Health Behavior Clinical Trial
Official title:
Community Health Campaign: Fitter Families Project
In recent years, Hong Kong has been undergoing rapid changes with macro social and economic trends. The increasingly complex and diverse family structure contribute to concerns regarding the well-being of families in Hong Kong, including their health, happiness and harmony (FAMILY 3Hs). Family life and health education should be strengthened to meet the increasing needs of promoting healthy active lifestyle among Hong Kong families. In this connection, the FAMILY Project initiates the Fitter Families Project (FFP) with a focus on "FAMILY Holistic Health", will be conducted in order to increase the awareness of the importance of FAMILY 3Hs. FFP is a community-based research project with 3 main components - train-the-trainers programs, community-based family interventions and public education events. It is expected that trainees from the train-the-trainers programs will acquire adequate skills to organize community-based health education programs effectively. Participants of the community-based family interventions will gain knowledge on family holistic health and live a healthy active lifestyle. Attendees of the public education events will become more aware of the importance of FAMILY 3Hs.
In 2011, United Nations (UN) addressed the prevention and control of four non-communicable
diseases (NCDs: cancer, cardiovascular disease, chronic respiratory disease, and diabetes
mellitus) worldwide. The UN, in its Political Declaration, recognized the critical importance
of reducing the exposure to the common modifiable risk factors for NCDs, namely, tobacco use,
unhealthy diet, physical inactivity, and the harmful use of alcohol. 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 have been undergoing rapid changes with macro, social and economic trends.
Demographic shifts, economic upheavals, changing societal norms and values, 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 contributes to concerns regarding the well-being of families in Hong Kong,
including their health, happiness and harmony (FAMILY 3Hs). Family life and health education
should be strengthened to meet the increasing needs of promoting healthy lifestyle among Hong
Kong families. 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 of oneself (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 conflicts with family members. In response to these changes in the contexts
and nature of the family, the Fitter Families Project (FFP) with a focus on "FAMILY Holistic
Health", will be conducted in order to increase the awareness of the importance of FAMILY
3Hs.
There are several definitions of family health. On the functional level, the terms family
health, family functioning, and healthy family are often used interchangeably. 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. 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. Therefore, family health may be described as a dynamic process that
maintains or changes the relative state of well-being, including elements of family systems,
such as biological, psychological, spiritual, and sociocultural aspects. Hence, the FFP
focuses on "FAMILY Holistic Health" which is to emphasize a more comprehensive and wide
reaching aim and includes physical, mental and social health and well-being.
Over the past six years, the FAMILY project has been working on community-based projects to
promote FAMILY 3Hs. Since 2010, the Christian Family Service Centre (CFSC) in collaboration
with the School of Public Health of the University of the Hong Kong (HKU) implemented a
community-based Learning Families Project (LFP) to promote family health, happiness and
harmony (3Hs). As a component of the FAMILY Project, the LFP had built up an effective
practice model through collaboration among various project partners and showed good evidence
of effectiveness in developing a learning culture in the families, enhancing family
communication time and quality, increasing neighborhood cohesion and resilience and promoting
FAMILY 3Hs. Therefore, the FFP is developed based on the strong foundation of the LFP in the
previous years. In view of the health challenges locally and globally, the new phase of
FAMILY project will put more emphasis on health in the upcoming three years. Following the
theme on FAMILY 3Hs, the FFP focuses on family holistic health with emphasis on the
interaction and integration of both 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. This new project focuses not only on
individuals' health but on the whole family and holistic health. The investigators strive to
help family members influence each other to have better holistic health. The focus on family
is a new and unique concept which is an innovative, long-term and highly sustainable approach
at the community level. With the involvement of family members, Hong Kong families can
develop and change their lifestyles which impact on families' health. The investigators will
use a family-focused approach and adopt a holistic perspective to design a sustainable family
holistic health intervention model in the community to meet the global health challenges
identified by UN.
The innovative family holistic health intervention model will emphasize on the interaction
and integration of physical health and psychosocial health, using physical exercise as the
platform to promote fitter families, which will ultimately enhance the FAMILY 3Hs. Thus, the
ultimate objective of this community-based project is "FAMILY holistic health" for FAMILY
3Hs.
In practice, the investigators will use innovative integrated public health theories and
minimal methods to plan brief, simple and cost-effective interventions targeted at families,
with collaboration with experienced NGO partners and community stakeholders. Hence, a larger
number of people will be able to benefit from the program, leading to greater sustainability
and wider dissemination as the administration of project will be easier and the costs will be
lower. The "FAMILY Holistic Health" community-based project aims at promoting a higher level
of physical exercise for people of all ages which will enhance family interaction, pleasure
and well-being. The project can help families to build positive attitudes with stronger
motivation for family members to improve their holistic health by encouraging each other to
have healthy active lifestyle and enjoy the processes with quick and measurable benefits.
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. The data will be provided to the participants for developing
their own health action plan. In order to assess the effectiveness of the interventions on
improving individual and family well-being and for future program development, the data will
also be used for program evaluation. Thus, this proposal is to seek approval from IRB to
collect data from the participants, to use the data for in depth analyses, and to write up
scientific papers based on the findings.
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