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Background: Neighborhood cohesion, which refers to the extent of the connectedness and solidarity among residents in a community or neighborhood, is an important determinant of human health. To enhance neighborhood cohesion, the “Learning Families Project” was developed with a series of intervention programs in Kwun Tong in Hong Kong, a district with low neighborhood cohesion. This project, based on the social ecological model, provided a platform for neighbors to learn, communicate and interact with each other. Methods: This quasi-experimental study included two nearby government subsidized low rent housing estates separated by busy main roads. One served as the intervention (Tsui Ping (South) Estate) and one as the control (Shun Tin Estate) estate. The intervention included promotion, resident training and learning programs, embodied by a series of community activities such as talks, day camp, thematic activities and horticulture class. Baseline (before the programs) and follow-up (one year after the programs) surveys were conducted both in the intervention and control estate to assess the impact of the programs on neighborhood cohesion. Results: The number of residents who completed both the baseline and follow-up surveys was 502 in the intervention estate and 476 in the control estate. Neighborhood cohesion significantly improved in the intervention group after the programs (Cohen effect size d: 0.15). Compared with the control group, the improvements in closeness of the neighborhood and trust in neighbors were significantly greater in the intervention group (Cohen effect size d: 0.13 and 0.14, respectively). Conclusion: This brief intervention program using a quasi-experimental study design increased neighborhood cohesion in a low rent housing estate. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Families are often faced with long working hours and stressful urban lifestyles which adversely affect family well-being. The Happy Family Kitchen Movement project, which emphasized the interaction and integration of physical health and psychosocial health, was conducted to promote well-being and health in Hong Kong families. Social workers and teachers from 54 social service units and schools in collaboration with the research team designed and implemented a brief community-based family "holistic health" intervention for 1983 individuals from 1467 families. In a 3-arm cluster randomized controlled trial, participants were allocated into positive physical activity (PPA), positive healthy diet (PHD), or control group. The positive psychology framework, which encompassed joy, gratitude, and savoring, was used to help families build positive attitudes with stronger motivation to engage in health promotion behaviors. Data were collected at pre-intervention, immediately post-intervention, and at 1-month and 3-month follow-up. Results showed that compared to the control, PPA was effective in improving subjective happiness at immediately post-intervention and PHD was effective in promoting family harmony at 1-month and subjective happiness at 3-month, with small effect size. Both PPA and PHD showed some evidence of effectiveness on mental quality of life at 3-month. Participants' evaluation of the program provided evidence for the perceived usefulness of PPA and PHD. Qualitative data provided additional support for program effectiveness with in-depth insights into the participants' experiences. These two innovative brief interventions could be a viable, attractive and low cost approach for promoting family "holistic health" in community settings. [ABSTRACT FROM AUTHOR]

A brief intervention using Zero‐time Exercise (ZTEx), a foot‐in‐the‐door approach, was developed to reduce sedentary behaviour and increase physical activity. ZTEx refers to the integration of simple strength‐ and stamina‐enhancing physical activity into daily life, which can be done anytime, anywhere and by anyone. This paper presents the development, feasibility, and preliminary evidence for the effectiveness of this intervention under the Hong Kong Jockey Club FAMILY Project. Needs assessments were conducted with social workers from the Christian Family Services Center(CFSC) and the Social Welfare Department (SWD). This single group prospective ZTEx intervention trial, guided by the Health Action Process Approach, included a 3‐hr core session at baseline and a 1‐hr booster session at 1‐month follow‐up. Fifty‐six participants (social and service‐related workers) from CFSC (n = 28) and SWD (n = 28) received the intervention and completed the self‐administered questionnaires at baseline. Forty‐nine and 43 participants completed the 1‐month and 3‐month self‐administered questionnaires, respectively. Fifteen participants attended the focus group interviews to share their feedback on ZTEx intervention after implementing their community‐based ZTEx activities. Intention‐to‐treat analysis was conducted with missing data replaced by baseline values. Participants reported significant decreases in sitting time by 27 (2, 52) minutes (mean [95% confidence interval]) and 36 (0.2, 71) minutes on a weekday, increases in physical activity while seated by 0.7 (0.2, 1.4) days and 1.1 (0.6, 1.7) days in a week, and improvements in perceived knowledge, outcome expectancies and plan on doing ZTEx at the 1‐month and 3‐month follow‐up, respectively. Balance and muscle strength significantly improved at the 1‐month follow‐up. The effect ranged from small to large (Cohen's d: 0.27–1.05, all p < 0.05). The qualitative feedbacks support the quantitative findings. Our findings show early evidence that ZTEx effectively reduced sedentary behaviour and enhanced physical activity and fitness. Further trials on this simple and low‐cost intervention as the first step to promote higher intensity exercise are warranted. [ABSTRACT FROM AUTHOR]

Health information and communication technologies (ICTs) are increasingly used but little is known about routine exposure to health information from ICTs and its associations with health behaviors. A territory-wide population-based dual landline and mobile telephone survey was conducted in 2016 in Hong Kong, where smartphone ownership and Internet access are among the most prevalent, easiest and fastest in the world. Health information exposure from traditional sources (television/radio/newspaper/magazine), Internet websites, social media sites and instant messaging (IM); and information on smoking, alcohol consumption and physical activity were recorded. Prevalence was weighted by age, sex and education level of the general population. Multinomial logistic regression was used to assess the association of health information exposure with smoking and alcohol consumption, whilst multivariable linear regression was used to assess the association with frequency of moderate and vigorous physical activity (days/week). Of 3063 respondents, most (71.6%) were often or sometimes exposed to health information from traditional sources, followed by Internet websites (40.9%), social media sites (40.7%), and IM (27.0%). Respondents with lower education and household income were less frequently exposed to health information from Internet websites, social media sites and IM (all P < 0.001). Health information exposure from IM was associated with being never smokers, and more frequent moderate and vigorous physical activity (all P for trend <0.05). Health information exposure from IM was least frequent but associated with healthier behaviors. Further public health education campaigns can consider using IM to deliver information, particularly to disadvantaged groups. [ABSTRACT FROM AUTHOR]

Positive psychology interventions commonly involve behavioral exercises to improve psychosocial well-being. Intervention effect on behavior is unclear. The Happy Family Kitchen project, one of the community-based brief intervention projects under The FAMILY: A Jockey Club Initiative for a Harmonious Society, was conducted in Hong Kong to develop and evaluate the effectiveness of a positive psychology family intervention. We have previously reported positive intervention effects on family communication, family well-being, and subjective happiness. This paper aims to explore the effectiveness of the intervention on behavioral outcomes and their associations with psychosocial well-being. A total of 23 social service units organized and conducted intervention programs for 1419 individuals from 612 families in Hong Kong. Each intervention was developed with emphasis on one of five positive psychology themes: gratitude, flow, happiness, health, and savoring. Intervention outcomes were assessed at pre-intervention, immediate post-intervention, and 6 weeks and 12 weeks post-intervention. Results showed that family communication time and frequency of meal preparation with family members increased with sustainable small effects up to 12 weeks. Theme-specific behavior change was observed in the gratitude, flow, and happiness interventions, respectively. Family communication time, frequency of eating with family members, and theme-specific behaviors, including gratitude, flow, happiness behavior, health attitude, and health behavior, were positively associated with psychosocial well-being. Qualitative data provided additional evidence of effectiveness with in-depth insights into behavior change. The positive associations between target behaviors and well-being suggest that improvements in well-being as a function of the intervention may be associated with behavior change. [ABSTRACT FROM AUTHOR]

This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled “Learning Families Project”, under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees’ knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees’ reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents’ survey results before and after participating in the community activities delivered by the trainees. The trainees’ learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen’s d: 0.5–1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen’s d: 0.4–0.6). The application of planning skills to implement community activities was higher at one year (Cohen’s d: 0.4), compared with baseline. At one year, the residents’ survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Background: Most positive psychology interventions conducted in the West have been focused on the individual. Family relationships are highly valued in the Chinese collectivist culture, and it is of interest to know whether family-focused interventions can improve the well-being of Chinese people. We have previously reported the effectiveness of a positive psychology family intervention in terms of family well-being. Based on the data derived from the Happy Family Kitchen II project, this paper examines the effectiveness of a community-based positive psychology family intervention on subjective happiness and health-related quality of life.Methods: Thirty-one social service units and schools organized intervention programs for 2070 participants in Hong Kong. In a cluster randomized controlled trial, participants were randomly assigned on the basis of computer-generated numbers into the intervention group or the control group. The intervention programs emphasized one of five positive psychology themes: joy, gratitude, flow, savoring, and listening. The control group engaged in activities unrelated to the intervention, such as arts and crafts workshops. Subjective happiness and mental and physical quality of life were assessed at baseline and at 4 weeks and 12 weeks postintervention.Results: Data of 1261 participants were analyzed. The results showed that the intervention was more effective than the control condition in improving subjective happiness, with a small effect size, at 12 weeks postintervention (β = .15, p = .020, Cohen's d = .16). However, there were no improvements in mental and physical quality of life in the intervention group compared with the control group at 4 weeks (β = .39, p = .494, d = .05; β = -.10, p = 1.000, d = -.01, respectively) and 12 weeks postintervention (β = .71, p = .233, d = .08; β = -.05, p = 1.000, d = -.01, respectively). Furthermore, the booster session was no more effective than the tea gathering session in improving subjective happiness (β = .00, p = .990, d = .00) or mental (β = 1.20, p = 1.000, d = -.04) and physical quality of life (β = .15, p = 1.000, d = -.01).Conclusions: The analyses extend previous findings of salutary effects on family well-being by showing that positive psychology family interventions can improve subjective happiness. Suggestions for future research are proposed.Trial Registration: ClinicalTrials.gov NCT01796275 . Retrospectively registered 19 February 2013. [ABSTRACT FROM AUTHOR]

Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the “train-the-trainer” workshop (TTT) for the first large scale, community-based, family intervention projects, entitled “Happy Family Kitchen Project” (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers’ competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees’ reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example of development, implementation and model-based evaluation of training programs, which may be helpful to others seeking to develop such programs in diverse communities. [ABSTRACT FROM AUTHOR]

Objective: Effective and brief positive parenting interventions could be adopted widely, but evidence is limited. We aimed to evaluate the effectiveness of a positive parenting programme in Hong Kong Chinese parents. Methods: We conducted a pilot cluster randomised controlled trial in 2017 in 144 Hong Kong Chinese parents (84.7% women, mean age 42.5 [SD 5.87] years) of school-age children (mean age 10.9 [2.8] years) in 4 family service centres (clusters). The intervention included two 2-hour interactive talks (4 hours in total). The contents covered skills of giving praise, showing appreciation and playing enjoyable family games. The control group was offered the intervention after all the data were collected. Praise, appreciation and enjoyment related behaviours were measured as primary outcomes at baseline, 1 month and 3 months. The secondary outcomes were subjective happiness, wellbeing, personal health and happiness, family health, family happiness and harmony, and family relationship. After the completion of all assessments, five focus group discussions with the parents and four individual in-depth interviews with community service providers were conducted to explore their experiences. Results: Compared with the control group (n = 69), the intervention group (n = 75) showed greater positive changes in appreciation and enjoyment at 3 months with small effect sizes (d = 0.42 and 0.32, respectively), and greater improvements in the secondary outcomes at 3 months with small effect sizes (d: 0.29–0.48). In the focus groups, the parents reported more praise to their children, better temper control, more focus on their children's strengths and better family relationships. According to the service providers, most of the parents enjoyed the activities. Conclusions: The brief intervention in community settings with the engagement of community service providers has shown preliminary effectiveness in promoting positive parenting and mental wellbeing of Hong Kong Chinese parents. Trial registration: The authors confirm that all ongoing and related trials for this intervention are registered. The study reported in this manuscript is registered as clinical trial at clinicaltrials.gov: NCT03282071. https://clinicaltrials.gov/ct2/show/NCT03282071. [ABSTRACT FROM AUTHOR]

Excessive sugar intake poses a significant risk factor for non-communicable diseases. A positive healthy eating (PHE) intervention was developed to promote low-sugar dietary practices in families. The PHE intervention capitalized on positive psychological constructs to overcome barriers to health behavior change by helping families associate feelings of joy, gratitude, and savoring with healthy eating. In a cluster randomized controlled trial, 1983 participants from 1467 families were recruited in Hong Kong. PHE included a core and booster session. Data were collected at pre-intervention, post-intervention, and at 1-month and 3-month follow-up. Compared to the control, PHE showed greater increase in intention to change at post-intervention, engagement in low-sugar dietary practices individually and with family members at 3-month follow-up, and greater reduction in sugar-sweetened beverage intake at 1-month and 3-month follow-up. Intentions to change mediated PHE’s effects on low-sugar dietary practices. Focus group interviews revealed the behavior-change process and family quality of life. [ABSTRACT FROM AUTHOR]

Our cluster randomized controlled trial tested, respectively, 2 brief interventions to promote more appreciation and less criticism in Hong Kong Chinese parents toward their children and to enhance family well-being. We randomized 56 primary schools and community service centers (clusters of parents of primary grades 3-6 students) to the more appreciation (MA) or less criticism (LC) intervention arms, or fruit and vegetable control arm (FV). A total of 803 parents received a 2-hr workshop on increasing appreciation (19 clusters, n = 270), reducing criticism (21 clusters, n = 336), or increasing fruit and vegetable consumption (16 clusters, n = 197) and were assessed at baseline, immediately after the workshop, at 2 weeks, and at 6 weeks. Primary outcomes were parents' frequency of appreciation and criticism behaviors. Secondary outcomes were family well-being and potential behavioral determinants proposed by the Health Action Process Approach, including outcome expectancies, self-efficacy, intention, and planning behavior. At 6 weeks, the MA and LC arms reported greater increases in appreciation behavior than the FV arm, and the LC arm reported greater decreases in criticism than the FV arm, with small effect sizes. Specific improvements were also observed in the behavioral determinants at various time points compared with the FV arm. Similar improvements in family well-being were observed across all arms. Our findings were the first to show that brief Health Action Process Approach-based workshops on Chinese parents were effective in promoting positive parental behaviors. (PsycInfo Database Record (c) 2020 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Purpose: Family happiness is one major theme of family well-being in Chinese culture. We investigated the reliability and validity of the single-item Self-reported Family Happiness Scale (SFHS-1) with the score of 0-10, based on two studies in Hong Kong Chinese.Methods: Study 1 was a territory-wide population-based telephone survey (n = 4038) conducted in 2016. Study 2 was a community-based family intervention program conducted during 2012-2013 (n = 1261) to enhance family communication and well-being. Test-retest reliability of the SFHS-1 was assessed over 1 month in Study 2. Family APGAR (Adaption, Partnership, Growth, Affection, Resolve) Scale, Family Communication Scale, Subjective Happiness Scale, 12-item Short Form Health Survey Version 2, and 2-item Patient Health Questionnaire were used to assess the convergent and discriminant validities of the SFHS-1 in both studies. Multiple regression analysis was used to assess the incremental validity by identifying the additional contribution of the SFHS-1 score in predicting subjective happiness.Results: The 1-month test-retest reliability assessed by intraclass correlation was 0.76. Family happiness was moderately to strongly correlated with family function, family communication, subjective happiness, mental health-related quality of life and depression, but weakly correlated with physical health-related quality of life. Furthermore, the score of the SFHS-1 added predictive power to mental health-related quality of life and depression in assessing subjective happiness.Conclusions: Our results have shown the SFHS-1 as a reliable and valid measurement of family happiness in Hong Kong Chinese, suggesting SFHS-1 is highly practicable for future large epidemiological and community-based intervention studies. [ABSTRACT FROM AUTHOR]

Background and aims: Problematic smartphone use (PSU) is an emerging but understudied public health issue. Little is known about the epidemiology of PSU at the population level. We evaluated the psychometric properties of the Smartphone Addiction Scale - Short Version (SAS-SV) and examined its associated sociodemographic factors and health behaviors in Chinese adults in Hong Kong. Methods: A random sample of 3,211 adults aged ≥18 years (mean ± SD: 43.3 ± 15.7, 45.3% men) participated in a population-based telephone survey in Hong Kong and completed the Chinese SAS-SV. Multivariable linear regressions examined the associations of sociodemographic factors, health behaviors, and chronic disease status with SAS-SV score. Data were weighted by age, sex, and education attainment distributions of the Hong Kong general population. Results: The Chinese SAS-SV is internally consistent (Cronbach's α = .844) and stable over 1 week (intraclass correlation coefficient = .76, p < .001). Confirmatory factor analysis supported a unidimensional structure established by previous studies. The weighted prevalence of PSU was 38.5% (95% confidence interval: 36.9%, 40.2%). Female sex, younger age, being married/cohabitated or divorced/separated (vs. unmarried), and lower education level were associated with a higher SAS-SV score (all ps <.05). Current smoking, weekly to daily alcohol drinking, and physical inactivity predict greater PSU after controlling for sociodemographic factors and mutual adjustment. Discussion and conclusions: The Chinese SAS-SV was found valid and reliable for assessing PSU in Hong Kong adults. Several sociodemographic and health behavioral factors were associated with PSU at the population level, which may have implication for prevention of PSU and future research. [ABSTRACT FROM AUTHOR]

This qualitative study describes participants' experiences with a community-based family intervention. Guided by a positive psychology framework, the brief intervention was designed to enhance positive communication among family members using cooking and dining as a platform. Our interest was in understanding perceptions of benefits and barriers, with the intention of improving future development of communitybased family programs. Purposive sampling was used to recruit focus group participants from those who had participated in the family programs. Overall, 10 focus groups including 65 participants were conducted from April to July 2013. Thematic analysis of the focus groups suggested that the intervention was effective in promoting positive communication, increasing the use of age-appropriate parenting practices, and promoting quality family mealtime. These changes in turn led to perceived positive outcomes by our participants, including a sense of happiness and enhanced family relationship. Cultural and gender beliefs were identified as challenges and are important to consider for future family interventions. Time constraint was further highlighted as an important consideration both in the context of integrating skills into the family routine as well as a barrier to participation in family programs. Our findings add to the small but steadily increasing body of knowledge, especially from qualitative studies, on the effectiveness of brief family interventions. [ABSTRACT FROM AUTHOR]

Urban families worldwide are often characterized by busy working lives which leave little time for family gatherings and communication. The Happy Family Kitchen project, which emphasized cooking and dining with family members, was conducted in a deprived district in Hong Kong. We hypothesized that the community-based family intervention, derived from a positive psychology framework, can improve family communication, family well-being, and subjective happiness. Twenty-three social service units organized and delivered the intervention programs for 1,419 individuals from 612 families. The core intervention was developed with emphasis on 1 of 5 positive psychology themes: gratitude, flow, happiness, health, and savoring. Intervention outcomes were assessed at preintervention, immediate postintervention, and 6 weeks and 12 weeks postintervention. Results showed that family communication, family well-being, and subjective happiness improved with small effect sizes which were sustained up to 12 weeks. The gratitude intervention improved all of the outcome measures. Qualitative data provided additional evidence for effectiveness with in-depth insights into family dynamics. We concluded that this brief intervention was a low-cost and simple approach to improve family communication and well-being. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Introduction: To investigate the associations of cigarette smoking and secondhand (SHS) exposure at home with family well-being among Chinese adults in Hong Kong. Methods: Telephone surveys were conducted among 3043 randomly selected adults (response rate 70%) in 2010 and 2012 to monitor family health information and tobacco use in Hong Kong. Family well-being was measured using three questions of perceived family harmony, happiness and health (3Hs) with responses ranging from 0–10 and a higher score indicating better family well-being. Smoking status, nicotine dependence, quitting behaviours and SHS exposure at home were recorded. Multiple linear regressions were used to calculate β-coefficients for individual family 3Hs component and an overall composite score representing family well-being. Results: Compared with never smokers, current smokers reported lower levels of family harmony (adjusted β = -0.15, 95% CI: -0.35 to -0.10), happiness (adjusted β = -0.12, 95% CI: -0.28 to -0.02), health (adjusted β = -0.15, 95% CI: -0.30 to -0.03) and overall family well-being (adjusted β = -0.17, 95% CI: -0.32 to -0.06). Quit attempt and intention to quit were not associated with family well-being. SHS exposure at home was associated with lower levels of family harmony (adjusted β = -0.17, 95% CI: -0.30 to -0.07), happiness (adjusted β = -0.19, 95% CI: -0.32 to -0.08), health (adjusted β = -0.13, 95% CI: -0.26 to -0.03) and family well-being (adjusted β = -0.19, 95% CI: -0.32 to -0.09). Conclusions: Smoking and SHS exposure at home were associated with the lower levels of perceived family well-being. Prospective studies are needed to confirm the results. [ABSTRACT FROM AUTHOR]

This paper describes a program of brief, universal, positive psychology-based interventions to increase targeted behaviors that enhance family relationships, developed and delivered to over 1500 participants using a community-based participatory approach. The cluster-randomized design combined interventions based on one of three themes (gratitude, hope, or open-mindedness) in one of two structures (intervention, or intervention with planning). The latter structure supplemented with materials and exercises derived from the Health Action Process Approach model of behavior change. Planning was more effective in increasing attitude and intention to perform behaviors, frequency of the targeted behaviors, and family health and happiness (Cohen’sds: 0.10–0.16,p < 0.05), particularly in the theme targeting open-mindedness. Qualitative data supported effectiveness. This project was a first effort to develop a large-scale preventive psychological intervention in an understudied culture with the goal of maximizing acceptability and utilization by involving community stakeholders in every stage of the design. [ABSTRACT FROM PUBLISHER]