To date we have published seven papers using data from the Stanford WELL for Life Study, provided to us by all participants, as well as an invited contribution to the American Journal of Health Promotion. Two papers were submitted this month and many more will be submitted over the next few months. Click on the links below to read about our findings!

Stanford WELL For Life: Learning What it Means to Be Well

Stanford WELL For Life researchers were invited to share how they approached the development of a new well-being index by first asking individuals what the conecept of well-being meant to them. Read on to discover what their top driver of well-being was, which represents an often overlooked area of measurement in workplace wellness.

Heaney, C.A.; Avery, E.C.; Rich, T.; Ahuja, N.J.; Winter, S.J.; Stanford WELL for Life Measures Work Group. Stanford WELL for Life: Learning What It Means to Be Well. American Journal of Health Promotion 2017, Vol 31(5) 444-456

An in-depth comparison of well-being among Latinx and non-Latinx White adults: A cautionary tale

Understanding how to optimize the health and well-being of Latinxs is crucial and will aid in informing actions to address inequities. Latinxs' unique cultural backgrounds and lived experiences could have implications for their well-being, which may differ from other racial/ethnic groups. We compared overall and domain-specific well-being and their socio-demographic correlates among two samples of Latinxs and a sample of non-Latinx Whites. Cross-sectional samples were independently drawn from the Stanford WELL Initiative (n = 217 Latinxs, n = 943 non-Latinx Whites) and the On the Move Trial (n = 238 Latinxs), both recruiting in Northern California. Well-being was assessed using the Stanford WELL scale, a novel multifaceted measure. Propensity score matching and mixed effect regressions were employed to compare well-being between samples. Overall well-being levels did not differ between groups. However, when examining constituent domains of well-being, several differences were found. Both Latinx samples reported experiencing more stress, having worse physical health, and being more religious than did the matched non-Latinx White sample. However, on four other well-being domains, only one of the Latinx samples differed from the non-Latinx White sample. Moreover, the two Latinx samples differed from each other in four out of nine domains examined. When evaluating well-being across racial/ethnic groups, we recommend employing multidimensional measures and multiple samples to promote greater confidence in the conclusions. This approach can better inform future research and the tailoring of public health efforts by furthering our understanding of the nature of group well-being differences. Our methods offer a blueprint for similar studies examining well-being in multi-ethnic groups.


Rodriguez Espinosa P, Patel ML, King AC, Campero I, Freeman M 2nd, Garcia DM, Winter SJ, Heaney CA. An in-depth comparison of well-being among Latinx and non-Latinx White adults: A cautionary tale. Prev Med Rep. 2021 Aug 3;24:101513. doi: 10.1016/j.pmedr.2021.101513. PMID: 34401222; PMCID: PMC8358695.

Changes in cannabis use, exposure, and health perceptions following legalization of adult recreational cannabis use in California: a prospective observational study

Most U.S. states have legalized cannabis for medical and/or recreational use. In a 6-month prospective observational study, we examined changes in adult cannabis use patterns and health perceptions following broadened legalization of cannabis use from medical to recreational purposes in California. Respondents were part of Stanford University's WELL for Life registry, an online adult cohort concentrated in Northern California. Surveys were administered online in the 10 days prior to state legalization of recreational use (1/1/18) and 1-month (2/1/18-2/15/18) and 6-months (7/1/2018-7/15/18) following the change in state policy. Online surveys assessed self-reported past 30-day cannabis use, exposure to others' cannabis use, and health perceptions of cannabis use. Logistic regression models and generalized estimating equations (GEE) examined associations between participant characteristics and cannabis use pre- to 1-month and 6-months post-legalization. The sample (N = 429, 51% female, 55% non-Hispanic White, age mean = 56 ± 14.6) voted 58% in favor of state legalization of recreational cannabis use, with 26% opposed, and 16% abstained. Cannabis use in the past 30-days significantly increased from pre-legalization (17%) to 1-month post-legalization (21%; odds ratio (OR) = 1.28, p-value (p) = .01) and stayed elevated over pre-legalization levels at 6-months post-legalization (20%; OR = 1.28, p = .01). Exposure to others' cannabis use in the past 30 days did not change significantly over time: 41% pre-legalization, 44% 1-month post-legalization (OR = 1.18, p = .11), and 42% 6-months post-legalization (OR = 1.08, p = .61). Perceptions of health benefits of cannabis use increased from pre-legalization to 6-months post-legalization (OR = 1.19, p = .02). Younger adults, those with fewer years of education, and those reporting histories of depression were more likely to report recent cannabis use pre- and post-legalization. Other mental illness was associated with cannabis use at post-legalization only. In a multivariate GEE adjusted for sociodemographic characteristics and diagnoses, favoring legalization and the interaction of time and positive health perceptions were associated with a greater likelihood of using cannabis. Legalized recreational cannabis use was associated with greater self-reported past 30-day use post-legalization, and with more-positive health perceptions of cannabis use. Future research is needed to examine longer-term perceptions and behavioral patterns following legalization of recreational cannabis use, especially among those with mental illness.


Gali K, Winter SJ, Ahuja NJ, Frank E, Prochaska JJ. Changes in cannabis use, exposure, and health perceptions following legalization of adult recreational cannabis use in California: a prospective observational study. Subst Abuse Treat Prev Policy. 2021 Feb 12;16(1):16. doi: 10.1186/s13011-021-00352-3. PMID: 33579324; PMCID: PMC7881543.

Association between contact with a general practitioner and depressive symptoms during the COVID-19 pandemic and lockdown: a large community-based study in Hangzhou, China

 In April 2020, a follow-up survey was conducted on the basis of a baseline survey conducted between October 2018 and May 2019. The survey was embedded in the Stanford Wellness Living Laboratory-China (WELL China) study, an ongoing prospective community-based cohort study during 2018-2019. The survey was conducted by telephone interview among 4144 adult urban residents participating in the WELL China study at baseline. We collected information on sociodemographic characteristics, depressive symptoms and GP contact during the lockdown period (February to March 2020). Depressive symptoms were measured using the WHO-Five Well-being Index, comprising five questionnaire items that briefly indicate psychological well-being. Logistic regression models were applied to assess the association between GP contact and depressive symptoms. In total, 3356 participants responded to the survey; 203 were excluded owing to missing data on depressive symptoms, leaving 3153 participants in the present study. During lockdown, 449 participants had GP contact. GP contact was significantly negatively associated with prevalent depressive symptoms (OR, 0.67; 95% CI 0.51 to 0.89; p<0.01) and incident depressive symptoms (OR 0.68; 95% CI 0.51 to 0.93; p<0.05). Stratified analysis showed a significant negative association between depressive symptoms and GP contact in individuals who were 45-64 years old (p<0.01), had a middle or high education (p<0.01) and had self-reported non-communicable diseases (p<0.05). Contact with GPs during the COVID-19 pandemic and lockdowns may have a negative association with depressive symptoms in community-dwelling populations. Given the possibility of further surges in COVID-19 infections, GPs' contact in the community should be enhanced.

Yang F, Lin W, Frost E, Min Y, Xu X, Wang X, Li W, Leng Y, Zhao X, He W, Hsing AW, Zhu S. Association between contact with a general practitioner and depressive symptoms during the COVID-19 pandemic and lockdown: a large community-based study in Hangzhou, China. BMJ Open. 2021 Aug 13;11(8):e052383. doi: 10.1136/bmjopen-2021-052383. PMID: 34389582; PMCID: PMC8366284.

Coping with the COVID-19 pandemic: Contemplative practice behaviors are associated with better mental health outcomes and compliance with shelter-in-place orders in a prospective cohort study

Psychosocial health can influence the development and experience of several chronic diseases, and has been negatively affected for many individuals amid the COVID-19 global pandemic. To understand the impact of contemplative practices on emotional and mental health during COVID-19, the Stanford WELL for Life Study (US component), incorporated a series of additional surveys into its ongoing study. A total of 1,097 participants residing in California who responded to at least one of three COVID-19 surveys were included in this analysis. Linear and generalized mixed-effects regression models were used to investigate relationships between individual contemplative practice behaviors (CPB) (embodied observing meditation, non-reactive mindfulness meditation, self-compassion cultivation, cultivation of compassion for others) and four psychosocial outcomes measured in the original WELL questionnaire (resilience, dealing with stress, positive emotions, and negative emotions). In addition, the associations between CPB and depression, distress, and compliance with local Shelter-In-Place orders were also investigated. Participants who engaged in any contemplative practice reported significantly more resilience and positive emotions, dealing better with stress, lower distress, and were less likely to report an experience with depression in the last week. Similar findings held when CPB was modeled as a continuous variable. Significant interactions between the duration of the SIP and CPB were also observed for resilience and SIP compliance outcomes, indicating that steeper declines were observed among participants with little or no CPB across the study period. Further investigation into the potential protective benefits of CPB during times of major disruption and uncertainty is warranted.

Chrisinger, B. W., Rich, T., Lounsbury, D., Peng, K., Zhang, J., Heaney, C. A., Lu, Y., & Hsing, A. W. (2021). Coping with the COVID-19 pandemic: Contemplative practice behaviors are associated with better mental health outcomes and compliance with shelter-in-place orders in a prospective cohort study. Preventive Medicine Reports, 23, 101451.

Associations of park access, park use and physical activity in parks with wellbeing in an Asian urban environment: a cross-sectional study

Relationships between park access, park use, and wellbeing remain poorly understood. The objectives of this study were to investigate: (1) perceived and objective park access in relation to park use and physical activity in parks; and; (2) perceived and objective park access, park use and physical activity in parks and their associations with wellbeing. An interviewer-assisted survey collected data on perceived time to walk to parks, park use time, park physical activity time and wellbeing (using a scale containing nine domains) amongst adult participants of the Singapore Multi-Ethnic Cohort. Geospatial maps of parks and the “walkable” street networks were created for the city-state of Singapore to objectively determine distances to accessible points on park boundaries. Multiple linear regression models estimated the importance of park access to park use and associations of park access and park use with wellbeing, adjusting for potential confounders. Participants’ (n = 3435) average age was 48.8 years (SD, 12.8), 44.8% were male and 72.6% were of Chinese ethnicity. Better perceived but not true park access was significantly associated with greater park use. Park access (perceived or true) was not associated with physical activity time in parks. Greater participant park time and physical activity time in parks were associated with higher wellbeing scores (p < 0.001). The differences in wellbeing scores between the reference groups, who spent negligible time in parks, and the highest quartiles of time in parks (10.8 h/month) and physical activity in parks (8.3 h/month) were 3.2 (95% CI 2.1–4.4) and 4.2 (95% CI 4.1–6.3) points out of 100 respectively. These associations were similar for most domains of wellbeing, with clear dose-response relationships. While perceived park access was strongly associated with park use and well-being, true park access was not, and neither park access measure was associated with park physical activity. Future studies could investigate the influence of park attributes on park use, physical activity in parks and wellbeing. The consistent associations of park use and particularly physical activity in parks with wellbeing suggest that promoting park use, and especially physical activity in parks, is a promising strategy for improving wellbeing in urban settings.

Petrunoff, N. A., Yi, N. X., Dickens, B., Sia, A., Koo, J., Cook, A. R., Lin, W. H., Ying, L., Hsing, A. W., van Dam, R. M., & Müller-Riemenschneider, F. (2021). Associations of park access, park use and physical activity in parks with wellbeing in an Asian urban environment: A cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 18(1), 87.

Physical activity and stress management during COVID-19: a longitudinal survey study

Physical activity (PA) during COVID-19 shelter-in-place (SIP) may offset stress. This study examined associations between PA, stress and stress management strategies during SIP. Participants (N = 990) from a cohort of Northern California adults completed surveys during early SIP (3/23/20-4/2/20) and mid-SIP (4/24/20-5/8/20). Participants self-reported past-month PA (meeting vs. not meeting guidelines), changes in stress (decreased/unchanged vs. increased) and use (yes/no) of 10 stress management strategies. We tested differences in mid-SIP stress and stress management strategies by PA, and differences in mid-SIP stress by stress management strategies. Compared to participants inactive at mid-SIP, active participants reported less stress (AOR = 0.60 [0.45, 0.81]). Active participants were more likely to manage stress using outdoor PA, indoor PA, yoga/meditation/prayer, gardening, and reading (AORs > 1.42), and less likely to sleep (AOR = 0.65 [0.48, 0.89]) or eat ([AOR = 0.48 [0.35, 0.66]) more. Managing stress using outdoor PA, indoor PA or reading was associated with lower stress; managing stress using TV/movies, sleeping or eating was associated with increased stress (ps < 0.05). Meeting PA guidelines during SIP was associated with less stress. Inactive participants reported greater sleeping and eating to cope; active participants used active stress management strategies. Engagement in physically active stress management was associated with lower stress.

Vogel EA, Zhang JS, Peng K, Heaney CA, Lu Y, Lounsbury D, Hsing AW, Prochaska JJ. Physical activity and stress management during COVID-19: a longitudinal survey study. Psychol Health. 2021 Jan 6:1-11. doi: 10.1080/08870446.2020.1869740. Epub ahead of print. PMID: 33405969.

Cohort Profile: WELL Living Laboratory in China (WELL-China)

Key Features of the WELL China Cohort

• WELL-China is a prospective longitudinal study for the investigation of well-being. The cohort aims to assess multidimensional well-being in a large sample and provides a platform for future intervention studies to help promote well-being at individual and community levels.

• A total of 10 268 participants aged between 18 and 80 years were recruited from the City of Hangzhou, China between 2016 and 2019; 40% of the cohort are men.

• Follow-up will take place between 2020 and 2021, and will reoccur every 2 years; the nested-omics sub-cohort will be followed every 6 months.

• WELL-China has collected in-person survey data, physical and clinical examinations, laboratory tests and biospecimens. The survey included >1000 questions and includes the Stanford WELL for Life Scale, lifestyle behaviours, eye disease and traditional Chinese medicine body constitutions. In-person examinations included anthropometrics, functionalities, vitals, eye exams, traditional Chinese medicine diagnosis and abdominal ultrasound. Laboratory tests included complete blood count, liver and renal panel, lipid panel, etc. Biospecimens included blood, stool, hair and toenails, which were collected at baseline. Specimens have been processed and aliquoted for storage at –80C in a freezer. Currently, WELL-China has >200 000 aliquots of biospecimens in the WELL-China biobank. A subset of 250 participants also currently have microbiome and metabolomic information.

• WELL-China data contain several unique features. The novel Stanford WELL for Life Scale quantifies one’s overall well-being and domain-specific well-being. Dual-energy X-ray absorptiometry (DXA) scans provide detailed information on body composition and bone mineral density. Thorough eye examinations and ophthalmology surveys are unique compared with other China-based cohorts. Abdominal ultrasound provides important information to identify fatty liver diseases, including non-alcoholic fatty liver disease. The cohort setup also permits the rapid implementation of intervention testing.

• WELL-China welcomes collaborations globally. Applicants must submit an ancillary study application package including a research proposal, requested variables and biospecimens. For more information, please contact (the USA-based PI) or (the China-based PI).

Yan Min, Xueyin Zhao, Randall S Stafford, Xiaoguang Ma, Shih-Hua Chen, Da Gan, Chen Wei, Chao Huang, Lijin Chen, Peng Gao, Fei Yang, Sandra J Winter, Yi-Hsuan Wu, Catherine A Heaney, Mike Baiocchi, John P A Ioannidis, Ann W Hsing, Shankuan Zhu, Cohort Profile: WELL Living Laboratory in China (WELL-China), International Journal of Epidemiology, 2021;, dyaa283,

Characterization of dietary patterns and assessment of their relationships with metabolomic profiles: A community-based study

Determining dietary patterns in China is challenging due to lack of external validation and objective measurements. We aimed to characterize dietary patterns in a community-based population and to validate these patterns using external validation cohort and metabolomic profiles. We studied 5145 participants, aged 18-80 years, from two districts of Hangzhou, China. We used one district as the discovery cohort (N = 2521) and the other as the external validation cohort (N = 2624). We identified dietary patterns using a k-means clustering. Associations between dietary patterns and metabolic conditions were analyzed using adjusted logistic models. We assessed relationships between metabolomic profile and dietary patterns in 214 participants with metabolomics data. We identified three dietary patterns: the traditional (rice-based), the mixed (rich in dairy products, eggs, nuts, etc.), and the high-alcohol diets. Relative to the traditional diet, the mixed (ORadj = 1.7, CI 1.3-2.4) and the high-alcohol diets (ORadj = 1.9, CI 1.3-2.7) were associated with type 2 diabetes and hypertension, respectively. Similar results were confirmed in the external validation cohort. In addition, we also identified 18 and 22 metabolites that could distinguish the mixed (error rate = 12%; AUC = 96%) and traditional diets (error rate = 19%; AUC = 88%) from the high-alcohol diet. Despite the complexity of Chinese diet, identifying dietary patterns helps distinguish groups of individuals with high risk of metabolic diseases, which can also be validated by external population and metabolomic profiles

Ru, Y.; Wang, N.; Min, Y.; Wang, X.; McGurie, V.; Duan, M.; Xu, X.; Zhao, X.; Wu, Y.; Lu, Y.; Lu, Y.; Hsing, A.W.; Zhu, S. Characterization of dietary patterns and assessment of their relationships with metabolomic profile: A community-based study. Clinical Nutrition 202017, 7228.

Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching

The morbidity and mortality experiences of people who are unhoused have been well-described, but much less is known about the overall well-being of these individuals. In this mixed methods study, housed and unhoused participants completed a multi-faceted 10 domain measure of well-being (the Stanford WELL Survey), and a subset of unhoused participants shared their experiences during qualitative interviews. Using propensity score matching, unhoused participants (n = 51) were matched at a ratio of 1:5 with housed participants (n = 255). The mean overall well-being score of the unhoused participants was significantly lower than that of the matched housed participants (B = -5.022, p = 0.013). Additionally, the two groups differed on some of the constituent domains of well-being, with unhoused participants reporting statistically significantly lower mean scores on social connectedness (B = -1.086, p = 0.000), lifestyle and daily practices (B = -1.219, p = 0.000), stress and resilience (B = -0.493, p = 0.023), experience of emotions (B = -0.632, p = 0.009), physical health (B = -0.944, p = 0.0001), and finances (B = -3.099, p = 0.000). The unhoused participants had a statistically significantly higher mean score for spirituality and religiosity (B = 2.401, p = 0.000) than their matched housed counterparts. The qualitative interviews further highlighted spirituality and religion as a coping mechanism for the unhoused. The results of this study highlight both unexpected strengths exhibited by the unhoused individuals and areas of challenge.

Ahuja, N.J.; Nguyen, A.; Winter, S.J.; Freeman, M.; Shi, R.; Rodriguez Espinosa, P.; Heaney, C.A. Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching. Int. J. Environ. Res. Public Health 2020, 17, 7228.

The WELL Diet Score Correlates with the Alternative Healty Eating Index-2010

The quality of one's overall diet has proven to be of great importance to health and well‐being. Unfortunately, diet quality is time‐consuming to assess. The Stanford Wellness Living Laboratory (WELL) administered an online survey that included the WELL Diet Score (a novel diet quality assessment calculated from 12 diet‐related items). Subsequently, WELL participants were asked to complete the 127‐item Block Food Frequency Questionnaire (FFQ) online. The present study's primary objective was to compare the WELL Diet Score with the established FFQ‐based Alternative Healthy Eating Index‐2010 (AHEI‐2010), in a subset of WELL participants (n = 248) who completed both dietary measures through WELL’s online platform. The two scores were significantly correlated (r = .69; p < .0001). Regression analyses demonstrated that the WELL Diet Score was positively significantly associated with sociodemographic determinants of diet quality and protective health factors, including older age, higher education, lower BMI, and higher physical activity. In summary, the WELL Diet Score, derived from 12 small diet‐related items that can be completed in 5 min, was significantly positively correlated with the AHEI‐2010 derived from the lengthy 127‐item FFQ, suggesting the potential utility of the WELL Diet Score in future large‐scale studies, including future WELL studies.


Springfield, S, Cunanan, K, Heaney, C, Peng, K, Gardner, C. The WELL diet score correlates with the alternative healthy eating index‐2010. Food Sci Nutr. 2020; 00: 1– 9.

Exploring health and well-being in Taiwan: what we can learn from individuals' narratives

Little is known about how individuals achieve health and well-being, and their roles in the pursuit of a good life. We hoped to identify important components of these concepts that may provide new targets and messages to strengthen existing public health programs. An improved understanding of health and well-being - or what it means to be well - can guide interventions that help people lead healthier, more fulfilling lives. Eight constituent domains emerged regarding well-being and health. While the same domains were found for both constructs, important frequency differences were found when participants discussed health versus well-being. Physical health and lifestyle behaviors emerged as key domains for health. Disease-related comments were the most frequently mentioned sub-category within the physical health domain, along with health care use and aging-related changes. For well-being, family and finances emerged as key domains. Family appears to be a cornerstone element of well-being in this sample, with participants often describing their personal well-being as closely tied to - and often indistinguishable from - their family. Other domains included work-life, sense of self, resilience, and religion/spirituality. 


Rodriguez Espinosa, P., Chen, Y., Sun, C. et al. Exploring health and well-being in Taiwan: what we can learn from individuals’ narratives. BMC Public Health 20, 159 (2020). PMID: 32013898 PMCID: PMC6998329 

Associations Between Body Fat, Muscle Mass, and Nonalcoholic Fatty Liver Disease: A Population-Based Study

Nonalcoholic fatty liver disease (NAFLD) is one of the most common forms of liver disease worldwide and has emerged as a significant public health concern in China. A better understanding of the etiology of NAFLD can inform effective management strategies for this disease. We examined factors associated with NAFLD in two districts of Hangzhou, China, focusing on the relationship of regional body fat distribution, muscle mass, and NAFLD. Multivariate logistic regressions were performed to assess independent associations between NAFLD and metabolic risk factors and dual x-ray absorptiometry (DX A)-derived measures (e.g., android fat ratio [AFR] and skeletal muscle index [SMI]). According to our analysis, android fat ration (AFR), insulin resistance, high alanine aminotransferase levels, smoking, and male sex were positively associated with NAFLD risk, while skeletal muscle index (SMI) was inversely associated with NAFLD risk.

Julianna C. Hsing, M. Nguyen, B. Yang, Y. Min, S. Han, E. Pung, S. J. Winter, X. Zhao, D. Gan, A. W. Hsing, S. Zhu. C. J. Wang. “Associations Between Body Fat, Muscle Mass, and Nonalcoholic Fatty Liver Disease: A Population-Based Study,” Hepatology Communications 0, no. 0, accessed July 12, 2019,

Sex-specific Association Between Gut Microbiome and Fat Distribution

The gut microbiome has been linked to host obesity; however, sex-specific associations between microbiome and fat distribution are not well understood. Here we show sex-specific microbiome signatures contributing to obesity despite both sexes having similar gut micro-biome characteristics, including overall abundance and diversity. Our comparisons of the taxa associated with the android fat ratio in men and women found that there is no widespread species-level overlap. We did observe overlap between the sexes at the genus and family levels in the gut microbiome, such as Holdemanella and Gemmiger; however, they had opposite correlations with fat distribution in men and women. Our findings support a role for fat distribution in sex-specific relationships with the composition of the microbiome. Our results suggest that studies of the gut microbiome and abdominal obesity-related disease outcomes should account for sex-specific differences.

Min, Yan, Xiaoguang Ma, Kris Sankaran, Yuan Ru, Lijin Chen, Mike Baiocchi, and Shankuan Zhu. "Sex-specific Association between Gut Microbiome and Fat Distribution." Nature Communications10, no. 1 (June 03, 2019). doi:10.1038/s41467-019-10440-5.

Understanding Where We Are Well: Neighborhood-Level Social and Environmental Correlates of WEll-Being in the Stanford Well for Life Study

Individual well-being is a complex concept that varies among and between individuals and is impacted by individual, interpersonal, community, organizational, policy and environmental factors. This research explored associations between select environmental characteristics measured at the ZIPcode level and individual well-being. Twelve identical or analogous neighborhood (ZIP-code level) indicators were selected to test against the SWLS measure and data were collected from secondary sources to describe socio-economic, demographic, and physical environment, and healthcare. Linear mixed models were fit to assess relationships between each neighborhood measure and each of the ten domains of well-being, as well as the overall SWLS well-being measure, and were adjusted for spatial autocorrelation and individual-level covariates. Our observational insights suggest that neighborhood factors are associated with individuals’ overall self-rated well-being, though variation exists among its constituent domains.

Chrisinger BW, Gustafson JA, King AC, Winter SJ. Understanding Where We Are Well: Neighborhood-Level Social and Environmental Correlates of Well-Being in the Stanford Well for life Study. Int J Environ Res Public Health. 2019 May 20;16(10).pii: E1786. doi: 10.3390/ijerph16101786. PubMed PMID: 31137589; PubMed Central PMCID: PMC6571676

Dry eye and sleep quality: a large community-based study in Hangzhou

Dry eye and sleep dysfunction draw global  public health concerns with their high prevalence and extensive adverse effects. Our study discovered a strong association between these two conditions. This is the firstpopulation-based study to evaluate the association of dry eye and sleep quality using previously validated tools, the Ocular Surface Disease Index (OSDI) and the Chinese version of the Pittsburg Sleep Quality index (CPS!I), respectively. Results indicated a strong positive association between poor sleep quality and higher severity for dry eye. It is plausible to suggest that improvement of sleep quality would alleviate the syndromes of dry eye, and vice versa. Our large comunity-based study showed a strong association between poor sleep quality and an increased severity of dry eye, suggesting that preventing either one of the discomforts might alleviate the other. 

Zhu S, Yao K. Dry eye and sleep quality: a large community-based study in Hangzhou. Sleep. 2019 Jul 15. pii: zsz160. doi: 10.1093/sleep/zsz160. [Epub ahead of pring] PubMed PMID: 31310315.


A Rapid Assessment of Psychological Distress and Well-Being: Impact of the COVID-19 Pandemic and Shelter-in-Place

Author list: Ann Hsing, Janice S. Zhang, Katy Peng, Wei-Kuang Lin, Yi-Hsuan Wu, Julianna C. Hsing, Patty LaDuke, Catherine Heaney, Ying Lu, David W. Lounsbury
Journal: Preprints with The Lancet



Association between retinal microcirculation and daytime napping: a population-based study in China

Author list: Xin Liu, Guowei Wang, Xiaoyan Wang, Yueye Wang, Yan Min, Janice Zhang, Robert T. Chang, Xueyin Zhao, Wei He, Darius M. Moshfeghi, Ying Lu, Ann W. Hsing, Ke Yao, Shankuan Zhu
Journal: Sleep Medicine
Submission Date: 10/24/20


The Dietary Inflammatory Index and cardiometabolic factors: A large population-based study in China

Author list: Anthony Crimarco, Michael D. Wirth, Marian Botchway, Yan Min, Xueyin Zhao, Christopher D. Gardner, Shankuan Zhu, Ann W. Hsing
Journal: American Journal of Lifestyle Medicine
Submission Date: 10/16/20


A Cautionary Tale: Lessons Learned and Methodological Implications from Comparing Well-Being between latino and Non-Latino White Adults

Author list: Rodriguez Espinosa, P., Patel, M.P., King, A.C., Campero, I., Freeman, M., Garcia, M., Winter, S.J. & Heaney, C.A.
Journal: Health Psychology

Planning to submit

Circulating Metabolites Mediate the Sex-specific Associations Between Gut Microbiome and Body Fat Distribution

Author list: Yan Min, Kris Sankaran, Ann Hsing, Ying Lu, Shankuan Zhu 
Potential Journal: Lancet Diabetes and Endocrinology
Potential Submission Date: TBD


Contemplative Practices Behavior is Postively Associated with Well-Being in Large, Diverse, Multi-National Cohorts

Author list: Chrisinger et al
Potential Journal: Journal of Behavioral Medicine
Potential Submission Date: TBD


Depressive Symptoms and Lifestyle Changes during the COVID-19 Lockdwon Period among residents with and without NCDs in Hangzhou, China

Author list: Xueyin Zhao, Qingcong Kang, Peng Gao, Yang Yang, Ann W. Hsing, Shankuan Zhu
Potential Journal: TBD
Potential Submission Date: TBD


Impact of General Practitioner Contact on Depressive Symptoms of Residents During Lockdown in COVID-19 Outbreak: A large Community-Based Study in Hangzhou, China

Author list: Fei Yang, Wenhui Lin, Xiaochen Xu, Xiaoyan Wang, Wei Li, Xueyin Zhao, Ann W. Hsing, Zhankuan Zhu 
Potential Journal: TBD
Potential Submission Date: TBD


Retinal Vessel Caliber is in Association with Water and Alcohol Intake Behavior: A Population-Based Study

Author list: Liu, X
Potential Journal: Opthalmology
Potential Submission Date: TBD


Understanding Well-Being in China: A Qualitative Study with a Narrative Approach

Author list: Xueyin Zhao, Yan Min, Patricia Rodriguez Espinosa, Lijin Chen, Peng Gao, Erin Avery, Shuyi Cen, Xiaochen Xu, Shankuan Zhu, Ann Hsing, Catherine Heaney
Potential Journal: International Journal of Public Health
Potential Submission Date: TBD



A Qualitative Exploration of Well-Being: What is Well-Being? How do we know? Why do we care?

Author list: Heaney, C.A. 
Potential Journal: TBD
Potential Submission Date: TBD


The Concept of Well-Being among English-speaking and Mandarin-speaking Ethnic Chinese in Singapore

Author list: Ping K, Nengzheng S, Tan L, Subramaniam M, Vaingankar J, Van Dan Martinus R, Min Y, Hsing A.W., Heaney CA, Wee HL 
Potential Journal: TBD
Potential Submission Date: TBD


Associations of Park Access and Park Use with Well-Being in an Asian Urban Environment: A Cross-Sectional Study using Objective and Subjective Measures

Author list: Nicholas Petrunoff, Xian Yi NG, Borame Dickens, Angelia Sia, Joel Koo, Alex Cook, Wee Hwee Lin, Rob M. van Dam, Falk Muller-Riemenschneider
Potential Journal: International Journal of Behavioural Nutrition and Physical Activity
Potential Submission Date: TBD



Sleep and Cardiometabolic conditions: a community-based study in Taiwan

Author list: Chun-Yu Liang, Yi-Hsuan Wu, Janice Zhang, Katy Peng, Huiting Yang, San Lin You, Chien An Sun, Jawtown Lin, Ying Lu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD


Metabolomics and Non-Alcoholic Fatty Liver Disease

Author list: George Cholankeril, Yan Min, Julianna C. Hsing, Ying Lu, Sherry Zhou, Shankuan Zhu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD


Non-alcoholic fatty liver screening and risk factors in a community based study in China

Author list: Caroline Young, Yan Min, Julianna C. Hsing, Mindie Nguyen, Ying Lu, Sherry Zhou, Shankuan Zhu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD


Association between retinal microcirculation and daytime napping: a population-based study in China

Author list: X Liu, G Wang, Y Wang, Y Min, JS Zhang, RT Chang, X Zhao, W He, DM Moshfeghi, AW Hsing, K Yao, S Zhu
Potential Journal: TBD
Potential Submission Date: TBD


More updates coming soon!