Healthy Lifestyle Clinical Trial
Official title:
Happy Family Kitchen Movement, A Community-based Research to Enhance Family Health, Happiness and Harmony in Hong Kong: A Cluster Randomized Controlled Trial
In recent years, Hong Kong is undergoing rapid changes together with macro social and economic trends. The increasingly complex and diverse family structure is leading to a major concern in the well-being of families, including their health, happiness and harmony (3Hs). Family life and health education should be strengthened to meet the increasing needs of healthy lifestyle promotion. In light of these concerns, the Happy Family Kitchen Movement (HFKM) project, with a focus on "FAMILY Holistic Health", will be conducted at territory-wide level in Hong Kong. HFKM is a community-based research project to develop, implement and evaluate a community-based family intervention program for improving family well-being. It is expected that participants of the community-based family interventions will gain knowledge on family holistic health and in turn promote a healthy lifestyle for 3Hs.
In 2011, United Nations (UN) gathered to address the prevention and control of
non-communicable diseases (NCDs) worldwide. The UN, in its Political Declaration, recognized
the critical importance of reducing the level of exposure to the common modifiable risk
factors for NCDs, such as physical inactivity and unhealthy diet. In Hong Kong, NCDs are
responsible for more than 85% of all deaths and most of these are preventable. FAMILY Project
Cohort Study (2014) also found that 88.6% of Hong Kong people had inadequate vegetable and
fruit intake, 70.6% had inadequate physical exercise, 26.4% were overweight and 5.4% were
obese. Hong Kong, being the most westernized and developed city of China, can take a leading
role in promoting and implementing the UN Political Declaration.
Families worldwide are undergoing rapid changes together with macro, social and economic
trends. Demographic shifts, economic upheavals, changing societal norms and values, both
immigration across national borders and migration within nations are creating new and altered
structures, processes, and relationships within families. The increasingly complex and
diverse family structure is leading to a major concern in the well-being of families in Hong
Kong, including their health, happiness and harmony (3Hs). Family life and health education
should be strengthened to meet the increasing needs of healthy lifestyle promotion. The
results from the baseline findings of FAMILY Project Cohort Study (2014) revealed that only
27.9% of the participants considered themselves to be 'happy' while 15.6% of the participants
were classified as 'unhappy'. Nearly one-third (30.7%) of the participants reported having
experienced at least one stressful life event in the previous year due to heavier workload
(10.8%), serious health problems of a family member (6.8%), worsening financial situation
(6.2%), health problems (5.1%), or death of a family member (4.7%). Furthermore, more than
half of the participants (52.5%) reported having some source of dyadic conflict with family
members. In response to these family and health challenges, the Happy Family Kitchen Movement
(HFKM) project, with a focus on "FAMILY Holistic Health", will be conducted at territory-wide
level in Hong Kong.
There are now many definitions and operationally defined terms on family health. On the
functional level, the terms family health, family functioning, and healthy family are often
used interchangeably (Hanson & Boyd, 1996). Family health has been described as complex
system, interactions, relationships and processes with the potential to enhance both
well-being and the entire household's health, and routines in the family may affect family
health (Denham, 1999, 2002; Yoshikawa, 2012). Despite the different perspectives in the
definitions, family health should be holistically defined, encompass both wellness and
illness variables and focus on the interactive, developmental, functional, psychosocial, and
health processes of family experience (Anderson & Tomlinso, 1992). Hence, the HFK Movement
project will focus on "FAMILY Holistic Health" which is to emphasize a more comprehensive and
wide reaching aim and includes the physical, psychological and social aspects of well-being.
Over the past six years, the FAMILY project has been working on community-based projects to
promote 3Hs. Since September 2010, the Happy Family Kitchen I project (HFK) was launched in
Yuen Long district, with the mission to promote 3Hs by building capacity for families on
positive communication. As a component of the FAMILY Project, the HFK project had
demonstrated the impact to build up an effective practice model through collaboration among
various project partners. HFK II was an improved version, extended and introduced to Tsuen
Wan & Kwai Tsing districts in April 2012. The School of Public Health, The University of Hong
Kong, collaborated with The Hong Kong Council of Social Service in the training, design and
implementation, and conducted project evaluations for HFK I & II projects, which showed that
the projects were well received by the family members in Yuen Long, Tsuen Wan and Kwai Tsing
districts, with significantly improved 3Hs and intervention-related behaviors. Therefore, the
HFKM project is developed based on the strong foundation of the HFK projects in the previous
years. In view of the physical health challenges locally and globally, the new phase of
FAMILY project will put more emphasis on physical health in the upcoming three years.
Following the theme on FAMILY 3Hs, the new work focus is to promote family holistic health
with emphasis on the interaction and integration of physical and psychosocial health.
In Hong Kong, most 'health projects' only focus on individual's physical health and usually
separate physical from mental or psychosocial health. The focus of this project not only
emphasizes on individuals' health but on the family's holistic health. It is aimed to help
family members influence each other for healthier lifestyles. The focus on family is a new
and unique concept which is an innovative, long-term and highly sustainable at the community
level. With the involvement of family members, Hong Kong families can change their lifestyles
and make a difference and impact on their health. A family-focused approach will be used and
a holistic perspective will be adopted to design a sustainable family holistic health
intervention model in the community to meet the global health challenges.
The innovative family holistic health intervention model will emphasize on the interaction
and integration of physical health and psychosocial health, based on positive psychology
(Seligman, 2002; Seligman, 2011; Seligman & Csikszentmihalyi, 2000), using physical exercise
and healthy diet as the platform to promote finer and fitter families, which will ultimately
enhance the 3Hs. Thus, the ultimate objective of the community-based project is family
holistic health for 3Hs.
In practice, innovative integrated positive psychology, public health theories and minimal
methods will be used to develop brief, simple and cost-effective interventions targeted at
families, in collaboration with experienced NGO partners and community stakeholders. Training
workshops for the promotion of family holistic health will be conducted for the facilitators
of the community-based family intervention programs. Hence, a larger number of people will be
able to benefit from the program which can have greater sustainability and wider
dissemination as it will be easy to administer and the costs will be low. The community-based
family intervention programs will be aimed at promoting a higher level of physical exercise
and a healthy diet for people of all ages which will enhance family interaction, pleasure and
well-being. The use of positive psychology approach can help families develop positive
attitudes and stronger motivation for healthy lifestyles. By working together with family
members to have more physical exercise and consume less sugar, the process will be enjoyable
with quick and measurable benefits, which will ultimately enhance sustainability within the
family and beyond.
The evaluations conducted will be vigorous and evidence generating with quantitative and
qualitative methods and follow-ups to assess behavioral changes and improvements in the key
components of family well-being. For program development, process evaluation will also be a
source for data collection.
This study has two major objectives:
1. To examine the effectiveness of positive psychology and physical exercise intervention
(PE) for the promotion of family health, happiness and harmony (3Hs).
2. To examine the effectiveness of positive psychology and healthy diet intervention (HD)
for the promotion of family health, happiness and harmony (3Hs).
The community-based family intervention is expected to:
1. improve family health, happiness and harmony
2. promote physical and psychosocial health
3. enhance family communication
4. encourage behaviors on positive psychology, physical exercise and healthy diet
;
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