Shuaijun Guo - Academia.edu (original) (raw)

Papers by Shuaijun Guo

Background: Racism is a fundamental cause of health inequities for Aboriginal and Torres Strait I... more Background: Racism is a fundamental cause of health inequities for Aboriginal and Torres Strait Islander children. We aimed to examine the potential to reduce inequities in Aboriginal and Torres Strait Islander children's mental health and sleep problems through eliminating interpersonal racial discrimination. Methods: We drew on cross-sectional data from the Speak Out Against Racism (SOAR; N=2818) and longitudinal data from the Longitudinal Study of Australian Children (LSAC; N=8627). The SOAR survey was completed in 2017 and the LSAC followed children from 2004 to 2014 in the kindergarten cohort and from 2008 to 2018 in the birth cohort. Exposure was measured by Aboriginal and Torres Strait Islander status (Aboriginal and Torres Strait Islander or Anglo-European), as a proxy measure of structural racism (SOAR: 10-15 years; LSAC: 4-5 years). Mediator was measured by interpersonal racial discrimination (yes/no) (SOAR: 10-15 years; LSAC: 12-13 years). Outcomes were measured by me...

Background Health literacy measurement lays a solid foundation to identify associations with heal... more Background Health literacy measurement lays a solid foundation to identify associations with health outcomes and monitor population health literacy levels over time. In mainland China, most existing health literacy instruments are either knowledge-based or practice-based, making health literacy results incomparable between China and other countries. This study aimed to examine the reliability and validity of the 12-item Health Literacy Population Survey (HLS19-Q12) in a general population of Chinese adults. Methods A cross-sectional study was conducted to recruit primary carers of students from 11 schools in Zhengzhou, Henan Province, using convenience cluster sampling. Participants completed an online self-administered survey that collected information on key sociodemographics, health literacy (HLS19-Q12 and a comparison tool: Health Literacy Questionnaire (HLQ)), and health-related outcomes. Using the COnsensus-based Standards for the selection of health status Measurement Instrum...

Australian Journal of Early Childhood, Jul 31, 2023

The COVID-19 pandemic has profoundly affected children’s care and education worldwide. This artic... more The COVID-19 pandemic has profoundly affected children’s care and education worldwide. This article reports on patterns of participation in early childhood education and care (ECEC) across Australia as influenced by the COVID-19 pandemic and national policies. Using ECEC data from Xplor – a software platform used across Australian childcare centres (2019: n = 229,349; 2020: n = 229,468), patterns of attendance rates were examined nationally in 2019 and 2020 by service-level and family-level characteristics. The average attended hours per week of ECEC nationally in 2020 (18.32 hours) was less than that in 2019 (21.26 hours). Attendance rates at ECEC in 2020 declined rapidly from 66% to 26.2% at the onset of the COVID-19 outbreak. Fee-free subsidy from Australian governments did not substantially increase attendance or reduce disparities in attendance for vulnerable families. Low ECEC attendance rates for prolonged periods could have significant implications for child development, particularly for children from vulnerable backgrounds.

medRxiv (Cold Spring Harbor Laboratory), Dec 4, 2020

Introduction: There is a growing body of research showing associations between experiences of rac... more Introduction: There is a growing body of research showing associations between experiences of racism and poor health and wellbeing outcomes for children and adolescents. The aim of this review protocol is to update the first systematic review conducted by Priest et al. 2013, including a meta-analysis of findings. Based on previous empirical data, it is anticipated that child and adolescent health will be negatively impacted by racism. This review will provide updated evidence of effect sizes across outcomes and identify moderators and mediators of relationships. Methods and analysis: This systematic review and meta-analysis will include studies that explore associations between experiences of racism and racial dissemination with health outcomes of children and adolescents aged 0-24 years of age from any racial/ethnic/cultural group. Outcome measures include general health and wellbeing, physical health, mental health, healthcare utilisation and health behaviours. Exposure measures include selfreported and proxy reported personal experiences of racism and reported experiences of vicarious racism. The authors will conduct a comprehensive search of studies from the earliest time available to September 2020. All relevant studies will be screened with data extraction, quality appraisal and publication bias conducted independently by at least two authors. .

Sage Open Medicine, 2020

Introduction: The mortality associated with non-communicable diseases has increased significantly... more Introduction: The mortality associated with non-communicable diseases has increased significantly in most countries in the World Health Organization Western Pacific Region over the last 20 years, as have the underlying risk factors. This study aimed to collate evidence on the prevalence of four major non-communicable diseases and their risk factors in Papua New Guinea in order to inform appropriate policy for their prevention and management. Methods: We performed a systematic review of Papua New Guinea-based population prevalence studies of cardiovascular diseases, type 2 diabetes mellitus, chronic respiratory diseases, and cancers, as well as non-communicable disease risk factors published before 2016. Five online databases were searched and screened against eligibility criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 57 articles were included in this review, most of which (n = 48) were published prior to 2000. Eleven articles reported on diabetes, six reported on chronic lung disease/asthma, two reported on cardiovascular diseases, and two reported cancer as the primary outcome, while the remaining 36 papers reported non-communicable disease risk factors. Conclusion: This review demonstrated variations in the prevalence of non-communicable diseases (0%-19%) and their risk factors (0%-80.6%) attributed to the lifestyle and genetic diversity of the Papua New Guinea population. There is a strong suggestion that the prevalence of non-communicable diseases (particularly type 2 diabetes mellitus) and key noncommunicable disease risk factors (hypertension, overweight, and obesity) has increased, but there is a lack of recent data. As such, there is an urgent need for new and up-to-date data in all areas of Papua New Guinea.

Journal of Attention Disorders, Dec 14, 2020

Objective: The present study examined the impact of Attention Deficit Hyperactivity Disorder (ADH... more Objective: The present study examined the impact of Attention Deficit Hyperactivity Disorder (ADHD) on core educational outcomes in two large community cohorts of Australian school children. Method: Academic (reading and numeracy) and non-academic (school engagement, attendance, peer victimization, and parental expectations) outcomes were compared between children with ADHD, subthreshold ADHD, and controls when children were in grade 5 (M age = 10.5). Data were drawn from the Longitudinal Study of Australian Children birth cohort (LSAC; N = 3,540) and the Children’s Attention Project (CAP; N = 356). Results: Both subthreshold ADHD and ADHD groups had poorer outcomes on all measures, with medium effects sizes. Differences were not evident between subthreshold ADHD and ADHD groups. Conclusions: Educational outcomes examined in this study highlight the educational risk for upperprimary school children with ADHD or subthreshold ADHD, in comparison to their peers. Monitoring these outcomes is necessary to inform policy, practice, and intervention.

Environmental Pollution, Apr 1, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Background: Exposure to early socioeconomic disadvantage is associated with a range of adverse he... more Background: Exposure to early socioeconomic disadvantage is associated with a range of adverse health and educational outcomes in later life, leading to substantial social and economic costs. Health literacy, as a personal asset to maintain and protect good health, has the potential to reduce socioeconomic inequities in these adverse outcomes. This study aimed to estimate the extent to which improving health literacy could reduce socioeconomic inequities in adolescents' health and educational outcomes. Methods: A cross-sectional study was conducted with 650 students (54.9% male and 45.1% female) in Years 7 to 9 from four secondary schools in Beijing. Socioeconomic disadvantage was assessed by the Family Affluence Scale. Health literacy was measured by the 8-item skills-based Health Literacy Assessment Tool overall and by three domains: functional, interactive and critical. Outcomes included self-report global health status, health behaviours (breakfast eating, teeth brushing, cigarette smoking, alcohol drinking, physical activity, two or more health-compromising behaviours), patient-provider communication, and academic achievement. An interventional effects approach to causal mediation analysis was conducted. Results: Improving disadvantaged adolescents' health literacy to the level of their non-disadvantaged peers could reduce 15.3%, 12.0%, 15.2% and 11.4% of socioeconomic differences in global health status, two or more health-compromising behaviours, patient-provider communication, and academic achievement, respectively. There were varying benefits of improving health literacy in each domain, depending on the outcome measured. Conclusion: Improving health literacy could contribute to reducing socioeconomic inequities in adolescents' health and educational outcomes. Health literacy interventions should be considered within a broader, multifaceted and sustained strategy via collaborations between schools, families and communities.

Frontiers in Public Health, Oct 4, 2021

Background: Accessible, equitable, and efficient pediatric service is critical to achieve optimal... more Background: Accessible, equitable, and efficient pediatric service is critical to achieve optimal child health. This study aimed to evaluate the effectiveness of a multi-component intervention on the pediatric health system over two different periods in Guangzhou. Methods: Based on the World Health Organization (WHO) "six building blocks" model and Donabedian's "Structure-Process-Outcomes" framework, an intervention package was developed to increase financial and human resouce investment to strengthen basic health care and strive for a better quality of pediatric care. This multi-component intervention package was conducted in Guangzhou to improve the pediatric service delivery during two stages (2011-2014 and 2016-2019). The main outcome indicators were the changes in the allocation of pediatricians and pediatric beds, pediatric service efficiency, and the impact of pediatricians on child mortality. Results: We found that pediatricians per 1,000 children (PPTC) and pediatric beds per 1,000 children (PBPTC) increased from 1.07 and 2.37 in 2010 to 1.37 and 2.39 in 2014, then to 1.47 and 2.93 in 2019, respectively. Infant mortality rate (IMR) and under-5 mortality rate (U5MR) dropped from 5.46‰ and 4.04‰ in 2010 to 4.35‰ and 3.30‰ in 2014 then to 3.26‰ and 2.37‰ in 2019. The Gini coefficients of PPTC and PBPTC decreased from 0.48 and 0.38 in 2010, to 0.35 and 0.28 in 2014, then to 0.35 and 0.22 in 2019, respectively, representing the improvement of pediatric resources distribution according to service population. However, equalities in the spatial distribution were not improved much. The average efficiency of pediatric service fluctuated from 2010 to 2019. A unit increase in PPTC was associated with an 11% reduction in IMR and a 16% reduction in U5MR. Conclusions: Findings suggest this multi-component intervention strategy is effective, particularly on the reduction of child mortality. In future, more rigorous and multi-faceted indicators should be integrated in a comprehensive evaluation of the intervention.

International Journal of Environmental Research and Public Health, Oct 20, 2020

Over the past two decades, health literacy research has gained increasing attention in global hea... more Over the past two decades, health literacy research has gained increasing attention in global health initiatives to reduce health disparities. While it is well-documented that health literacy is associated with health outcomes, most findings are generated from cross-sectional data. Along with the increasing importance of health literacy in policy, there is a lack of specificity and transparency about how to improve health literacy in practice. In this study, we are calling for a shift of current research paradigms from judging health literacy levels towards observing how health literacy skills are developed over the life course and practised in the real world. This includes using a life-course approach, integrating the rationale of precision public health, applying open science practice, and promoting actionable knowledge translation strategies. We show how a greater appreciation for these paradigms promises to advance health literacy research and practice towards an equitable, precise, transparent, and actionable vision.

Health literacy research and practice, Jan 11, 2021

Background: Health literacy enables a person to make good decisions regarding health care, diseas... more Background: Health literacy enables a person to make good decisions regarding health care, disease prevention, and health promotion to maintain and improve health. Although health literacy research in China has gained increasing attention in recent years, most existing studies focus on adults rather than adolescents. In addition, little theory-driven empirical research has been conducted to fully understand the relationship among health literacy, its influencing factors, and health outcomes scored on a skills-based health literacy instrument. Objective: This study applied Manganello's framework to investigate how health literacy was related to its antecedents and health status in secondary students in Beijing, China. Methods: A cross-sectional study was conducted with 650 students in Years 7 to 9 (age 11-17 years) from four secondary schools. Students completed a self-administered questionnaire based on Manganello's health literacy framework, which measured key upstream determinants, including health literacy and self-report health status. Health literacy was measured on an 8-item skills-based instrument that assesses a person's ability to find, understand, appraise, and communicate health information in everyday life (scores range from 0-37). Descriptive statistics and path analysis were conducted to investigate the mediating role of health literacy in predicting health status. Key Results: Overall, the average scores of students' health literacy was 26.37 (±5.89). Manganello's framework was supported by the data collected (χ 2 /df = 2.049, p = .001, comparative fix index = 0.966, root mean square error of approximation = 0.041). Personal self-efficacy (r = 0.11, p = .007), social support (r = 0.18, p < .001), and school environment (r = 0.27, p < .001) predicted health literacy, which in turn predicted students' health status (r = 0.12, p = .005). Conclusions: Adolescent health literacy is not only a person's capability to protect health, but also an interactive outcome with the broader environment. Promoting health literacy could be a useful strategy to improve health status for adolescents; however, a holistic approach is needed to increase students' self-efficacy, promote social support, and create positive school environments to achieve optimal health literacy and health outcomes.

Archives of Disease in Childhood, Dec 22, 2020

Background Diagnosis of congenital syphilis (CS) is not straightforward and can be challenging. T... more Background Diagnosis of congenital syphilis (CS) is not straightforward and can be challenging. This study aimed to evaluate the validity of an algorithm using timing of maternal antisyphilis treatment and titres of nontreponemal antibody as predictors of CS. Methods Confirmed CS cases and those where CS was excluded were obtained from the Guangzhou Prevention of Mother-to-Child Transmission of syphilis programme between 2011 and 2019. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using receiver operating characteristics (ROC) in two situations: (1) receiving antisyphilis treatment or no-treatment during pregnancy and (2) initiating treatment before 28 gestational weeks (GWs), initiating after 28 GWs or receiving no treatment for syphilis seropositive women. Results Among 1558 syphilis-exposed children, 39 had confirmed CS. Area under the curve, sensitivity and specificity of maternal non-treponemal titres before treatment and treatment during pregnancy were 0.80, 76.9%, 78.7% and 0.79, 69.2%, 88.7%, respectively, for children with CS. For the algorithm, ROC results showed that PPV and NPV for predicting CS were 37.3% and 96.4% (non-treponemal titres cutoff value 1:8 and no antisyphilis treatment), 9.4% and 100% (non-treponemal titres cutoff value 1:16 and treatment after 28 GWs), 4.2% and 99.5% (non-treponemal titres cutoff value 1:32 and treatment before 28 GWs), respectively. Conclusions An algorithm using maternal nontreponemal titres and timing of treatment during pregnancy could be an effective strategy to diagnose or rule out CS, especially when the rate of loss to follow-up is high or there are no straightforward diagnostic tools.

BMJ Open, Jun 1, 2021

et al. Updated systematic review and metaanalysis of studies examining the relationship between r... more et al. Updated systematic review and metaanalysis of studies examining the relationship between reported racism and health and well-being for children and youth: a protocol. BMJ Open 2021;11:e043722.

BioMed Research International, May 5, 2020

Background. To eliminate mother-to-child transmission of syphilis, the Chinese government recomme... more Background. To eliminate mother-to-child transmission of syphilis, the Chinese government recommends a treatment regimen that slightly differs from the World Health Organization-(WHO-) recommended treatment. However, little is known about their difference in efficacy. This study is aimed at comparing the effect of China-recommended and WHO-recommend treatment regimens on adverse pregnancy outcomes (APOs) and at examining associated risk factors of APOs among syphilis-seropositive women. Methods. Using the syphilis registry data, we retrospectively collected data from 4488 syphilis-infected pregnant women in Guangzhou during 2011-2018. Multivariate analyses were used to investigate the association between treatment regimens and APOs (ectopic pregnancy, spontaneous abortion, stillbirth, preterm birth or low birth weight, newborn smaller than gestational age, congenital syphilis, and infant death) and the association between risk factors and APOs. Results. Of 3474 participants, 27.3% had at least one APO. Compared to those receiving WHO-recommended treatment, women who received Chinarecommended treatment were less likely to have APOs (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.38-0.57), whereas those who received no treatment had 1.6 times higher odds of experiencing APOs. One common risk factor across different APOs was high levels of log 2-transformed toluidine red unheated serum test (TRUST) titers before treatment (OR 1.14, 95% CI 1.10-1.19). China-recommended treatment was effective in reducing APOs for those with TRUST ≥ 1 : 8 (OR 0.21, 95% CI 0.14-0.29) and those with TRUST < 1 : 8 (OR 0.62, 95% CI 0.50-0.77). Conclusions. Syphilis-seropositive women receiving Chinarecommended treatment had lower odds of APOs, especially when TRUST titers before treatment were high. Findings can be used to guide health professionals to reduce APOs among syphilis-infected mothers and promote nationwide use of Chinarecommended treatment.

Academic Pediatrics, Aug 1, 2022

Health literacy research and practice, Oct 1, 2022

Background: Health literacy is a critical driver of achieving an equitable world for every child ... more Background: Health literacy is a critical driver of achieving an equitable world for every child and adolescent. Although the relationship between health literacy and health-related quality of life (HRQoL) has been documented, little is known among adolescents. In addition, due to lack of theory-driven empirical research, it remains unknown about the full relationship between health literacy, its antecedents, and HRQoL. Objective: This study aimed to apply Manganello's framework to investigate how health literacy was associated with its antecedents and HRQoL in Beijing secondary students. Methods: A cross-sectional study was conducted with 650 students in years 7 to 9 from four secondary schools in Beijing. Based on Manganello's health literacy framework, a self-administered questionnaire was used to collect information on health literacy, its antecedents (i.e., sociodemographics, self-efficacy, social support, school and community environment), and HRQoL. The 8-item Health Literacy Assessment Tool was used to measure health literacy (score range 0–37), and the KIDSCREEN-10 was used to measure HRQoL (score range 10–50). Path analysis was conducted to examine the mediating role of health literacy in the relationship between its antecedents and HRQoL. Key Results: Overall, the average score of students' health literacy and HRQoL was 26.37 (±5.89) and 37.49 (±5.78), respectively. Health literacy was positively correlated with HRQoL ( r = 0.36, p < .01). In the final path model, health literacy was not associated with HRQoL. However, students' social support, school environment, and community environment were associated with HRQoL. Health literacy was affected by self-efficacy, social support, and school environment (all p < .05). Conclusions: A range of intrapersonal, interpersonal, and environmental factors were associated with health literacy and HRQoL. A holistic approach is needed to improve health literacy and HRQoL through multilevel intervention strategies such as increasing personal self-efficacy, promoting social support, and creating positive environments. [ HLRP: Health Literacy Research and Practice . 2022;6(4):e300–e309. ] Plain Language Summary: We investigated how health literacy was related to its influencing factors and HRQoL among Beijing secondary students in years 7 to 9. Health literacy and HRQoL were independent outcomes affected by a range of social-ecological factors including self-efficacy, social support, and perceptions of school and community environments.

International Journal of Epidemiology, Sep 1, 2021

Background: Some birth cohorts experience a larger burden of depression than others. We hypothesi... more Background: Some birth cohorts experience a larger burden of depression than others. We hypothesize that lifestyle, i.e. BMI, alcohol consumption, smoking and physical activity, are potential drivers of these generational differences. Methods: We analyzed data from US adults aged 50-80 years enrolled in the Health and Retirement Study (N ¼ 163,760 personyears). Birth cohort effects were estimated with the age-periodcohort model approach according to Carstensen. Consequently, we assessed the contribution of lifestyle factors by comparing the predicted probability of elevated depressive symptoms to a counterfactual scenario in which all birth cohorts are assigned the lifestyle factor distribution of the 1945 cohort (counterfactual decomposition analysis). We stratified all analyses by sex and ethnicity. Results: BMI contributes to an increased probability of elevated depressive symptoms of up to 32.7% (95%CI: 190.9-11.23%, 1923 cohort) for cohorts born before 1927 and a decrease of up to 16.7% (95%CI: 0.5-26.8, 1964 cohort) for cohorts born after 1959. Contributions are most pronounced in females and white/ Caucasians. Alcohol consumption contributes up to 20% (95%CI: 0.8%;45.3%, 1925 cohort) to cohort effects of elevated depressive symptoms, whereas the magnitude differs by ethnicity. We found no evidence for contributions of smoking or physical activity. Conclusions: Birth cohort effects of elevated depressive symptoms can be partly explained by lifestyle. In particular, mental health of females and the white/Caucasian population may have suffered from the increase in obesity levels in the US. Key messages: BMI and alcohol consumption, but not smoking or physical activity, contribute to birth cohort differences in depression risk.

Children (Basel), Jul 28, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Health Promotion Journal of Australia, Oct 19, 2020

This is the author manuscript accepted for publication and has undergone full peer review but has... more This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as