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Study Protocol | Open Access

Study protocol: A national cross‐sectional study on psychology and behavior investigation of Chinese residents in 2023

Diyue Liu1, Siyuan Fan2,3, Xincheng Huang4, Wenjing Gu5, Yifan Yin6, Ziyi Zhang7, Baotong Ma8, Ruitong Xia9, Yuanwei Lu10, Jingwen Liu11, Hanjia Xin12, Yumeng Cao13, Saier Yang14, Runqing Li15, Han Li16, Ji Zhao17, Jin Zhang18, Zheng Gao19, Yaxin Zeng20, Yixiao Ding21, Zhuolun Ren22, Yan Guan23, Na Zhang24, Jia Li25, Yan Ma26, Pei Wei27, Jingjing Dong28, Yajing Zhou29, Yong Dong30, Yan Qian31, Chen Chen32, Yujie Zhao33, Yimiao Li34, Yujia Zheng35, Rongyi Chen36, Xiaomeng Li37, Yuke Han38, Yaoyao Xia39, Huixin Xu28, Zhaolin Wu40, Mingyou Wu41, Xinrui Wu42, Junyi Hou43, Yuelai Cai44, Xiaofan Dai45, Wenbo Li46, Ting Nie47, Chongzhe Zhang48, Xiaoya Wang49, Dan Li29, Siyao Yan50, Zhiheng Yi51, Chenxi Liu52, Xinyue Zhang53, Lei Shi23, Haomiao Li54, Feng Jiang55,56, Xiaoming Zhou57,58, Xinying Sun59 (), Yibo Wu59 (),  Psychology and Behavior Investigation of Chinese Residents project team
International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
Yanjing Medical College, Capital Medical University, Beijing, China
Department of Health Education, Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China
School of Journalism and Communication, South China University of Technology, Guangzhou, Guangdong, China
School of Philosophy, Anhui University, Hefei, Anhui, China
School of Public Health, Qingdao University, Qingdao, Shandong, China
School of Stomatology, North Sichuan Medical College, Nanchong, Sichuan, China
School of Management, Hainan Medical University, Haikou, Hainan, China
School of Humanities and Foreign Languages, Qingdao University of Technology, Qingdao, Shandong, China
School of Management, North Sichuan Medical College, Nanchong, Sichuan, China
College of Medical Sciences, Shanxi Medical University, Taiyuan, Shanxi, China
School of Nursing, Nanchang University, Nanchang, Jiangxi, China
Department of Stomatology, Jitang College of North China University of Science and Technology, Tangshan, Hebei, China
School of Geriatric Nursing and Wellness, Tianfu College of Southwestern University of Finance and Economic, Chengdu, Sichuan, China
School of Philosophy and Social Development, Shandong University, Jinan, Shandong, China
School of Foreign Languages, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
School of Medical, Tibet University, Lhasa, Tibet, China
Department of Journalism and Communication, Jinan University, Guangzhou, Guangdong, China
Medical School, Nanjing University, Nanjing, Jiangsu, China
School of Economics & Management, Nanchang University, Nanchang, Jiangxi, China
School of Teachers College, Shihezi University, Shihezi, Xinjiang, China
School of Journalism and Communication, Renmin University of China, Beijing, China
School of Health Management, Guangzhou Medical University, Guangzhou, Guangdong, China
School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
School of Literature and Communication, Yunnan Minzu University, Kunming, Yunnan, China
School of First Clinical Medical College, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
School of Accounting and Audit, Guangxi University of Finance and Economics, Nanning, Guangxi, China
School of Nursing, Henan University of Science and Technology, Luoyang, Henan, China
School of Nursing, North Sichuan Medical College, Nanchong, Sichuan, China
The Third Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
School of Public Administration, Guangdong University of Foreign Studies, Guangzhou, Guangdong, China
School of Journalism and Communication, Lanzhou University, Lanzhou, Gansu, China
School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China
School of Nursing, Tianjin Medical University, Tianjin, China
School of Medicine, Fujian Medical University, Fuzhou, Fujian, China
School of Nursing, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
School of Mental Health, Capital Medical University, Beijing, China
School of Journalism and Communication, Southwest University of Political Science & Law, Chongqing, China
School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
School of Second Clinical College, China Medical University, Shenyang, Liaoning, China
School of Government, Yunnan University, Kunming, Yunnan, China
School of Liberal Arts and Media, Guangdong Polytechnic Normal University, Guangzhou, Guangdong, China
School of Third Clinical Medical, Beijing University of Chinese Medicine, Beijing, China
School of Journalism and Communication, Minzu University of China, Beijing, China
School of Medical Humanities Sciences, China Medical University, Shenyang, Liaoning, China
Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
School of Law, Yangtze University, Jingzhou, Hubei, China
School of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
School of Statistics and Mathematics, Shandong University of Finance and Economics, Jinan, Shandong, China
Xiangya School of Public Health, Central South University, Changsha, Hunan, China
Department of Aeronautics and Astronautics, Fudan University, Shanghai, China
School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China
School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
Dongying People's Hospital, Dongying, Shandong, China
School of Public Health, Peking University, Beijing, China

Diyue Liu and Siyuan Fan contributed equally to this study and share the co‐first authorship.

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Graphical Abstract

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Surveyed from June 20 to August 31, 2023, across 150 cities and various urban–rural settings in China, our study employed stratified sampling to gather comprehensive data on Chinese residents' psychology and behavior. Trained surveyors conducted face‐to‐face interviews, covering health, family, social environment, psychological conditions, and behavioral patterns. Quality control ensured robust data for informing health policies and services.

Abstract

Introduction

This study protocol specifies the primary research line and theoretical framework of the 2023 Survey of the Psychology and Behavior of the Chinese Population. It aims to establish a consistent database of Chinese residents' psychological and behavioral surveys through multi‐center and large‐sample cross‐sectional surveys to provide robust data support for developing research in related fields. It will track the public's physical and psychological health more comprehensively and systematically.

Methods

The study was conducted from June 20, 2023 to August 31, 2023, using stratified and quota sampling methods. A total of 150 cities across 800 communities/villages were surveyed, selected from China (Despite extensive coordination, we have been unable to contact our counterparts in the Taiwan region of China to obtain relevant statistical data). The questionnaires were distributed to the public one‐on‐one and face‐to‐face by trained surveyors. The questionnaires included basic information about the individual, personal health status, basic information about the family, the social environment in which the individual lives, psychological condition scales, behavioral level scales, other scales, and attitudes towards topical social issues. Supervisors conducted quality control during the distribution process and returned questionnaires, logically checked and cleaned for data analysis.

Discussion

Data collection has been finished, and scientific outputs based on this data will support the development of health promotion strategies in China and globally. In the aftermath of the pandemic, it will guide policymakers and healthcare organizations to improve their existing policies and services to maximize the physical and mental health of the Chinese population.

Trial Registration

This study was filed in the National Health Security Information Platform (Record No.: MR‐37‐23‐017876) and officially registered in the China Clinical Trials Registry (Registration No.: ChiCTR2300072573).

Keywords

Chinese residentsphysical and psychological healthhealth behaviorcross‐sectional study

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Health Care Science
Volume 3 Issue 6,
December 2024
Pages 475-492
DOI: 10.1002/hcs2.125
Cite this article:
Liu D, Fan S, Huang X, et al. Study protocol: A national cross‐sectional study on psychology and behavior investigation of Chinese residents in 2023. Health Care Science, 2024, 3(6): 475-492. https://doi.org/10.1002/hcs2.125
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Scales used for the questionnaire.

ScaleAbbreviationLevelApplicable age (years)Target populationDimensionItemScore
Abbreviations: CFI, Comparative Fit Index; GFI, Goodness‐of‐Fit Index; RMSEA, Root Mean Square Error of Approximation; TLI, Tucker–Lewis Index.*1. Community Citizen Behavior Scale‐5 items: The Cronbach\'s alpha (α) for internal consistency was 0.744. The Kaiser‐Meyer‐Olkin measure of sampling adequacy was 0.830. The Bartlett\'s test of sphericity was significant (p < 0.01), with a chi‐square value of χ2 = 599.756467, and df = 21.*2. Intimate Relationship Violence Scale: Cronbach\'s α of 0.948 and a split‐half reliability of 0.914 (both > 0.800). Factor analysis of the 5 items yielded a KMO value of 0.900 and Bartlett\'s test of sphericity was significant (p < 0.001). One factor was extracted via principal axis factoring, explaining 83.227% of the variance (greater than 40%). All item loadings on this factor ranged from 0.862 to 0.926, aligning with the unidimensional construct. Model fit indices confirmed good validity (χ2/df = 1.61, GFI = 0.88, CFI = 0.95, RMSEA = 0.05, TLI = 0.99). The average variance extracted was 0.832 (>0.5), and composite reliability was 0.961 (>0.7). The optimal cut‐off points based on the Youden Index are 8.5 and 13.5, classifying the categories.
Adverse Childhood Experiences [44]ACEsOther scale≥18All populations717“Yes” or “No”, with a total score can be categorized by binary groups or more groups
Big Five Inventory‐10Items [45]BFI‐10Psychological Level Scale≥12All populations5101–5 (strongly disagree to strongly agree). reverse score: questions 1.3.4.5.7, forward score: questions 2.6.8.9.10Higher scores indicate higher levels of a given personality trait.
Patient HealthQuestionnaire‐9 items [46]PHQ‐9Psychological Level Scale≥12All populations190–3 (never to nearly every day)0–4 no depression, 5–9 mild depression, 10–14 moderate depression, 15–19 moderate to severe depression, 20–27 severe depression
Generalized AnxietyDisorder‐7 items [47]GAD‐7Psychological Level Scale≥12All populations170–3 (never to nearly every day)0–4 no anxiety, 5–9 mild anxiety, 10–13 moderate anxiety, 14–18 moderate anxiety, 19–21 severe anxiety
Perceived Stress Scale‐4Items [48, 49]PSS‐4Psychological Level Scale≥12Junior highschool or above240–4 (never to always) with a total score ranging from 0 to 16 points, higher scores indicating more perceived stress.
Perceived Social SupportScale [50]PSSS‐SFPsychological Level Scale≥18All populations131–7 (strongly disagree to strongly agree), higher scores indicating greater perception of social support
New GeneralSelf‐efficacy Scale [51, 52]NGSES‐SFPsychological Level Scale≥12All populations131–5 (strongly disagree to strongly agree), with a total score ranging from 3 to 15 points, with higher scores indicating greater self‐efficacy
Body Image–Acceptance and Action Questionnaire–5 [53]BI‐AAQ‐5Psychological Level Scale≥18All populations151–7 (never ture to always ture), the total score range is 5–35 points, higher scores indicate higher levels of body image flexibility.
Connor‐Davidson Resilience Scale‐2 [54]CD‐RISC2Psychological Level Scale≥18All populations120–4 (not true at all to true nearly all of the time), with a total score ranging from 0 to 8 points, with higher scores indicating greater resilience.
General Risk Propensity Scale [55]GRiPSPsychological Level Scale≥18All populations181–5 (strongly disagree to strongly agree), with a total score ranging from 5 to 40 points, with higher scores indicating a higher propensity to take risks.
The Stigma‐9 Questionnaire [56]STIG‐9Psychological Level Scale≥18All populations190–3 (disagree to agree), with a total score ranging from 0 to 27 points, with higher scores indicating more stigmatization.
Public Service Motivation Scale‐8 items [57]PSM‐SFPsychological Level Scale≥18All populations481–5 (strongly disagree to strongly agree), with a total score ranging from 5 to 40 points, with higher scores indicating higher public service motivation.
Smoking and Alcohol Behavior QuestionnaireBehavior Level Scale≥18People over 18years oldSelf‐developedscale11
Fagerstrom Test of Nicotine Dependence [58]FTNDBehavior Level Scale≥18People over 18years oldSelf‐developedscale6The total scores ranging from 0 to 10, with higher scores indicating higher nicotine dependence.
The InternationalPhysical ActivityQuestionnaire [59, 60]IPAQ‐7Behavior Level Scale≥18All populations47(1) Walking MET = 3.3 × average daily walking time × weekly walking days. (2) Moderately strong MET = 4.0 × average time engaged in moderate intensity activity per day × days engaged in moderate intensity activity per week. (3) Strenuous activity MET = 8.0 × average time engaged in strenuous activity per day × days engaged in strenuous activity per week. Therefore, basal metabolic time per week (minutes) = (1) + (2) + (3).
Pittsburgh Sleep QualityIndex [61]B‐PSQIBehavior Level Scale≥18All populations56Total score ranges from 0 to 15, with higher scores indicating poorer sleep quality
Morningness‐Eveningness Questionnaire‐5 items [62]MEQ‐5Other scale≥15All populations151–5, with total scores ranging from 4 to 25.4–7 Definitely Evening, 8–11 Moderately Evening, 12–17 Neutral, 18–21 Moderately Morning, 22–25 Definitely Morning.
Community Citizen Behavior Scale‐5 items*1CCB‐5Behavior Level Scale≥18All populations151–5 (strongly disagree to strongly agree), with a total score ranging from 5 to 25 points, with higher scores indicating more community citizenship behavior.
Intimate RelationshipViolence Scale*2Behavior Level Scale≥12All populationsSelf‐developedscale61–5 (never to almost always), the total score range is 5–25 points, scores from 5 to 8 indicate a low level, 9–13 represent a moderate level, and 14–25 correspond to a high level.
Media Use Behavior Scale [63, 64]Behavior Level Scale≥12All populationsSelf‐developedquestionnaire61–5 (never to always), with a total score ranging from 6 to 30 points, with higher scores indicating more frequent use of media
Family CommunicationScale [65]FCS‐4Other scale≥11All populations141–5 (strongly disagree to strongly agree), with a total score ranging from 4 to 20 points, with higher scores indicating higher levels of family communication
Antibiotic Use Behavior and Cognition QuestionnaireBehavior Level Scale≥12All populationsSelf‐developedscale171–5 (strongly agree to strongly disagree), with a total score ranging from 17 to 85 points.
Simplified Nutritional Appetite Questionnaire [66, 67]SNAQOther scale≥18All populations241–5 (from “a” to “e”), with total scores ranging from 4 to 20 points, a total score less than 14 indicates that there is a risk of weight loss of more than 5% or 10% in the next months.
Quality of Life Scale [68]EQ‐5D‐5LOther scale≥18All populations55 + EQ‐ VAS1–5, with total scores ranging from 5 to 25, with higher scores indicating higher quality of life. Gliding multiple choice questions with EQ‐VAS score of 0–100.
the Electronic Health Literacy Scale [69, 70]eHEALS‐SFOther scale≥18All populations151–5 (strongly disagree to strongly agree), with a total score ranging from 5 to 25 points, with higher scores indicating a higher level of electronic health literacy.
Family HealthScale‐Short Form [71, 72]FHS‐SFOther scale≥18All populations4101–5 (strongly disagree to strongly agree), with total scores ranging from 10 to 50 points, with higher scores indicating higher levels of family health
Health LiteracyScale‐Short Form‐4 [73]HLS‐SF4Other scale≥12All populations340–3 (very difficult to very easy), with total scores ranging from 0 to 12, with higher scores indicating higher levels of health literacy
Doctor‐patient Communication Preferences QuestionnaireOther scale≥12All populationsSelf‐developedscale7
Medication Literacy Scale [74]Other scale≥12All populations61–5 (always ture to never ture), with total scores ranging from 6 to 30 points.