Hybrid-delivered community psychoeducation for people aged 50 and older: A mixed-method evaluation and lesson learned.

Introduction: Hybrid training mode comprising in-person and teleconferencing sessions is effective and sustainable, yet no standardized principles guide its development for older people. This study aimed to develop a set of principles for hybrid-mode psychoeducation for older people from the experiences of middle-aged and older people in two folds: (1) examining the effects of hybrid-mode community psychoeducation and (2) identifying features that could enhance participants' experience. Methods: We delivered 12-hour Older Person Mental Health First Aid and 3-hour late-life depression training to adults aged 50 and older in in-person and hybrid modes. Hybrid group participants received technology-related support, including in-advance training and on-site support. All participants completed assessments on depression literacy, depression stigma, meaning in life, social support, depressive symptoms, and anxiety pre-and post-intervention and evaluated the program in open-ended questions. Results: A total of 471 in-person and 346 hybrid group participants completed the psychoeducation and post-assessment (80.4 % female, mean age = 64.73 years, SD = 7.29). Linear mixed models revealed improvements in depression literacy, depression stigma, meaning in life, social support, and anxiety (B = -1.43 to 0.13, all p < .001), with no significant difference between in-person and hybrid groups. Thematic analysis of open-ended questions identified three themes: (1) informational content with case studies, (2) hardcopy course handouts, and (3) interactive learning environment. Discussion/conclusion: Hybrid-mode and in-person psychoeducation had comparable benefits on middle-aged and older people. The TORCH principles, an acronym for Technology provision, On-site technical support, Rehearsal, Connection with group members, and Hardcopy notes, was derived from practice wisdom and qualitative findings to support older people in online learning.

A core competency framework for mental health peer supporters of older adults in a Chinese community: cross-culturally informed Delphi study.

AIMS AND METHOD: Non-Western literature on the core competencies of mental health peer supporters remains limited. Therefore, we used a three-round Delphi study with peer supporters, service users (i.e. someone using peer support services) and mental health professionals to develop a core competency framework for peer supporters in the Chinese context. RESULTS: The final framework included 35 core competencies, the conceptual origins of which were local (14.3%), Western (20%) and both local and Western (65.7%). They were grouped into five categories in ascending peer supporter role specificity: (1) self-care and self-development, (2) general work ethics, (3) work with others, (4) work with service users and (5) peer support knowledge. CLINICAL IMPLICATIONS: A culturally valid mental health peer support competency framework can minimise role confusion and refine training and practice guidelines. In a Chinese context, peer supporters were valued as generic support companions, whereas functions highlighted in the West, such as role modelling, were perceived as less critical.

Dimensionality and risk factors of the personal stigma of depression in adults aged 50 years and older at risk of depression.

Objectives: Knowledge about the mechanism of the personal stigma of depression may inform strategies to reduce stigma and promote help-seeking. We examined the dimensionality and risk factors of the personal stigma of depression in older adults at risk of depression.Methods: Seven-hundred and one Hong Kong adults aged 50 years and older at risk of depression completed the personal stigma subscale of the depression Stigma Scale (DSS-personal) at two-time points. We used exploratory factor analysis (EFA) to explore the factor structure of DSS personal and confirmatory factor analysis to examine the model fit of the EFA-informed factor structure and structures proposed in previous studies. Regression analyses examined the relationships between risk factors and personal stigma dimensions.Results: Factor analyses identified a 3-factor structure of DSS-personal resembling the social-cognitive model consistent over time and included stereotype, prejudice, and discrimination (CFI = 0.95, TLI = 0.92, RMSEA = 0.05). Regression analyses indicated all stigma dimensions were associated with older age, less education, and no personal history of depression (B = -0.44 to 0.06); discrimination was also associated with more depressive symptoms (B = 0.10 to 0.12).Conclusion: Findings illustrated the potential theoretical underpinning of DSS-personal. Stigma reduction interventions could target and tailor to older adults with risk factors to enhance effectiveness and promote help-seeking.

Economic Abuse as a Form of Intimate Partner Violence: A Literature Review of the Instruments and Mental Well-Being Outcomes.

Intimate partner violence (IPV) exists in various forms including physical, psychological, sexual, and economic. Although abundant literature documented the association between physical, psychological, or sexual violence with the associated mental well-being outcomes on survivors, the literature on economic violence, and its consequences were insufficient. In the past, most of the literature captured economic abuse within the scope of psychological abuse. However, different from psychological abuse, survivors of economic abuse may directly suffer from deteriorating economic well-being. Therefore, there is a need to explicitly investigate economic abuse. This paper aims to critically appraise and summarize the instruments of economic abuse and the associated mental well-being outcomes on women. This study highlights the lack of vigorous study in the area and also an underreporting of the negative impact of economic abuse. The implications and future research directions are discussed.

Risk Factors for and Mental Well-Being Outcomes of Economic Abuse in Hong Kong Chinese Population.

Although economic abuse is one of the major tactics of intimate partner violence, there has been a lack of empirical evidence on the factors associated with economic abuse and its mental well-being outcomes in Chinese population. This study aimed to identify risk factors for and mental well-being of economic abuse in Chinese population. This was a cross-sectional household survey with 504 Chinese adults in Hong Kong. It was found that unmarried individuals and individuals with tertiary education or above were at risk of economic abuse. Moreover, there were significant association between economic abuse experience and anxiety, depression, and psychosomatic symptoms. Resilience was the protective factor against anxiety, depression, and psychosomatic symptoms. The findings were discussed alongside with Chinese culture.

Transcultural Validation of the 12-Item Scale of Economic Abuse in Chinese Population.

The aim of this study was to report translation and transcultural adaptation of the Chinese version of the 12-item scale of economic abuse (C-SEA-12) and evaluate its psychometric properties. Forward translation, backward translation followed by consensus meeting with expert committees were done to create the Chinese version. Then, the translated C-SEA-12 was validated on 399 Chinese adults from a territory-wide household survey in Hong Kong. A second-order factor model of C-SEA-12 was demonstrated with adequate goodness of fit (root mean square error of approximation [RMSEA] = .05, comparative fit index [CFI] = .99, Tucker-Lewis Index [TLI] = .98, SRMR = .03) through exploratory and confirmatory factor analysis. The reliability (Cronbach's α coefficient = .92) and validity were satisfactory. The C-SEA-12 was demonstrated to be a reliable and valid measurement to assess economic abuse in Chinese population.

Dating CAFE Ambassador Programme: Chinese College Students to Help Peers in Dating Violence.

Dating violence prevention programs have been understudied in Asia, including China. The current study sought to evaluate the feasibility of the Dating Compassion, Assessment, reFerral, and Education (CAFE) Ambassador Programme in China. This program is designed to enhance the behavioral intentions of Chinese students to help peers who are experiencing dating violence and to compare students' attitudes toward dating violence, students' subjective norms about helping peers, and students' perceived behavioral control in helping peers before and after attending the 7.5 hour program. A quasi-experimental design was used, including two student groups (n = 85) assessed at baseline and 3-month follow-up. Quantitative pre- and postintervention measurements, in conjunction with qualitative focus group interviews, were used to evaluate the program's effectiveness. The findings indicated a significant enhancement in the behavioral intentions of participants in the intervention group to help peers experiencing dating violence, a stronger subjective norm regarding helping others, and an enhanced sense of perceived behavioral control to help, compared with the control group, over time. Focus group data revealed that students who participated in the program developed a more comprehensive definition of dating violence, increased awareness of dating violence in peers, a shift in their focus concerning the role of intention in dating violence and felt more responsible for helping their peers. The findings support the effectiveness of the Dating CAFE Ambassador Programme.

Using the Woman Abuse Screening Tool to Screen for and Assess Dating Violence in College Students.

The study aimed to evaluate the measurement properties of the Woman Abuse Screening Tool (WAST) in Chinese college students. A cross-sectional survey was conducted in Hong Kong. A cutoff score of 10 was found to be able to discriminate between abused and nonabused Chinese young adults. The total score was significantly correlated with total scores for anxiety and depression on the Chinese version of the Hospital Anxiety and Depression Scale. Two-factor structure of the WAST was supported by exploratory and confirmatory factor analyses. The Chinese WAST was found to be valid in screening for and assessing intimate partner violence.

Chinese women health ambassadors programme: A process evaluation.

AIMS AND OBJECTIVES: The aim of this study was to assess a community-women health ambassadors programme and report the areas that were successful and those that required improvement. The objectives were to assess the feasibility, effectiveness, implementation and sustainability of the programme. BACKGROUND: Health promotion for the prevention of chronic diseases has always been the top priority in the health sector. To ensure that the relevant health messages are well received in local communities, a health promotion programme must be accessible, acceptable and culturally relevant. DESIGN: We conducted and evaluated a women health ambassador programme based on the lay health advisor model for health promotion in Hong Kong during November 2014 to February 2015. Health needs and the subsequent focus of the programme were determined by underprivileged Chinese women. METHODS: University health educators from different disciplines trained the women (N = 80) to be health ambassadors through mini-lectures and training workshops. The trained women raised awareness about the importance of health within their families and social networks. The programme was evaluated through attendance rates, questionnaires and quizzes, changes in knowledge and behaviour, as well as qualitative discussion. RESULTS: While the majority of participants found the programme valuable and useful, retention rates were unideal. A statistically significant improvement was found in eating habits, but no significant change was identified for other knowledge and behaviour assessments. CONCLUSIONS: The programme empowered underprivileged women to reflect on the importance of health, take responsibility for their own health and actively promote health to their families and personal communities. RELEVANCE TO CLINICAL PRACTICE: Our study supports that health promotion programmes based on the lay health advisor model are effective and encourage large-scale programmes of this nature. Our results also support that future health promotion efforts should deliver brief, clear and simple content as opposed to intricate information.