Edmond Pui Hang Choi’s research while affiliated with The University of Hong Kong and other places

Background We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements. Methods From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network. Results Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). Conclusions In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study's cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research. Keywords global; across-country comparisons; lifestyle; health outcomes; network analysis

Introduction Technology-facilitated sexual violence and abuse (TFSVA) refers to a range of behaviours in which digital technologies are used to facilitate both virtual and face-to-face sexual harm. The proliferation of smartphone usage and increasing internet penetration rates across the world have made it easier for individuals to become perpetrators and victims of TFSVA. Since empirical studies of TFSVA remain limited in the academic arena, and there is an absence of evidence to support the development of a standardised TFSVA measurement, this review aims to explore what TFSVA measurements are currently available and their potential use in measuring TFSVA. Methods and analysis This scoping review will be structured according to the Joanna Briggs Institute recommended framework. Keywords related to ‘technology’, ‘sexual violence’ and ‘measure’ will be used. Any paper related to measurements of TFSVA will be included without limitation to any population or setting. A search will be conducted from database inception until May 2024 for published literature in English and Chinese electronic databases, which included PubMed, Embase, CINAHL, Scopus, ProQuest, Web of Science, Chinese National Knowledge Infrastructure, SinoMed, Index to Taiwan Periodical Literature and Ariti Library. Screening and study selection will be conducted by two independent reviewers. Data will be extracted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. The PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) Framework will be used to report the findings. Ethics and dissemination Since the scoping review methodology consists of reviewing and collecting data from publicly available materials, this study does not require ethics approval. This scoping review has the potential to serve as the most appropriate way to explore existing evidence related to this emerging phenomenon. The results of this review are expected to highlight various types of TFSVA measurement developed in different settings. Further work is required to develop measurements adapted for specific populations and tested to ensure acceptability and cultural competence. The results will be disseminated through a peer-reviewed publication and conference presentations. Review registration The protocol of this review was registered within the Open Science Framework ( https://doi.org/10.17605/OSF.IO/Q5ETW ) on 13 March 2024.

Background Individuals of reproductive age with cancer may experience reproductive concerns (RCs) due to impaired fertility and disrupted family planning, which can negatively impact their quality of life and psychological well‐being. There is limited research on interventions that mitigate the negative effects of RCs among individuals with cancer. Objective This systematic review aimed to identify and evaluate the effectiveness of interventions developed to mitigate RCs among individuals with cancer. Methods This systematic review was conducted following the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. A systematic search of nine English and Chinese electronic databases including PubMed, Cochrane Library, CINAHL Plus, Embase, PsycINFO, Web of Science, Wan Fang Data, Chinese National Knowledge Infrastructure (CNKI), and SinoMed, was conducted for relevant studies from inception to November 2023. Intervention studies designed to mitigate RCs among individuals with cancer were included. Two reviewers independently performed study selection, data extraction, and quality appraisal where JBI Critical appraisal tools were used. Narrative syntheses were conducted to summarize the characteristics and effectiveness of interventions due to high heterogeneity across studies. Results Nine studies were included. Interventions were categorized into psychoeducational interventions ( n = 6), couple‐based interventions facilitating open communication and intimate relationships ( n = 2), and mindfulness‐based interventions ( n = 1). A statistically significant reduction in RCs was observed in five psychoeducational interventions, two couple‐based interventions, and one mindfulness‐based stress reduction intervention. The effect sizes (Cohen's d ) of the interventions on RCs varied substantially from 0.08 to 5.66. Linking Evidence to Action Psychoeducation, couple‐based, and mindfulness‐based interventions demonstrated promising findings in mitigating RCs among individuals with cancer. However, more randomized controlled trials with larger sample sizes and rigorous designs are warranted to strengthen the current evidence.

Background Technology-facilitated sexual violence and abuse (TFSVA) encompasses a range of behaviors where digital technologies are used to enable both virtual and in-person sexual violence. Given that TFSVA is an emerging and continually evolving form of sexual abuse, it has been challenging to establish a universally accepted definition or to develop standardized measures for its assessment. Objective This study aimed to address the significant gap in research on TFSVA within the Chinese context. Specifically, it sought to develop a TFSVA measurement tool with robust content validity, tailored for use in subsequent epidemiological studies within the Chinese context. Methods The first step in developing the measurement approach for TFSVA victimization and perpetration was to conduct a thorough literature review of existing empirical research on TFSVA and relevant measurement tools. After the initial generation of items, all the items were reviewed by an expert panel to assess the face validity. The measurement items were further reviewed by potential research participants, who were recruited through snowball sampling via online platforms. The assessment results were quantified by computing the content validity index (CVI). The participants were asked to rate each scale item in terms of its relevance, appropriateness, and clarity regarding the topic. Results The questionnaire was reviewed by 24 lay experts, with a mean age of 27.96 years. They represented different genders and sexual orientations. The final questionnaire contained a total of 89 items. Three key domains were identified to construct the questionnaire, which included image-based sexual abuse, nonimage-based TFSVA, and online-initiated physical sexual violence. The overall scale CVI values of relevance, appropriateness, and clarity for the scale were 0.90, 0.96, and 0.97, respectively, which indicated high content validity for all the instrument items. To ensure the measurement accurately reflects the experiences of diverse demographic groups, the content validity was further analyzed by gender and sexual orientation. This analysis revealed variations in item validity among participants from different genders and sexual orientations. For instance, heterosexual male respondents showed a particularly low CVI for relevance of 0.20 in the items related to nudity, including “male’s chest/nipples are visible” and “the person is sexually suggestive.” This underscored the importance of an inclusive approach when developing a measurement for TFSVA. Conclusions This study greatly advances the assessment of TFSVA by examining the content validity of our newly developed measurement. The findings revealed that our measurement tool demonstrated adequate content validity, thereby providing a strong foundation for assessing TFSVA within the Chinese context. Implementing this tool is anticipated to enhance our understanding of TFSVA and aid in the development of effective interventions to combat this form of abuse.

Stressful contexts like the COVID-19 pandemic precipitated remarkable socio-economic changes, exacerbating universal uncertainty and a pervasive loss of control. Improving mental health outcomes on the operational definition and measurement of related concepts. This study analyzed cross-sectional data from 20 countries and regions, collected between January 25 and November 10, 2021. Psychometric evaluation occurred in two stages: initially, item review and factor analysis with a 2,749 adult sample from Mainland of China and Hong Kong SAR; subsequently, confirmation of factor structure, measurement invariance testing, and advanced analyses with a 4,000 adult sample from 20 countries and regions. A six-item, single-factor structure was verified, confirming satisfactory factor loading, fit indices and consistency. Measurement invariance across geographies and groupings was also confirmed. Three Out-of-Control profiles representing low, medium, and high stress levels, were identified, with age, depression/anxiety symptoms, education, socio-economic status, and exposure to COVID-19-affected acquaintances significantly influencing affiliation. The item “I think I cannot control things that I previously could” was the most critical node. This newly validated scale represents a substantial advancement in measuring stress within the context of global health crises, thus enhancing comprehension of psychological responses. Continual evaluation of the scale’s effectiveness and accuracy is crucial.

Our globalized world means that most public health challenges cannot be tackled alone; they require unified and collaborative working across countries. Overseas fellowships offer an immersive experience that empowers nursing researchers to enhance global collaborations and synergize diverse research expertise from various cultural contexts. This enriched collaboration leads to more innovative solutions to public health issues and significantly enhances the overall impact of their research. This paper presents a self‐reflection from the perspective of a community and public health nursing researcher, based in Hong Kong. During a 2‐month research secondment at a university in the UK, I explored ways to leverage my fellowship to strengthen global connections, expand collaborations, and enhance my research capabilities in addressing health equity issues among LGBTQ+ populations, particularly concerning sexual violence. By sharing my journey, I aim to inspire more nursing researchers to engage with global academic communities and collectively advance global public health initiatives.

BACKGROUND Technology-facilitated sexual violence and abuse (TFSVA) encompasses a range of behaviors where digital technologies are used to enable both virtual and in-person sexual violence. Given that TFSVA is an emerging and continually evolving form of sexual abuse, it has been challenging to establish a universally accepted definition or to develop standardized measures for its assessment. OBJECTIVE This study aimed to address the significant gap in research on TFSVA within the Chinese context. Specifically, it sought to develop a TFSVA measurement tool with robust content validity, tailored for use in subsequent epidemiological studies within the Chinese context. METHODS The first step in developing the measurement approach for TFSVA victimization and perpetration was to conduct a thorough literature review of existing empirical research on TFSVA and relevant measurement tools. After the initial generation of items, all the items were reviewed by an expert panel to assess the face validity. The measurement items were further reviewed by potential research participants, who were recruited through snowball sampling via online platforms. The assessment results were quantified by computing the content validity index (CVI). The participants were asked to rate each scale item in terms of its relevance, appropriateness, and clarity regarding the topic. RESULTS The questionnaire was reviewed by 24 lay experts, with a mean age of 27.96 years. They represented different genders and sexual orientations. The final questionnaire contained a total of 89 items. Three key domains were identified to construct the questionnaire, which included image-based sexual abuse, nonimage-based TFSVA, and online-initiated physical sexual violence. The overall scale CVI values of relevance, appropriateness, and clarity for the scale were 0.90, 0.96, and 0.97, respectively, which indicated high content validity for all the instrument items. To ensure the measurement accurately reflects the experiences of diverse demographic groups, the content validity was further analyzed by gender and sexual orientation. This analysis revealed variations in item validity among participants from different genders and sexual orientations. For instance, heterosexual male respondents showed a particularly low CVI for relevance of 0.20 in the items related to nudity, including “male’s chest/nipples are visible” and “the person is sexually suggestive.” This underscored the importance of an inclusive approach when developing a measurement for TFSVA. CONCLUSIONS This study greatly advances the assessment of TFSVA by examining the content validity of our newly developed measurement. The findings revealed that our measurement tool demonstrated adequate content validity, thereby providing a strong foundation for assessing TFSVA within the Chinese context. Implementing this tool is anticipated to enhance our understanding of TFSVA and aid in the development of effective interventions to combat this form of abuse.

Background Many individuals consider nocturia a significant nuisance, leading to a reduced health-related quality of life (HRQOL). However, there has been a lack of psychometrically sound patient-reported outcome measures to assess the impact of nocturia on patients in Chinese contexts. This study aimed to translate, culturally adapt, and validate the International Consultation on Incontinence Questionnaire Nocturia Quality of Life Module (ICIQ-NQOL) for use among primary care patients in Hong Kong, China. Additionally, it sought to investigate the mechanisms that link nocturia and sleep quality with HRQOL by employing moderated mediation analysis. Methods The traditional Chinese version of the ICIQ-NQOL was developed through iterative translations, cognitive debriefing interviews, and panel reviews. The psychometric evaluation included assessments of factor structure, convergent validity, concurrent validity, known-group validity, internal consistency, test-retest reliability and responsiveness. Study instruments included the ICIQ-NQOL, International Prostate Symptom Score (IPSS), Pittsburgh Sleep Quality Index (PSQI), and a modified Incontinence Impact Questionnaire-Short Form (IIQ-7). Results A total of 419 primary care patients were recruited from general outpatient clinics, among whom 228 experiencing an average of two or more nocturia episodes per night over the past four weeks. Confirmatory factor analysis supported the two-factor structure of the ICIQ-NQOL. Concurrent validity was confirmed by moderate correlations between the IIQ-7 total score and the total score as well as two domain scores of the ICIQ-NQOL ( r ranging from 0.43 to 0.49, all p < 0.001). The ICIQ-NQOL also had moderate correlations with the IPSS total symptom score ( r ranging from 0.40 to 0.48, all p < 0.001). Convergent validity was supported by moderate correlations between the global PSQI score and the total score as well as two domain scores of the ICIQ-NQOL ( r ranging from 0.42 to 0.52, all p < 0.001). Known-group comparisons showed that the ICIQ-NQOL could differentiate between patients with and without nocturia in terms of sleep/energy domain score ( p < 0.001), bother/concern domain score ( p < 0.001), and total score ( p < 0.001), each demonstrating a moderate Cohen’s d effect size. Item-total correlations corrected for overlap exceeded 0.4, and Cronbach’s alpha coefficients were greater than 0.7. Test-retest reliability was confirmed with intraclass correlation coefficients exceeding 0.7 among patients reporting no change in their nocturia symptoms at a 2-week follow-up. Regarding responsiveness, the Cohen’s d effect sizes for differences in domain and total scores between the baseline and 2-week follow-up assessments were greater than 0.3 among patients showing improvement in nocturia. Our moderated mediation analysis indicated that sleep quality significantly moderated the impact of nocturia on HRQOL, with a notably stronger indirect effect among females compared to males. Conclusions The ICIQ-NQOL is a reliable and valid instrument for assessing the HRQOL in primary care patients suffering from nocturia. The findings advocate for gender-specific approaches in the management and treatment of nocturia to optimize HRQOL.