Background: Managing type 1 diabetes can be challenging, especially for youth, so there is a need for effective interventions to help youth live with diabetes.Objective: To determine the efficacy of a coping skills training (CST) program for Chinese youth with type 1 diabetes and to explore whether the efficacy of the program was different for school-aged children than for adolescents with type 1 diabetes.Methods: A total of 100 youth with type 1 diabetes aged 8 to 20 years were randomly placed in either an intervention group (CST + standard care [SC]) or a control group (SC). Data were collected at baseline, 6-month, and 12-month follow-ups on primary outcomes of perceived stress, coping, and self-efficacy and secondary outcomes of diabetes self-management, quality of life, and glycated hemoglobin A1c (HbA1c). A generalized estimating equation analysis for repeated measures was used to determine the program effects and differential effects by age group.Results: The CST program had no significant effect on primary or secondary outcomes over 12 months. However, there was a significant increase in positive coping (P < .001), self-efficacy (P = .017), diabetes problem-solving and goals of diabetes self-management (P = .007, P = .001), and quality of life (P = .016) of school-aged children in the intervention group compared with the control group. There were no significant differences in primary or secondary outcomes between the intervention group and the control group (P > .05). Conclusions:The CST program was effective for school-aged children, improving psychosocial and diabetes self-management outcomes. Further research is needed to develop programs that improve outcomes in adolescents with type 1 diabetes.

(1) Background: China has the highest number of rural-to-urban floating women in the world, and the majority of them are of childbearing age. However, few studies have focused on maternal self-efficacy (MSE) for these women. This research aims to explore MSE and its influencing factors for primiparous women among the rural-to-urban floating population in China. (2) Methods: A quantitative longitudinal study was conducted, and primiparous women from the floating population were recruited in China. Face-to-face demographic questionnaires were collected from obstetric wards by the researchers, three days postpartum. The 6-week and 12-week questionnaires, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS), and the Postpartum Social Support Scale (PSSS), were sent to participants by wechat or email to measure MSE, postnatal depression, and social support, respectively. The completed 6-week and completed 12-week questionnaires were returned to the researchers. (3) Results: The mean MSE scores at 6 and 12 weeks postpartum were 67.16 (SD = 14.35) and 68.71 (SD = 15.00). The variables of social support, postnatal depression, whether women attended parenting training, baby fussiness, baby health, maternal educational level, occupation, and family income affected MSE at the two time points. (4) Conclusions: Primiparous women among the rural-to-urban floating population had a low MSE level. As a vulnerable and special group, more attention should be paid to the negative parenting status of floating women by health workers and family members. Effective measures must be taken to improve the floating women’s accessibility to parenting training from health services to strengthen their social support and alleviate postpartum depression. Health professionals should be more concerned with floating women with relatively low MSE levels, such as new mothers with lower education, poor working and living conditions, unhealthy babies, and babies with fussy temperaments.

Resilience, a psychological trait conceptualized as the ability to recover from setbacks, can be weakened by childhood maltreatment, which comprises childhood abuse and childhood neglect. The current study aimed to investigate whether childhood maltreatment could increase automatic negative thoughts (ANT), thus weakening resilience. Furthermore, as psychological characteristics are commonly subject to the moderating effects of cultural context and biology, the study also explored whether and how cultural and genetic factors separately interact with childhood maltreatment to predict resilience. In study 1, the participants comprised 237 American and 347 Chinese individuals; study 2 included 428 genotyped Chinese individuals. We combined regression, mediation, moderation, and machine learning methods to test the mediating effect of ANT on the link between childhood maltreatment and resilience as well as the moderating roles of culture and genetics. Study 1 found that both childhood abuse and childhood neglect increased ANT and thus weakened resilience. In addition, the ANT-mediating effects of childhood neglect were stronger in American than Chinese participants. In Study 2, using the leave-one-out approach, we constructed two separate prediction models based on 22 and 16 important single nucleotide polymorphisms (SNPs), and we found that the interaction between childhood abuse/neglect and polygenic scores based on important SNPs could predict ANT. The mediating effects of ANT on the relationship between childhood abuse/neglect and resilience were significant for participants with low polygenic scores but not for those with high polygenic scores. In conclusion, both the cultural environment and individual genetic makeup moderated the mediating effects of ANT on the association between childhood maltreatment and resilience. These findings indicated the roles of culture and genetics in protecting against the adverse effects of childhood maltreatment on resilience.

COVID-19 has caused mental health issues among adolescents. This study aimed to explore the related factors of nutrition, physical activity (PA), and symptoms of insomnia, depression and anxiety, and to investigate associations between the two lifestyle behaviors (insolated or combined) with symptoms of insomnia, depression and anxiety. Cross-sectional data of 1,756 middle school students from a survey conducted in May 2020 was used. The t-tests or c2 tests were used to determine the related factors of nutrition, PA, and symptoms of insomnia, depression and anxiety across the subgroups when appropriate. Logistic regression analysis was used to explore the relationships between nutrition and PA, and symptoms of insomnia, depression and anxiety. Girls, rural students, left-behind, sibling, students with low family income or excessive fear had worse lifestyle or mental status. Both poor nutrition and inactive PA were related to higher odds of reporting symptoms of insomnia, depression and anxiety. Students with both poor nutrition and inactive PA tended to report insomnia symptoms (OR = 2.16) and depressive symptoms (OR = 2.57) than those with only one behavior or neither of them after controlling for confounding factors. The present study indicates the importance of helping adolescents to pursue a healthier lifestyle.

Aims (a) To explore the effect of perceived stress on satisfaction with quality of life (QOL) among Chinese adolescents with type 1 diabetes (T1D); and (b) to determine if coping styles and self‐efficacy are mediators of the association between perceived stress and satisfaction with QOL. Background Adolescents with T1D experience ongoing stress related to a complex treatment regimen and live with a condition that differentiates them from their peers. It is important to know how adolescents with T1D cope with the stress and what psychosocial attributes contribute to satisfaction with QOL. Design Cross‐sectional study. Methods Data were collected from a sample of adolescents with T1D (N = 90) who had enrolled in a randomized control trial (baseline data) and a supplemental sample of N = 59 adolescents with T1D was recruited from a diabetes clinic from January 2016 ‐ December 2016. Results The mean age of the participants was 13.91 years (range 8–20 years), the mean diabetes duration was 4.02 years. Approximately one‐quarter of the sample exceeded the criterion score for perceived stress of 26, indicating stress sufficient to have a negative impact on physical and mental health. Adolescents with increased stress reported lower satisfaction with QOL compared with adolescents with less stress. Both externalization coping and self‐efficacy were the mediators of the relationship between perceived stress and satisfaction with QOL. Conclusions Many Chinese adolescents with T1D reported elevated stress levels which was associated with decreased satisfaction with QOL. There is a need for culturally relevant interventions to improve coping by limiting the use of externalized coping styles and strengthening self‐efficacy.

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China has the largest population of floating rural-to-urban women worldwide, most of whom are of childbearing age. However, few studies have been conducted to monitor the changing trends in parenting outcomes, mental health and social support for these women in the early postpartum period. In this quantitative longitudinal study, 680 primiparous women among the floating population were recruited in Shenzhen, China. Face-to-face collection of socio-demographic questionnaires was completed by researchers in maternity wards on the third postnatal day. Follow-up electronic questionnaires were dispatched to women via email or WeChat at 6 weeks and 12 weeks following childbirth, including the Self-efficacy in Infant Care Scale (SICS), Edinburgh Postnatal Depression Scale (EPDS) and Postnatal Social Support Scale (PSSS), to measure maternal self-efficacy (MSE), postpartum depression (PPD) and social support, respectively. The mean scores of MSE for these floating women were 67.16 (14.35) at 6 weeks postpartum and slightly increased to 68.71 (15.00) at 12 weeks postpartum. The mean scores of EPDS remained almost stable, from 11.19 (4.89) to 11.18 (5.34) at the two time points. The prevalence of mild and severe PPD among floating women at 6 and 12 weeks after childbirth decreased from 54.4% to 40.1% and from 50.6% to 35.4%, respectively. The mean score of social support was 37.04 (10.15) at 6 weeks postpartum and slightly improved to 38.68 (10.46) at 12 weeks postpartum. Primiparous women among the rural-to-urban migrant population had an obviously negative status of parenting outcomes and mental health; and there was a lack of social support after childbirth. In future, tailored evidence-based interventions are highly needed to promote floating women’s parenting outcomes, mental wellbeing and social support in the early stages of motherhood. As a higher-risk group of PPD, primiparous women among the floating population require effective and accessible mental health care after childbirth, such as early PPD screening and timely therapeutic methods.

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