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Widespread adoption and continued developments in mobile health care technologies have led to the improved accessibility and quality of medical services. In China, WeChat, an instant messaging and social networking app released by the company Tencent, has developed a specific type of user account called WeChat official account (WOA), which is now widely adopted by hospitals in China. It enables health care providers to connect with local citizens, allowing them to, among other actions, send regular updates through mass circulation. However, with the diversity in function provided by WOA, little is known about its major constitution as well as the influence factors on the WeChat communication index (WCI). The WCI has been widely used in social media impact ranking with various types of WeChat content to fully reflect the dissemination and coverage of tweets as well as the maturity and impact of WOA. There are two typical WOAs available to users, namely, WeChat subscription account (WSSA) and WeChat service account (WSVA). The biggest difference between them is the frequency of messages transmitted. This study aimed to explore the function constitution of WSVA adopted by top tertiary hospitals in China and the major contributors of the WCI score. A total of 681 top tertiary hospitals were selected from the Hospital Quality Monitoring System; the WOA of every top tertiary hospital was retrieved in the WeChat app. We divided core functional items of WSVAs using categorical principal component analysis. To elicit the factors that influenced the use of WSVA, quantile regression was employed to analyze the WCI score. From the 668 WOAs identified, adoption of WSVAs (543/668, 81.3%) was more than that of WSSAs (125/668, 18.7%). Functional items of WSVAs were categorized into four clusters: (1) hospital introduction, (2) medical services, (3) visiting assistants, and (4) others. With regard to the influence factors on the WCI, the impact of the activity index of WSVA and the total visiting number of outpatients and emergencies on WCI were statistically significant and positive in all quantiles. However, the year of certification, the type of hospital, the year of public hospital reform, and the number of beds merely affected the WCI at some quantiles. Our findings are considered helpful to tertiary hospitals in developing in-depth functional items that improve patient experience. The tertiary hospitals should take full advantage of times of posting and provide high-quality tweets to meet the various needs of patients.

This book provides a balanced and nuanced study of how the super-sticky WeChat platform interweaves into the fabric of Chinese social, cultural, and political life. It keeps the wider global and national social media landscape in view and compares and contrasts WeChat with Weibo, QQ and other Western social media platforms.

Social media is currently becoming a new channel for information acquisition and exchange. In China, with the growing popularity of WeChat and WeChat official accounts (WOAs), health promotion agencies have an opportunity to use them for successful information distribution and diffusion online. We aimed to identify features of articles pushed by WOAs of Chinese provincial Centers for Disease Control and Prevention (CDC) that are associated with user engagement. We searched and subscribed to 28 WOAs of provincial CDCs. Data for this study consisted of WeChat articles on these WOAs between January 1, 2017 and December 31, 2017. We developed a features frame containing title type, article content, article type, communication skills, number of marketing elements, and article length for each article and coded the data quantitatively using a coding scheme that assigned numeric values to article features. We examined the descriptive characteristics of articles for every WOA and generated descriptive statistics for six article features. The amount of reading and liking was converted into the level of reading and liking by the 75% position. Two-category univariate logistic regression and multivariable logistic regression were conducted to explore associations between the features of the articles and user engagement, operationalized as reading level and liking level. All provincial CDC WOAs provided a total of 5976 articles in 2017. Shanghai CDC articles attracted the most user engagement, and Ningxia CDC articles attracted the least. For all articles, the median reading was 551.5 and the median liking was 10. Multivariable logistic regression analysis revealed that article content, article type, communication skills, number of marketing elements, and article length were associated with reading level and liking level. However, title type was only associated with liking level. How social media can be used to best achieve health information dissemination and public health outcomes is a topic of much discussion and study in the public health community. Given the lack of related studies based on WeChat or official accounts, we conducted this study and found that article content, article type, communication skills, number of marketing elements, article length, and title type were associated with user engagement. Our study may provide public health and community leaders with insight into the diffusion of important health topics of concern.

As social media posts reflect users' emotions, WeChat Moments, the most popular social media platform in China, may offer a glimpse into postpartum depression in the population. This study aimed to investigate the features of the images that mothers posted on WeChat Moments after childbirth and to explore the correlation between these features and the mothers' risk of postpartum depression. We collected the data of 419 mothers after delivery, including their demographics, factors associated with postpartum depression, and images posted on WeChat Moments. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale. Descriptive analyses were performed to assess the following: content of the images, presence of people, the people's facial expressions, and whether or not memes were posted on WeChat Moments. Logistic regression analyses were used to identify the image features associated with postpartum depression. Compared with pictures of other people, we found that pictures of their children comprised the majority (3909/6887, 56.8%) of the pictures posted by the mothers on WeChat Moments. Among the posts showing facial expressions or memes, more positive than negative emotions were expressed. Women who posted selfies during the postpartum period were more likely to have postpartum depression (P=.003; odds ratio 2.27, 95% CI 1.33-3.87). The vast majority of mothers posted images conveying positive emotions during the postpartum period, but these images may have masked their depression. New mothers who have posted selfies may be at a higher risk of postpartum depression. International Clinical Trials Registry Platform ChiCTR-ROC-16009255; http://www.chictr.org.cn/showproj.aspx?proj=15699.

The mental health consequences of the coronavirus disease (COVID-19) pandemic, community-wide interventions, and social media use during a pandemic are unclear. The first and most draconian interventions have been implemented in Wuhan, China, and these countermeasures have been increasingly deployed by countries around the world. The aim of this study was to examine risk factors, including the use of social media, for probable anxiety and depression in the community and among health professionals in the epicenter, Wuhan, China. We conducted an online survey via WeChat, the most widely used social media platform in China, which was administered to 1577 community-based adults and 214 health professionals in Wuhan. Probable anxiety and probable depression were assessed by the validated Generalized Anxiety Disorder-2 (cutoff ≥3) and Patient Health Questionnaire-2 (cutoff ≥3), respectively. A multivariable logistic regression analysis was used to examine factors associated with probable anxiety and probable depression. Of the 1577 community-based adults, about one-fifth of respondents reported probable anxiety (n=376, 23.84%, 95% CI 21.8-26.0) and probable depression (n=303, 19.21%, 95% CI 17.3-21.2). Similarly, of the 214 health professionals, about one-fifth of surveyed health professionals reported probable anxiety (n=47, 22.0%, 95% CI 16.6-28.1) or probable depression (n=41, 19.2%, 95% CI 14.1-25.1). Around one-third of community-based adults and health professionals spent ≥2 hours daily on COVID-19 news via social media. Close contact with individuals with COVID-19 and spending ≥2 hours daily on COVID-19 news via social media were associated with probable anxiety and depression in community-based adults. Social support was associated with less probable anxiety and depression in both health professionals and community-based adults. The internet could be harnessed for telemedicine and restoring daily routines, yet caution is warranted toward spending excessive time searching for COVID-19 news on social media given the infodemic and emotional contagion through online social networks. Online platforms may be used to monitor the toll of the pandemic on mental health.

For patients with metabolic dysfunction-associated fatty liver disease (MAFLD), weight loss is advised but challenging in practice. In China, there is a pronounced shortage of tailored digital lifestyle interventions for this population. This study aimed to assess the effects of a WeChat mini-program-delivered lifestyle intervention on weight loss and hepatic steatosis among individuals with MAFLD who were overweight or obese. Adults who are overweight or obese and have clinically diagnosed MAFLD with transient elastography examination were enrolled in this prospective randomized controlled trial. Patients were randomly assigned to receive either WeChat mini-program management (intervention group) or standard care (control group) at a 1:1 ratio. The intervention was structured around the development and implementation of personalized diet and exercise plans, supplemented by guided exercise video courses and reinforced through continuous monitoring and informational support. Body weight and clinical parameters were assessed at baseline and then at 6 months. A total of 89 patients met the inclusion criteria and were randomly assigned to the intervention group (n=45) or control group (n=44). Among the 89 patients with MAFLD, 60% (27/45) of them achieved a weight loss of ≥5%, and 24.4% (11/45) of them had a weight loss of ≥10% in the intervention group, which was greater than those in the control group (27/45 vs 7/44; relative risk [RR] 3.771, 95% CI 1.836-7.748; P<.001; 11/45 vs 3/44, RR 3.585, 95% CI 1.072-11.988; P=.02). Importantly, patients receiving the intervention were significantly more likely to achieve a ≥10% reduction or normalization of controlled attenuation parameter (CAP) than those in the control group (26/45 vs 14/44; RR 1.816, 95% CI 1.102-2.992; P=.01). After adjusting for key baseline covariates, multivariate analysis confirmed the intervention's positive effect on achieving a weight loss of ≥5% (OR [odds ratio] 8.380, 95% CI 2.886-24.331; P<.001) of ≥10% (OR 4.612, 95% CI 1.138-18.686; P=.03), as well as on CAP reduction of ≥10 % or normalization (OR 2.853, 95% CI 1.092-7.456; P=.03). In parallel, the intervention group presented greater reductions in liver enzymes (alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transpeptidase) and metabolic parameters (fasting insulin, hemoglobin A1c, and triglyceride) than the control group (all P<.05). According to the fibrosis assessment, only the FibroScan-aspartate aminotransferase score decreased more in the intervention group than in the control group (median difference -0.06, 95% CI -0.13 to -0.01; P=.02), as compared to other non-invasive indicators. Readily scalable in primary care and varied-resource settings, our WeChat mini-program-based intervention extends beyond weight loss to reduce hepatic steatosis and improve metabolic parameters, thereby addressing the critical gap in targeted MAFLD management in China with a low-cost model for high-burden populations. Nevertheless, larger future studies are needed to confirm these findings with greater precision and assess long-term sustainability.

PurposeThis study aims to examine the impact of social media marketing (SMM) efforts, including entertainment, customisation, interaction and trendiness via WeChat, on consumers' online brand-related activities (COBRAs) and their related outcomes, including on-going search behaviour and repurchase intention.Design/methodology/approachThe theoretical framework is tested for luxury cosmetics brands. Data were collected in China from 433 WeChat users utilising a self-administered online survey. Data analysis uses partial least squares–structural equation modelling.FindingsEntertainment and interaction drive consumers' consuming, contributing and creating behaviours, whilst trendiness drives creating behaviour only. Inconsistent with previous research findings, customisation has a non-significant impact on consumers' consuming, contributing and creating behaviours. Consuming and creating behaviours assist in driving on-going search behaviour and repurchase intention. Contributing behaviours assist in driving on-going search behaviour only.Research limitations/implicationsCross-sectional in nature, this research adds to the marketing literature by explaining how to use SMM to drive COBRAs for luxury cosmetics in China using WeChat. To enhance the generalisability of the findings, future research might consider a longitudinal design, including comparisons between countries with diverse cultures as well as other industries and product types.Practical implicationsCOBRAs may be heightened by using entertaining and trendy content. Incorporating interactive content on social media platforms encourages consumers to consume, contribute and create content on social media brand communities, further driving their on-going search behaviour and repurchase intention.Originality/valueExamination of SMM's role in the marketing literature largely overlooks the impact of SMM elements on COBRAs. This study contributes to the SMM research by empirically testing a theoretical model, confirming that specific SMM elements – including entertainment and interaction – are key factors in driving consumers' consuming, contributing and creating behaviour on social media brand communities, influencing consumers' on-going search behaviour and repurchase intention.

China's diabetes epidemic faces critical gaps in glycemic control, with only 50.1% of treated patients achieving hemoglobin A1C (HbA1c) targets in 2021. Conventional interventions struggle with scalability in primary care, particularly for vulnerable populations. This study aimed to evaluate the use of a WeChat-based health education tool (the WeWalk mini program, the Bayu Health public account, and a WeChat group) for improving glycemic control in community-dwelling patients with type 2 diabetes mellitus. This multicenter randomized controlled trial enrolled 600 adults with type 2 diabetes from 3 communities in Chongqing, randomly allocating participants 1:1 to either a 12-week WeChat-based intervention (n=300, 50%) or a control group (n=300, 50%) in September 2020. The control group received 4 face-to-face traditional health education sessions, whereas the intervention group participated in a digital program: a 4-week course followed by an 8-week practical implementation. At baseline and 12 weeks after the intervention began, both groups were examined in terms of HbA1c and fasting blood glucose (FBG) as the primary outcomes, as well as variables such as blood lipid profile, blood pressure, and physical fitness-related indexes as secondary outcomes. Longitudinal glycemic control was assessed through triplicate FBG measurements extracted from standardized electronic health records at the 2-year follow-up. Independent t tests or Mann-Whitney U tests were used to assess changes from baseline to follow-up between groups. A total of 92.7% (556/600) of the participants completed the 12-week follow-up visit. The WeChat-based intervention demonstrated superior glycemic control outcomes, with intervention participants achieving a 0.59% greater HbA1c reduction than controls (-0.03% vs 0.56%; P<.001) and significant improvements in FBG levels (-0.69 vs 0.00 mmol/L; Δ=0.69; P=.001). Subgroup analysis revealed that WeChat-based health education was significantly effective in patients with diabetes with a disease duration of <10 years, educational level of junior high school or lower, and annual family income of

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