Awareness of initiative practice for health in the Chinese population: A questionnaire survey based on a network platform

INTRODUCTION

The self-designed electronic questionnaire was administered on an online crowdsourcing platform from March 26 to April 18, 2020, and it was sent to Moments and WeChat groups in the form of network links by researchers who voluntarily transmitted the links. Before starting the survey, the aims of the questionnaire were shown, informed consent was obtained, and people could refuse to participate. All information was guaranteed to be confidential. The content could not be changed after completion.

To address health challenges effectively, countries around the world, including China, have adopted different policies[7-9]. In October 2016, the Central Committee of the Communist Party of China and the State Council released the Healthy China 2030 plan, which aims to address the challenges posed by the United Nations SDGs, as well as the accompanying economic burden, and to improve people’s health by promoting healthy lifestyles, optimizing health services, improving health security, building a healthy environment, and developing health industries by 2030[10]. The Healthy China 2030 plan aims to improve the health system of China and make China a modern and healthy country[11]. First, the focus of health services will shift from the treatment of diseases to health management and disease intervention to decrease health-related costs to some extent[12]. The Chinese government’s investment in health has continuously increased in recent decades, with nearly 70% of the investment being for treatment[4]. Additionally, the Healthy China 2030 plan is beneficial for establishing a system in which all citizens participate on a government-led basis and for improving health awareness and enhancing the concept of taking responsibility for one’s own health. Furthermore, the plan may be conducive to promoting the rapid development of health-related industries such as health monitoring and management consulting services, thus promoting economic development. In addition, by taking the opportunity that the plan represents, traditional Chinese medicine will develop rapidly.

Health is an inevitable requirement for promoting all-around human development, and it is a basic condition for economic and social development. Different people have different understandings of health. The World Health Organization definition of health-“a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”-mainly includes four different dimensions, the physical, the psychological, the socially adaptable, and the moral, and it has been accepted worldwide[13]. The “initiative practice for health” (IPFH) concept derives from the Healthy China 2030 blueprint. IPFH is a process in which people take the initiative to gain health-related knowledge, improve their lifestyle, and ensure their health status. It is based on health management and emphasizes the long-term continuous and dynamic tracking of the individuals’ entire life cycle behavioral systems as well as comprehensive detection, assessment, effective intervention, and continuous follow-up services for individual or group health conditions and their risk factors affecting health. It highlights the active participation of individuals in personal health management and citizen participation in the healthy development of China. It encourages individuals to find personal ways and to acquire effective knowledge to promote modifiable health-related behaviors in terms of diet, exercise, society, and mentality to enable healthier lives.

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The Chinese government has made great efforts to promote the Healthy China 2030 plan and IPFH. However, few surveys have explored people’s awareness, knowledge, and understanding of IPFH. Therefore, we investigated the relevant knowledge and behaviors related to IPFH as well as the attitudes of people using a self-designed questionnaire to improve the promotion of IPFH and indirectly improve the health of all people.

MATERIALS AND METHODS

Questionnaire

Based on the literatures and suggestions of experts in health management, epidemiology, and clinical medicine, a self-designed questionnaire including 49 questions was compiled based on the purpose of this research after the group discussion and the preliminary investigation of 55 samples. The survey items mainly covered four parts: (1) Demographic characteristics and socioeconomic status, including respondents’ gender, place of residence, age, educational level, work experience, personal income per month, height, weight, body mass index (BMI),

; (2) knowledge related to health and IPFH; (3) healthrelated behaviors; and (4) the will to promote IPFH.

IPFH awareness was assessed in terms of five aspects: The view on the aging population in China; knowing about IPFH; the frequency with which the respondent receives health-related science information; the frequency of health consultations; and the will to promote IPFH. The IPFH awareness was evaluated based on the sum of the scores on these five aspects. According to the results of the preliminary investigation, respondents were considered to have strong IPFH awareness if the score was ≥ 8 points (75% of the median). Otherwise, they were considered to have weak IPFH awareness.

Data collection

Population health is a common theme worldwide. In 2015, the United Nations published the Sustainable Development Goals (SDGs) to ensure sustainable development globally and to solve predictable challenges by 2030. The SDGs have over 100 targets in different fields, including medicine and health[1,2]. As the largest developing country with a population of over 1.4 billion, China has achieved most of the targets and has made great achievements in promoting health, such as ensuring nutrition for children, decreasing neonatal and under-5 year mortality rates as well as the maternal mortality rate, reducing physical maldevelopment of children, and extending people’s lifespan[3]. However, there are still challenges, such as industrialization and environmental problems, that threaten the health of the Chinese population, especially the aging society and the increasing burden of various age-related chronic diseases[4,5]. It is predicted that the number of people aged ≥ 65 years will be 400 million by 2050, accounting for approximately 26.9% of the total population, and the number of people aged ≥ 80 years will increase to 150 million by 2050[6].

Statistical analysis

The content was exported from the network platform. Demographic characteristics are represented as the mean ± standard deviation for continuous variables based on a normal distribution; otherwise, the median (P

-P

) was used. The differences in continuous variables between the two groups were tested by a Student’s t-test or Mann–Whitney U test. Categorical variables are represented as

(%), and the differences between the two groups were tested by the

test or Fisher’s exact test. Multiple logistic regression analysis was performed, and the odds ratios (ORs) and 95% confidence intervals (CIs) of the variables are reported. Data analysis and analysis of the credibility of the questionnaire were performed using SPSS for Windows version 25.0 (IBM Corp., Armonk, NY, United States). All reported

values are two-tailed, and

< 0.05 was considered statistically significant.

在脱贫攻坚进程中，除了改善农民的经济条件外，基层村委会（社区）还应该引导树立以爱情为基础的择偶观。现阶段，农村女青年过分看重男方的经济条件，而忽略了婚姻缔结的重要纽带——爱情。在过于物化和商品化择偶观的冲击下，往往会因为婚姻双方缺乏同甘同苦的奋斗目标，以至于在婚姻生活中遇到一点挫折就会分手或者离婚。因此，建议采用讲座、板报、文娱节目等形式在各村（社区）宣传正确的择偶观和爱情观，树立社会主义农村婚姻新风尚。

Ethical considerations

The multivariate logistic regression model used the strength of IPFH awareness as the dependent variable and the factors significantly associated with IPFH awareness (age, place of work or residence, medical-related work experience, monthly income and BMI) as independent variables. Age (OR = 1.752, 95%CI: 1.485-2.067,

< 0.001), medical-related work experience (OR = 1.577, 95%CI: 1.308-1.902,

< 0.001), and monthly income (OR = 1.123, 95%CI: 1.035-1.217,

= 0.002) significantly affected the strength of IPFH awareness (Table 3).

This survey was reviewed and approved by the Academic Ethics Committee of the Sanbo Brain Hospital, Capital Medical University.

除上述危机预防与化解的主要方法、对策外，还有“心灵净化”法、“治者自律”法、“报怨以德”法、“精细管理”法、“柔性艺术”法等。可分别参见(十六章)“致虚极，守静笃。”[3](六十七章)“我有三宝，持而保之。一曰慈，二曰俭，三曰不敢为天下先。慈故能勇；俭故能广；不敢为天下先，故能成器长。”[3](六十三章)“大小多少，报怨以德。”[3](六十三章)“图难于其易，为大于其细；天下难事必作于易，天下大事必作于细。”[3](四十三章)“天下之至柔，驰骋天下之至坚。”[3]限于篇幅，不一一展开论述。

RESULTS

Questionnaire

The Cronbach’s alpha coefficient for the questionnaire was 0.823 and > 0.7 for all dimensions, indicating that the self-designed questionnaire had high credibility. Through expert discussion and evaluation, it was considered that the questionnaire had a certain validity. In total, 2699 questionnaires were collected, with 21 incomplete questionnaires. Thus, 2678 questionnaires were included in our analyses.

上述研究的关键点就是电力变压器等效网络的仿真计算。这也是系统研究电力变压器绕组机械故障(径向变形和轴向位移)和内部电气故障(匝间短路故障和局部放电故障)的故障程度以及位置对变压器差动保护影响的重点之一。本文通过建立集总参数模型,可以仿真绕组变形位移以及匝间短路故障,以期后续对故障类型、故障程度以及故障位置的检测提供参考。

Sociodemographic characteristics of the participants

Based on the methods mentioned above, IPFH awareness was divided into the “strong group” and the “weak group”. As illustrated in Table 2, 1065 participants had strong IPFH awareness and 1613 had weak awareness. Age, place of work or residence, medical-related work experience, monthly income, and BMI were significant factors (

< 0.05).

Knowledge of health and IPFH

Regarding the statement “China’s aging population exerts or will exert great pressure on society, families, and individuals”, 2286 (85.4%) of the respondents expressed agreement, 121 (4.5%) disagreed, and 271 (10.1%) felt unsure. Only 973 (36.3%) of the participants had heard of the IPFH.

Over 30% of the participants in our study thought that participating in IPFH was unable to decrease the chance of hospitalization or extend the lifespan. Over 20% of the respondents denied that IPFH would have an impact on the progression of diseases. Most participants thought that the use of healthcare products and participation in relevant activities were related to IPFH, which was similar to the results shown by Yang and Meng[17]. This may be because, on the one hand, some people lack knowledge and awareness of IPFH as well as the occurrence and development of some diseases and lifespan. On the other hand, some people neglect the role of health-related factors such as lifestyle and the environment in the development of diseases and overlook the role of social adaptation in maintaining health status. Fewer than half of the respondents in our survey agreed with the role of health professionals including hospitals, family doctors, and health managers in promoting IPFH, and only 33.5% wanted to discuss their own health plan with professionals. The reasons may be as follows: First, the traditional opinion holds that hospitals and doctors are merely related to treating diseases, ignoring the role of health professionals in health improvement. In fact, the role of hospitals as well as doctors has already shifted[19] from only treating diseases to addressing the entire health and lifespan process. Second, health managers are unpopular because IPFH has not spread widely; thus, many people do not accept this occupation. Finally, this result shows that although family doctors have already been advocated by the government, people have less knowledge about the role of family doctors. Despite the importance of family doctors in improving disease management and health awareness[20], the rate of enjoying contractual services from family doctors is still low[21-23]. It is reassuring that most participants wanted to be promoters and practitioners of IPFH and health projects. We have every reason to look forward to the development and optimistic results of the Healthy China 2030 plan and IPFH because individuals are willing to take responsibility as members of the health industry. It is not difficult to imagine that with the wide publicity and smooth implementation of the plan and IPFH, people will accept and know this concept better and take the initiative to put their knowledge into practice.

Health-related behaviors

As shown in Figure 2A, the majority of the respondents usually paid close attention to health-related knowledge in their daily lives. In addition, 89.5% of the subjects usually acquired health-related popular science knowledge

WeChat official accounts or MicroBlogs, and 57.4% and 49.2% of the respondents received such knowledge

television and print publications, such as magazines and newspapers, respectively (Figure 2B). Over 70% of the respondents were more concerned about aspects such as weight, emotion, appetite, and sleep (Figure 2C). Only 33.5% of the participants discussed their own health promotion plans with professionals such as dieticians, fitness instructors, and health managers (Figure 2D). With regard to common wearable devices, such as smart watches, bracelets, sphygmomanometers, and insulin pumps, only 71 (2.7%) of the participants had no thoughts about them (Figure 2E).

Will to promote IPFH

A total of 85.9% of the participants had a desire to become promoters and pioneers of IPFH (Figure 3).

Factors influencing IPFH awareness

The sociodemographic characteristics of the participants are listed in Table 1. In terms of gender, 1566 (58.5%) were female, and 1112 (41.5%) were male, for a gender ratio of 1:1.4. The mean age and BMI were 43.3 ± 11.7 years and 23.54 ± 3.15 years, respectively. The respondents were from 31 provinces, autonomous regions, and municipalities directly under the central government, with 1291 (48.2%) from northern China, followed by 463 (17.3%) and 328 (12.2%) from central and eastern China, respectively. Most of the participants (93.6%) lived in urban areas. With regard to educational level, 1770 (66.1%) of the respondents had a college education, and 652 (24.3%) had a master’s degree or above. Nearly threequarters of the participants (74.2%) had medical-related work experience. For personal income, 1738 (64.9%) of the participants earned > ¥5000/mo.

This survey was approved by the Academic Ethics Committee of the Sanbo Brain Hospital, Capital Medical University. This survey was voluntary, and residents could refuse to participate. All were assured of the confidentiality of their information.

DISCUSSION

This study is one of the first to examine IPFH awareness and related knowledge among Chinese people by using a network platform. It is of importance to understand and promote China’s development of IPFH and raise awareness of it. Based on the multivariable binary logistic regression, age, monthly income, and medical-related work experience were factors influencing IPFH awareness. Specifically, participants who were older, had a higher monthly income, and had medical-related work experience had strong IPFH awareness. It is not difficult to think that people who are older and who have worked in the medical industry are more inclined to pay more attention to their health and acquire more health knowledge, which makes their IPFH awareness higher. Participants who have a higher monthly income usually experience less life pressure and, at the same time, usually pay attention to all kinds of information in their daily lives. Thus, they may have more chances and energy to pay attention to their body and gain access to health knowledge as well as related policies, resulting in a relatively high IPFH awareness. This is consistent with the views of Braveman and Gottlieb[14] who stated that lower income is associated with lower health awareness and health status. However, it is different from the survey about the awareness of health knowledge among rural residents in western China conducted by Yuan

[15] from July 2011 to April 2012. It indicated that the health knowledge level of lower income families was higher than that of rich families, and it declined with increasing age. This may be because the rural population has particular characteristics and the respondents we surveyed lived in urban areas. We think that more attention should be paid to people with poor IPFH awareness. Finding the reasons for their poor health awareness and improving the reasons individually will contribute to the development and improvement of the health of the whole population.

十几年前，先是有人在妈妈的家乡开挖海沙和海底珊瑚礁。因为过度开采，海水变得越来越浑浊，海水慢慢上涨，没过白色的沙滩，漫进椰林，很多从海里漂浮上来的垃圾四处散落。近几年，政府开始严打挖沙和挖珊瑚礁的行为，投入资金重新买沙填海……没承想，一个资金雄厚的商人把椰林周围的地全都承包了，建起了海边度假村。原来的椰林不见了，到处是外表原始、内在奢华的小木屋。人们要想再去那片海，已不似从前那么容易了。若不是到度假村去住宿或吃饭，到村口就会被阻拦，要不掏点钱，就甭想去海滩。

Although older people are healthier than in the past, aging of the population is still a huge burden at the societal and individual levels because the number of older people is increasing and they are characterized as being more fragile and susceptible to disease[16]. According to the Healthy China Action Promotion Committee, older people have been suffering from different diseases for approximately 8.3 years, and approximately 75% of the population had various chronic diseases in 2018[17]. The annual economic burden of age-related diseases will account for > 40% of the whole population. Our research showed that 85.4% of the participants agreed with the view “China’s aging population exerts or will exert great pressure on society, families, and individuals”, although some of the participants (4.5%) held the opposite view, which may mean that most citizens in China and worldwide could realize this serious situation. Therefore, they may be more likely to handle this challenge by taking the initiative through related policies led by the government.

Health management is a medical practice and a process of comprehensive detection, assessment, effective intervention and follow-up services for health status, and the risk factors for individuals and groups[18]. IPFH is a process based on health management in which people take the initiative to learn health-related knowledge, improve their lifestyle, and ensure their own health status. It emphasizes the active participation of individuals in personal health management and citizen participation in the development of a healthy China. With the coordinated development of the internet and IPFH, a population information platform for internet and health care and health-related big data systems are expected to be established, thereby executing the plan for internet-based Chinese health services. According to our research, only 36.3% of the respondents had heard of IPFH, which is unsatisfactory for promoting IPFH and, moreover, the Healthy China 2030 plan. The reason for this may be that, on the one hand, the plan is at the early stage in this long-term project, and thus far, the main task has been to build infrastructure and content. Additionally, IPFH appeared based on the implementation of the plan; thus, only a small number of people had heard of it. On the other hand, it is possible that many people may have acquired related knowledge and put it into practice in their daily lives without knowing that the knowledge was related to IPFH. This reminds us that it is better to be specific and comprehensive during the promotion of IPFH.

Over 95% of the respondents thought that health status included physical and mental health, and 85.3% and 81.8% of the respondents thought that good social adaptability and moral health, respectively, were part of health status (Figure 1A). A total of 89.5% and 88.9% of the respondents agreed that IPFH is beneficial for improving quality of life and preventing diseases, respectively. However, only 62.2% of the respondents thought that it would help to reduce the chance of visiting doctors (Figure 1B). Over 50% of the participants selected the following items: Regular schedule, a reasonable diet, tobacco and alcohol control, a cheerful mood, specific life goals and plans, taking the initiative to accept healthrelated education and implement health knowledge, good interpersonal relationships, and regular physical examinations, which have close relationships with IPFH (Figure 1C). In terms of promoting IPFH, more than 70% of the participants thought it would mainly depend on individuals and family members, and less than 50% of those selected hospitals and family doctors (Figure 1D).

Our survey showed that most participants paid close attention to health-related information and almost every health-related indicator, and there were hardly any participants who did not know about health-related wearable devices. This means that, with the development of society and improved living standards, as well as the promotion of health awareness, people are increasingly paying more attention to their health, and there are more chances to know things about high-tech health-related equipment. This is a good condition for promoting the Healthy China 2030 plan and IPFH.

As one of the most important components of IPFH, health knowledge and health behaviors are important to improving health status[19,24,25]. We found that the main approach to obtaining health information was

a network platform. This is related to the fact that people are inclined to spend more time on and obtain various information from mobile devices rather than from magazines and newspapers[26,27]. With the development of 5G and various applications on mobile devices, there should be more ways to promote IPFH and health monitoring, except for the traditional approaches such as Health Days, Media Publicity,

Mobile phone technology can be a possible solution to improve healthcare outcomes, and it has already been used in the management of some diseases and health monitoring[28,29]. This reminds us that it is better to promote the Healthy China 2030 plan and IPFH by using network platforms on mobile devices such as WeChat and MicroBlogs, which are some of the most common applications for all ages. A comprehensive, effective, and low-cost health management network-platform may be a good way. As an essential component of health projects, numerous types of high-tech wearable equipment can be applied, and individuals can acquire health information and indicators quickly so that they know their own body status in a timely manner and result in a healthy life condition[30-33]. This has the potential for the development and promotion of the Healthy China 2030 plan and IPFH to popularize and rapidly develop the health industry in the future.

This survey-based study had several limitations. Firstly, although the self-designed questionnaire that we used to collect data on the network platform was proven to be reliable based on statistical testing, there were still some disadvantages. For example, we cannot guarantee the authenticity of the data and the distribution of the participants. The participants’ distribution was biased. Most were from urban areas, had a college degree or above, and had medical-related work experience. The reason for this may be that we administered the questionnaire over the internet and its network link spread mainly

WeChat and Moments, leading to a limitation of the survey population. This reminds us that we have ignored the population who are disconnected from the internet and missed some people who really need to raise IPFH awareness, such as those in rural areas. There should be further surveys with comprehensive methods to assess the situation of the entire population. In addition, we have ignored the possibility that many individuals have knowledge related to IPFH and put it into practice in their daily lives but have never heard of the concept. Further studies require us to expand the methods and content of the survey in the form of questionnaires. Despite these limitations, this survey provides key insights to promote IPFH and develop health programs in China, and the results may affect future interventions to promote the health status of the Chinese population, as a whole, as well as the development of the global health industry.

CONCLUSION

The Chinese population has limited knowledge about IPFH, although most people in the population are concerned about health in their daily lives. People with strong IPFH awareness are older, earn more, and have medical-related work experience. To ensure the rapid popularization of IPFH and smooth development of the Healthy China 2030 plan, more focus should be given to young people, the lowincome populations, rural populations, and people with a low level of education by the government, medical-related personnel, and health managers.

ARTICLE HIGHLIGHTS

ACKNOWLEDGEMENTS

Thanks to all who contributed to the investigation and Ms. Yang XR and Mr. Jiao GY for their careful revision and guidance for the manuscript.

FOOTNOTES

Zhang YQ and Jiang MY participated in data analysis and drafted the manuscript; Zhou MY participated in the design of the questionnaire and the collection and analysis of the data; Zhang XY participated in data management and performed the statistical analysis; Wang X participated in the design of the questionnaire and collected data; Wang BG conceived the study and participated in its design and coordination.

the National Key R&D Program of China, No. 2018YFC2000704.

第三代移动通信技术（3rd-generation，3G），是指支持高速数据传输的蜂窝移动通讯技术。3G服务能够同时传送声音及数据信息，在室内、室外和行车的环境中能够分别支持至少2Mbps、384kbps以及144kbps的传输速度（此数值根据网络环境不同会发生变化）。3G是将无线通信与国际互联网等多媒体通信结合的新一代移动通信系统，目前3G存在四种标准：CDMA2000，WCDMA，TD-SCDMA，WiMAX。

治疗后两组的PT、APTT与TT值都高于治疗前，同组治疗前后比较差异有统计学意义（P＜0.05）；治疗后观察组与对照组相比也显著降低，差异有统计学意义（P＜0.05），见表5。

Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

We have no financial relationships to disclose.

幼儿园教育指导纲要中对利用乡土资源开展幼儿美术活动进行了明确要求，强调了在幼儿园教育教学中，教师需要充分开发并利用丰富的自然环境以及社区的教育资源，来扩展幼儿的学习空间，提升幼儿的学习能力。乡土资源具有极为浓郁的乡土气息，尤其是农村的幼儿园拥有优美的自然环境，富含大量的自然资源，开展以乡土资源为材料的美术活动可以充分激发幼儿对大自然的喜爱之情，培养幼儿的环保意识；同时农村所特有的风俗习惯和生活方式，可以给幼儿更多的接触生活、体验生活的机会，保证幼儿能够不断增强生活能力，培养社会生活意识。因此在幼儿园的美术活动中，教师需要充分利用乡土资源，保证教学的顺利、高效开展

No additional data are available.

有关马克思哲学终极关怀维度的深入探讨开展于本世纪。俞吾金在《人文关怀：马克思哲学的另一个维度》一文中，旗帜鲜明地提出了“人文关怀是马克思哲学的基本维度之一”的观点。由于对实践概念理解的差异，杨学功、陆剑杰、徐长福等学者分别就马克思哲学的终极关怀维度与之展开讨论，但对于马克思哲学的终极关怀维度的存有是没有分歧的。

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

China

Yi-Qiang Zhang 0000-0001-5922-0444; Ming-Yue Zhou 0000-0001-6372-6974; Meng-Yang Jiang 0000-0001-5488-6706; Xiao-Yu Zhang 0000-0001-6431-2159; Xin Wang 0000-0002-2952-5690; Bao-Guo Wang 0000-0001-6879-8491.

在走廊上展出的菊花，有的含苞欲放，像个还未睡醒的小姑娘，有的盛开吐蕊，有的三五朵开在一起竞相争艳，有的探出个小脑袋，仿佛害羞地和我微笑。一株株、一盆盆、一丛丛、一堆堆，红的似火，黄的如金，绿的像玉，白的若云……这些菊花如同娇小的小姑娘，亭亭玉立于湛蓝的天空下，沐浴着温暖的阳光。一时刻，五光十色，满堂生辉。恍惚间，我宛如进入仙境。

Guo XR

Filipodia

Zhang YL

1 Ramirez-Rubio O, Daher C, Fanjul G, Gascon M, Mueller N, Pajín L, Plasencia A, Rojas-Rueda D, Thondoo M,Nieuwenhuijsen MJ. Urban health: an example of a "health in all policies" approach in the context of SDGs implementation.

2019 ; 15 : 87 [PMID: 31856877 DOI: 10 .1186 /s12992 -019 -0529 -z]

2 Morton S, Pencheon D, Squires N. Sustainable Development Goals (SDGs), and their implementation: A national global framework for health, development and equity needs a systems approach at every level.

2017 ; 124 : 81 -90[PMID: 29069332 DOI: 10 .1093 /bmb/ldx031 ]

3 Chen H, Qian Y, Dong Y, Yang Z, Guo L, Liu J, Shen Q, Wang L. Patterns and changes in life expectancy in China, 1990 -2016 . PLoS One 2020 ; 15 : e0231007 [PMID: 32236129 DOI: 10 .1371 /journal.pone.0231007 ]

4 Chen S, Guo L, Wang Z, Mao W, Ge Y, Ying X, Fang J, Long Q, Liu Q, Xiang H, Wu C, Fu C, Dong D, Zhang J, Sun J,Tian L, Wang L, Zhou M, Zhang M, Qian M, Liu W, Jiang W, Feng W, Zeng X, Ding X, Lei X, Tolhurst R, Xu L, Wang H, Ziegeweid F, Glenn S, Ji JS, Story M, Yamey G, Tang S. Current situation and progress toward the 2030 health-related Sustainable Development Goals in China: A systematic analysis.

2019 ; 16 : e1002975 [PMID: 31743352 DOI:10 .1371 /journal.pmed.1002975 ]

5 He X, Song M, Qu J, Guo Y, Cao H, Sun R, Liu GH, Shen Y; Major Program Expert Group. Basic and translational aging research in China: present and future.

2019 ; 10 : 476 -484 [PMID: 30937856 DOI: 10 .1007 /s13238 -019 -0617 -0 ]

6 Fang EF, Scheibye-Knudsen M, Jahn HJ, Li J, Ling L, Guo H, Zhu X, Preedy V, Lu H, Bohr VA, Chan WY, Liu Y, Ng TB. A research agenda for aging in China in the 21 st century. Ageing Res Rev 2015 ; 24 : 197 -205 [PMID: 26304837 DOI:10 .1016 /j.arr.2015 .08 .003 ]

7 Gase LN, Schooley T, Lee M, Rotakhina S, Vick J, Caplan J. A Practice-Grounded Approach for Evaluating Health in All Policies Initiatives in the United States.

2017 ; 23 : 339 -347 [PMID: 27598713 DOI:10 .1097 /PHH.0000000000000427 ]

8 Bolton KA, Kremer P, Gibbs L, Waters E, Swinburn B, de Silva A. The outcomes of health-promoting communities: being active eating well initiative-a community-based obesity prevention intervention in Victoria, Australia.

2017 ; 41 : 1080 -1090 [PMID: 28321132 DOI: 10 .1038 /ijo.2017 .73 ]

9 Tan X, Wu Q, Shao H. Global commitments and China's endeavors to promote health and achieve sustainable development goals.

2018 ; 37 : 8 [PMID: 29650054 DOI: 10 .1186 /s41043 -018 -0139 -z]

10 Tan X, Kong S, Shao H. New strategies to improve the health of Chinese people by 2030 . Aust J Prim Health 2017 ; 23 :307 -308 [PMID: 28803612 DOI: 10 .1071 /PY16146 ]

11 Tan X, Zhang Y, Shao H. Healthy China 2030 , a breakthrough for improving health. Glob Health Promot 2019 ; 26 : 96 -99[PMID: 29297762 DOI: 10 .1177 /1757975917743533 ]

12 Fu W, Zhao S, Zhang Y, Chai P, Goss J. Research in health policy making in China: out-of-pocket payments in Healthy China 2030 . BMJ 2018 ; 360 : k234 [PMID: 29437565 DOI: 10 .1136 /bmj.k234 ]

13 Rattan SI. Healthy ageing, but what is health? Biogerontology 2013 ; 14 : 673 -677 [PMID: 23852043 DOI:10 .1007 /s10522 -013 -9442 -7 ]

14 Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes.

2014 ; 129 Suppl 2 : 19 -31 [PMID: 24385661 DOI: 10 .1177 /00333549141291 S206 ]

15 Yuan F, Qian D, Huang C, Tian M, Xiang Y, He Z, Feng Z. Analysis of awareness of health knowledge among rural residents in Western China.

2015 ; 15 : 55 [PMID: 25637079 DOI: 10 .1186 /s12889 -015 -1393 -2 ]

16 Fang EF, Xie C, Schenkel JA, Wu C, Long Q, Cui H, Aman Y, Frank J, Liao J, Zou H, Wang NY, Wu J, Liu X, Li T, Fang Y, Niu Z, Yang G, Hong J, Wang Q, Chen G, Li J, Chen HZ, Kang L, Su H, Gilmour BC, Zhu X, Jiang H, He N, Tao J,Leng SX, Tong T, Woo J. A research agenda for ageing in China in the 21 st century (2 nd edition): Focusing on basic and translational research, long-term care, policy and social networks.

2020 ; 64 : 101174 [PMID: 32971255 DOI: 10 .1016 /j.arr.2020 .101174 ]

17 Yang Y, Meng Y. Is China Moving toward Healthy Aging? Int J Environ Res Public Health 2020 ; 17 [PMID: 32560573 DOI: 10 .3390 /ijerph17124343 ]

18 Steenkamer BM, Drewes HW, Heijink R, Baan CA, Struijs JN. Defining Population Health Management: A Scoping Review of the Literature.

2017 ; 20 : 74 -85 [PMID: 27124406 DOI: 10 .1089 /pop.2015 .0149 ]

19 Owen N, Healy GN, Dempsey PC, Salmon J, Timperio A, Clark BK, Goode AD, Koorts H, Ridgers ND, Hadgraft NT,Lambert G, Eakin EG, Kingwell BA, Dunstan DW. Sedentary Behavior and Public Health: Integrating the Evidence and Identifying Potential Solutions.

2020 ; 41 : 265 -287 [PMID: 31913771 DOI:10 .1146 /annurev-publhealth-040119 -094201 ]

20 Lam CL. The role of the family doctor in the era of multi-disciplinary primary care. Fam Pract 2016 ; 33 : 447 -448 [PMID:27435181 DOI: 10 .1093 /fampra/cmw059 ]

21 Huang J, Zhang T, Wang L, Guo D, Liu S, Lu W, Liang H, Zhang Y, Liu C. The effect of family doctor-contracted services on noncommunicable disease self-management in Shanghai, China.

2019 ; 34 : 935 -946[PMID: 31373079 DOI: 10 .1002 /hpm.2865 ]

22 Shang X, Huang Y, Li B, Yang Q, Zhao Y, Wang W, Liu Y, Lin J, Hu C, Qiu Y. Residents' Awareness of Family Doctor Contract Services, Status of Contract with a Family Doctor, and Contract Service Needs in Zhejiang Province, China: A Cross-Sectional Study.

2019 ; 16 [PMID: 31505783 DOI: 10 .3390 /ijerph16183312 ]

23 Huang J, Liu S, He R, Fang S, Lu W, Wu J, Liang H, Zhang Y. Factors associated with residents' contract behavior with family doctors in community health service centers: A longitudinal survey from China.

2018 ; 13 : e0208200[PMID: 30496254 DOI: 10 .1371 /journal.pone.0208200 ]

24 Liu YB, Liu L, Li YF, Chen YL. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese.

2015 ; 12 : 9714 -9725 [PMID: 26295246 DOI:10 .3390 /ijerph120809714 ]

25 Mulder JWCM, Galema-Boers AMH, de Jong-Verweij LM, Hazelzet JA, Roeters van Lennep JE. The development and first results of a health-related outcomes set in familial hypercholesterolemia (FH) patients: Knowledge is health.

2020 ; 293 : 11 -17 [PMID: 31821958 DOI: 10 .1016 /j.atherosclerosis.2019 .11 .030 ]

26 Christensen MA, Bettencourt L, Kaye L, Moturu ST, Nguyen KT, Olgin JE, Pletcher MJ, Marcus GM. Direct Measurements of Smartphone Screen-Time: Relationships with Demographics and Sleep.

2016 ; 11 : e0165331[PMID: 27829040 DOI: 10 .1371 /journal.pone.0165331 ]

27 Panova T, Carbonell X. Is smartphone addiction really an addiction? J Behav Addict 2018 ; 7 : 252 -259 [PMID: 29895183 DOI: 10 .1556 /2006 .7 .2018 .49 ]

28 Sahu M, Grover A, Joshi A. Role of mobile phone technology in health education in Asian and African countries: a systematic review.

2014 ; 7 : 269 -286 [PMID: 25161104 DOI: 10 .1504 /ijeh.2014 .064327 ]

29 Chauhan V, Negi PC, Raina S, Bhatnagar M, Guleri R, Kanwar V, Pandey KS. Smartphone-based teleelectrocardiography support for primary care physicians reduces the pain-to-treatment time in acute coronary syndrome.

2018 ; 24 : 540 -546 [PMID: 28750576 DOI: 10 .1177 /1357633 X17719395 ]

30 Styles CE, Cheng A, Hoad VC, Kiely P, Watson M, Seed CR. Excluding Occult Hepatitis B Infection before Assigning False-Positive Status to Non-Repeatable NAT Reactivity: Concerning Stolz

. "Safe-Testing Algorithm for Individual-Donation Nucleic Acid Testing: 10 Years of Experience in a Low-Prevalence Country" [Transfus Med Hemother. 2019 Apr;46 (2 ):104 -10 ]. Transfus Med Hemother 2020 ; 47 : 272 -274 [PMID: 32595432 DOI: 10 .1159 /000502552 ]

31 Xin Q, Wu J. A novel wearable device for continuous, non-invasion blood pressure measurement.

2017 ; 69 : 134 -137 [PMID: 28676201 DOI: 10 .1016 /j.compbiolchem.2017 .04 .011 ]

32 Sun J, Guo Y, Wang X, Zeng Q. mHealth For Aging China: Opportunities and Challenges. Aging Dis 2016 ; 7 : 53 -67[PMID: 26816664 DOI: 10 .14336 /AD.2015 .1011 ]

33 Kekade S, Hseieh CH, Islam MM, Atique S, Mohammed Khalfan A, Li YC, Abdul SS. The usefulness and actual use of wearable devices among the elderly population.

2018 ; 153 : 137 -159 [PMID: 29157447 DOI: 10 .1016 /j.cmpb.2017 .10 .008 ]