Group-based instrumental musical training to enhance resilience among school-aged children from low-income families: A pilot randomised waitlist controlled trial.

AIM: To evaluate the acceptability, feasibility and potential effectiveness of a group-based instrumental musical training programme in improving resilience, depressive symptoms, self-esteem and quality of life among school-aged children from low-income families. DESIGN: Assessor-blinded pilot randomised waitlist controlled trial with process evaluation. METHODS: This study was conducted in the community from January 2022 to July 2023. Sixty-four children from low-income families (aged 8-12 years) were randomised (1:1) to intervention and waitlist control groups. The intervention group (n = 32) received weekly 1-hour instrumental musical training for 6 months in groups of four to five from professionally qualified musicians at a music centre. The participants in the waitlist control group (n = 32) received the same intervention as the participants in the intervention group after the completion of all outcome assessments. The primary outcome was the children's levels of resilience, measured using the Resilience Scale for Children - 10. The secondary outcomes were depressive symptoms, self-esteem and quality of life. Assessments were conducted at baseline (T0) and immediately post-intervention (T1). An intention-to-treat analysis was performed. RESULTS: The 64 participants had a mean (SD) age of 9.5 (1.44) years, and 37 (57.8%) were boys. Compared with the waitlist control group, participants in the intervention group showed significantly greater improvements in resilience levels from baseline to T0 (group-by-time interaction coefficient ß = 4.41; 95% CI, 1.82-6.99; p = 0.001), depressive symptoms (ß = -6.42; 95% CI, -11.12 to -1.71; p = 0.008), self-esteem (ß = -2.60; 95% CI, 0.28-4.92; p = 0.028) and quality of life (ß = 6.69; 95% CI, 0.18-13.2; p = 0.044). CONCLUSION: The group-based instrumental musical training programme was feasible and acceptable for school-aged underprivileged children and showed the potential to improve the resilience and quality of life of this vulnerable population.

Experiences of caregivers of children with cancer in Malawi: A qualitative study.

BACKGROUND: Studies have shown that caregivers of children with cancer experience challenges when caring for their children. To date, no studies have examined the experience of caregivers of children with cancer in Malawi, a low-income country in sub-Saharan Africa. Hence, this study aimed to explore the experiences of caregivers of Malawian children receiving cancer treatment. METHODS: This explorative qualitative study used semi-structured interviews to collect data from 22 caregivers of children receiving cancer treatment. The data were analysed using qualitative content analysis. RESULTS: Five themes emerged from the QCA. The caregivers perceived their children's cancer as a burden, a form of psychological torture and a disruptor of family routines and social lifestyles. They also reported self-isolation due to the stigma that they faced in the course of caring for their children and a need for informational, psychosocial, spiritual and financial support. CONCLUSION: Caregivers of Malawian children with cancer experience physical and psychosocial challenges as they are caring for their children with cancer. Developing appropriate interventions would enable nurses to offer optimal support to these caregivers in dealing with these challenges and meeting their needs effectively.

Effectiveness of psychoeducation interventions in reducing negative psychological outcomes and improving coping skills in caregivers of children with cancer: A systematic review and meta-analysis.

PURPOSE: Psychoeducation interventions (PEIs) have been used as an adjunct treatment for negative psychological outcomes in caregivers of children with cancer. This systematic review and meta-analysis aimed to evaluate the evidence on the effectiveness of PEIs in reducing anxiety and depressive symptoms and improving health-related quality of life (HRQoL) and coping skills in caregivers of children with cancer. METHOD: Ten English databases were searched to identify studies on PEIs for caregivers of children with cancer. Studies inclusion criteria were as follows: (1) participants who were caregivers of children with cancer receiving treatment; (2) psychoeducational interventions assessing anxiety, depressive symptoms, HRQoL, and coping outcomes; and (3) usual care, waitlist, or active control as a control group. Meta-analysis and narrative synthesis were used to analyse data. RESULTS: Fourteen randomised control trials were included. PEIs have a beneficial effect on anxiety levels (SMD: -0.59, 95% CI [-0.92, -0.25], p = 0.0007), quality of life (SMD: -0.31, 95% CI [-0.00, -0.61], p = 0.05) and depressive symptoms (SMD: -1.18, 95% CI [-2.08, -0.28], p = 0.01) immediately post-intervention. The effect of PEIs was maintained at long-term follow-up on depressive symptoms (SMD: -0.52, 95% CI [-1.54, -0.36], p = 0.0004). Similarly, the synthesised data suggest that PEIs are effective in improving coping skills. CONCLUSION: The review provides evidence that PEIs effectively reduce negative psychological outcomes and improve coping skills in caregivers of children with cancer. However, due to methodological flaws and heterogeneity of the interventions evaluated, more research is needed to determine the most effective PEI design and improve the quality of evidence.

The Association of Resilience with Way of Coping, Psychological Well-Being and Quality of Life in Parents of Children with Cancer.

Evidence shows that resilience is crucial to maintain psychological well-being and quality of life in the face of stress and adversity. However, the relationships between resilience and psychological well-being and factors associated with quality of life in Hong Kong Chinese parents of children with cancer are underexplored. This study aimed to examine the interrelationships among resilience, ways of coping, psychological well-being, and quality of life among Chinese parents of children with cancer, and identify factors associated with their quality of life. A cross-sectional study was conducted with 119 Chinese parents of children with cancer at the Hong Kong Children's Hospital between January 2020 and March 2022. Parents' resilience level, ways of coping, depressive symptoms, state anxiety scores, perceived social support, and quality of life were assessed. Participating parents (n = 119) included 98 mothers (82.4%) and 11 parents were from single-parent families (9.2%). Almost half (47.9%) of the parents were potentially at risk for depression. The results showed that participants from single-parent families reported statistically significantly lower levels of resilience (p < 0.001), more depressive symptoms (p < 0.001), and poorer quality of life (p < 0.001) than those who lived with their partners (married). In addition, parents who adopted problem-focused coping strategies reported statistically significantly higher levels of resilience (p < 0.001), fewer depressive symptoms (p < 0.001), and better quality of life (p < 0.001) than those who adopted emotion-focused coping strategies. A multiple regression analysis revealed that resilience (p < 0.001) was associated with quality of life among parents of children with cancer. This study provides further support that resilience is an important factor associated with quality of life in parents of children with cancer. Assessing resilience in parents is an important prerequisite for designing appropriate interventions to increase their resilience and enhance their quality of life.

Helping patients with chronic diseases quit smoking by understanding their risk perception, behaviour, and smoking-related attitudes.

Continued smoking among patients with chronic diseases detrimentally affects their health and treatment outcomes. However, a majority of smokers with chronic diseases appear to have no intention to quit. Understanding the needs and concerns of this population is a crucial step in facilitating the design of an appropriate smoking cessation intervention. This study aimed to understand the risk perception, behaviours, attitudes, and experiences related to smoking and smoking cessation among patients with chronic diseases, including cardiovascular diseases, chronic respiratory diseases, and/or diabetes in Hong Kong. Individual semi-structured interviews with smokers with chronic diseases (n = 30) were conducted from May to July 2021. The methods and results are reported according to the COREQ. Four themes were generated: (1) perceptions of the association between chronic diseases and smoking/smoking cessation; (2) perceptions of the health/disease status; (3) quitting smoking is not the first priority; and (4) perceived barriers to quitting smoking. This study addressed a gap in the literature by gathering data concerning the perspectives of smokers with chronic diseases on smoking and smoking cessation. The deficit of knowledge among smokers with chronic diseases warrants the reinforcement of health education targeting this population. Our findings indicate the need for further efforts in designing appropriate smoking cessation interventions targeting smokers with chronic diseases, which will match the needs and concerns identified in this study.

Health-Risk Behaviors among Chinese Adults during the COVID-19 Pandemic.

This study analyzed archived data from a previous large-scale survey study on multiple health-risk behaviors among Chinese adults in Hong Kong between 21 June and 31 August 2021. In addition, this study examined participants' perceptions of the risks associated with their behaviors, their attitudes toward adopting healthy behaviors, and the impact of COVID-19 on their health-risk behaviors. A total of 4605 participants who had at least one health-risk behavior were included in the analysis. The results showed that about half of the participants were unaware that non-communicable diseases (NCDs) can be caused by health-risk behaviors such as tobacco use, harmful use of alcohol, physical inactivity, and an unhealthy diet. More than half of the participants did not have regular body checkups or monitor their physical health at home. Many participants paid more attention to their health due to the COVID-19 pandemic, but few made changes to their unhealthy habits or adopted a healthier lifestyle. Of the 704 smokers, 60.9% did not realize that smoking increases the risk of transmitting COVID-19 to others. Only 32.2% and 11.9% smokers had the intention to quit smoking and reduced their cigarette consumption, respectively. Additionally, 13.6% reported that their daily cigarette consumption had increased, and 78.8% changed their smoking behavior during the pandemic. Healthcare professionals must educate the public about the association between health-risk behaviors and NCDs and between COVID-19 and NCDs. The government should formulate a long-term plan to strengthen the primary healthcare system and address the challenges posed by the rising prevalence of NCDs.

A general health promotion approach to helping smokers with non-communicable diseases quit smoking: A pilot randomized controlled trial.

Background: Despite evidence showing that continued smoking in patients with non-communicable diseases can reduce treatment efficacy and increase the risk of disease progression and multimorbidity, many smoker patients either have no intention to quit or have had failed attempts at quitting. Objective: To examine the feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking. Methods: In total, 60 participants who had medical follow-up in a special out-patient clinic were randomized into two groups, 30 in the intervention group received brief motivational interviewing to assist them with their chosen behavioral changes, and 30 in the control group received only a smoking cessation booklet. The outcome measures included self-reported 7-day point prevalence of smoking abstinence and any behavioral change reported by the participants at 6 and 12 months. Biochemical validation was performed for those who verbally reported a 7-day point prevalence of smoking abstinence at 12 months. Results: The majority (95%) of smokers who attended the out-patient clinic owned a smartphone. The response rate was 73.2%. Retention rates at 6-month and 12-month follow-up were 83.3 and 71.7%, respectively. The process evaluation indicated that participants were satisfied with the content of the brief MI messages and appreciated the use of instant messaging as a way to provide them with professional advice and support for managing their health-related lifestyles. The intervention group had a higher biochemically validated abstinence rate than the control group at 12 months (16.7 vs. 6.7 P = 0.23) although the difference was not statistically significant (Adjusted odd ratio 2.4, 95% confidence interval, 0.43-13.75; P = 0.32.), In addition, the proportion of participants reporting a behavioral change was higher in the intervention group at 6 and 12 months. Conclusion: This study suggested the potential efficacy and feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking. The findings can be used to create a new smoking cessation service model that implements a flexible, proactive and personalized approach to help smokers quit smoking. Clinical trial registration: ClinicalTrials.gov, identifier: NCT03983330.

A Descriptive Study on Multiple Health-Risk Behaviors among Chinese Adults in Hong Kong.

This study investigated the prevalence and clustering patterns of multiple health-risk behaviors and their associations with non-communicable diseases among Chinese adults in Hong Kong. A large sample survey was conducted in all 18 districts of Hong Kong between 21 June and 31 August 2021. A total of 5737 adults completed the survey. Overall, 4605 (80.3%) had at least one health-risk behavior and 2696 (47.0%) had two or more health-risk behaviors. Multiple health-risk behaviors were more prevalent among men. The prevalence of smoking and alcohol consumption among Hong Kong Chinese women was considerably lower than in most Western countries. In contrast to previous findings, this study revealed that a high proportion of adults with high educational attainment or household income had multiple health-risk behaviors. In addition, this study revealed that the health-risk behaviors in Chinese adults co-occurred in clusters, with smoking and alcohol consumption co-occurring with other health-risk behaviors. Those who smoked or consumed alcohol had the highest proportion of multiple health-risk behaviors and the highest proportion of non-communicable diseases. The findings of this study add further evidence that health-risk behaviors co-occur in clusters and can contribute to non-communicable diseases.

The Lived Experience of Resilience in Parents of Children With Cancer: A Phenomenological Study.

Background: Resilience is vital in parents of children with cancer as it can promote parental well-being and minimize maladaptation in the face of the children's cancer. Although existing quantitative studies investigated the influence factors of resilience in the parents, it has not been fully explored about the factors contributing to the resilience of parents and how they respond to and cope with their children's cancer. Objective: To investigate the lived experience of resilience in the parents of children with cancer from a qualitative perspective to complement existing findings in quantitative studies. Methods: A phenomenological approach was used. Purposive sampling was performed to recruit parents of children with cancer from two tertiary hospitals in mainland China, followed by one-to-one semi-structured interviews. All of the interviews were audio-recorded and data were analyzed using thematic analysis. Results: Twenty-three parents, comprising 15 mothers and eight fathers, of children with cancer participated in the interview. Four themes were identified: positive and negative experiences of their children's disease, going through hardships, perceived competence and perceived social support. The most prominent facilitating factor of resilience was the presence of positive attitudes toward the children's cancer, while low level of confidence was the main obstacle. Conclusion: This study identified certain factors that affect resilience in parents of children with cancer. The findings of this study provide important implications for the development of targeted resilience training programs to enhance resilience in parents of children with cancer. It is crucial for future interventions to focus on cultivating parental resilience to promote parents' mental well-being and improve their quality of life. ClinicalTrialsgov ID: NCT03631485; URL: https://clinicaltrials.gov/ct2/show/NCT03631485.

Efficacy of Mobile Instant Messaging-Delivered Brief Motivational Interviewing for Parents to Promote Physical Activity in Pediatric Cancer Survivors: A Randomized Clinical Trial.

Importance: Physical activity has beneficial effects that mitigate cancer- and treatment-related late effects. However, children who survive cancer are often physically inactive. Brief motivational interviewing may be an effective approach for increasing children's physical activity levels. Objective: To examine the effects of mobile instant messaging-delivered brief motivational interviewing for parents in promoting regular physical activity in children who have survived cancer. Design, Setting, and Participants: An assessor-blinded randomized clinical trial was conducted at 2 Hong Kong pediatric oncology outpatient clinics from March 1, 2019, to January 29, 2021. A total of 161 children who had survived cancer, aged 9 to 16 years, and their parents were randomized (1:1) to an intervention or control group. Interventions: The intervention group received a 6-month mobile instant messaging-delivered brief motivational interviewing using a strategy menu. Parent-child dyads in both groups received a health advice session and were directed to a physical activity website at baseline. Main Outcomes and Measures: The primary outcome was the children's physical activity levels at 12-month follow-up, measured by the Chinese University of Hong Kong: Physical Activity Rating for Children and Youth (total sores: 0-10, higher scores indicate greater physical activity levels). Secondary outcomes were cancer-related fatigue levels, handgrip strength, peak expiratory flow rate, and quality of life. Intention-to-treat analysis was performed. Results: Of the 161 children included in the study, 93 were boys (57.8%), and the mean (SD) age was 12.4 (2.4) years. Generalized estimating equation analyses showed a significant improvement in outcomes in the intervention group compared with the control group: physical activity levels (group-by-time interaction, 6 months: ß = 3.09; 95% CI, 2.65-3.53; P < .001; 12 months: ß = 3.91; 95% CI, 3.45-4.36; P < .001), cancer-related fatigue (6 months: ß = -5.69; 95% CI, -8.03 to -3.35; P < .001; 12 months: ß = -9.16; 95% CI, -11.31 to -7.00; P < .001), left handgrip strength (6 months: ß = 2.69; 95% CI, 0.96-4.43; P = .002; 12 months: ß = 5.52; 95% CI, 3.70-7.33; P < .001), right handgrip strength (6 months: ß = 2.75; 95% CI, 1.01-4.50; P = .002; 12 months: ß = 5.45; 95% CI, 3.62-7.27; P < .001), peak expiratory flow rate (12 months: ß = 28.51; 95% CI, 16.10-40.92; P < .001), and quality of life (6 months: ß = 5.01; 95% CI, 1.19-8.82; P = .01); 12 months: ß = 14.19; 95% CI, 10.84-17.54; P < .001). Conclusions and Relevance: In this randomized clinical trial, mobile instant messaging-delivered brief motivational interviewing was effective in promoting the adoption and maintenance of regular physical activity and ameliorating cancer- or treatment-related adverse effects in children who survived cancer. Trial Registration: ClinicalTrials.gov Identifier: NCT03859271.

Impact of Poverty on Parent-Child Relationships, Parental Stress, and Parenting Practices.

Objectives: To explore the impact of poverty on parent-child relationships, parental stress and parenting practices. Design: A mixed methods study. Sample: Four hundred and eighty five Hong Kong Chinese parents who had children aged 3-6 years, and who were from low-income families. Eleven of these parents were randomly selected for individual semi-structured interviews. Measurements: A sociodemographic questionnaire, the parent-child relationship score, the Parental Stress Scale and the Perceived Parental Aggression Scale. Results: The parents were found to have an impaired relationship with their children. The findings indicated that employment status, parental stress and harsh parenting were significantly associated with parent-child relationships. The qualitative findings revealed that parents from low-income families encountered a wide range of difficulties, which made these parents more likely to experience parental stress, thereby increasing their tendency to adopt harsh parenting practices that undermined parent-child relationships. Conclusion: This study sheds light on the associations between parent-child relationships, parental stress and parenting practices in low-income families. These findings will enhance nurses' understanding of the impact of poverty on parent-child relationships, and highlight the need for nurses to ensure that underprivileged parents and their children receive adequate primary care to prevent the development of psychological problems in this vulnerable group.

Associations of Physical Activity and Handgrip Strength with Different Domains of Quality of Life in Pediatric Cancer Survivors.

There is a paucity of evidence about the associations of physical activity (PA) and handgrip strength (HGS) within different domains of quality of life (QoL) in Chinese pediatric cancer survivors. We, therefore, conducted this multicenter cross-sectional study aimed to investigate whether increased PA level and HGS are associated with higher scores in different QoL domains (i.e., physical, emotional, social, and school functioning) in pediatric cancer survivors. PA was assessed with a validated self-reported PA rating scale. In total, 191 Chinese pediatric cancer survivors aged 9 to 16 years were included in the analysis. Results showed that engaging in a higher level of PA was significantly associated with improved QoL in different domains, including physical (ß = 0.543, p < 0.001), emotional (ß = 0.449, p < 0.001), social (ß = 0.434, p < 0.001), and school functioning (ß = 0.407, p < 0.001). Greater HGS was also associated with better physical (ß = 0.230, p ≤ 0.001) and emotional (ß = 0.261, p ≤ 0.001) functioning. Findings from this study provide evidence of the significant beneficial impact of regular PA on pediatric cancer survivors' QoL along their survivorship trajectory.

Evaluating the experiences of parents of children with cancer engaging in a mobile device-based resilience training programme: a qualitative study.

PURPOSE: A mobile device-based resilience training programme has been found to improve psychological well-being in parents of children with cancer. However, the essential elements underlying the programme's efficacy and the factors that affect parents' advocacy of the online resilience training remain unknown. This study explored the lived experience of engaging in a mobile device-based resilience training programme in parents of children with cancer. METHODS: A descriptive phenomenological approach was used. Parents of children with cancer who had received the mobile device-based resilience training in a previous randomised controlled trial were selected to attend one-to-one semi-structured interviews. All interviews were audio-recorded. Data were analysed using Colaizzi's descriptive phenomenological method. RESULTS: Twenty-one parents, comprising 15 mothers and 6 fathers, of children with cancer participated in the interview. The two following themes were identified: perceptions about the training (be beneficial for psychological well-being, be beneficial for parent-child communication and be beneficial for coping) and evaluation of the training (increased knowledge and skills, be satisfied with the intervention form and content, challenges to adhere to the programme and recommendations for future interventions). CONCLUSION: This study explored which features of a mobile device-based resilience training programme improved the psychological well-being of parents of children with cancer. Its findings highlight the importance of providing a resilience training programme that is based on the parents' intervention form preferences and their mental health needs. TRIAL REGISTRATION: NCT04038242, registered 17 July 2019.

Efficacy of a blended learning programme in enhancing the communication skill competence and self-efficacy of nursing students in conducting clinical handovers: a randomised controlled trial.

BACKGROUND: A clinical handover is an essential nursing practice that ensures patient safety. However, most newly graduated nurses struggle to conduct clinical handovers as they lack sufficient communication skill competence and self-efficacy in this practice. This study aimed to examine the efficacy of a blended learning programme on the communication skill competence and self-efficacy of final-year nursing students in conducting clinical handovers. METHODS: A randomised controlled design was used. A convenience sample of 96 final-year baccalaureate nursing students at a local university. Data were collected in 2020. Participants were randomly assigned to either an experimental group (n = 50) that received a blended learning programme with face-to-face training and an online module on handover practice, or a waitlist control group (n = 46) that received only face-to-face handover training during the study period and an online module immediately after the completion of data collection. The primary outcome was the communication skill competence and the secondary outcome was the self-efficacy of the participants in conducting clinical handovers. An analysis of covariance was used to examine the between-subjects effects on self-efficacy and communication skill competence in conducting clinical handovers after controlling for the significantly correlated variables. A paired sample t-test was used to determine the within-subjects effects on self-efficacy. RESULTS: The participants in the experimental group had significantly higher communication skill competence (p < 0.001) than those in the waitlist control group. Although both groups showed a significant improvement in self-efficacy, the mean scores of the experimental group were higher than those of the waitlist control group (p < 0.001). CONCLUSIONS: This study demonstrated the efficacy of a blended learning approach in improving the communication skill competence and self-efficacy of final-year nursing students in conducting clinical handovers. Nurse educators should incorporate a blended learning approach into the nursing curriculum to optimise the content of training programmes for teaching nursing students in conducting clinical handovers. TRIAL REGISTRATION: The study protocol was registered in the Registration ClinicalTrials.gov ( NCT05150067 ; retrospective registration; date of registration 08/12/2021).

Psychological distress experienced by nurses amid the fifth wave of the COVID-19 pandemic in Hong Kong: A qualitative study.

Introduction: The fifth wave of COVID-19 has significantly overburdened the health care system in Hong Kong. Health care professionals, particularly nurses continue to experience significant levels of psychological distress when tackling this ongoing outbreak. Yet, no study has explored the psychological experiences of nurses during the most recent outbreak of the highly transmissible Omicron variant in Hong Kong. The aim of this qualitative study was to explore the psychological distress experienced by nurses during the fifth wave of the COVID-19 pandemic in Hong Kong. Methods: Twenty-two nurses (14 female and 8 male nurses; average age, 36.7 ± 8.5 years) were recruited to attend the one-to-one semi-structured telephone interviews from June to July, 2022. Data were analyzed using thematic analysis. Results: Four main themes emerged from the interview: (1) Intense fear, worry, and anxiety; (2) Feeling worn out and psychologically distress; (3) Impact on psychosocial and physical health; and (4) Limited options to cope with psychological distress during the difficult times. Discussion: Our study findings may provide concerned stakeholders with useful insights into reducing the psychological distress experienced by nurses in Hong Kong. Offering psychological support is of paramount importance to address the unmet psychological needs of nurses and reduce their psychological distress during the pandemic, particularly when they are working under high levels of workplace stress.

The association between heated tobacco product use and cigarette cessation outcomes among youth smokers: A prospective cohort study.

INTRODUCTION: The U.S. Food and Drug Administration authorized the marketing of heated tobacco products (HTPs) with modified-risk information for adults on July 7, 2020. However, the effects of HTP use on cigarette cessation among youth smokers remain unclear. This study aimed to explore the association of HTP use with cigarette abstinence and cessation outcomes among youth smokers in Hong Kong who were willing to receive telephone counseling for smoking cessation. METHODS: This prospective cohort study included youth smokers aged ≤25 years who were enrolled in the Hong Kong Youth Quitline service. From December 1, 2016, to September 30, 2019, this study identified as HTP users 106 youth cigarette smokers who reported using HTPs on at least 1 of the past 30 days at enrollment, and identified as non-HTP users 473 smokers who reported smoking at least one conventional cigarette in the past 30 days and never using HTPs. The participants received follow-ups at 1 week and 1-, 3-, and 6-months postenrollment. The primary outcome was self-reported 7-day point prevalence of cigarette abstinence (PPA) at the 6-month follow-up. Secondary outcomes included reduction in cigarette smoking (excluding quitters), the number of cessation attempts, and the level of readiness to quit. RESULTS: The self-reported 7-day PPA was statistically significantly lower among HTP users than among non-HTP users after 6 months (19.0% vs. 34.2%; p = 0.009), with an adjusted relative risk of 0.47 (95% confidence interval: 0.24-0.91; p = 0.03). The study identified no significant differences in secondary outcomes between the two groups. CONCLUSIONS: Youth HTP users were less likely to abstain from tobacco use than their non-HTP-using counterparts. These results suggest that HTPs should not be promoted as smoking cessation or reduction aids among the youth population.

Structured online training for university students to deliver peer-led addiction counselling for young drug abusers in China: Effect on improving knowledge, attitude, confidence, and skills.

OBJECTIVES: To measure the effect of a structured online training programme on improving the knowledge, attitude, confidence, and skills of university students to deliver peer-led addiction counselling to young drug abusers. METHODS: A structured training programme was designed for university students with a background in health-related disciplines. Pre- and post-training evaluations were conducted for 245 university students with health-related backgrounds who completed the training programme. The participants' knowledge of and attitudes towards drug abuse and their confidence in delivering addiction counselling were evaluated and compared before and after the training. Counselling skills were assessed using a simulated standardised case. RESULTS: A paired test indicated that after attending the training programme, the participants' knowledge of and attitudes towards drug abuse and their confidence in delivering addiction counselling were significantly improved. Most of the trained participants demonstrated satisfactory counselling skills. CONCLUSION: Participation in a one-day structured addiction training programme significantly improved students' knowledge of and attitudes towards drug abuse and their confidence and skills to deliver addiction counselling. PRACTICE IMPLICATION: Future research should elucidate the implementation of the counselling skills in terms of the counselling outcomes and successful referral. The clients' health outcomes should be assessed to reflect the peer counsellors' skills.