Residents Of Town Research Articles

Determinants of M-Commerce Platform Adoption Among Individuals in South African Township Communities

Since the COVID-19 pandemic outbreak in 2020, there has been an increase in the adoption of e-commerce (electronic commerce) from which m-commerce (mobile commerce) was born. M-commerce is the use of a mobile phone to purchase goods and services. Most of the South African population resides in townships and rural areas and contributes significantly to the economy. The study researched m-commerce adoption in South African townships by determining the factors that affect m-commerce adoption in South African townships. The study only focused on two townships in Johannesburg: Soweto and Tembisa. A conceptual research model based on the following factors from the UTAUT2 technology model: performance expectancy, hedonic motivation, and facilitating conditions, with social media and trust as two additional constructs. A digital online survey was used to collect respondents’ data, and it was analysed quantitatively using SPSS. The findings of the study are discussed in detail, including testing the hypotheses formulated. Social media and perceived security have a significant, positive effect on the trust of South African township residents to adopt m-commerce platforms. Performance expectancy, hedonic motivation, trust, and facilitating conditions positively affect the intention of South African township residents to adopt m-commerce; however, trust and facilitating conditions were insignificant.

Mieszkańcy Ostrołęki w latach 1950-1960 i ich warunki mieszkaniowe

The purpose of the article is to characterize the residents of peripheral town in the initial stage of industrialization, i.e. in 1960 against the background of 1950. The characterization of the residents was made possible thanks to the statistical database derived from population censuses. Research results: between 1946 and 1960, Ostrołęka's population increased from 10409 to 15206. During this period, employment grew faster than the number of residents, particularly in industry, contributing to an increase in professional activity from 35.9% in 1950 to 37.7% in 1960. There was also a decrease in the burden on 100 working individuals by those they supported. During these 10 years, there was a change in the structure of employment. In 1950, only 9.8% of those professionally active worked in the “industry” sector, whereas in 1960 it was 33,4%. The living conditions of residents improved. While in 1950 only 56% of homes had electricity, in 1960 it was 91.9%. There was also an increase in the percentage of residents with access to water supply systems from 4.2% to 25%, and those with sanitary facilities from 2.8% to 20%. The development of housing construction contributed to a change in the structure of housing resources and a decrease of in their density from 1.85 in 1950 to 1.46 persons per room in 1960. Conclusions: 1.The initiated process of the industrialization of the city contributed to an increase in jobs, an increase in population, the development of infrastructure and housing, and a marked improvement in the living conditions of the population. 2. The society of Ostrołęka in 1960 was young, as a result of nationwide demographic processes. The high proportion of children in the total population contributed to relatively low professional activity among women and, at the same time, to a high burden on working individuals by their dependents, which in turn delayed the improvement of the population’s living conditions.

Beliefs and perceptions towards congenital anomalies in Dilla town, Gedeo Zone, Southern Ethiopia; a qualitative study

IntroductionMorbidity and mortality associated with congenital anomalies are higher in low-income countries. People’s knowledge, beliefs, and attitudes towards congenital anomalies vary from community to community. In some communities, it is believed to be untreatable and the burden remains devastating. Studies addressing the societal perspectives were scarce, therefore this study aimed to explore beliefs and perceptions in the community about congenital anomalies.MethodologyThis study was conducted in Southern Ethiopia, Dilla town from September to November 2023. A qualitative study with a community-based exploratory study design was implemented. A total of 33 participants who were selected conveniently among permanent residents of Dilla town were included. Data were collected using face-to-face in-depth interviews and focus group discussions. The collected data were transcribed verbatim and translated into the English language. Data analysis was implemented thematically using Open Code 4.03 software. Finally, the result was presented descriptively based on the themes that emerged. Trustworthiness was ensured throughout the data analysis.ResultIn this study, most participants poorly understood congenital anomalies. God’s punishment, curse, parents’ sin, magical practices and evil spirits, illness, lack of pregnancy care and contraceptive pills were the believed causes of congenital anomalies. The burden of congenital anomalies dismantles the social, economic, and psychological dimensions of the life of parents. In addition, the study identified attitudinal variations and doubts about treatment outcomes and prevention strategies of congenital anomalies.ConclusionThis study highlights that people’s perceived knowledge, beliefs, and awareness of congenital malformations were limited to socio-cultural and religious roots. Understanding beliefs and perceived knowledge would be significant in planning risk-reduction strategies. Hence health education, behavioral change communications, and information dissemination strategies should be strengthened at each community level.

Rural Communities in the Deep South: Examining the Relationship Between Social Function and General Health Perceptions in Older Black Americans.

Increased mortality in rural southern areas has persisted and worsened among older Black adults due to high prevalence of chronic conditions combined with limited healthcare access resulting from social and structural factors. Our objective was to examine the relationship between general health perceptions, social functioning, mental health, and demographic characteristics among Black adults living in the rural south. This cross-sectional study examined health perceptions in older Black Americans residing in four rural towns within Alabama (Clayton, Fort Deposit, Hobson City, and York). Participants completed a self-report survey exploring general health, social functioning, mental health, and demographic characteristics. Linear regression was used to examine the relationship between these variables and the primary outcome of general health. The average age of participants (N = 119) was 64.8years (SD = 9.4). Social functioning, depressive symptoms, age group, and town of residence were all significantly associated with general health (p < 0.05). A one unit increase in social functioning was associated with a .28 unit increase in general health scores, p = 0.002. General health scores decreased by 19.4 units for participants reporting depressive symptoms (p < 0.0001) and by 9.8 units for those aged 65 and older (p = 0.003). These findings support the need for targeted health resources in rural communities based on population needs and replicates prior studies that have shown increases in social networks may help improve physical and emotional health among the aging adult population.

Lifestyle changes among older adults during and after COVID-19 pandemic in Lithuania.

to analyze lifestyle changes among older adults during and after COVID-19 pandemic in Lithuania, with a particular focus on eating habits, physical activity, social engagement and harmful habits. The representative sample of Lithuanian population over 65 years old (1,503 individuals) was involved in the questionnaire survey, performed in January 2024. Most of the eating habits and the body weight of the older adults did not change during the COVID-19 pandemic in Lithuania. Respondents noted that their physical activity decreased, face-to-face communication became rarer, while remote communication increased. During pandemic, the increased frequency of snacking was more often indicated by persons with lower than secondary education, working, receiving higher incomes, as well as increased snacking and body weight were more prevalent among younger, single or overweight persons; increased body weight during the pandemic was more often mentioned by the persons who assessed their health poorly. Physical activity decreased more often among rural residents and groups with higher or college education; face-to-face communication has become rarer among younger people, rural residents, pensioners, disabled, people with higher income and those with overweight, while remote communication has increased among women, respondents with a university education and those with an average income (p < 0.05). Nearly half of the respondents indicated that the changes in food consumption and smoking frequency that occurred during the pandemic remained after it. After the pandemic, the habits of consuming fast food, confectionery or other sweets and changes in body weight mostly remained, while the patterns of communication returned to the pre-pandemic level. Most of the healthy lifestyle habits formed during the pandemic persisted after the pandemic. The lifestyle habits formed during the pandemic remained more stable in the groups of older persons, residents of smaller towns, respondents with lower than secondary education, higher income, singles, disabled, obese, and those who assessed their health poorly (p < 0.05). During the COVID-19 pandemic in Lithuania, there were various changes in eating habits, physical activity, communication patterns, and harmful habits. Certain habits formed during the pandemic continued afterward, particularly among specific groups of the older Lithuanian adults.

Help-seeking intention for mental illness and associated factors among Dessie town residents in Northeast Ethiopia

Despite the increasing global burden of mental illness and the availability of effective evidence-based treatments, many individuals with mental illness do not seek professional help. Therefore, this study aimed to assess help-seeking intention for mental illness and associated factors among Dessie town residents, Northeast Ethiopia, 2021. A community-based cross-sectional study was conducted among 501 Dessie town residents. The data were collected by face-to-face interview. The General Help Seeking Questionnaire was used to assess help-seeking intention. Bivariable and multivariable logistic regression analysis techniques were used. Finally, a statistically significant level was declared at a p-value less than 0.05. Among 501 participants, 67.5% were likely to seek help from health professionals. Being female (AOR = 4.695, 95% CI = 1.63– 13.50), being single (AOR = 0.330, 95% CI = 0.12–0.89), and having good knowledge (AOR = 3.030, 95% CI = 1.25–7.35) were significantly associated with help-seeking intention. This study indicated that the participants’ help-seeking intention was inadequate. Sex, marital status, monthly income, and knowledge of mental illness were found to be associated with help-seeking intentions for mental illnesses. Therefore, community healthcare workers, healthcare administrators, and religious and community leaders should work to enhance the help-seeking intention of the community.

Theoretical framework of life circles in Chinese small towns and the optimization of spatial layout for public service facilities based on residents’ distance sensitivity

Due to China’s rapid urbanization, its residential areas and the residents in small towns exhibit dual and complex urbanization patterns and characteristics. The relevant national standards currently do not provide detailed guidance regarding the planning and construction of public service facilities and have failed to address the complexities of human–land urbanization patterns. Their “one-size-fits-all” approach toward facility programming has resulted in misalignment of facility supply and demand and in poor accessibility of public service facilities. As a result, many existing facilities are not used; frequently, facilities not included in the public service system are used, resulting in inefficient usage. Previously, the authors have investigated the functional programming of facilities, proposing a “required + optional item” public service facility guidance-control system based on the actual needs of residents, which addresses the issue of what types of facilities should be provided to residents. Building upon prior research, this study focuses on the spatial layout of facilities and explores the logic of suitable life circle planning in small towns in China. Specifically, this study extracts indicators such as tolerance distance, usage frequency, and functional demand to assess residents’ “distance sensitivity” in accessing facilities. It uncovers the differentiated characteristics of distance sensitivity among residents at different stages of urbanization regarding rural and non-rural facilities. The study proposes the determining principles for a life circle–layered partitioning mode in small towns and develops a model framework for suitable life circle. It defines the life circle partitioning and layers for residents at different stages of urbanization. Based on this framework, this study establishes a fundamental principle for preventing dissatisfaction among residents with low service expectations, proposing a “basic assurance + optimization enhancement” plan for life circle layers in rural- and urban-biased residential areas. This study addresses the uneven urbanization levels within small towns, revealing the spatial hierarchical relationships between facilities in urban- and rural-biased residential areas. Guided by the principle of “control + guidance,” it aims to offer local policymakers more flexibility, clarifying and correcting past “one-size-fits-all” approaches to facility planning. The goal is to elevate the standard of public services in small towns by providing methods of optimization and theoretical foundations for renewal practices and the refinement of construction-related regulations.

Using routinely available electronic health record data elements to develop and validate a digital divide risk score.

Digital health (patient portals, remote monitoring devices, video visits) is a routine part of health care, though the digital divide may affect access. To test and validate an electronic health record (EHR) screening tool to identify patients at risk of the digital divide. We conducted a retrospective EHR data extraction and cross-sectional survey of participants within 1 health care system. We identified 4 potential digital divide markers from the EHR: (1) mobile phone number, (2) email address, (3) active patient portal, and (4) >2 patient portal logins in the last year. We mailed surveys to patients at higher risk (missing all 4 markers), intermediate risk (missing 1-3 markers), or lower risk (missing no markers). Combining EHR and survey data, we summarized the markers into risk scores and evaluated its association with patients' report of lack of Internet access. Then, we assessed the association of EHR markers and eHealth Literacy Scale survey outcomes. A total of 249 patients (39.4%) completed the survey (53%>65 years, 51% female, 50% minority race, 55% rural/small town residents, 46% private insurance, 45% Medicare). Individually, the 4 EHR markers had high sensitivity (range 81%-95%) and specificity (range 65%-79%) compared with survey responses. The EHR marker-based score (high risk, intermediate risk, low risk) predicted absence of Internet access (receiver operator characteristics c-statistic=0.77). Mean digital health literacy scores significantly decreased as her marker digital divide risk increased (P <.001). Each of the four EHR markers (Cell phone, email address, patient portal active, and patient portal actively used) compared with self-report yielded high levels of sensitivity, specificity, and overall accuracy. Using these markers, health care systems could target interventions and implementation strategies to support equitable patient access to digital health.

Drivers of car driving: lessons on infrastructure, peer-group, habits and socio-demographics from a survey on car ownership and usage in Germany

AbstractCar ownership is the primary driver of car use, which in turn is the leading contributor to passenger transport sector emissions. Hence, understanding the key determinants of car ownership is crucial to designing a policy framework that will effectively reduce emissions. Based on a 2022 German mobility survey, this study utilizes multinomial logit models to analyse a range of influences on car ownership including socio-demographic and infrastructural factors, respondents’ stated policy responses, and their motives for car ownership. We find that car ownership increases with an individual’s age, income, the share of social contacts owning cars and with smaller towns of residence. Habits, measured as the number of years already spent as a car owner or non-owner emerges as a dominant factor. Our three main insights include: First, car ownership in rural Germany is particularly high and can be effectively reduced by public transport supply measures. Second, situations of radical change—when individuals overcome the force of routine to reflect on their car ownership status – present unique opportunities for policy intervention. And third, isolated or mild policy interventions may only have a limited impact. To significantly influence car ownership levels, policies will likely have to be very stringent.

Influence of Policy Awareness and Satisfaction With Service on the Willingness to Engage in Rural Elderly Medical and Nursing Care Service Programs in Rural China.

In rural China, the participation of residents in elderly medical and nursing care service programs is notably low. To understand the reasons behind this underutilization or reluctance to use such services, an empirical study is warranted. This study adopts a cross-sectional research design, utilizing survey data collected between January and March 2023. Retired elderly individuals aged 50 and above who were permanent residents of LS Town. The survey collects data concerning several key aspects of the older adult population, including their fundamental demographic information, awareness levels regarding integrated medical and nursing care services offered by local township health clinics, their current enrollment status in family doctor contract services, and their propensity to subscribe to such healthcare arrangements. The findings indicate a significant positive relationship between awareness of the integrated medical and elderly care nursing model and the willingness of rural older adults to adopt these services. Furthermore, satisfaction with the services also directly influences the willingness to engage with these services. This study contributes to the existing body of knowledge by highlighting the significance of policy dissemination and enhancing service quality as pivotal strategies for governments and health service organizations to foster increased uptake of these services among the rural elderly population.

Empowering communities: The transformative influence of School Agenda 21

Could a school initiative modify pro-environmental behaviors in an entire village? For three years (2016-2018), the School Agenda 21 program was implemented in a rural primary school in Spain. The study evaluated participants’ perceptions (64 students, 48 parents, 11 teachers, and 22 town residents) through qualitative questionnaires after the experience, and quantitative data collected during and after it. We qualitatively explored four dimensions before, during, and after the three years of intervention: pro-environmental behavior, critical environmental literacy, civic participation, and perceived satisfaction with the project. Results showed enhanced pro-environmental behaviors, such as decreased car usage and school-waste, and increased recycling and reusing, along with a rise in recycling areas in the village. The perceptions of the educational community were positive, highlighting a significant level of environmental awareness and behavior that extends beyond the school. Habits were transmitted from students to families, involving the entire community. Changes were visible and positively perceived by citizens. However, behaviors decreased over time, indicating the necessity to maintain yearly activities to sustain them.

Prevalence and Determinants of Household Self-Reported Diabetes Mellitus in Gauteng, South Africa.

Diabetes mellitus is one of the leading causes of morbidity and mortality worldwide. Type 2 diabetes mellitus is the most prevalent type of diabetes mellitus, and it is associated with both hereditary and lifestyle risk factors. South Africa is not exempt from this pandemic; hence, this paper aims to assess the prevalence and determinants of household self-reported diabetes mellitus in Gauteng, South Africa. Data were sourced from the Gauteng City-Region Observatory (GCRO) quality of life survey (2020/2021). Bivariate and multivariate logistic regressions were applied. The prevalence of household self-reported diabetes mellitus in Gauteng was 11.1%. The 'other population' group (which included Whites, Coloureds and Indians), as well as older respondents, higher household monthly food expenditure, poor self-perceived health status and household self-reported hypertension were factors that increased the odds of household self-reported diabetes mellitus. Only informal housing decreased the odds of household self-reported diabetes mellitus. Screening of diabetes mellitus among those with poor living conditions, no medical aid and lack of access to healthcare facilities such as Gauteng township and informal settlement residents should be intensified. This secondary disease prevention intervention is crucial, as it will enhance the appropriate referrals and timeous chronic treatment for those with diabetes mellitus.

Political legitimacy after the pits: Corruption narratives and labour power in a former coalmining town in England.

This article examines the erosion of political legitimacy in ex-mining towns in England. Political sociologists and political scientists have long taken an interest in the politics of coalmining areas, which were characterised by high strike rates and militant left values. More recently, the question of legitimacy in these areas has resurfaced, as now-deindustrialised pit towns register unusually high levels of political discontent and disengagement compared to areas with similar economic and demographic profiles. In interviews and group discussions with 93 residents of the former mining town of Mansfield, England, I find that many express ideas that profoundly challenge the system of representative democracy in its current form, with almost one in three participants understanding politics primarily through the frame of corruption. Drawing on an emergent literature which casts corruption talk as a moralised discourse of political in/exclusion, I argue that the corruption frame is best understood as the inversion of a now-defunct symbolic economy. As workers in pit towns no longer received the same tokens of care from their representatives, reflecting their reduced power, many came to understand the political system as corrupt and illegitimate.

Carving spaces of hospitality: Place attachment among migrant and non-migrant residents in a rural town undergoing rapid demographic change

This article explores the complex and evolving nature of place attachment in the rural Lincolnshire town of Boston, a new immigration destination. Drawing on 28 semi-structured interviews with residents, it examines the ways in which migrant and non-migrant communities make Boston their home, how they react to change and disruption, navigate (in)hospitable encounters and narrate their belonging in the town post the EU referendum, which saw residents overwhelmingly voting against EU membership. The findings show that in the face of place alteration and turbulence, both migrant and non-migrant residents demonstrate a nuanced and differentiated form of commitment to place and, despite intractable systemic challenges, actively work to bring communities together and reframe negative place narratives. Community leadership emerges as integral to the collective effort of creating spaces of hospitality. For migrant and non-migrant communities, place attachment is a dynamic and fluid process, shaped and constantly reshaped by socio-economic and political factors, media discourses and experiences of hospitality/hostility. It is an embodied and emotional process that involves individual and collective discursive efforts to reframe dominant narratives, material and social ways of connecting as well as pragmatic ways of distancing.

Inequalities in access to early child services in Bulgaria

Abstract Background Children’s health has been a major focus of European health policy since 2000, with particular emphasis on early childhood and integrated services for children with chronic diseases. However, research on early child care in Bulgaria is sparse, mainly focusing on the role of nurseries, kindergartens and nursing care. Our aim is to investigate whether there are disparities in access to early childhood health services in Bulgaria. Methods A survey was conducted among mothers of children up to 7 years old between April and June 2022. The questionnaire, containing 49 questions, was based on the theoretical framework from the EU project ‘Models of child health appraise’, covering topics as: geographical and financial access to services, equity, quality, responsiveness to children and family needs, considered key features of outpatient child medical care. Statistical analysis utilized Chi-square, Fisher’s exact and ANOVA tests. Results A total of 413 Bulgarian women, with a mean age of 34.3 (±5.1), participated in the study. Almost all women (91.3%) reported that their children had a primary care provider. The mean time to reach the GP/pediatrician’s office was 16 minutes (95% CI 14.6 - 16.7), longest for residents of small towns and villages (21 minutes), p = 0.004. Parents from small towns (including villages) were six times more likely to experience financial difficulties related to their children’s healthcare services compared to those from the capital city (p = 0.047), as well as parents with low-income (p = 0.031). Emergency healthcare was the most demanded service by families with children under 7 years old, possibly due to its free availability. Parents with secondary education and from small towns lack access to non-medical health-promoting or preventive services such as breastfeeding consultations, speech therapy and others. Conclusions Significant financial and geographic disparities in access to early child health services exist in Bulgaria. Key messages • There are serious social health inequalities related to the access to outpatient child health services in Bulgaria. • There is an urgent need for specific child and family health strategy based on the principles of proportionate universalism.

Wireless sensor network-based health monitoring and smart home assistance for the older adults in sports and wellness towns.

Integrating technology with rural development is essential for addressing the unique challenges faced by aging populations in rural areas. China's national rural revitalization strategy emphasizes the importance of developing characteristic towns that focus on health and wellness demands, particularly for the older adults. However, there is a gap in the literature regarding the systematic use of technology to support the health and daily living needs of this demographic. This study aims to bridge this gap by proposing a wireless sensor network (WSN)-based system that integrates health monitoring and smart home assistance, specifically tailored for older adults residents in sports and wellness towns. The system's design involves collecting and analyzing historical activity data and basic physiological parameters from older adults residents' homes. The data are cleaned, combined and stored to prepare it for behavior analysis, which is vital for controlling smart home equipment. Preliminary health assessments are conducted using the collected physiological data. A hybrid network leveraging Sub-G and Wi-Fi technologies is optimized for the purposes of collecting and uploading data, based on a comparative analysis of wireless communication options. This study significantly contributes to the advancement of sports and wellness towns by promoting healthy aging through cutting-edge technological solutions.

Urbanization, loneliness and mental health model - A cross-sectional network analysis with a representative sample

With increasing urbanization, more people are exposed to mental health risk factors stemming from the urban social or physical environment. However, research on the relationship between urbanization and mental health is lacking. This cross-sectional study aimed to explore the relationships of the physical environment (spatial cohesion and urban environment) and social factors (neighborhood cohesion) with mental health (stress, anxiety and depression symptoms) and physical health and the mediating role of loneliness based on the proposed theoretical model. The study was conducted in Metropolis GZM (Silesia, Poland) in a representative sample of 3296 residents (48% women). The measurements used were the PSS-10, GAD-7, PHQ-9, R-UCLA3 and neighborhood cohesion scale. ANOVA results showed that city residents had better mental health indices than residents of villages and small towns. The network approach revealed that urbanization was one of the most influential nodes and played the role of a bridge between all other nodes. The model was confirmed and showed that the relationships between the physical environment and mental health were consecutively mediated by neighborhood cohesion and loneliness. Spatial cohesion related to factors of the physical environment and physical health, while physical health was directly connected to sociodemographic factors and weakly to stress. Anxiety was the strongest risk factor. Mental health can be improved by social and architectural factors, such as strengthening neighborhood cohesion and improving neglected buildings.

Assessing the Utilization of Commercialized Public Toilets in Kakamega Town

Human waste management continues to be a major global challenge facing urban growth. Managing sanitation is therefore a challenge facing most governments. The objective of this study was to assess the utilization of commercialized public toilets in Kakamega Town. The study adopted a descriptive research design carried out in Kakamega Town. The target population comprised residents of Kakamega town and those on daily transit. Purposive sampling was done for Kakamega County town and key informants, while Simple random sampling was done for town residents and business people. Systematic sampling was conducted on individuals using public toilets. A sample size of 351 participants was finally used and data was collected using observation, interviews, questionnaires, and document review. 265 (75.5%) of respondents knew of public toilets and their location with only 25.9% of females being very often users. The majority of respondents 256 (72.9%) chose public toilets because of their cleanliness and appearance. Physically challenged respondents were less likely to use commercial toilets in contrast to the able-bodied respondents (OR: 0.4; 95%CI: 0.2 – 0.8; p=0.008). Location, signage, and maps were among the factors identified as determining the utilization of the public toilet facilities in Kakamega Town. There were low incidents of open defecation, urination, and flying toilets in places where commercialized public toilets were. In conclusion, commercialized public toilets were highly utilized and preferred in Kakamega town due to their cleanliness, location, and accessibility. The study recommends the town increase the number of commercialized public toilet facilities and the management of non-commercialized public toilets in the county government of Kakamega to enhance cleanliness and access to all public toilets within the town

Indiana High School’s Computer Science Enrollment and Disparity Indices: On Gender, Ethnicity, Locale, and Economic Status

This study analyzed the longitudinal data of Indiana high school students’ Computer Science (CS) enrollments from 2014 to 2020. The result showed while Indiana CS enrollments have increased in recent years, gaps in participation by minoritized student populations have still been observed. The CS enrollment rates in terms of different student populations including gender, ethnicities, locales, and economic status have been increasing, and the disparities according to these demographic profiles have been somewhat alleviated. However, the degrees of inequity varied by classification. Female underrepresentation was found to be largest followed by rural and town residents, then economically disadvantaged, and then ethnic minorities in CS education (Black, Hispanic, and Multiracial). These findings indicate where our future efforts should be concentrated.

Impact of an Epstein-Barr Virus Serology-Based Screening Program on Nasopharyngeal Carcinoma Mortality: A Cluster-Randomized Controlled Trial.

Screening for nasopharyngeal carcinoma (NPC) has shown an improvement in early detection and survival rates of NPC in endemic regions. It is critical to evaluate whether NPC screening can reduce NPC-specific mortality in the population. Sixteen towns in Sihui and Zhongshan cities, China, were selected; eight were randomly allocated to the screening group and eight to the control group. Residents age 30-69 years with no history of NPC were included from January 1, 2008, to December 31, 2015. Residents in the screening towns were invited to undergo serum Epstein-Barr virus (EBV) viral capsid antigen/nuclear antigen 1-immunoglobulin A antibody tests; others received no intervention. The population was followed until December 31, 2019. Nonparametric tests and Poisson regression models were used to estimate the screening effect on NPC mortality, accounting for the cluster-randomized design. The trial is registered with ClinicalTrials.gov (identifier: NCT00941538). A total of 174,943 residents in the screening group and 186,263 residents in the control group were included. NPC incidence and overall mortality were similar between the two groups. A total of 52,498 (30.0% of 174,943) residents participated in the serum EBV antibody test. The overall compliance rate for endoscopic examination and/or biopsies among baseline and ever-classified high-risk participants was 65.9% (1,110 of 1,685) and 67.6% (1,703 of 2,518), respectively. A significant 30% reduction in NPC mortality was observed in the screening group compared with the control group (standardized NPC-specific mortality rate of 8.2 NPC deaths per 1,000 person-years versus 12.5; adjusted rate ratio [RR], 0.70 [95% CI, 0.49 to 0.997]; P = .048). This benefit was most evident among individuals age 50 years and older (RR, 0.56 [95% CI, 0.37 to 0.85]; P = .007) compared with those younger than 50 years (RR, 0.96 [95% CI, 0.64 to 1.46]; P = .856). In this 12-year trial, EBV antibody testing resulted in a significant reduction in NPC mortality.