Effectiveness of telehealth in preventive care: a study protocol for a randomised controlled trial of tele-exercise programme involving older people with possible sarcopenia or at risk of fall.

BACKGROUND: Continuous loss of muscle mass and strength are the consequences of the ageing process, which increase the risk of falls among older people. Falls can lead to severe consequences such as bone fractures and hampered physical and psychological well-being. Regular exercise is the key to reversing muscle atrophy and relieving sarcopenia. However, the frailty of older people and the recent COVID-19 pandemic may affect their confidence to leave home to attend classes in the community. A feasible and effective alternative should be explored. METHODS: The primary objective is to evaluate the effectiveness of tele-exercise (TE) in relation to physical functioning and exercise adherence among community-dwelling older people at risk of falls in comparison with a community-based group (CB). The secondary objective includes evaluating older people's experience with tele-exercise, emphasizing their psychological welfare, social well-being, and acceptance of the telehealth approach. The design, conduct, and report follow the SPIRIT guidelines (Standard Protocol Items: recommended items to address in a Clinical Trial Protocol and Related Documents). Older people will be recruited from 10 local community centres in Hong Kong and randomly allocated into two groups. All participants will attend the exercise training 3 days per week for 3 months but the mode of delivery will differ, either online as the tele-exercise group (TE) or face-to-face as the community-based group (CB). The outcome measures include muscle strength, physical function, exercise adherence and dropout rate, psychological and social well-being will be assessed at the baseline, and the 3rd, 6th and 12th month. Some participants will be invited to attend focus group interviews to evaluate their overall experience of the tele-exercise training. DISCUSSION: Tele-exercise reduces the barriers to exercise, such as time constraints, inaccessibility to facilities, and the fear of frail older people leaving their homes. Promoting an online home-based exercise programme for older people can encourage them to engage in regular physical activity and increase their exercise adherence even when remaining at home. The use of telehealth can potentially result in savings in cost and time. The final findings will provide insights on delivering exercise via telehealth to older people and propose an exercise delivery and maintenance model for future practice. TRIAL REGISTRATION: Chinese Clinical Trial Registry ( https://www.chictr.org.cn/hvshowprojectEN.html?id=219002&v=1.1 ), registration number: ChiCTR2200063370. Registered on 5 September 2022.

The Application and Outcome Evaluation of a Social Marketing Intervention to Increase Seasonal Influenza Vaccination among University Students.

Seasonal flu vaccination rates among university students are exceedingly low and research focused on voluntarily influencing vaccination uptake is limited. This study outlines the development, implementation, and evaluation of a theory-driven social marketing vaccination intervention following the co-create-build-engage (CBE) framework. This study drew upon a pre-intervention segmentation study and co-created interventions targeted at receptive segments. The intervention delivered a significant 343% increase in vaccination rates using a difference-in-difference analysis. Online communication channels effectively engaged students to register for and receive their flu vaccine Almost 90% of students who received vaccinations signed up in the first two weeks of the intervention program indicating that those who can be motivated will act early in the flu season. Financial incentives, as found in previous studies, were confirmed as highly effective in increasing awareness and influencing vaccination uptake behaviours. Friend referral incentives were also found to be influential in motivating vaccination uptake. Suggestions are provided for future research and practical implementation of interventions on university campuses to motivate flu vaccination and other health behaviours.

Advance directives in Hong Kong: moving forward to legislation.

BACKGROUND: An advance directive (AD) is a legal statement indicating the form of healthcare the patient would like to receive at a future time when he/she is no longer mentally competent to make decisions. As there are increased concerns to respect the preferences of medical treatment of patients suffering from terminal illnesses, AD receives more attention and recognition in healthcare settings. However, Hong Kong has neither statue nor direst case law on the legal status of AD. A public consultation was therefore launched by the government in 2019. The present study aimed to examine the views towards ADs in response to the proposed legislation. METHODS: Fifty-nine responses were received from questionnaires and the findings formed a protocol and guideline for the focus groups. Twenty-three participants participated in two focus group discussions. A thematic analysis revealed three themes of views towards ADs legislations: public awareness, completion of ADs, and dying in place. RESULTS: Older and young participants held slightly different views on the acceptance of verbal and written format, and the presence of witnesses of ADs. Overall, participants considered the general public did not have adequate knowledge of AD. CONCLUSIONS: Findings suggested that public education should be enhanced, and guidance and protocols for healthcare professionals were needed after legislation of ADs. In addition, dying in place should also be facilitated while legislative barriers on Coroners Ordinance should be amended.

The use of technology for online learning among older adults in Hong Kong.

The use of technology to facilitate better living and learning is gaining popularity worldwide. More and more older adults are technology users and participating in online learning. While there is ample research examining the factors affecting older adults' behavioural intention to use technology more generally, less is known about their views of using technology in online learning environments. Applying the model for the adoption of technology by older adults (MATOA) developed by Kenneth Hsiche Wang et al., the authors of the study presented here investigated the attitudes of older adults towards technology adoption for online learning. They interviewed 20 adults aged 52-73 who had enrolled in a diploma course in a higher educational institution in Hong Kong. The results show that participants held favourable attitudes towards online learning after several practice sessions. While they had confidence in their future use of technology, they stated that the availability of technical and social support affected their intention of continuous learning using technology in online settings.

Utilisation de la technologie par les seniors à Hongkong pour apprendre en ligne ­ Utiliser la technologie pour faciliter l'amélioration de la qualité de vie et l'apprentissage, une activité qui jouit d'un engouement croissant dans le monde entier. De plus en plus de seniors se servent de la technologie pour se livrer à des activités d'apprentissage en ligne. Tandis que de nombreuses recherches portent sur les facteurs qui influent sur l'intention comportementale des seniors à utiliser la technologie d'une manière plus générale, nous savons peu de choses sur leurs points de vue à ce sujet dans les environnements d'apprentissage en ligne. S'appuyant sur le modèle pour l'adoption de la technologie par les seniors (model for the adoption of technology by older adults/MATOA) élaboré par Kenneth Hsiche Wang et coll., les auteurs de la présente étude se sont penchés sur les attitudes des seniors concernant l'adoption de la technologie pour apprendre en ligne. Ils ont interviewé 20 adultes âgés de 52 à 73 ans qui s'étaient inscrits à un cours diplômant dans un établissement d'enseignement supérieur à Hongkong. Les résultats indiquent que les participants se montraient favorables à l'apprentissage en ligne une fois qu'ils avaient participé à plusieurs séances d'entraînement. Tout en se sentant confiants quant à l'utilisation qu'ils feraient à l'avenir de la technologie, ils ont déclaré que la disponibilité d'un soutien technique et social influait sur leur intention d'apprendre en permanence en utilisant la technologie dans un environnement en ligne.

Predictors of the intention to use traditional Chinese medicine (TCM) using extended theory of planned behavior: a cross-sectional study among TCM users in Hong Kong.

BACKGROUND: Traditional Chinese medicine (TCM) and Western medicine are available and have a long history in Hong Kong. Little is known on the intention to use TCM in Hong Kong. In this study, the intention to use TCM was examined by the extended theory of planned behavior. METHODS: An online cross-sectional survey was conducted from 15 and 29 November 2021. Respondents' attitude towards using TCM, intention to use TCM, knowledge, perceived behavioral control, perceived service quality, satisfaction, subjective norms and demographic characteristics were collected from the survey. To examine the conceptual framework in this study, partial least square structural equation model (PLS-SEM) was adopted. RESULTS: In total, 446 responses (completion rate = 74.3%) were analysed. Attitude towards TCM was the strongest predictor to the intention to use TCM followed by satisfaction and subjective norms. Attitude had a partial mediating effect on the relationship between subjective norms, perceived behavioral control and intention to use TCM. Attitude had a full mediating effect on the relationship between knowledge and intention to use TCM. Satisfaction had a full mediating effect on the relationship between perceived service quality and intention to use TCM. CONCLUSIONS: This is the first study to investigate the predictors of the intention to use TCM in Hong Kong by using TPB. Individuals' attitude towards TCM has showed stronger effect to the intention to use TCM than other predictors, such as satisfaction, perceived behavioral control and subjective norms. To enhance the intention to use TCM in Hong Kong, key stakeholders, including TCM professional organisations, health professionals and policymakers, should develop a positive attitude towards TCM among Hong Kong population.

A Review Study of a Green Diet and Healthy Ageing.

Nowadays people are living longer, and there has been a substantial growth in the global elderly population in the past decades. While life expectancy is increasing, there are growing concerns towards the heavy financial and social burdens related to chronic diseases among the elderly. These have been critical health care issues, and healthy ageing is considered a top priority in public health. Diet and eating habits are crucial factors contributing to healthy ageing. These important aspects have attracted much attention in health research, particularly in consideration of the causes and management of chronic conditions which affect most elder adults in the world. Recently, a growing number of investigations have reported significant findings on the association of reduction in the risks of chronic non-communicable diseases with plant-based diets. Meanwhile, there have been worldwide initiatives and programmes implemented for reduction of salt intake. A green diet, which emphasises the consumption of a diet rich in plant foods with minimal portions of red or processed meat and reduced salt intake, is advocated with due consideration to the importance of sustainable environment and healthy ageing. This paper highlights a brief review of the recent advance of knowledge in diet and health, its effects on the elderly and the significance of a green diet on healthy ageing. Implications for a green diet and recommendations for future research are also discussed.

Relationships between Physical and Social Behavioural Changes and the Mental Status of Homebound Residents in Hong Kong during the COVID-19 Pandemic.

In Hong Kong, social distancing has been adopted in order to minimise the spread of COVID-19. This study aims to examine the changes in physical health, mental health, and social well-being experienced by local residents who were homebound during the pandemic. An online questionnaire in both Chinese and English versions was completed by 590 eligible participants from 24 April to 13 May 2020. The questionnaire found that individuals aged 18 to 25 years spent more time resting and relaxing but experienced more physical strain. Working status was associated with social contact, with participants working full-time jobs scoring higher in "maintaining social communication via electronic means" and "avoiding social activities outside the home". Additionally, approximately one third of the participants (29.7%) had moderate to severe depression, and participants aged 18 to 25 were found to have higher scores in PHQ-9. Changes in physical health and social contact were significantly associated with developing depressive symptoms. From the results, it is clear that the COVID-19 pandemic has the potential to exert a negative impact on the mental health status of individuals.

University binge drinking patterns and changes in patterns of alcohol consumption among chinese undergraduates in a Hong Kong university.

OBJECTIVE: To examine patterns of binge drinking and changes in drinking patterns among Chinese university students. PARTICIPANTS AND METHODS: Responses to an anonymous questionnaire were compared between a random sample of 411 second year Chinese undergraduate students in 2006 and 2,630 first year students from the previous year. Students reporting any symptoms of alcohol abuse were classified as alcohol abusers whereas those reporting repeated inability to curtail use were categorized as alcohol dependent. RESULTS: After 1 year of university, greatly increased rates of past-month drinking of different degrees were found in both genders. Binge drinking among second year undergraduates was significantly correlated with male gender, living in a student residence hall, smoking, drinking to relieve stress, and having friends who frequently drank. CONCLUSIONS: Alcohol misuse is a health hazard to Chinese students in a university environment. Proactive policies aimed at preventing harmful alcohol use should be considered by university authorities.