of mitigation of plastic pollution. Using survey and geo-location data after a tsunami and a monsoon season, this survey employs a latent class analysis through a Generalized Structural Equation Model (GSEM) to identify similarities between groups’ willingness to pay (WTP) to mitigate macroplastic pollution in riverbeds and beaches in Indonesia. Results show that more environmentally-conscious respondents were also more sensitive to the issue of pollution while having observed more plastic pollution also increases support for pollution mitigation. Proximity to polluted waterways also increased WTP, especially to urban participants. Overall, accounting for prior experiences, environmental concern and awareness levels does lead to statistical differences between classes, with those scoring higher in these categories being also more willing to monetarily contribute to mitigate that issue. The use of such an integrated latent class model (LCM) can help with disentangling drivers of preferences, especially in the context of determining levels of support for pollution abatement in a developing country.

Gendered sweetpotato trait preferences and implications for improved variety acceptance in Uganda

AbstractThe principal selection objective in crop breeding has for a long time been driven by agronomic gains like yield maximization and climate resilience. Nevertheless, the continued low adoption of new varieties and documented gender technology adoption gap has triggered re‐thinking of this strategy, with end‐user acceptability of released varieties a key strategy in breeding objectives. Using a mixed‐methods approach with a survey of 122 producers and focus group discussions with 200 male and female producers in two major sweetpotato [Ipomoea batatas (L.) Lam] producing districts in Uganda, this study set out to understand gender‐disaggregated traits that drive acceptance for improved sweetpotato varieties as a guide to development of new varieties in the region. A generalized structural equation model approach is used to analyze how interrelated trait preferences shape acceptance for improved varieties, while in‐depth insights from a qualitative approach are used to further ground observed results. Traits such as high root yields, drought tolerance, and vitamin A are shown to be key drivers to acceptance of improved varieties, while good taste and dry matter content dampen acceptance of improved varieties in favor of landraces. Male farmers are also shown to mainly prefer agronomic traits such as high yields and stress tolerance, while women mostly prefer quality traits such as good taste, vitamin A, and high dry matter content. To achieve higher acceptability and adoption of improved varieties across the gender divide, new varieties need to not only consider agronomic gains, but also quality‐related traits such as taste and dry matter content.

Does Internet usage make middle-aged and older adults feel healthier? Mediating role of social engagement

PurposeThis study explores whether and how Internet usage improves the subjective health of middle-aged and older adults by analyzing the mediating role of social engagement and heterogeneity of different living arrangements.Design/methodology/approachBased on data from the China Health and Retirement Longitudinal Study, the ordinary least squares (OLS) method is adopted to explore the relationship between Internet usage and the subjective health of middle-aged and older adults. Propensity score matching method (PSM) is used to alleviate self-selection bias in the samples. The bootstrap method is adopted to test the mediating role of social engagement, and generalized structural equation modeling (GSEM) is employed to resolve endogeneity. A permutation test is adopted to examine the heterogeneous effects of Internet usage on different living arrangements.FindingsInternet access can help relieve depression among middle-aged and older adults and enhance their self-rated health, leading to perceived changes in health status. However, Internet usage is not directly associated with health satisfaction among middle-aged and older adults. Nevertheless, Internet usage can enhance middle-aged and older adults' subjective health by facilitating social engagement and significantly influences middle-aged and older adults living with their children.Originality/valueThis study reveals the underlying role of Internet usage among older adults and provides insights for governments and families to help middle-aged and older adults actively adapt to a digital society and improve their health.

Does Trust Mediate the Relationship Between Experiences of Discrimination and Health Care Access and Utilization Among Minoritized Canadians During COVID-19 Pandemic?

We sought to determine if trust in government institutions mediate the relationship between experiences of discrimination and health care utilization during the COVID-19 pandemic. We used datafrom Statistics Canada's Crowdsourcing Data: Impacts of COVID-19 on Canadians-Experiences of Discrimination. We used generalized linear latent and mixed models (Gllamm) with a binomial and logit link function as well as generalized structural equation modeling (GSEM) to determine if reported discrimination and trust were associated with difficulties in accessing health services, health care, and the likelihood of experiencing negative health impacts. We also examined if trust mediated the relationship between experiences of discrimination and these health outcomes. Our analytical sample consisted of 2568 individuals who self-identified as belonging to a visible minority group. The multivariate results indicate that experiences of discrimination during COVID-19 were associated with higher odds of reporting difficulties in accessing general health services (OR = 1.99, p ≤ 0.01), receiving care (OR = 1.65, p ≤ 0.01), and higher likelihood of reporting negative health impacts (OR = 1.68, p ≤ 0.01). Our mediation analysis indicated that trust in public institutions explained a substantial portion of the association between reported discrimination and all the health outcomes, although the effects of experiencing discrimination remain significant and robust. The findings show that building and maintaining trust is important and critical in a pandemic recovery world to build back better.

Ambition or comparison? Socioeconomic status and wellbeing differences between local and migrant workers.

Pursuing wellbeing is an essential part of human life and plays a determining role in public health and social sustainability. Prior research identified objective socioeconomic status (O-SES), such as real income and homeownership, as facilitators of human subjective wellbeing (SWB). However, not all humans with better SES reported high SWB. This paper expects that subjective socioeconomic status (S-SES) is the key path through which O-SES shapes SWB and that this indirect relationship varies by household registration status, length of residentship, and type of migrant status. Based on a national representative survey dataset-China General Social Survey 2010 (CGSS), the results of generalized structural equation modeling (GSEM) show that household income and homeownership as O-SES are positively related to SWB. Self-evaluated household SES as an important indicator of S-SES not only has a positive relationship with SWB but also significantly mediates the relationship between O-SES and SWB, especially for the new-local residents (NLRs), urban-to-urban migrants (UUMs) and rural-to-urban migrants (RUMs). This study has substantial implications for targeting the comparative psychology and sustainable productivity of Chinese migrants and the local labor force since it is currently facing a growing aging society.

Willingness to Prepare for Disasters among Individuals with Disabilities: An Essential Component for Building Disaster Resiliency

This study focuses on exploring the factors influencing individuals’ preparedness for disasters. Drawing upon the protection motivation theory (PMT) and the prototype willingness model (PWM), a conceptual framework was proposed to investigate the determinants of willingness to prepare for disasters and its impact on disaster preparedness. Data was collected through an online survey, involving 377 participants with disabilities and medical special needs residing in the Rio Grande Valley (RGV). The collected data was analyzed using generalized structural equation modeling (GSEM) to examine the associations among the selected study variables. The findings indicate that both coping appraisal and threat appraisal significantly influence individuals’ willingness to prepare for disasters, which, in turn, has a notable impact on disaster preparedness. Recognizing the significance of disaster preparedness in building resilience and effectively responding to and recovering from disasters, it is crucial to acknowledge the importance of the willingness component in these efforts to cope effectively with future extreme events.

Associations of health literacy, personality traits, and pro-individualism with the willingness to complete advance directives in Taiwan

BackgroundStudies indicated that patients with advance directives (ADs) have a generally better quality of life near death. Yet, the concept of ADs is relatively new in East Asian countries. This study examined the associations between health literacy, pro-individualism in end-of-life (EOL) decisions (i.e., EOL pro-individualism), and master-persistence personality traits with the willingness to complete ADs.MethodsThe data is from a representative data of 1478 respondents from the 2022 Taiwan Social Change Survey. Generalized structural equation modeling (GSEM) was used to conduct path analysis.ResultsNearly half of the respondents (48.7%) were willing to complete ADs. Health literacy has direct and indirect effects through EOL pro-individualism values on the willingness to complete ADs. Noncognitive factors such as mastery-persistence personality traits and EOL pro-individualism values enhanced the willingness to complete ADs.ConclusionA personalized communication strategy, mindful of personality dimensions and cultural values, can address individual fears and concerns, promoting the benefits of advance care planning (ACP). These influences can provide a roadmap for healthcare providers to customize their approach to ACP discussions, improving patient engagement in AD completion.