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Cai Y.,Shanghai JiaoTong University | Li R.,Shanghai JiaoTong University | Zhu J.,Shanghai JiaoTong University | Na L.,Shanghai JiaoTong University | And 4 more authors.
PLoS ONE | Year: 2015

Background: Smoking among youths is a worldwide problem, particularly in China. Many endogenous and environmental factors influence smokers' intentions to smoke; therefore, a comprehensive model is needed to understand the significance and relationship of predictors. This study aimed to develop a prediction model based on problem-behavior theory (PBT) to interpret intentions to smoke among Chinese youths. Methods: We conducted a cross-sectional study of 26,675 adolescents from junior, senior, and vocational high schools in Shanghai, China. Data on smoking status, smoking knowledge, attitude toward smoking, parents' and peers' smoking, and media exposure to smoking were collected from students. A structural equation model was used to assess the developed prediction model. Results: The experimental smoking rate and current smoking rate among the students were 11.0% and 3%, respectively. Our constructed model showed an acceptable fit to the data (comparative fit index = 0.987, root-mean-square error of approximation = 0.034). Intention to smoke was predicted by perceived environment (β = 0.455, P < 0.001) system consisting of peer smoking (β = 0.599, P < 0.001), parent smoking (β = 0.152, P < 0.001), and media exposure to smoking (β = 0.226, P < 0.001), and behavior system (β = 0.487, P < 0.001) consisting of tobacco experimentation ( β = 0.663, P < 0.001) and current smoking (β = 0.755, P < 0.001). Smoking intention was irrelevant for personality system in students (β = -0.113, P >0.05) which consisted of acceptance of tobacco use (β = 0.668, P < 0.001) and academic performance (β = 0.171, P < 0.001). Conclusion: The PBT-based model we developed provides a good understanding of the predictors of intentions to smoke and it suggests future interventions among youths should focus on components in perceived environment and behavior systems, and take into account the moderating effects of personality system. © 2015 Cai et al. Source


Wang Y.,Shanghai JiaoTong University | Ma J.,Shanghai JiaoTong University | Wang J.,Pudong Institute for Health Development | Huang H.,Shanghai JiaoTong University | And 2 more authors.
Journal of Shanghai Jiaotong University (Medical Science) | Year: 2013

Objective: To evaluate the validity and reliability of the IMB based questionnaire for reproductive health among unmarried rural-urban female migrants, and assess the application of the questionnaire in the target population in Shanghai. Methods: Convenience sampling was adopted, and 944 unmarried rural-urban female migrants were selected from the examination centers for migrant workers in three districts of Shanghai to fill out the questionnaire for reproductive health. The questionnaire included basic personal information, knowledge, attitude, behaviors and demands of participants on reproductive health. The content validity was evaluated by experts discussion, the constructive validity was assessed by factor analysis, and the internal reliability was determined by calculating reliability coefficients. The test-retest reliability was measured with the same questionnaire among 40 participants at the interval of 2 weeks. Results: All Cronbach's alpha coefficients ranged between 0.313 and 0.824. Information of reproductive health and attitude towards regular sex partner were two internal reliability scales of the highest scores. The spearman correlation coefficients were larger than 0.5, which showed fine test-retest reliability (P<0.05). Four factors explained 78.66% of the questionnaire by using factor analysis, and all factors could be regarded as information, motives, behavior techniques, and preventive action about reproductive health. Conclusion: Overall the designed IMB based questionnaire can be applied to assess reproductive health among unmarried rural-urban female migrants with good reliability and validity, but relative scales of self-efficacy should be revised to accommodate the research about reproductive health of the population. Source


Zhu C.,Shanghai JiaoTong University | Cai Y.,Shanghai JiaoTong University | Ma J.,Shanghai JiaoTong University | Li N.,Shanghai JiaoTong University | And 4 more authors.
PLoS ONE | Year: 2013

Background: Adolescent smoking is a worldwide problem that is particularly severe in low- and middle-income countries. Many endogenous and environmental factors affect the intention to smoke, so a comprehensive model is needed to understand the significance and relationship of predictors. The study aimed to test the associations among information-motivation-behavioral skills (IMB) model constructs as predictors of intention to smoke in junior high school students in Shanghai, China. Methods: We conducted a cross-sectional study of 16,500 junior high school students in Shanghai, China. Data on tobacco-related information, motivation, behavioral skills, and behaviors were collected from students. Structural equation model (SEM) was used to assess the IMB model. Results: The mean age of participants was 13.8 years old (standard deviation = 1.02; range 11-17). The experimental smoking rate among junior high school students was 6.6% and 8.7% of the participants expected that they would be smokers in 5 years. The IMB model provided acceptable fit to the data (comparative fit index = 0.984, root mean square error of approximation = 0.04). Intention to smoke was predicted by behavioral skills (β= 0.670, P < 0.001) and motivation (β= 0.095, P<0.001) among junior high school students. Conclusion: The IMB model provides a good understanding of the predictors of intention to smoke and it suggests future interventions among junior high school students should focus on improving motivation and behavioral skills. © 2013 Chendi Zhu. Source


Zhang Y.,Fudan University | Zhang Y.,Pudong Institute for Health Development | Zhang Y.,Key Laboratory of Public Health Security | Feng X.,Fudan University | Feng X.,Key Laboratory of Public Health Security
BMC Health Services Research | Year: 2011

Abstract. Background: Throughout China, a growing number of physicians are leaving or intending to depart from their organizations owing to job dissatisfaction. Little information is available about the role of occupational burnout in this association. We set out to analyze the relationship between job satisfaction, burnout, and turnover intention, and further to determine whether occupational burnout can serve as a mediator among Chinese physicians from urban state-owned medical institutions. Methods. A cross-sectional survey was carried out in March 2010 in Hubei Province, central China. The questionnaires assessed sociodemographic characteristics, job satisfaction, burnout, and turnover intention. The job satisfaction and occupational burnout instruments were obtained by modifying the Chinese Physicians' Job Satisfaction Questionnaire (CPJSQ) and the Chinese Maslach Burnout Inventory (CMBI), respectively. Such statistical methods as one-way ANOVA, Pearson correlation, GLM-univariate and structural equation modeling were used. Results: Of the 1600 physicians surveyed, 1451 provided valid responses. The respondents had medium scores (3.18 +/-0.73) on turnover intention, in which there was significant difference among the groups from three urban areas with different development levels. Turnover intention, which significantly and negatively related to all job-satisfaction subscales, positively related to each subscale of burnout syndrome. Work environment satisfaction (b = -0.074, p < 0.01), job rewards satisfaction (b = -0.073, p < 0.01), organizational management satisfaction (b = -0.146, p < 0.01), and emotional exhaustion (b = 0.135, p < 0.01) were identified as significant direct predictors of the turnover intention of physicians, with 41.2% of the variance explained unitedly, under the control of sociodemographic variables, among which gender, age, and years of service were always significant. However, job-itself satisfaction no longer became significant, with the estimated parameter on job rewards satisfaction smaller after burnout syndrome variables were included. As congregated latent concepts, job satisfaction had both significant direct effects (gamma21= -0.32, p < 0.01) and indirect effects (gamma11× beta21= -0.13, p < 0.01) through occupational burnout (62% explained) as a mediator on turnover intention (47% explained). Conclusions: Our study reveals that several, but not all dimensions of both job satisfaction and burnout syndrome are relevant factors affecting physicians' turnover intention, and there may be partial mediation effects of occupational burnout, mainly through emotional exhaustion, within the impact of job satisfaction on turnover intention. This suggests that enhancements in job satisfaction can be expected to reduce physicians' intentions to quit by the intermediary role of burnout as well as the direct path. It is hoped that these findings will offer some clues for health-sector managers to keep their physician resource motivated and stable. © 2011 Zhang and Feng; licensee BioMed Central Ltd. Source


Cai Y.,Shanghai JiaoTong University | Li N.,Shanghai JiaoTong University | Zhu J.-F.,Shanghai JiaoTong University | He Y.-P.,Shanghai JiaoTong University | And 3 more authors.
Journal of Shanghai Jiaotong University (Medical Science) | Year: 2012

Objective: To analyse the perceived environment system of tobacco experimentation among junior middle school students in Shanghai. Methods: Cross-sectional study was conducted among 12 413 students from 23 junior middle schools in Shanghai by stratified cluster sampling. The conditions of tobacco experimentation and perceived environment system of these students were surveyed. The potential factors in perceived environment system were assessed using Logistic regression analysis, and their impact on tobacco experimentation was analysed. Results: The rate of tobacco experimentation in junior middle school students was 6.8%. The rate of tobacco experimentation of boy students was 9.3%, which was significantly higher than that of girl students (4.6%)(P<0.001). Multivariate regression analysis indicated that 7 factors in perceived environment system had impact on tobacco experimentation in junior middle school students, which included high smoking press from peers (OR=4.12, 95%CI: 3.50-4.84), more exposure to cigarette smoke in family (OR=1.46, 95%CI: 1.38-1.96), more exposure to smoking from media (OR=1.40, 95%CI:1.19-1.65) and high tobacco use acceptance (OR=1.37, 95%CI:1.17-1.60). Conclusion: Factors in perceived environment system are closely related to tobacco experimentation in junior middle school students, which should be attached great importance in tobacco control among junior middle school students. Source

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