Background: Intention to smoke is an important predictor of future smoking among adolescents. The purpose of our study was to examine the interaction between academic performance and parents/peer tobacco use on adolescents’ intention to smoke. Methods: A multi-stage stratified sampling was used to select participants, involving 9394 students aged between 9–16 years in Changchun city, northeastern China. Multiple logistic regression analyses were conducted to examine the individual effect of academic performance and peer/parental smoking behavior. Stratified logistic regressions were conducted to examine the protective effect of academic performance based on peer or parental smoking. Interaction effects of academic performance × peer/parental smoking on adolescents’ intention to smoke were tested. Results: Of all the non-smoking students sampled, 11.9% intended to smoke within the next five years. The individual effect of academic performance and peer/parental smoking was significant. The protective effect of academic performance on the intention to smoke was significant regardless of whether peers smoked or not. However, the protective effect was not significant among adolescents with only maternal smoking and both parental smoking. The current study found the significant interaction effects of academic performance × peer smoking and the academic performance × both parents’ smoking. Students with poor academic performance were more likely to intend to smoke if their peers or both parents smoked. Conclusion: These preliminary results suggest that peer smoking or smoking by both parents reinforces the association between low academic performance and the intention to smoke among adolescents. Enhancing school engagement, focusing on social interaction among adolescents with low academic performance, and building smoke-free families may reduce adolescents’ intention to smoke.
Background As a global pandemic, The Corona Virus Disease 2019 (COVID-19) has brought significant challenges to the primary health care (PHC) system. Health professionals are constantly affected by the pandemic's harmful impact on their mental health and are at significant risk of job burnout. Therefore, it is essential to gain a comprehensive understanding of how their burnout was affected. The study aimed to examine the relationship between COVID-19 event strength and job burnout among PHC providers and to explore the single mediating effect of job stress and work engagement and the chain mediating effect of these two variables on this relationship. Methods We used multilevel stratified convenience sampling to recruit participants from PHC institutions in Jilin Province, China. A total of 1148 medical professionals completed questionnaires regarding sociodemographic characteristics, COVID-19 event strength, job stress, work engagement, and job burnout. The chain mediation model was analysed using SPSS PROCESS 3.5 Macro Model 6. Results COVID-19 event strength not only positively predicted job burnout, but also indirectly influenced job burnout through the mediation of job stress and work engagement, thereby influencing job burnout through the "job stress → work engagement" chain. Conclusions This study extends the application of event systems theory and enriches the literature about how the COVID-19 pandemic impacted PHC medical staff job burnout. The findings derived from our study have critical implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.
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