Imperial College London

Dr Chen Shen

Faculty of MedicineSchool of Public Health

Research Associate in Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 1694chen.shen Website

 
 
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Location

 

160Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

25 results found

Shen C, Smith RB, Heller J, Spiers ADV, Thompson R, Ward H, Roiser JP, Nicholls D, Toledano MBet al., 2024, Depression and Anxiety in Adolescents During the COVID-19 Pandemic in Relation to the Use of Digital Technologies: Longitudinal Cohort Study., J Med Internet Res, Vol: 26

BACKGROUND: Adolescents are susceptible to mental illness and have experienced substantial disruption owing to the COVID-19 pandemic. The digital environment is increasingly important in the context of a pandemic when in-person social connection is restricted. OBJECTIVE: This study aims to estimate whether depression and anxiety had worsened compared with the prepandemic period and examine potential associations with sociodemographic characteristics and behavioral factors, particularly digital behaviors. METHODS: We analyzed cross-sectional and longitudinal data from a large, representative Greater London adolescent cohort study: the Study of Cognition, Adolescents and Mobile Phones (SCAMP). Participants completed surveys at T1 between November 2016 and July 2018 (N=4978; aged 13 to 15 years) and at T2 between July 2020 and June 2021 (N=1328; aged 16 to 18 years). Depression and anxiety were measured using the Patient Health Questionnaire and Generalized Anxiety Disorder scale, respectively. Information on the duration of total mobile phone use, social network site use, and video gaming was also collected using questionnaires. Multivariable logistic regression was used to assess the cross-sectional and longitudinal associations of sociodemographic characteristics, digital technology use, and sleep duration with clinically significant depression and anxiety. RESULTS: The proportion of adolescents who had clinical depression and anxiety significantly increased at T2 (depression: 140/421, 33.3%; anxiety: 125/425, 29.4%) compared with the proportion of adolescents at T1 (depression: 57/421, 13.5%; anxiety: 58/425, 13.6%; P for 2-proportion z test <.001 for both depression and anxiety). Depression and anxiety levels were similar between the summer holiday, school opening, and school closures. Female participants had higher odds of new incident depression (odds ratio [OR] 2.5, 95% CI 1.5-4.18) and anxiety (OR 2.11, 95% CI 1.23-3.61) at T2. A high level of total mobile

Journal article

Patjamontri S, Spiers A, Smith R, Shen C, Adaway J, Keevil BG, Toledano M, Ahmed SFet al., 2023, Salivary androgens in adolescence and their value as a marker of puberty: results from the SCAMP cohort, Endocrine Connections, Vol: 12, ISSN: 2049-3614

Context: Salivary androgens represent non-invasive biomarkers of puberty that may have utility in clinical and population studies.Objective: To understand normal age-related variation in salivary sex steroids and demonstrate their correlation to pubertal development in young adolescents.Design, Setting, and participants: School-based cohort study of 1,495 adolescents at two time points for collecting saliva samples approximately two years apart.Outcome measures: The saliva samples were analyzed for five androgens (testosterone, androstenedione (A4), 17-hydroxyprogesterone (17-OHP), 11-ketotestosterone (11-KT) and 11β-hydroxyandrostenedione (11-OHA4)) using LC-MS/MS; in addition, salivary dehydroepiandrosterone (DHEA) and oestradiol (OE2) were analyzed by ELISA. Pubertal staging was self-reported using the pubertal development scale (PDS).Results: In 1,236 saliva samples from 903 boys aged between 11-16 years, salivary androgens except DHEA exhibited an increasing trend with an advancing age (ANOVA, p<0.001), with salivary testosterone and A4 concentration showing the strongest correlation (r=0.55, p<0.001 and r=0.48, p<0.001, respectively). In a subgroup analysis of 155 and 63 saliva samples in boys and girls, respectively morning salivary testosterone concentrations showed the highest correlation with composite PDS scores and voice-breaking category from PDS self-report in boys (r=0.75, r=0.67, respectively). In girls, salivary DHEA and OE2 had negligible correlations with age or composite PDS scores.Conclusion: In boys aged 11-16 years, increase in salivary testosterone and A4 is associated with self-reported pubertal progress and represent valid non-invasive biomarkers of puberty in boys.

Journal article

Thompson R, Smith RB, Bou Karim Y, Shen C, Drummond K, Teng C, Toledano MBet al., 2023, Air pollution and human cognition: a systematic review and meta-analysis, Science of the Total Environment, Vol: 859, ISSN: 0048-9697

Background:This systematic review summarises and evaluates the literature investigating associations between exposure to air pollution and general population cognition, which has important implications for health, social and economic inequalities, and human productivity.Methods:The engines MEDLINE, Embase Classic+Embase, APA PsycInfo, and SCOPUS were searched up to May 2022. Our inclusion criteria focus on the following pollutants: particulate matter, NOx, and ozone. The cognitive abilities of interest are: general/global cognition, executive function, attention, working memory, learning, memory, intelligence and IQ, reasoning, reaction times, and processing speed. The collective evidence was assessed using the NTP-OHAT framework and random-effects meta-analyses.Results:Eighty-six studies were identified, the results of which were generally supportive of associations between exposures and worsened cognition, but the literature was varied and sometimes contradictory. There was moderate certainty support for detrimental associations between PM2.5 and general cognition in adults 40+, and PM2.5, NOx, and PM10 and executive function (especially working memory) in children. There was moderate certainty evidence against associations between ozone and general cognition in adults age 40+, and NOx and reasoning/IQ in children. Some associations were also supported by meta-analysis (N = 14 studies, all in adults aged 40+). A 1 μg/m3 increase in NO2 was associated with reduced performance on general cognitive batteries (β = −0.02, p < 0.05) as was a 1 μg/m3 increase in PM2.5 exposure (β = −0.02, p < 0.05). A 1μgm3 increase in PM2.5 was significantly associated with lower verbal fluency by −0.05 words (p = 0.01) and a decrease in executive function task performance of −0.02 points (p < 0.001).Discussion:Evidence was found in support of some exposure-outcome associations, however more good quality research is required, particula

Journal article

Eeftens M, Shen C, Sonksen J, Schmutz C, van Wel L, Liorni I, Vermeulen R, Cardis E, Wiart J, Toledano M, Roosli Met al., 2023, Modelling of daily radiofrequency electromagnetic field dose for a prospective adolescent cohort, Environment International, Vol: 172, ISSN: 0160-4120

IntroductionRadiofrequency electromagnetic fields originate from a variety of wireless communication sources operating near and far from the body, making it challenging to quantify daily absorbed dose. In the framework of the prospective cohort SCAMP (Study of Cognition, Adolescents and Mobile Phones), we aimed to characterize RF-EMF dose over a 2-year period.MethodsThe SCAMP cohort included 6605 children from greater London, UK at baseline (age 12.1 years; 2014–2016) and 5194 at follow-up (age 14.2; 2016–2018). We estimated the daily dose of RF-EMF to eight tissues including the whole body and whole brain, using dosimetric algorithms for the specific absorption rate transfer into the body. We considered RF-EMF dose from 12 common usage scenarios such as mobile phone calls or data transmission. We evaluated the association between sociodemographic factors (gender, ethnicity, phone ownership and socio-economic status), and the dose change between baseline and follow-up.ResultsWhole body dose was estimated at an average of 170 mJ/kg/day at baseline and 178 mJ/kg/day at follow-up. Among the eight tissues considered, the right temporal lobe received the highest daily dose (baseline 1150 mJ/kg/day, follow-up 1520 mJ/kg/day). Estimated daily dose [mJ/kg/day] increased between baseline and follow-up for head and brain related tissues, but remained stable for the whole body and heart. Doses estimated at baseline and follow-up showed low correlation among the 3384 children who completed both assessments. Asian ethnicity (compared to white) and owning a bar phone or no phone (as opposed to a smartphone) were associated with lower estimated whole-body and whole-brain RF-EMF dose, while black ethnicity, a moderate/low socio-economic status (compared to high), and increasing age (at baseline) were associated with higher estimated RF-EMF dose.ConclusionThis study describes the first longitudinal exposure assessment for children in a critical period of development. Dos

Journal article

Schmutz C, Burgler A, Ashta N, Soenksen J, Karim YB, Shen C, Smith RB, Jenkins RH, Mireku MO, Mutz J, Maes MJA, Hirst R, Chang I, Fleming C, Mussa A, Kesary D, Addison D, Maslanyj M, Toledano MB, Roosli M, Eeftens Met al., 2022, Personal radiofrequency electromagnetic field exposure of adolescents in the Greater London area in the SCAMP cohort and the association with restrictions on permitted use of mobile communication technologies at school and at home, Environmental Research, Vol: 212, ISSN: 0013-9351

Personal measurements of radiofrequency electromagnetic fields (RF-EMF) have been used in several studies to characterise personal exposure in daily life, but such data are limitedly available for adolescents, and not yet for the United Kingdom (UK). In this study, we aimed to characterise personal exposure to RF-EMF in adolescents and to study the association between exposure and rules applied at school and at home to restrict wireless communication use, likely implemented to reduce other effects of mobile technology (e.g. distraction).We measured exposure to RF-EMF for 16 common frequency bands (87.5 MHz–3.5 GHz), using portable measurement devices (ExpoM-RF), in a subsample of adolescents participating in the cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP) from Greater London (UK) (n = 188). School and home rules were assessed by questionnaire and concerned the school's availability of WiFi and mobile phone policy, and parental restrictions on permitted mobile phone use. Adolescents recorded their activities in real time using a diary app on a study smartphone, while characterizing their personal RF-EMF exposure in daily life, during different activities and times of the day.Data analysis was done for 148 adolescents from 29 schools who recorded RF-EMF data for a median duration of 47 h. The majority (74%) of adolescents spent part of their time at school during the measurement period. Median total RF-EMF exposure was 40 μW/m2 at home, 94 μW/m2 at school, and 100 μW/m2 overall. In general, restrictions at school or at home made little difference for adolescents’ measured exposure to RF-EMF, except for uplink exposure from mobile phones while at school, which was found to be significantly lower for adolescents attending schools not permitting phone use at all, compared to adolescents attending schools allowing mobile phone use during breaks. This difference was not statistically significant for total personal exposure.Total ex

Journal article

Spiers A, Patjamontri S, Smith RB, Shen C, Toledano MB, Ahmed SFet al., 2022, Urinary gonadotrophins as markers of puberty in girls and boys during late childhood and adolescence: Evidence from the SCAMP Cohort, Publisher: KARGER, Pages: 342-342, ISSN: 1663-2818

Conference paper

Shen C, Mireku MO, Di Simplicio M, Dumontheil I, Thomas MSC, Röösli M, Elliott P, Toledano MBet al., 2022, Bidirectional associations between sleep problems and behavioural difficulties and health‐related quality of life in adolescents: Evidence from the SCAMP longitudinal cohort study, JCPP Advances, Vol: 2, Pages: 1-11, ISSN: 2692-9384

BackgroundSleep problems show associations with negative outcomes in both physical and mental health in adolescents, but the associations may be reciprocal. We aimed to assess bidirectional associations between sleep problems and mental health symptoms including behavioural difficulties (internalising and externalising difficulties) and low health-related quality of life (HRQoL).MethodsA total of 6616 adolescents (52.4% females) across Greater London completed baseline assessments when they were aged 11–12 years, and 3803 of them (57.2% females) completed follow-up assessments at aged 13–15 years. Weekday and weekend sleep duration were derived from self-reported bedtime, sleep onset latency and wake time. Sleep disturbance was assessed using a standardized sleep disturbance scale. Internalising and externalising difficulties were assessed using subscales of the Strength and Difficulties Questionnaire. HRQoL was assessed using the KIDSCREEN-10 questionnaire. Cross-lagged structural equation modelling was used with multiple imputation to examine bidirectional associations between sleep problems and mental health symptoms.ResultsFemales had greater internalising difficulties, worse HRQoL and more sleep disturbance than males. Persistent insufficient weekday and weekend sleep, and sleep disturbance (i.e., at both baseline and follow-up) were associated with internalising and externalising difficulties and low HRQoL at follow-up (ORs ranged from 1.53 to 3.63). Persistent externalising difficulties and low HRQoL were also associated with insufficient weekend sleep and sleep disturbance at follow-up (ORs ranged from 1.68 to 4.25). Using continuous variables, we found bidirectional associations between weekday sleep duration and HRQoL, weekend sleep duration and externalising score, sleep quality and internalising score, and sleep quality and HRQoL. The association magnitudes were mostly similar in the two directions.ConclusionsOur study showed bidirectional as

Journal article

Filippi R, Ceccolini A, Booth E, Shen C, Thomas MSC, Toledano MB, Dumontheil Iet al., 2022, Modulatory effects of SES and multilinguistic experience on cognitive development: a longitudinal data analysis of multilingual and monolingual adolescents from the SCAMP cohort, International Journal of Bilingual Education and Bilingualism, Pages: 1-18, ISSN: 1367-0050

Previous research has shown that cognitive development is sensitive to socio-economic status (SES) and multilinguistic experiences. However, these effects are difficult to disentangle and SES may modulate the effects of multilingualism. The present study used data from a large cohort of pupils who took part in the Study of Cognition, Adolescents and Mobile Phones (SCAMP) at ages 11–12 (T1) and 13–15 years old (T2). Cognitive measures were derived from tasks of cognitive flexibility, verbal, spatial and visuo-spatial working memory, speech processing and non-verbal reasoning. Using SES information collected through questionnaires (school type, level of deprivation, parental education and occupation), the sample was clustered into high/medium/low SES groups. Comparisons focused on 517 monolingual and 329 multilingual pupils in the high/low SES groups. Having controlled for multiple comparisons, the results indicated a significant beneficial effect of bilingualism in measures of working memory, visuo-spatial processing and non-verbal reasoning. These effects were present in both high and low SES individuals and sustained at both times of development, with a particularly significant improvement of working memory abilities in low SES bilinguals at T2 as compared to monolingual peers. Theoretical and practical implications of these findings are considered and guidance for educators is discussed.

Journal article

Thompson R, Smith RB, Bou Karim Y, Shen C, Drummond K, Teng C, Toledano MBet al., 2022, Noise pollution and human cognition: An updated systematic review and meta-analysis of recent evidence, Environment International, Vol: 158, Pages: 1-27, ISSN: 0160-4120

BackgroundThis systematic review provides a comprehensive synthesis of recent epidemiological evidence that environmental noise negatively impacts human cognition.MethodsWe update a prior review with recent publications (PROSPERO CRD42019151923). The strength of evidence for associations was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. We also conducted random-effects meta-analyses where suitable.Results16 studies were identified and reviewed in tandem with 32 studies previously reviewed by Clark & Paunovic (2018). A meta-analysis from 3 studies found that reading comprehension scores in quiet classrooms were 0.80 (95% confidence interval: 0.40; 1.20) points higher than children in noisier classrooms. Meta-analysis of the impact of 1 dB (dB) increase in environmental noise on reading and language abilities gave a pooled beta coefficient of −0.11(95% confidence interval: −0.32; 0.10). A meta-analysis of Odds Ratios (OR) from 3 studies found higher odds of cognitive impairment in people aged 45 + with higher residential noise exposure (OR 1.40, 95% CI: 1.18;1.61). After qualitative synthesis of remaining studies, there was high quality evidence for an association between environmental noise and cognitive impairment in middle-to-older adults, moderate quality evidence for an association between aircraft noise and reading and language in children, and moderate quality evidence against an association between aircraft noise and executive functioning in children. Generally the literature was supportive for other cognitive outcomes, but with low or very low-quality evidence.DiscussionThe evidence so far suggests that noise exposure is associated with cognition, but more good quality research using standardised methodology is required to corroborate these results and to allow for precise risk estimation by larger meta-analyses. There is also a need for more research with older teenagers and young-to

Journal article

Patjamontri S, Spiers ADV, Smith RB, Shen C, Adaway J, Keevil BG, Toledano MB, Ahmed Fet al., 2021, Salivary sex steroids as markers of puberty in boys during late childhood and adolescence, European Society for Paediatric Endocrinology

Introduction: Salivary androgens represent a non-invasive marker of puberty that may have utility in population studies as well as in the clinical arena.Objectives: To establish normal reference values of salivary androgens using LC-MS/MS and demonstrate the correlations between salivary androgens and pubertal development in boys.Methods: School-based adolescent cohort study with two time points for collecting saliva samples two years apart. Five androgens (Testosterone;T, androstenedione; A4, 17-hydroxyprogesterone; 17-OHP, 11-ketotestosterone; 11-KT and 11β-hydroxyandrostenedione; 11OHA4 were analyzed in saliva samples using LC-MS/MS. In addition, self-reported assessment of puberty through the Pubertal Development Scale (PDS) was also collected at both time points. Receiver-operating characteristic (ROC) curves were used to determine the areas under the curves (AUCs), of each androgen as a predictor of self-reported voice maturation.Results: A total of 1,166 saliva samples were available from 929 boys aged between 11-16 years at either baseline or follow up or both time points with the median age of 12.3 yrs (range 11.3-13.2) and 14.3 yrs (range 13.4-15.8) at baseline and follow up time point, respectively. Median salivary T increased from 7 pmol/l (10th,90th centile, 5, 41) in participants aged 11-12 yrs to 122 pmol/l (21.6, 267.4) in participants aged 15-16 yrs and median salivary A4 increased from 53 pmol/l (26.2, 92.0) in participants aged 11-12 yrs to 144 pmol/l (50.7, 241.2) in participants aged 15-16 yrs. In a subgroup analysis of 147 saliva samples that were collected within 90 days before or after PDS, salivary T and A4 concentrations showed the highest correspondence with self-reported voice-breaking (One-way ANOVA P < 0.005). ROC curve analysis showed that a salivary testosterone of 82.7 pmol/l and a salivary A4 of 113.4 pmol/l provided a sensitivity of 77% and 74%, respectively and a specificity of 76% and 74%, respectively. Salivary T concent

Poster

Patjamontri S, Spiers A, Smith RB, Shen C, Adaway J, Keevil BG, Toledano MB, Ahmed SFet al., 2021, Salivary sex steroids as markers of puberty in boys during late childhood and adolescence, 59th Annual Meeting of the European Society for Paediatric Endocrinology - 2021, Publisher: KARGER, Pages: 366-366, ISSN: 1663-2818

Conference paper

Maes MJA, Pirani M, Booth ER, Shen C, Milligan B, Jones KE, Toledano MBet al., 2021, Benefit of woodland and other natural environments for adolescents' cognition and mental health, Nature Sustainability, Vol: 4, Pages: 851-858, ISSN: 2398-9629

Epidemiological studies have established positive associations of urban nature with cognitive development and mental health. However, why specifically these health benefits are received remains unclear, especially in adolescents. We used longitudinal data in a cohort of 3,568 adolescents aged 9 to 15 years at 31 schools across London, UK, to examine the associations between natural-environment types and adolescents’ cognitive development, mental health and overall well-being. We characterized natural-environment types in three tiers, where natural space was distinguished into green and blue space, and green space was further distinguished into woodland and grassland. We showed that, after adjusting for other confounding variables, higher daily exposure to woodland, but not grassland, was associated with higher scores for cognitive development and a lower risk of emotional and behavioural problems for adolescents. A similar but smaller effect was seen for green space, but not blue space, with higher scores for cognitive development. Our results suggest that urban planning decisions to optimize ecosystem benefits linked to cognitive development and mental health should carefully consider the type of natural environment included.

Journal article

Shen C, Dumontheil I, Thomas M, Röösli M, Elliott P, Toledano Met al., 2021, Digital technology use and BMI: evidence from a cross-sectional analysis of an adolescent cohort study, Journal of Medical Internet Research, Vol: 23, Pages: 1-16, ISSN: 1438-8871

Background:The use of digital technology such as mobile phones is ubiquitous in adolescents. However, excessive use may have adverse health effects, possibly partially mediated by disruptions to sleep.Objective:This study aims to assess the social predictors of digital technology use and their cross-sectional association with BMI z scores and being overweight in a large sample of adolescents.Methods:We used baseline data from a subset of a large adolescent cohort from 39 schools across Greater London who participated in the Study of Cognition, Adolescents and Mobile Phones (n=1473). Digital technology use included phone calls, internet use on mobile phones, and video gaming on any device. Multilevel regression was used to assess the associations between digital technology use and age-specific and sex-specific BMI z scores and being overweight (including obesity). Measurements were derived from height and weight, obtained by the Tanita BC-418 Body Composition Analyzer. We examined whether these associations were mediated by insufficient sleep.Results:Generally, participants with lower socioeconomic status reported more use of digital technology. Controlling for socioeconomic status, internet use on mobile phones for more than 3 hours per day was associated with higher BMI z scores (adjusted β=.30, 95% CI 0.11-0.48) and greater odds of being overweight (adjusted odds ratio 1.60, 95% CI 1.09-2.34), compared with low use (≤30 minutes). Similar associations were found between video gaming and BMI z scores and being overweight. The BMI z score was more strongly related to weekday digital technology use (internet use on mobile phones and video gaming) than weekend use. Insufficient sleep partly mediated the associations between digital technology use and BMI z scores (proportion of mediation from 8.6% to 17.8%) by an indirect effect.Conclusions:We found an association between digital technology use and BMI in adolescents, partly mediated by insufficient sleep, sugg

Journal article

Ran J, Zhang Y, Han L, Sun S, Zhao S, Shen C, Zhang X, Chan K-P, Lee RS-Y, Qiu Y, Tian Let al., 2021, The joint association of physical activity and fine particulate matter exposure with incident dementia in elderly Hong Kong residents, Environment International, Vol: 156, Pages: 106645-106645, ISSN: 0160-4120

OBJECTIVE: The evidence for the beneficial effects of physical activity (PA) and potentially detrimental effects of long-term exposure to fine particulate matter (PM2.5) on neurodegeneration diseases is accumulating. However, their joint effects remain unclear. We evaluated joint associations of habitual PA and PM2.5 exposure with incident dementia in a longitudinal elderly cohort in Hong Kong. METHODS: A total of 57,775 elderly participants (≥65 years) without dementia were enrolled during 1998-2001 and followed up till 2011. Their information on PA and other relevant covariates were collected at baseline (1998-2001) by a standard self-administered questionnaire, including PA volumes (high, moderate, low, and inactive) and types (aerobic exercise, traditional Chinese exercise, stretching exercise, walking slowly, and no exercise). Their annual mean PM2.5 exposures at the residential address were estimated using a satellite-based spatiotemporal model. We then adopted the Cox proportional hazards model to examine the joint associations with the incidence of all-cause dementia, Alzheimer's diseases, and vascular dementia on additive and multiplicative scales. RESULTS: During the follow-up period, we identified 1,157 incident cases of dementia, including 642 cases of Alzheimer's disease and 324 cases of vascular dementia. A higher PA level was associated with a lower risk of incident all-cause dementia (hazard ratio (HR) for the high-PA volume was 0.59 (95% CI, 0.47, 0.75), as compared with the inactive-PA), whereas a high level of PM2.5 was related to the higher risk with an HR of 1.15 (95%CI: 1.00, 1.33) compared with the low-level of PM2.5. No clear evidence was observed of interaction between habitual PA (volume and type) and PM2.5 inhalation to incident dementia on either additive or multiplicative scale. CONCLUSION: Habitual PA and long-term PM2.5 exposure were oppositely related to incident dementia in the Hong Kong aged population. The benefits of PA re

Journal article

Maes MJA, Pirani M, Booth ER, Shen C, Milligan B, Jones KE, Toledano MBet al., 2021, Benefits of natural habitat particularly woodland on children’s cognition and mental health

<jats:title>ABSTRACT</jats:title><jats:p>Life in urban areas is associated with adverse human health effects, including risks of developing cognitive problems and mental health issues. Many epidemiological studies have established associations between urban nature, cognitive development and mental health, but why specifically we receive these health benefits remains unclear, especially in children. Here, we used longitudinal data in a cohort of 3,568 children aged 9 to 15 years at 31 schools across London to develop a model and examine the associations between natural habitat type, and children’s cognitive development and mental health. We show that, after adjusting for other environmental, demographic and socioeconomic variables, higher daily exposure rates to natural habitat and particularly woodland were associated with enhanced cognitive development and mental health from late childhood to early adolescence. Our results suggest that optimising ecosystem services linked to cognitive development and mental health benefits should prioritise the type of natural habitat for sustainable urban planning decisions.</jats:p>

Journal article

Shen C, Dumontheil I, Thomas M, Röösli M, Elliott P, Toledano Met al., 2020, Digital Technology Use and Body Weight: Evidence From an Adolescent Cohort Study (Preprint)

<sec> <title>BACKGROUND</title> <p>Use of digital technology such as mobile phones is ubiquitous in adolescents. However, excessive usage may have adverse health effects.</p> </sec> <sec> <title>OBJECTIVE</title> <p>We aimed to assess the social predictors of digital technology use and their association with body weight outcomes in a large cohort of adolescents.</p> </sec> <sec> <title>METHODS</title> <p>We used baseline data from a subset of a large adolescent cohort of 39 schools across Greater London who participated in the Study of Cognition, Adolescents and Mobile Phones (n=1,473). Digital technology use included phone calls, internet use on mobile phones, and video gaming on any device. Multi-level regression was used to assess the associations between digital technology use and age- and sex-specific body mass index (BMI) z-score and overweight (including obesity) derived from measured height and weight. We examined whether the associations were mediated by insufficient sleep.</p> </sec> <sec> <title>RESULTS</title> <p>Generally, participants with lower socioeconomic status reported more use of digital technology. Internet use on mobile phones for more than 3 h per day was associated with higher BMI z-score (adjusted β=0.30, 95% confidence interval (95% CI) 0.11, 0.48) and greater odds of being overweight (adjusted odds ratio=1.60, 95% CI 1.09, 2.34), compared with low use (≤30 min). Similar associations between video gaming and body weight were found. BMI z-score was more strongly related to weekday digital technology use

Journal article

Jenkins R, Shen C, Dumontheil I, Thomas MSC, Elliott P, Roosli M, Toledano Met al., 2020, Social networking site use in young adolescents: association with health-related quality of life and behavioural difficulties, Computers in Human Behavior, Vol: 109, Pages: 1-10, ISSN: 0747-5632

Despite Social Networking Sites (SNS) having a minimum age of 13, younger adolescents are using them. In this study, we examine self-reported overall SNS use and SNS use if awake at night in relation to Health-Related Quality of Life (HRQOL, measured by KIDSCREEN-10) and behaviour (measured by Strengths and DifficultiesQuestionnaire, SDQ) in 5229 adolescents aged 11–12 in the Study of Cognition, Adolescents and Mobile Phones (SCAMP) cohort. Two-thirds of the study population used SNS. Weekday and weekend SNS use on mobile phones and other devices was significantly associated with lower HRQOL in females (all p-values for linear trend < 0.01) but not males. Using SNS if awake at night was also significantly associated with lower HRQOL in females (adjustedβ-coefficient - 2.20 (95% CI - 3.18, - 1.22)). Higher SNS use on mobile phones and other devices was associated with increased behavioural difficulties in both genders (p-value for trend < 0.001). Similarly, SNS useif awake at night was associated with greater behavioural difficulties (adjusted β-coefficient 2.54 (95% CI 2.09, 2.98)). We recommend further longitudinal research in this area in order have a better understanding of the direction of relationships between SNS and wellbeing and behaviour in adolescents.

Journal article

Feng S, Shen C, Xia N, Song W, Fan M, Cowling BJet al., 2020, Rational use of face masks in the COVID-19 pandemic, LANCET RESPIRATORY MEDICINE, Vol: 8, Pages: 434-436, ISSN: 2213-2600

Journal article

Guo N, Luk TT, Ho SY, Lee JJ, Shen C, Oliffe J, Chan SS-C, Lam TH, Wang MPet al., 2020, Problematic Smartphone Use and Mental Health in Chinese Adults: A Population-Based Study, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 17

Journal article

Sun S, Cao W, Qiu H, Ran J, Lin H, Shen C, Siu-Yin Lee R, Tian Let al., 2020, Benefits of physical activity not affected by air pollution: a prospective cohort study, International Journal of Epidemiology, Vol: 49, Pages: 142-152, ISSN: 0300-5771

BACKGROUND: Physical activity (PA) is beneficial to human health, whereas long-term exposure to air pollution is harmful. However, their combined effects remain unclear. We aimed to estimate the combined (interactive) mortality effects of PA and long-term exposure to fine particulate matter (PM2.5) among older adults in Hong Kong. METHODS: Participants aged ≥65 years from the Elderly Health Service Cohort (n = 66 820) reported their habitual PA at baseline (1998-2001) and were followed up till 31 December 2011. We used a satellite-based spatiotemporal model to estimate PM2.5 concentration at the residential address for each participant. We used Cox proportional hazards regression to assess the interaction between habitual PA and long-term exposure to PM2.5 on cardiovascular and respiratory mortality. We tested for additive interaction by estimating relative excess risk due to interaction and multiplicative interaction employing P-value for the interaction term. RESULTS: The death risks were inversely associated with a higher volume of PA and were positively associated with long-term exposure to PM2.5. The benefits of PA were more pronounced for participation in traditional Chinese exercise (e.g. Tai Chi) and aerobic exercise (e.g. cycling). We found little evidence of interaction between PA (volume and type) and long-term exposure to PM2.5 on either additive or multiplicative scales. CONCLUSIONS: In this cohort of older Chinese adults, PA may decrease the risk of mortality, be it in areas of relatively good or bad air quality. The beneficial mortality effects of habitual PA outweighed the detrimental effects of long-term exposure to air pollution in Hong Kong.

Journal article

Sun Y, Luk TT, Wang MP, Shen C, Ho SY, Viswanath K, Chan SSC, Lam THet al., 2019, The reliability and validity of the Chinese Short Warwick-Edinburgh Mental Well-being Scale in the general population of Hong Kong, Quality of Life Research, Vol: 28, Pages: 2813-2820, ISSN: 1573-2649

PURPOSE: To evaluate the reliability and validity of the 7-item Chinese Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) in Hong Kong Chinese. METHODS: Under "A Jockey Club Initiative for a Harmonious Society" project, a random telephone survey was conducted in 2017 on 1331 Hong Kong Chinese residents aged ≥ 18. A confirmatory factor analysis (CFA) was conducted to test the factorial validity. The Spearman correlations of the SWEMWBS with other scales including the 12-item short form health survey (SF-12), family well-being, self-rated health, the global happiness item (GHI), subjective happiness scale (SHS), and patient health questionnaire-4 (PHQ-4), were used to evaluate the convergent and divergent validity. Known-group validity was also assessed. We calculated congeneric reliability based on standardized factor loadings and error variances. Two-week test-retest reliability was assessed in 100 randomly selected respondents using intraclass correlation coefficient (ICC). RESULTS: Among the weighted sample, 55.9% were female and 72.9% were 25 to 64 years old. The CFA indicated good validity of the SWEMWBS. The SWEMWBS had moderate correlations with SHS, SF-12 mental component, PHQ-4 and GHI, but a weak correlation with SF-12 physical component. Older respondents, those with higher education level, married, working, with higher household income reported higher level of well-being. The congeneric reliability of the SWEMWBS was 0.85. Moderate to good test-retest reliability was observed (ICC 0.70, 95% CI 0.55 to 0.80). CONCLUSION: The Chinese SWEMWBS showed good validity and reliability for measuring well-being in the general population of Hong Kong.

Journal article

Mireku MO, Barker MM, Mutz J, Shen C, Dumontheil I, Thomas MSC, Röösli M, Elliott P, Toledano MBet al., 2019, Processed data on the night-time use of screen-based media devices and adolescents’ sleep quality and health-related quality of life, Data in Brief, Vol: 23, ISSN: 2352-3409

The data presented in this article relate to the research article entitled “Night-time screen-based media device use and adolescents' sleep and health-related quality of life”. The present data reports findings from the investigation of the relationship between night-time screen-based media devices (SBMD) use and both sleep quality and health-related quality of life (HRQoL) among 11 to 12-year-olds. Baseline data from a large cohort of 6,616 adolescents from 39 schools in and around London, UK, participating in the Study of Cognition Adolescents and Mobile Phone (SCAMP) were analysed. Self-report data on adolescents’ use of any SBMD (mobile phone, tablet, laptop, television etc.) were the main exposures of interest. Mobile phone and television were the most commonly used portable and non-portable device, respectively. Sleep variables were derived from self-reported weekday and/or weekend bedtime, sleep onset latency (SOL) and wake time. Sleep quality was assessed using four standardised dimensions from the Swiss Health Survey. HRQoL was estimated using the KIDSCREEN-10 questionnaire.

Journal article

Shen C, Wang MP, Ho HCY, Wan A, Stewart SM, Viswanath K, Chan SSC, Lam THet al., 2019, Test-retest reliability and validity of a single-item Self-reported Family Happiness Scale in Hong Kong Chinese: findings from Hong Kong Jockey Club FAMILY Project, Quality of Life Research, Vol: 28, Pages: 535-543, ISSN: 1573-2649

PURPOSE: Family happiness is one major theme of family well-being in Chinese culture. We investigated the reliability and validity of the single-item Self-reported Family Happiness Scale (SFHS-1) with the score of 0-10, based on two studies in Hong Kong Chinese. METHODS: Study 1 was a territory-wide population-based telephone survey (n = 4038) conducted in 2016. Study 2 was a community-based family intervention program conducted during 2012-2013 (n = 1261) to enhance family communication and well-being. Test-retest reliability of the SFHS-1 was assessed over 1 month in Study 2. Family APGAR (Adaption, Partnership, Growth, Affection, Resolve) Scale, Family Communication Scale, Subjective Happiness Scale, 12-item Short Form Health Survey Version 2, and 2-item Patient Health Questionnaire were used to assess the convergent and discriminant validities of the SFHS-1 in both studies. Multiple regression analysis was used to assess the incremental validity by identifying the additional contribution of the SFHS-1 score in predicting subjective happiness. RESULTS: The 1-month test-retest reliability assessed by intraclass correlation was 0.76. Family happiness was moderately to strongly correlated with family function, family communication, subjective happiness, mental health-related quality of life and depression, but weakly correlated with physical health-related quality of life. Furthermore, the score of the SFHS-1 added predictive power to mental health-related quality of life and depression in assessing subjective happiness. CONCLUSIONS: Our results have shown the SFHS-1 as a reliable and valid measurement of family happiness in Hong Kong Chinese, suggesting SFHS-1 is highly practicable for future large epidemiological and community-based intervention studies.

Journal article

Luk TT, Wang MP, Shen C, Wan A, Chau PH, Oliffe J, Viswanath K, Chan SS-C, Lam THet al., 2018, Short version of the Smartphone Addiction Scale in Chinese adults: Psychometric properties, sociodemographic, and health behavioral correlates., J Behav Addict, Vol: 7, Pages: 1157-1165

BACKGROUND AND AIMS: Problematic smartphone use (PSU) is an emerging but understudied public health issue. Little is known about the epidemiology of PSU at the population level. We evaluated the psychometric properties of the Smartphone Addiction Scale - Short Version (SAS-SV) and examined its associated sociodemographic factors and health behaviors in Chinese adults in Hong Kong. METHODS: A random sample of 3,211 adults aged ≥18 years (mean ± SD: 43.3 ± 15.7, 45.3% men) participated in a population-based telephone survey in Hong Kong and completed the Chinese SAS-SV. Multivariable linear regressions examined the associations of sociodemographic factors, health behaviors, and chronic disease status with SAS-SV score. Data were weighted by age, sex, and education attainment distributions of the Hong Kong general population. RESULTS: The Chinese SAS-SV is internally consistent (Cronbach's α = .844) and stable over 1 week (intraclass correlation coefficient = .76, p < .001). Confirmatory factor analysis supported a unidimensional structure established by previous studies. The weighted prevalence of PSU was 38.5% (95% confidence interval: 36.9%, 40.2%). Female sex, younger age, being married/cohabitated or divorced/separated (vs. unmarried), and lower education level were associated with a higher SAS-SV score (all ps <.05). Current smoking, weekly to daily alcohol drinking, and physical inactivity predict greater PSU after controlling for sociodemographic factors and mutual adjustment. DISCUSSION AND CONCLUSIONS: The Chinese SAS-SV was found valid and reliable for assessing PSU in Hong Kong adults. Several sociodemographic and health behavioral factors were associated with PSU at the population level, which may have implication for prevention of PSU and future research.

Journal article

Shen C, Wang MP, Wan A, Viswanath K, Chan SSC, Lam THet al., 2018, Health information exposure from information and communication technologies and its associations with health behaviors: Population-based survey, PREVENTIVE MEDICINE, Vol: 113, Pages: 140-146, ISSN: 0091-7435

Journal article

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