Usage of Social Media and Smartphone Application in Assessment of Physical and Psychological Well-Being of Individuals in Times of a Major Air Pollution Crisis

Zhang, Melvyn WB; Ho, Cyrus SH; Fang, Pan; Lu, Yanxia; Ho, Roger CM

The questionnaire (Multimedia Appendix 1), which included (1) demographics, (2) physical symptoms experienced during haze, (3) perspectives on usefulness of health care equipment, and (4) Impact of Event Scale–Revised (IES-R) was written in English and was included in both the Facebook direct link as well as in our Web-based, mobile smartphone application. The Web-based questionnaire being featured was coded using a website (Polldaddy). This Web-based database development software was specially chosen, as it is one of the most robust platforms on the market that enables the capture of detailed information, such as the mechanisms of accessing the database (whether via a direct link or from a mobile device) and other pertinent information that is relevant to our current study. The demographics questionnaire comprised of seven items in total, and was used to acquire the baseline characteristics of the participants in the study, such as gender, age, ethnicity, marital status, level of education, occupation, and most importantly, presence or absence of chronic medical illnesses. The questionnaire on physical symptoms assessed the presence or absence of the following physical symptoms: mental slowing, headache, dizziness, eye discomfort, nose discomfort, mouth and throat discomfort, breathing difficulty, heart or chest pain, nausea and vomiting, gastric or abdominal discomfort, slowness in movement, and muscle ache or pain. The participants rated on the range of self-perceived dangerous Pollutant Standards Index (PSI) values, personal possession and perceived usefulness of the N-95 mask on 5-point Likert scales. The IES-R is a 22-item, self-administered questionnaire that has been well validated for determining extent of stress reaction after exposure to stressful circumstances within 1 week of exposure across different cultural groups. Each item on the scale was administered via a 5-point frequency scale (0=not at all, 1=a little bit, 2=moderately, 3=quite a bit, 4=extremely) and higher scores indicate higher level of psychological stress. The IES-R provides three subscores, the mean avoidance, intrusion, and hyperarousal scores, a total mean IES-R score (divided by the total number of items) and a total IES-R score (without division by the total number of items). A total IES-R score greater than or equal to 33 signifies the likely presence of post-traumatic stress disorder.