Medicine and Health Sciences Commons^™

The Effect Of Maternal Traumatic Life Events And Social Support On Maternal-Child Interaction At Child Age 3 Years, Sandra I. Madubuonwu

Theses and Dissertations (ETD)

Introduction: Becoming a parent is a very important role and responsibility in people’s lives and knowing the role traumatic life events (TLEs) may play on a mother-child relationship is a very important area to explore. TLEs are known to have adverse effect on individuals; however, little is known regarding the effect of maternal TLEs on maternal-child interaction. Social support has been known to positively affect the overall wellbeing of individuals, but little is known about the effect of social support on mothers who experienced TLEs and interaction with their children thus the need for this study. This study examines the …

The Molecular Mechanisms Of Estrogen Receptor Α On Two Single Nucleotide Polymorphisms To Regulate Wnt Signaling In Osteoblasts, Sarocha Suthon

Theses and Dissertations (ETD)

Osteoporosis is the most common bone metabolic disorder, affecting over 200 million people globally. It is characterized by bone mass depletion and microarchitectural deterioration, leading to bone fragility and susceptibility to bone fracture. Genetic factors, estrogen deficiency, and dysregulation of the WNT signaling pathway contribute to the development of this disease. Genome-wide association studies have predicted that the single nucleotide polymorphisms (SNPs) rs2887571 and rs9921222 associate with low bone mass, but the mechanism of these SNPs has remained unknown. Analysis of osteoblasts from 112 different joint replacement patients reveals that the genotype of rs2887571 correlates with WNT5B expression, and the …

Advancing Rna Virus Discovery And Biology With Whole Genome Sequencing, Mariah Katherine Taylor

Theses and Dissertations (ETD)

Two RNA virus families that pose a threat to human and animal health are Hantaviridae and Coronaviridae. These RNA viruses which originate in wildlife continue and will continue to cause disease, and hence, it is critical that scientific research define the mechanisms as to how these viruses spillover and adapt to new hosts to become endemic. One gap in our ability to define these mechanisms is the lack of whole genome sequences for many of these viruses. To address this specific gap, I developed a versatile amplicon-based whole-genome sequencing (WGS) approach to identify viral genomes of hantaviruses and severe acute …

Role Of Smad2 And Smad3 On Adipose Tissue Development And Function, Roshan Kumari

Theses and Dissertations (ETD)

Introduction: Obesity and its associated metabolic syndrome are major medical problems worldwide including United States. Adipose tissue is the primary site of energy storage, playing important roles in health. Adipose tissue also has other critical functions, producing adipocytokines and contributing to normal nutrient metabolism, which in turn play important roles in satiety, inflammation, and total energy homeostasis. Activin A and activin B play important roles in maintaining body composition and energy homeostasis. This dissertation highlights the role of activin/SMADs signaling in adipose tissue development, function, and maintenance.

SMAD2/3 proteins are downstream mediators of transforming growth factor-β (TGFβ) family signaling, including …

Rooting Out Genetic Structure Of Invasive Wild Pigs In Texas, Anna M. Mangan, Antoinette J. Piaggio, Michael J. Bodenchuk, Courtney F. Pierce, Timothy J. Smyser

United States Department of Agriculture Wildlife Services: Staff Publications

Invasive wild pigs (Sus scrofa), also called feral swine or wild hogs, are recognized as among the most destructive invasive species in the world. Throughout the United States, invasive wild pigs have expanded rapidly over the past 40 years with populations now established in 38 states. Of the estimated 6.9 million wild pigs distributed throughout the United States, Texas supports approximately 40% of the population and similarly bears disproportionate ecological and economic costs. Genetic analyses are an effective tool for understanding invasion pathways and tracking dispersal of invasive species such as wild pigs and have been used recently …

Wildlife Responses To Livestock Guard Dogs And Domestic Sheep On Open Range, Daniel Kinka, Jeffrey T. Schultz, Julie K. Young

United States Department of Agriculture Wildlife Services: Staff Publications

Domestic sheep (Ovis aries) are an attractant to carnivores; however, sheep are often accompanied by humans and livestock guardian dogs (LGDs; Canis familiaris), which defend sheep from depredation. Sheep also compete directly with wildlife for grazing resources. Although practiced for millennia in much of the world outside North America, the effect that transhumance has on wildlife is poorly understood. To test the effect of sheep bands (sheep, humans, and LGDs) on wildlife, we modeled the detection probability of wild mammals relative to the presence of sheep bands in the Northwestern United States. Sheep band presence was associated …

Mongooses (Urva Auropunctata) As Reservoir Hosts Of Leptospira Species In The United States Virgin Islands, 2019–2020, Hannah M. Cranford, A. Springer Browne, Karen Lecount, Tammy Anderson, Camila Hamond, Linda Schlater, Tod Stuber, Valicia J. Burke-France, Marissa Taylor, Cosme J. Harrison, Katia Y. Matias, Alexandra Medley, John Rossow, Nicholas Wiese, Leanne Jankelunas, Leah De Wilde, Michelle Mehalick, Gerard L. Blanchard, Keith R. Garcia, Alan S. Mckinley, Claudia D. Lombard, Nicole F. Angeli, David Horner, Thomas Kelley, David J. Worthington, Jennifer Valiulis, Bethany Bradford, Are Berentsen, Johanna S. Salzer, Renee Galloway, Ilana J. Schafer, Kristine Bisgard, Joseph Roth, Brett R. Ellis, Esther M. Ellis, Jarlath E. Nally

United States Department of Agriculture Wildlife Services: Staff Publications

During 2019–2020, the Virgin Islands Department of Health investigated potential animal reservoirs of Leptospira spp., the bacteria that cause leptospirosis. In this cross-sectional study, we investigated Leptospira spp. exposure and carriage in the small Indian mongoose (Urva auropunctata, syn: Herpestes auropunctatus), an invasive animal species. This study was conducted across the three main islands of the U.S. Virgin Islands (USVI), which are St. Croix, St. Thomas, and St. John. We used the microscopic agglutination test (MAT), fluorescent antibody test (FAT), real-time polymerase chain reaction (lipl32 rt-PCR), and bacterial culture to evaluate serum and kidney specimens and compared the …

Availability Of Essential Diagnostics In Ten Low-Income And Middle-Income Countries: Results From National Health Facility Surveys, Harika Yadav, Devanshi Shah, Shahin Sayed, Susan Horton, Lee F. Schroeder

Pathology, East Africa

Background: Pathology and laboratory medicine diagnostics and diagnostic imaging are crucial to achieving universal health coverage. We analysed Service Provision Assessments (SPAs) from ten low-income and middle-income countries to benchmark diagnostic availability.

Methods: Diagnostic availabilities were determined for Bangladesh, Haiti, Malawi, Namibia, Nepal, Kenya, Rwanda, Senegal, Tanzania, and Uganda, with multiple timepoints for Haiti, Kenya, Senegal, and Tanzania. A smaller set of diagnostics were included in the analysis for primary care facilities compared with those expected at hospitals, with 16 evaluated in total. Surveys spanned 2004–18, including 8512 surveyed facilities. Country-specific facility types were mapped to basic primary …

Relationship Of Age, Atherosclerosis And Angiographic Stenosis Using Artificial Intelligence, Rebecca Jonas, James Earls, Hugo Marques, Hyuk-Jae Chang, Jung Hyun Choi, Joon-Hyung Doh, Ae-Young Her, Bon Kwon Koo, Chang-Wook Nam, Hyung-Bok Park, Sanghoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang Gao, Faisal Nabi, Ryo Nakazato, U Joseph Schoepf, Roel S Driessen, Michiel J Bom, Randall C Thompson, James J Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Généreux, Paul Knaapen, Guus A De Waard, Gianluca Pontone, Daniele Andreini, Mouaz H Al-Mallah, Robert Jennings, Tami R Crabtree, Todd C Villines, James K Min, Andrew D Choi

Department of Neurosurgery Faculty Papers

Objective: The study evaluates the relationship of coronary stenosis, atherosclerotic plaque characteristics (APCs) and age using artificial intelligence enabled quantitative coronary computed tomographic angiography (AI-QCT).

Methods: This is a post-hoc analysis of data from 303 subjects enrolled in the CREDENCE (Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia) trial who were referred for invasive coronary angiography and subsequently underwent coronary computed tomographic angiography (CCTA). In this study, a blinded core laboratory analysing quantitative coronary angiography images classified lesions as obstructive (≥50%) or non-obstructive (<50%) while AI software quantified APCs including plaque volume (PV), low-density non-calcified plaque (LD-NCP), non-calcified plaque (NCP), calcified plaque (CP), lesion length on a per-patient and per-lesion basis based on CCTA imaging. Plaque measurements were normalised for vessel volume and reported as % percent atheroma volume (%PAV) for all relevant plaque components. Data were subsequently stratified by age <65 and ≥65 years.

Results: The cohort was 64.4±10.2 years and 29% women. Overall, patients >65 had more PV …

Effects Of Sesame Consumption On Inflammatory Biomarkers In Humans: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Shabnam Rafiee, Roghaye Faryabi, Mohammad Ali Zareian, Jessie Hawkins, Nitin Shivappa Mbbs, Mph, Ph.D., Laila Shirbeigi

Faculty Publications

Objectives. Existing evidence produces conflicting findings regarding the effect of sesame intake on inflammatory biomarkers; thisknowledge gap has yet to be met through systematic review and meta-analysis. )is meta-analysis of randomized, controlledclinical trials (RCTs) was conducted to evaluate the effects of sesame consumption on markers of inflammation in humans. Methods. PubMed, Scopus, and the Cochrane Database of Systematic Reviews were searched through August 2020 to identify relevant papers for inclusion. Using the random-effects model, data were evaluated as weighted mean differences (WMD) with 95% confidence intervals (CI). Cochrane’s Q and I-squared (I2) tests were used to …

Complete (Communication Plan Early Through End Of Life): Development Of A Research Program To Diminish Suffering For Children At End Of Life, Verna L. Hendricks-Ferguson, Amy R. Newman, Katharine E. Brock, Joan E. Haase, Jennifer L. Raybin, Shermini Saini, Karen M. Moody

College of Nursing Faculty Research and Publications

While overall survival has improved significantly for children with cancer over the past 75 years, cancer remains the leading cause of death from disease among children and adolescents. Further, despite the many advances in medical and nursing care, children with cancer still experience significant physical and emotional suffering over the course of their illness, especially at the end of life (EOL). Children endure significant rates of high-intensity medical interventions (e.g., intubation, intensive care unit admission) at the EOL despite many parents, adolescents, and young adult patients identifying home as their preferred location of death. Hospice care has the potential to …

Prevalence And Sociodemographic Factors Associated With Vision Difficulties In Ghana, Gambia, And Togo: A Multi-Country Analysis Of Recent Multiple Indicator Cluster Surveys, Abdul-Aziz Seidu, Pascal Agbadi, Precious Adade Duodu, Nutifaga Eugene Yaw Dey, Henry Ofori Duah, Bright Opoku Ahinkorah

College of Nursing Faculty Research and Publications

Background

The sense of sight is one of the important human sensory abilities that is required for independent functioning and survival. The highest burden of sight-related problems is recorded in low-and middle-income countries, especially in sub-Saharan Africa. Despite the burden, nationally representative analyses to understand the prevalence and determinants of vision difficulties are hard to find. Therefore, this study addressed this knowledge gap by estimating the prevalence of vision difficulties and its correlates in gender-stratified models in three West African countries: Ghana, Gambia, and Togo.

Methods

The study used the most recent Multiple Indicator Cluster Surveys of Ghana (2017–2018), Gambia …

Complementary And Alternative Medicine Mind-Body Approaches Used Among Racially And Ethnically Diverse Adolescents, Dora L. Clayton-Jones, Lee Za Ong, Mauricio Garnier-Villarreal, Lori Vick, Rachel Sawdy, Safiya George, Kristin Haglund

College of Nursing Faculty Research and Publications

Purpose

The aim of this paper is to examine complementary and alternative medicine (CAM) use among racially and ethnically diverse adolescents. Greater understanding of CAM use among this group is warranted to better inform health care providers in delivering a culturally relevant health promotion approach.

Design and methods

A secondary data analysis was conducted using the 2012 Child Complementary and Alternative Medicine Supplement of the National Health Interview Survey (CAM-NHIS) data, which was collected from a national sample of adolescents aged 12–17 years. A logistic regression test was employed to investigate the predictors associated with CAM use among racially and …

Interpersonal Violence And Contraceptive Method Use By Women Sex Workers, Jessica L. Zemlak, Rebecca Hamilton White, Danielle Friedman Nestadt, Kamila A. Alexander, Ju Nyeong Park, Susan G. Sherman

College of Nursing Faculty Research and Publications

Objective

More than one-half of women sex workers (sex workers) in the United States experience interpersonal violence, defined as physical or sexual violence, by sexual partners, including clients or intimate partners. Women experiencing interpersonal violence by intimate partners often choose hidden, woman-controlled contraception (e.g., intrauterine devices, pills, or sterilization) because fear of violence can impede condom negotiation. Yet, little is known about how interpersonal violence relates to contraception among sex workers who may have different sexual partner perpetrators (clients and intimate partners). The purpose of this study was to examine associations between interpersonal violence perpetrated by clients or intimate partners …

N Y State Dent J November 2021

The New York State Dental Journal

The New York State Dental Journal (NYSDJ) is produced by the New York State Dental Association (NYSDA) six times a year, in January, March, April, July, September and November. Each issue features clinical and scientific articles written by researchers and practitioners from around the globe and is subject to review by a panel of specialists convened by the Editor.

Issues include cover and feature articles alongside regular columns with regional news impacting the New York membership including editorial and perspectives columns, legal, association activities, component news, continuing education opportunities, and classifieds.

J Mich Dent Assoc November 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Cover stories with a “Focus on Advocacy: Helping Dentistry Succeed”, including “MDA Dental PAC: What It Is and Why It Matters “, “2021 Advocacy Success — and More to Come “, and “Dental Programs Maintained in 2021-22 State Budget”.
• A feature article on “The Anishinaabe Dental Outreach Program”.
• A feature article, “How Your Website and …

Reducing The Potential For Physical Harm In Student Nurses Caring For Clients Who Are Under The Influence, Hunter William Halford

Electronic Theses and Dissertations

This DNP project was conducted to identify gaps in knowledge and adequate preparation of nursing students in safely caring for a client who is behaving violently and is under the influence of illicit drugs. Student nurses are trained using a generalist approach, meaning they are taught the essentials of a variety of topics. It is not until these students enter the workforce that they are trained specifically for a certain position. Currently, the curriculum does not address specific measures to maintain client and personal safety. It is an almost unavoidable fact that a nurse will encounter a violent client or …

Loneliness, Social Isolation, And Their Connection To Overall Health Across The Lifespan, Paige Miller

Senior Honors Theses

Due to recent circumstances, the incidence of loneliness and social isolation has skyrocketed. Fortunately, there have already been countless studies examining the longer-term implications of these two factors on health. Loneliness and social isolation have been found to impact cardiovascular health, stress response, immune function, resilience, mental health, attachment, spiritual health, and many other determinants of health. A variety of research was examined outlining the psychological implications of loneliness and social isolation. These factors also influence physiological processes and can exacerbate a variety of diseases. After presentation of this evidence, a collection of possible interventions will be discussed, and their …

An Investigative Analysis Of Underlying Alzheimer’S Disease Pathology: Understanding The Pathology Of Neurofibril Tangles, William Barker

Senior Honors Theses

Researchers familiar with Alzheimer’s Disease (AD) refer to two common pathological hallmarks: β-amyloid plaques and Neurofibril Tangles (NFTs). The development of these pathologies are the leading theory to explain the cause of cognitive decline and dementia-like symptoms of individuals with AD. The literature supports the theory that NFTs are caused by the hyperphosphorylation of the precursor tau protein. However, the mechanism that causes this hyperphosphorylation is still unknown. This review seeks to evaluate the normal function of tau then analyze and expound upon the current research concerning the underlying mechanisms for the hyperphosphorylation of tau observed in Neurofibril Tangles pathologies. …

Intracorporeal And Extracorporeal Anastomosis For Robotic-Assisted And Laparoscopic Right Colectomy: Short-Term Outcomes Of A Multi-Center Prospective Trial, Robert K. Cleary, Matthew Silviera, Tobi J. Reidy, James Mccormick, Craig S. Johnson, Patricia Sylla, Jamie Cannon, Henry Lujan, Andrew Kassir, Ron Landmann, Wolfgang Gaertner, Edward Lee, Amir Bastawrous, Ovunc Bardakcioglu, Sushil Pandey, Vikram Attaluri

Department of Surgery Faculty Research

Background: Studies to date show contrasting conclusions when comparing intracorporeal and extracorporeal anastomoses for minimally invasive right colectomy. Large multi-center prospective studies comparing perioperative outcomes between these two techniques are needed. The purpose of this study was to compare intracorporeal and extracorporeal anastomoses outcomes for robotic assisted and laparoscopic right colectomy. Methods: Multi-center, prospective, observational study of patients with malignant or benign disease scheduled for laparoscopic or robotic-assisted right colectomy. Outcomes included conversion rate, gastrointestinal recovery, and complication rates. Results: There were 280 patients: 156 in the robotic assisted and laparoscopic intracorporeal anastomosis (IA) group and 124 in the robotic …

Self-Perceived Leadership Behaviors Of Collegiate Athletic Trainers And Strength And Conditioning Coaches: A Case Study, James Thomas Daley

All Theses And Dissertations

The purpose of the case study was to examine the self-perceived leadership characteristics, behaviors, and communication styles of professionals within the pillars of the high-performance sport model, specifically athletic trainers, and strength and conditioning coaches, to gain perspective on their ability to influence student-athletes and colleagues at the NCAA DIII level. A qualitative case study format allowed the researcher to engage with a small sample of participants and explore the differences and similarities between the participant groups. Participants were selected based on their primary job title and setting at over 80 institutions of higher education that participate in NCAA Division …

Does Mass Drug Administration Of Azithromycin Reduce Child Mortality?, Samwel Gatimu, Rachel Kimani

School of Nursing & Midwifery, East Africa

Child mortality remains prevalent in low-income and middle-income countries, with the sub-Saharan Africa region accounting for the largest under-5 mortality rates. Although under-5 mortality rates have significantly decreased, most countries in sub-Saharan Africa with high mortality rates are unlikely to achieve the Sustainable Development Goal of at least as low as 25 deaths per 1000 livebirths by 2030.

Fidelity Monitoring In The Solution Focused Wellness For Hiv (Sfwh) Intervention For Women, Helen Taylor Yates, Spencer Elise Lee

Journal of Solution Focused Practices

Solution Focused methods are often interpreted by different practitioners with a degree of flexibility and adaptation to specific practice settings (Lehmann & Patton, 2012). This flexibility is one of the features that makes SFBT a very client-centered approach and has been highlighted as one of the key aspects of successful co-construction of desired outcomes with clients (Franklin et al., 2017). This collaborative approach is possible due to SFBT’s utilization of social constructionist principals in the solution-building process (Blundo & Simon, 2015). While encouraging flexibility of implementation of SFBT, identifying the main tenets of the therapy, including specific techniques and mindsets …

Implementing Geriatric Frailty Screening In Acute Care, Christine Longley

Student Scholarly Projects

Practice Problem: Frailty is a syndrome of age-related physiologic decline characterized by an increased burden of symptoms and higher susceptibility to adverse health, including higher functional decline rates, pressure ulcers, falls, and delirium. In the general medicine unit of this project, geriatric patients were not screened for frailty.

PICOT: The PICOT question that guided this project was: In hospitalized patients 65-years-of-age and older (P), how does implementing a geriatric frailty screening tool (I), compared to standard assessments (C), influence frailty identification and personalized plans of care (O) over eight weeks (T)?

Evidence: Literature supports screening for frailty in the hospitalized …

Performance In Mortality Prediction Of Saps 3 And Mpm-Iii Scores Among Adult Patients Admitted To The Icu Of A Private Tertiary Referral Hospital In Tanzania: A Retrospective Cohort Study, Nadeem Kassam, Eric Aghan, Samina Somji, Omar Aziz, James Orwa, Salim R. Surani

Internal Medicine, East Africa

Background: Illness predictive scoring systems are significant and meaningful adjuncts of patient management in the Intensive Care Unit (ICU). They assist in predicting patient outcomes, improve clinical decision making and provide insight into the effectiveness of care and management of patients while optimizing the use of hospital resources. We evaluated mortality predictive performance of Simplified Acute Physiology Score (SAPS 3) and Mortality Probability Models (MPM0-III) and compared their performance in predicting outcome as well as identifying disease pattern and factors associated with increased mortality.

Methods: This was a retrospective cohort study of adult patients admitted to the ICU of the …

Up And Moving: An Integrative Review Evaluating Early Mobility In The Intensive Care Unit, Rachel Huffman

Doctoral Dissertations and Projects

Existing literature has highlighted the benefits of early mobility of patients in intensive care units. This integrative review (IR) sought to determine the best methods of early mobility intervention implementation. The search process utilized databases relevant to the selected topic, and the flow of information abstracted from the search process was placed into a PRISMA flow diagram. Additionally, review software was used to manage the collected data, ensuring that the search was documented with precision. To appraise the literature, a matrix was developed. The literature revealed that early mobility programs, protocols, and algorithms were guiding themes noted throughout this IR, …

Effectiveness Of Smoking Cessation In Heart Disease Patients: An Integrative Review, Dolly Ruth Griggs

Doctoral Dissertations and Projects

Tobacco smoking is associated with cardiovascular, respiratory, cancer-related illnesses, and deaths. Tobacco toxin clogs blood arteries, leading to increased risks of cardiovascular diseases or death. Smoking cessation programs have been implemented to aid patients with abstaining from tobacco usage, particularly those with heart-related diseases. The challenges experienced in implementing smoking cessation interventions include a lack of follow-ups, support, and education regarding the risks associated with smoking tobacco. The aim of this project was to examine the effectiveness of the smoking cessation intervention and programs implemented in patients diagnosed with heart diseases. An integrative study review was applied to assess interventions …

A Qualitative Phenomenological Study On Moral Distress And The Nursing Student During The Covid-19 Pandemic, Alan Peter Howard

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the phenomenon of moral distress on nursing students who engaged in clinical experiences during the COVID-19 pandemic. This research study was supported by Jean Watson’s theory of human caring (Watson, 2006) as it explained the relationship between a nursing students’ provision of care and the moral dilemma and potential moral distress related to threats to that care. This study was also presented within the conceptual framework of Patricia Benner’s model from novice to expert (Benner, 1984). Within this framework, the nursing student as novice may not have the skills or experience …

Exploratory Data Mining Techniques (Decision Tree Models) For Examining The Impact Of Internet-Based Cognitive Behavioral Therapy For Tinnitus: Machine Learning Approach, Hansapani Rodrigo, Eldré W. Beukes, Gerhard Andersson, Vinaya Manchaiah

School of Mathematical & Statistical Sciences Faculty Publications

Background: There is huge variability in the way that individuals with tinnitus respond to interventions. These experiential variations, together with a range of associated etiologies, contribute to tinnitus being a highly heterogeneous condition. Despite this heterogeneity, a “one size fits all” approach is taken when making management recommendations. Although there are various management approaches, not all are equally effective. Psychological approaches such as cognitive behavioral therapy have the most evidence base. Managing tinnitus is challenging due to the significant variations in tinnitus experiences and treatment successes. Tailored interventions based on individual tinnitus profiles may improve outcomes. Predictive models of treatment …

Implementation Of A Wechat-Based Smoking Cessation Program For Chinese Smokers, Ting Luo, Mirandy S. Li, Donna Williams, Jackson Fritz, Stephen Phillippi, Qingzhao Yu, Stephen Kantrow, Liwei Chen, Yongchun Chen, Kaylin Beiter, Tung-Sung Tseng

School of Public Health Faculty Publications

Introduction: Although smoking prevalence has recently declined, the smoking prevalence in China remains high. Extensive research has demonstrated ways that social media can assist in quitting smoking. WeChat is the most commonly used social media platform in China but has not been used for smoking cessation. A process evaluation of a novel WeChat-based smoking cessation intervention was conducted to measure its efficacy of content delivery, participant satisfac-tion, engagement, and likelihood of recommendation to others. Methods: A three-week, three-arm, single-blind randomized control trial was established. WeChat was used to recruit 403 participants and to deliver intervention messages and process evaluation surveys …