1. Introduction
Family is rated the most important among six aspects of life, surpassing friends, leisure time, politics, work, and religion [
1]. Family wellbeing, usually conceptualized as family functioning, family life satisfaction, or family quality of life [
2,
3], not only enhances the physical and mental health of individuals across the lifespan but also fosters stable and cohesive societies [
4]. Family wellbeing is affected by external and internal factors irrespective of the cultural context. External factors include the availability of social and community resources, such as income, social networks, and medical services, which build the material and social foundation of family life [
5]. Internally, family communication is central to sustaining family relationships and family wellbeing regardless of family structure [
6]. Quality family communication through verbal and nonverbal interactions enables members to share attitudes and beliefs, be related, act with cohesion and flexibility, achieve satisfaction, and share information inside and outside the family boundaries [
6,
7].
Internet use and information and communication technology (ICT) have dramatically changed interpersonal communication within the family [
8,
9]. Advanced ICT applications, such as WhatsApp or WeChat, provide convenient instant messaging (IM) functions that allow family members to connect and share information in real-time [
10,
11,
12]. Specifically, e-chat groups in these applications allow three or more users to simultaneously share texts, images, voice messages, short videos, and even make video calls at low or no costs. Previous studies found more family communication using IM messages and video calls was associated with higher levels of family wellbeing [
13,
14].
The coronavirus disease 2019 (COVID-19) pandemic disrupts the external factors of family wellbeing, posing grave threats to both individuals and families by the interruption of daily routines, financial insecurity, lockdown, physical distancing, and social disruptions [
15,
16]. Increased family-related mental burdens have been reported. Over 75.0% of Chinese reported concerns about family members’ health during the initial outbreak in China [
17]. A subsequent report in Canada also showed that 32.0% of respondents were very or extremely concerned about family stress from confinement [
18]. In Hong Kong, 33.3% of respondents reported increased family negative emotion, 18.9% reported decreased family happiness [
19], and the prevalence of individual unhappiness doubled that in 2016 and 2017 [
20]. While face-to-face communication has reduced with physical distancing restrictions, digital communication via IM tools has increased [
21,
22].
The present study was informed by two related theoretical frameworks. First, Prime and Wade’s framework emphasizes the importance of family communication amidst the COVID-19 pandemic on the basis of Walsh’s family resilience framework [
16,
23]. Constructive and effective family communication preserves and nourishes relationships and shares beliefs to cope with risks during social disruption [
16]. Second, Castellacci and Tveito’s theoretical framework on Internet use and wellbeing posits that Internet use shapes wellbeing through creating new activities and improved forms of remote communication [
24]. Family e-chat groups using various IM functions help maintain instant interactions and avoid mental isolation in periods of physical distancing. We hypothesized that IM use in the family may be associated with family and individual wellbeing through communication quality.
In Hong Kong, 98.4% of Internet users took online social activities as a major purpose for getting online in 2018 [
25], and the smartphone penetration rate increased to 91.5% in 2019 [
26]. We searched PubMed and Web of Science using keywords of “2019 nCoV”, “COVID-19”, “SARS-CoV-2”, “instant messages”, “e-chat group”, “family”, and “happiness” up to 16 August 2021 and found no survey reports on how people make use of family e-chat groups amidst the COVID-19 pandemic. Only one study reported that, in 2017, 72.0% of Hong Kong adults had at least one family e-chat group, and 72.0% and 83.7% of them received and sent at least one message daily [
14]. No study has reported the IM functions used or contents delivered in family e-chat groups before and amidst the pandemic. The aims of the present study were to examine the use of family e-chat groups, especially different IM functions, amidst the COVID-19 pandemic and the associations with family wellbeing and personal happiness, and the mediating effects of family communication on these associations.
3. Results
Table 1 shows that, after weighting, 52.9% of respondents were female, 37.7% were aged 45–64 years, and 21.3% ≥65 years, 65.7% had secondary or below education, 52.6% had lower monthly household income, 63.4% lived in owned housing, and 33.3% and 14.4% had medium and high socioeconomic status, respectively. For respondents having family e-chat groups, 55.9% were female, 38.5% were aged 45–64 years, and 22.1% ≥65 years, 66.1% had secondary or below education, 52.1% had lower monthly household income, 65.4% lived in owned housing, and 33.8% and 14.5% had medium and high socioeconomic status, respectively.
Table 2 shows that, after weighting, 16.1% of respondents had no family e-chat groups, and 34.4% had three or more groups. The most common function used in family e-chat groups was receiving/sending text messages (78.4%), followed by receiving/sending photos/pictures (76.5%), making voice calls (46.2%), receiving/sending short videos (37.2%), and voice messages (13.8%), and making video calls (8.2%). Forty-eight point three percent of respondents used three or more functions in family e-chat groups, and 93.0% and 89.6% received and sent at least one IM daily, respectively.
Table 3 shows that more female and older respondents used three or more IM functions in family e-chat groups (aPRs 1.04 to 1.22, all
p ≤ 0.001). More women reported making voice calls (aPR 1.11, 95% CI 1.02–1.21,
p = 0.02), receiving/sending short videos (aPR 1.10, 95% CI 1.00–1.20,
p = 0.047), receiving/sending voice messages (aPR 1.27, 95% CI 1.07–1.52,
p = 0.007), and making video calls (aPR 1.31, 95% CI 1.05–1.65,
p = 0.02). Older respondents, especially those aged ≥65 years, used more non-text functions, including receiving/sending photos/pictures, voice calls, receiving/sending short videos, and video calls (aPRs 1.17 to 3.10, all
p for trend ≤0.03). Fewer women and respondents aged ≥65 years reported receiving/sending text messages (aPRs 0.97 and 0.86, respectively, both
p ≤ 0.02). More respondents having higher socioeconomic status received/sent text messages (aPRs: medium 1.06 and high 1.08) and fewer received/sent voice messages (aPRs: medium 0.78 and high 0.72) (both
p for trend ≤0.004).
Table 4 shows that receiving/sending photos/pictures (adjusted β = 0.39), making voice calls (adjusted β = 0.25), receiving/sending voice messages (adjusted β = 0.23), and making video calls (adjusted β = 0.50) were associated with better family communication (all
p ≤ 0.03). Receiving/sending photos/pictures, making voice calls, and making video calls were associated with higher levels of family wellbeing (adjusted βs 0.18 to 0.45, all
p ≤ 0.003). Only making voice calls and video calls were associated with higher scores of personal happiness (adjusted βs 0.30 and 0.32, respectively, both
p ≤ 0.009).
Table 5 shows that having more family e-chat groups, using more IM functions, and receiving and sending more IM messages daily in family e-chat groups were associated with better family communication (adjusted βs 0.32 to 0.83, all
p ≤ 0.01) and family wellbeing (adjusted βs 0.27 to 0.77, all
p ≤ 0.004), and higher personal happiness (adjusted βs 0.30 to 0.72, all
p ≤ 0.03) (all
p for trend ≤0.02).
Family communication partially mediated the associations of having more family e-chat groups, and more IM functions used in family e-chat groups with family wellbeing (proportion of total effects mediated: 75.5% and 66.4%, respectively) and personal happiness (proportion mediated: 69.5% and 46.2%, respectively) (Sobel–Goodman test:
p < 0.001) (
Table 6).
4. Discussion
This is the first report showing that receiving/sending photos/pictures and making video calls were independently associated with family communication quality, family wellbeing, and personal happiness. We also first reported that having more family e-chat groups and using more IM functions in family e-chat groups had dose–response associations with higher levels of family wellbeing and higher personal happiness. About half to three-quarters of these associations were mediated by family communication quality.
The mediating effects of family communication quality add new evidence to the theoretical frameworks [
16,
24]. Previous studies mainly focused on the effects of social networking sites and social media use on personal life satisfaction and psychological health in young people [
37,
38,
39]. We showed that family e-chat groups used in closed communication circles were associated with better wellbeing when face-to-face communication was restrained during the pandemic. Using IM functions may protect families and individuals from the risks and mental burdens of the pandemic through better communication quality.
Both photo/picture messaging and video calls are methods of visual interpersonal communication. Enriched communication channels can facilitate social interaction to create closer interpersonal social relationships [
40]. Emoji and pictures in IM are widely popular, which incorporate playful elements into a plain message to attract receivers’ attention, vividly express personal emotion, and thus facilitate communication effect [
40,
41]. Photo messaging enables users to timely share memorable moments in daily life with all family members, especially those being geographically separated or across generations, which has been shown to enhance intimate family communication [
42].
Despite the overlapping 95% CIs with other IM functions, video calls appeared to be most strongly associated with higher levels of family wellbeing. This is consistent with a previous study in 2016, which showed sharing family life information through video calls was associated with much higher levels of family wellbeing [
13]. The present study further reported its strong associations with better family communication and personal happiness. Amidst the COVID-19 pandemic, almost all face-to-face social activities are regarded as high risk. Family members of all generations faced elevated social isolation due to the physical distancing and lockdown policy. Instead of one-on-one in-person communications, online group settings allow more effective and simultaneous information exchange and interactions among many separated family members, which can evoke warm feelings of family gathering and close connection when face-to-face gatherings are impossible. Family video calls can partly overcome the barrier to traditional family reunions, such as birthday parties or other celebrations [
16]. Even the inactive family members and those who live far away can participate in and enjoy the online gathering time. The physical distancing due to COVID-19 could have motivated more people to use video calls to reduce emotional distancing within the family.
Although women and older people had less access to smartphones and the Internet in Hong Kong [
26], they had more family e-chat groups and used more non-text IM functions amidst the COVID-19 pandemic. A web-based survey in the Netherlands found more men than women used the Internet for COVID-19–related communications, but it was not restricted to the use of family e-chat groups [
43]. In line with our results, several studies have reported that women used more digital communication to interact with family before or amidst the pandemic, especially video calls [
13,
14,
44,
45]. Such behaviors could be explained by perceived usefulness and enjoyment, attachment motivation, and relationship commitment, which were associated with the adoption of IM communication [
46]. The COVID-19 pandemic has increased the care burden for women [
47], and Chinese women were found to perceive a higher level of family demands than men [
48]. Non-text functions through photos, voice, and video interaction could partially make up for the lack of face-to-face communication, provide greater communication satisfaction over distance [
44], and thus preferred by women to help maintain their roles in care activities and connectedness with remote family members. In addition, older people show more care for family affairs and view family communication as being worthy of time and dedication [
49]. Elderly family members, such as grandparents, are believed to have more barriers in accessing digital functions [
50]. However, they attach greater importance to digital communication and use smartphones increasingly [
26,
51]. To fit into younger family members’ schedules, they have shown a willingness to adopt new communication media [
52]. Compared with text messaging, non-text functions in family e-chat groups are more receptive as being easier to use, especially for older people who may have difficulties in text typing [
52].
We also found more family e-chat groups and IM function use being associated with higher personal happiness and the mediating effects of family communication quality. Previous studies have reported that IM use had no associations with emotionally closer relationships and happiness [
53,
54], while the present study stressed the importance of family communication and provided the first evidence linking more IM use in family e-chat groups with happiness amidst the COVID-19 pandemic. Family members have interconnections and influence each other’s functioning [
55]. According to the attachment theory, pleasant and frequent interactions with others are critical for personal mental and emotional wellbeing [
46]. Better family communication can provide support for individuals to manage stress [
16,
56] and maintain personal wellbeing [
57]. Our finding also offered support to the media naturalness hypothesis, which posits effective communication modes with visual or vocal cues improve positive interaction and relationships [
54,
58].
Family wellbeing and personal happiness have a mutually reinforcing linkage, whereby the achievement and disruptiveness in one begets the same in the other [
16]. Family wellbeing is valued above personal happiness across cultures and is the foundation to individual family members’ happiness across the lifespan [
1]. Meanwhile, the level of personal happiness may differ across family members and could inversely affect one’s perception of family wellbeing [
59]. Quality family communication is crucial for both.
While we have discussed the positive aspects of the above associations, our results also suggest that those without or with low use of family e-chat groups could be vulnerable. Policymakers and social health care professionals need to pay special attention to these risk factors and provide interventions and assistance amidst the pandemic.
Our study had some limitations. First, recall errors were an inevitable but random error of self-reported family e-chat group use would have led to under-estimated effect size. Second, better family relationships and higher communication quality could also promote more use of family e-chat groups to keep connected. Reverse causality was possible due to the cross-sectional survey design. However, to provide a clearer temporal sequence, we asked the respondents to report their ICTs use when the COVID-19 outbreak was severe and their perceived family communication quality, wellbeing, and personal happiness during the easing period. Prospective studies are needed to confirm such associations. Third, considering the dynamic and unpredictable changes of the COVID-19 pandemic, we tried to collect the largest sample possible within a short period and a constrained budget. The included respondents were younger and better educated than the general population in Hong Kong. The prevalence, even after weighting, might not be generalizable to the general population. However, because only small differences were found between the unweighted and weighted prevalence of use of family e-chat groups, selection bias would not have substantial influences on the observed associations. We also reported the dose–response associations between IM messages received/sent in family e-chat groups per day and family wellbeing, being consistent with previous findings [
14], which would support our results. Fourth, although family members may tend to share family, health, and epidemic-related information in family e-chat groups, we did not ask about the delivered or shared contents as the questionnaire was already quite long. Future studies are warranted. Lastly, although we showed the benefits of using e-chat groups for family communication amidst the pandemic, heavy use of digital platforms, including social media, may reduce the opportunities of face-to-face communication and lead to loneliness, reduced social connectedness, and other psychosocial problems [
60]. Family e-chat groups should be used to complement face-to-face communication, not to replace it.