Project description:BACKGROUND:Family communication is important to maintain family relationships and family well-being. To enhance family communication and family well-being, a community-based "Learning Families Project," based on the social ecological model was developed in Kwun Tong in Hong Kong, a district with high prevalence of family problems. METHODS:This quasi-experimental study included two nearby government subsidized low-rent housing estates separated by busy main roads, as the intervention [Tsui Ping (South) Estate] and control (Shun Tin Estate) estate. The main intervention was resident training programs, such as talks, day camps, and thematic activities. No program was implemented in the control estate. Participants in the intervention group received assessments before the intervention (T1), immediately after the intervention (T2), and 6 weeks after the intervention (T3). Control group participants were assessed at baseline (March to April 2011) and follow-up (December 2011 to March 2012). Assessments of family communication (time and perceived adequacy) and family well-being (harmony, happiness, and health) at T1 and T3 were obtained in the intervention group to examine within-group changes. In addition, these differences in outcomes in the intervention group were compared with those in the control group to examine the effectiveness of the intervention. RESULTS:Family communication time and perceived communication adequacy increased significantly in the intervention group (n = 515) with a small effect size (Cohen effect d: 0.10 and 0.24, respectively). Compared with the control group (n = 476), the improvements in family communication time and perceived communication adequacy (Cohen effect d: 0.13 and 0.14, respectively), and perceived family harmony and happiness (Cohen effect d: 0.12 and 0.12, respectively) were significantly greater in the intervention group, adjusting for age and education, suggesting the intervention was effective in improving family communication and family well-being. Mediation analysis showed that perceived communication adequacy mediated the effects of the intervention on family harmony [β = 0.10, 95% confidence interval (CI) 0.03, 0.18], happiness (β = 0.12, 95% CI 0.04, 0.20), and health (β = 0.10, 95% CI 0.02, 0.17), adjusting for age and education. CONCLUSION:This community intervention based on the social ecological model improved family well-being through improving family communication, which could be an effective target to promote family well-being in other communities. TRIAL REGISTRATION:This study was registered under ClinicalTrials.gov, identifier NCT02851667. URL: https://clinicaltrials.gov/ct2/show/NCT02851667?term=02851667&rank=1.

Project description:Background and study aims Colorectal cancer is one of the most common cancers worldwide, and the risk of its development increases with age. It is therefore of great importance to undertake preventive measures against colorectal cancer in order to reduce its increasing prevalence. Undergoing cancer screening is one of the most effective ways of preventing the development of colorectal cancer through early detection, leading to increased chances of successful treatment and survival. Despite the proven benefits of cancer screening, studies showed that South Asian ethnic minorities, both in Hong Kong and worldwide, do not tend to use the publicly available cancer screening services, resulting in a higher chance of these individuals developing colorectal cancer, particularly among older adults. It was shown that their reduced tendency to undergo cancer screening is partly contributed by their low level of health knowledge and barriers to accessing health and cancer preventive services. In view of this, educational programmes are required to educate older South Asians ethnic minorities on the importance of cancer screening. With studies showing that younger family members educated on the importance of cancer screening are more able to recommend their older family members to undergo cancer screening, such an education programme should be targeted for families rather than older adults alone. This study aims to develop a multimedia health promotion programme for families of South Asian ethnic minorities in Hong Kong, to increase their awareness of the importance of undergoing cancer screening in colorectal cancer prevention. Who can participate? Pairs of healthy South Asian (Indian, Pakistani and Nepali) adults living in Hong Kong, comprising a younger family member aged between 18 and 61 and an older family member aged between 62 and 71 What does the study involve? Each pair of participants is randomly allocated into either group A or group B. Participants in group A receive the educational programme. It is delivered in one session using multiple means including a health talk on colorectal cancer and cancer screening, presentation of a video clip depicting the benefits of family support in motivating an older family member to undergo cancer screening, and a health information booklet. Participants in group B receive this programme after those in group A have completed the programme. For participants in both groups, before and after group A participants have received the programme, the researchers assess the following: whether the younger family members of each participant pair are willing to encourage their older family members to consult a family doctor for undertaking colorectal cancer screening, and are prepared to assist older family members in collecting samples for colorectal cancer screening; whether the older family members of each participant pair have seen a family doctor for an appointment in colorectal cancer screening. The researchers also assess whether participants in both groups are satisfied with the programme after they have attended it.

Project description:BackgroundColorectal cancer (CRC) screening, such as fecal occult blood test (FOBT), is an effective way to prevent CRC, one of the most common cancers worldwide. However, studies found that South Asian ethnic minorities tend not to utilize CRC screening, whose importance on CRC prevention shall be educated among those from ethnic minorities, especially older adults. The purpose of this study is to develop and implement a family-based, multimedia intervention to augment the knowledge of CRC prevention among older South Asian adults in Hong Kong and enhance their motivation for undergoing FOBT. The acceptability and effectiveness of the intervention will be assessed using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.MethodsA cluster randomized controlled trial will be carried out. Three hundred and twenty South Asian dyads, comprising an older adult aged between 50 and 75 and a younger family member aged between 18 and 49, will be recruited in ten districts in Hong Kong through community organizations that provide support services for South Asians in local communities. Dyads will be randomly allocated to either the intervention or wait-list control group. Intervention dyads will receive intervention, whose contents are based on the health belief model, via multiple forms of media including PowerPoint presentation, video clip and health information booklet. Control dyads will receive intervention after post-intervention data are collected. For dyads in both groups, an appointment with a family doctor will be arranged for those willing to undergo FOBT. Outcomes will be assessed at baseline and post-intervention. Data will be analysed using the Generalised Linear Models Procedure in an intention-to-treat manner.DiscussionFindings of this study will provide evidence of the benefits of utilizing multimedia and family-based approaches in intervention development to enhance the effectiveness of health promotion interventions for ethnic minorities. Further, the findings would provide reference to the potential incorporation of the intervention in the existing support services for South Asian ethnic minorities in local communities.Trial registrationThis trial is registered at the ISRCTN Registry ( ISRCTN72829325 ) on 19th July 2018.

Project description:Introduction: Non-adherence to medication is a complex health care problem. In spite of substantial efforts, up till now little progress has been made to effectively tackle the problem with adherence-enhancing interventions. The aim of this study was to investigate the effectiveness of a patient-tailored, pharmacist-led and theory-driven intervention program aimed to enhance self-reported adherence to antihypertensive medication. Materials and Methods: A parallel-group randomized controlled trial in 20 community pharmacies with nine months follow-up was conducted. Patients (45-75 years) using antihypertensive medication and considered non-adherent based on both pharmacy dispensing data and a self-report questionnaire were eligible to participate. The intervention program consisted of two consultations with the pharmacist to identify participants' barriers to adhere to medication and to counsel participants in overcoming these barriers. The primary outcome was self-reported medication adherence. Secondary outcomes were beliefs about medicines, illness perceptions, quality of life and blood pressure. Mixed-model and generalized estimating equation (GEE) analyses were used to assess overall effects of the intervention program and effects per time point. Results: 170 patients were included. No significant differences between intervention and control groups were found in self-reported adherence, quality of life, illness perceptions, beliefs about medicines (concern scale), and blood pressure. After nine months, intervention participants had significantly stronger beliefs about the necessity of using their medicines as compared to control participants (mean difference 1.25 [95% CI: 0.27 to 2.24], p = 0.012). Discussion: We do not recommend to implement the intervention program in the current form for this study population. Future studies should focus on how to select eligible patient groups with appropriate measures in order to effectively target adherence-enhancing interventions. Trial Register: NTR5017 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5017.

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YACHA-led intervention program to enhance the CRC screening among South Asians in Hong Kong

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