Associations of the perceived benefits and harms of COVID-19 with confidence in coping with the pandemic and mental health symptoms: a population-based survey in Hong Kong

IntroductionBoth perceived benefits and harms of COVID-19 have been reported, but whether they affect confidence in coping with the pandemic and mental health remains uncertain.ObjectiveTo examine the association of perceived benefits and harms of COVID-19 with confidence in coping with the pandemic and mental health symptoms.MethodsA population-based survey was conducted on 7,535 Hong Kong adults from 22 February to 23 March 2021, when the 4th wave of COVID-19 was under control. Information on sociodemographic characteristics, perceived benefits (10 options) and harms (12 options) of COVID-19, confidence in coping with the pandemic (range 0–10), loneliness (range 0–4), anxiety (General Anxiety Disorders-2, range 0–6) and depression (Patient Health Questionnaire-2, range 0–6) was collected. Latent profile analysis was used to identify the combined patterns of perceived benefits and harms of COVID-19. The associations of combined patterns with confidence in coping with COVID-19, loneliness, anxiety, and depression were examined using linear regression (β coefficient) adjusting for sociodemographic characteristics.ResultsThe combined patterns of perceived benefits and harms were classified into benefit (n = 4,338, 59.3%), harm (n = 995, 14.0%), and ambivalent (n = 2,202, 26.7%) groups. Compared with the ambivalent group, the benefit group had a significantly higher level of confidence (adjusted β 0.46, 95% CI 0.33 to 0.58), and lower levels of loneliness (−0.35, −0.40 to-0.29), anxiety (−0.67, 0.76 to-0.59), and depression (−0.65, −0.73 to-0.57). The harm group had a significantly lower level of confidence (−0.35, −0.53 to-0.16), and higher levels of loneliness (0.38, 0.30 to 0.45), anxiety (0.84, 0.73 to 0.96), and depression (0.95, 0.84 to 1.07).ConclusionPerceived greater benefit from COVID-19 was associated with better mental health and stronger confidence in coping with the pandemic

Continuous positive airway pressure education on adherence in adults with obstructive sleep apnoea

Poor adherence to continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnoea (OSA) limits its therapeutic effectiveness and has a major impact on clinical outcomes. Effective education programme is important to enhance CPAP use. However, existing education programmes are either manpower or resource demanding and may not be feasible in clinical practice. Moreover, the Self-Efficacy Measure for Sleep Apnoea (SEMSA) has been widely adopted for assessing adherence-related cognitions on CPAP therapy in OSA patients, but it was not available for Chinese. The aims of this thesis are: (i) to perform linguistic and psychometric evaluation of a Chinese version of SEMSA (SEMSA-C); (ii) to examine the efficacy of brief motivational enhancement education programme in addition to standard care versus standard care only on improving adherence to CPAP treatment in patients with OSA. The SEMSA-C was obtained after the standard forward-backward translation process. A randomised controlled trial was then conducted on newly diagnosed OSA patients. Patients in the control group received standard care (SC) comprising advice on the importance of CPAP therapy and its care while those in the intervention group received SC plus motivational enhancement education programme (ME). ME focused to enhance subjects’ knowledge, motivation and self-efficacy to use CPAP, comprising one 45-minute session on the day after CPAP titration and one 10-minute telephone follow-up shortly after commencing CPAP treatment. Epworth Sleepiness Scale (ESS), SEMSA-C, and quality of life were assessed. CPAP usage data were downloaded at the completion of this 3-month study. The primary outcome was the CPAP adherence. Furthermore, 21 patients were randomly sampled at baseline and completed the SEMSA-C at one week. 100 patients (Men : Women, 84 : 16) with OSA indicated for CPAP treatment were recruited, with an average age of 52±10 years, and apnoea hypopnoea index (AHI) of 36.2±22 events/hour. Factor analysis of SEMSA-C identified three factors: risk perception, outcome expectancies and treatment self-efficacy. Their corresponding internal consistency was high with Cronbach’s alpha >0.88, which were larger than all correlations between subscales (Range: 0.14 to 0.58). The correlations between items and their hypothesized subscale (Range: 0.58 to 0.85) were generally higher than the correlations between items and their competing subscales (Range: -0.10 to 0.58). One-week test-retest intra-class correlation ranged from 0.70 to 0.82. CPAP adherence was associated with outcome expectancies and treatment self-efficacy at 3-month assessment. Furthermore, SEMSA-C demonstrated an improvement in self-efficacy (standardised response mean = 0.33, p = .044) but no significant changes were observed in the other two factors, after CPAP use. The 100 patients were followed for 3 months. The interventional effects maintained during the 3-month study period. There were a better CPAP use [higher daily CPAP usage of 2 hours/day (Cohen d = 1.33, p < .001), four-fold the number of subjects using CPAP for ≥ 70% of days with ≥ 4 hours per day (p < 0.001)], and greater improvements in ESS by 2.2 (p = 0.001) and treatment self-efficacy by 0.2 (p = 0.012) in the intervention group, relative to the control group. The traditional Chinese SEMSA-C possesses satisfactory psychometric properties. It is a reliable and responsive instrument to measure perceived risks, outcome expectancies and treatment self-efficacy in Chinese patients with OSA. Moreover, the newly developed brief motivational enhancement education programme in addition to standard care is effective in improving adherence to CPAP treatment, treatment self-efficacy and daytime sleepiness.published_or_final_versionNursing StudiesDoctoralDoctor of Nursin

Train-the-trainer programmes for community-based intervention projects to enhance family well-being in Hong Kong

Long working hours and changing societal norms in family relationships pose major challenges to harmony and health in families in Hong Kong. The FAMILY Project funded by the Hong Kong Jockey Club Charity Trust, has collaborated with various social service organizations to conduct a series of train-the-trainer programmes (TTTs) to build capacity for large scale preventive community-based intervention projects. The community-based intervention projects aimed to promote family wellbeing with the ultimate goal of family health, happiness and harmony (FAMILY 3Hs). The objectives of this thesis are to (i) provide evidences on the academic and community partnerships and the effectiveness of a series of TTTs for community-based intervention projects, (ii) offer practical examples of using a three-phrase procedure and the Logic Model for programme development; and (iii) provide a template of a four-level framework for programme evaluation; and (iv) introduce and evaluate a Zero-time Exercise (ZTEx) (new and simple exercise concept) intervention to enhance physical activity. The brief TTTs and ZTEx intervention programme ranged from 2 to 4 sessions (3.5 hours to 12 hours), aimed to promote trainees’ knowledge and skills for the development (design and implementation) of community-based interventions to improve community participants’ family communication, well-being and holistic health. The theory-based training included pre-training need asssessments, experiential training implemented by a multidisciplinary team and post-training support. The content comprised the general constructs of positive psychology, ZTEx, healthy eating, the Logic Model and the implementaion skills. The TTTs were systematically examined by four-level training evaluation framework through self-administered questionnaires, physical fitness assessments and focus group interviews at multiple time points up to two years after training. Missing data were replaced by baseline values in an intention-to-treat analysis. Four TTTs were conducted for 106 social service workers and 59 volunteers; and a ZTEx intervention was implemented for 56 social service workers. The trainees indicated the training and intervention programmes were informative and easy-to-understand. Perceived knowledge, self-efficacy and motivation for applying the learning in community interventions were signifantly increased with small to large effect size (Cohen’s d: 0.29 - 1.54, p<0.05). Significant improvements in physical activity and fitness performance were found with small to moderate effect size (Cohen’s d: 0.30 - 0.69, p<0.05). Perceived health and subjective happiness were significantly increased with small to moderate effect size (Cohen’s d: 0.43 - 0.56, p<0.05). The qualitative feedback corroborated and enriched the quantitative results. Trainees also successfully designed and/or implemented a series of community-based family interventions for almost 7000 residents (community participants) living in the districts with a larger proportion of underprivileged groups. The community participants reported an improvement in their family well-being. This thesis shows good evidence on academic and community partnerships in advocating the fusion of the scientific knowledge from academia (Best Science) with the practical experience from social service providers (Best Practice). Our TTTs have laid a good foundation for a deeper collaboration between social service organizations and academics, and future policy formulation. These practical examples should be helpful to others seeking to develop such programmes in diverse communities.published_or_final_versionPublic HealthDoctoralDoctor of Philosoph

Development and Evaluation of an Innovative Web-Based Training, Learning, and Sharing Platform for Social Workers (Hong Kong Jockey Club SMART Family-Link Project): Mixed Methods Evaluation Study

BackgroundInformation and communication technology (ICT) use may enhance social work practice and continuous professional development. Under the Hong Kong Jockey Club SMART Family-Link Project, we developed an innovative web-based training, learning, and sharing platform (i-TLS) to support not only ICT and other learning needs of Hong Kong social workers but also their practice. ObjectiveWe developed i-TLS with 3 major components (i-Training, i-Learning, and i-Sharing) and assessed its acceptability and impact on facilitating ICT use in family services. MethodsWe described the i-TLS development based on a 4-phase model and evaluated i-TLS using the platform database, Google Analytics, a self-administered survey, and individual phone interviews 1 year after launching. Resultsi-TLS was launched in 12 nongovernmental organizations on July 1, 2019. The COVID-19 outbreak in December 2019 limited face-to-face services, which galvanized digital transformation in social work practice. By July 31, 2020, 313 social workers had registered with i-TLS. Approximately 79.6% (249/313) of users accessed i-TLS at least once in the past 28 days, averaging 3.2 (SD 1.35) platform visits per day and viewing 4.8 (SD 1.42) pages per visit. i-Training provided 41 mini-modules on applying ICT to family services, with 730 enrollments. Approximately 70% (511/730) of users completed the mini-modules and obtained digital mini-certificates. i-Learning provided 112 items of learning resources centered on ICT use in family services, with nearly 4000 page views. i-Sharing had 25 discussion threads with 59 posts. Approximately 53.7% (168/313) of users completed the 1-year evaluation survey, including 7.1% (12/168) who were phone interviewed. The mean i-TLS satisfaction score (out of 10) increased from light (4.99, SD 1.54) to occasional (6.15, SD 1.34) and frequent (6.31, SD 2.29) users. Frequent users showed higher scores (out of 10) than light users for an increase in knowledge (5.84, SD 1.34 vs 4.09, SD 1.74; P<.001), self-efficacy (5.23, SD 1.92 vs 3.96, SD 1.77; P=.02), and knowledge application (6.46, SD 1.33 vs 1.91, SD 1.40; P<.001). Interviewees reported increased ICT use in services and considered i-TLS an acceptable and supportive tool for learning and practice, especially during the pandemic. Conclusionsi-TLS is acceptable to social workers and enhances their learning and use of ICT in family services. This was achieved through access to self-directed and collaborative learning and sharing of experiences within their practice. Further research on enhancing web-based platforms is needed to expand participation and capacity building among social workers and other health and social care professionals

A Population Study on COVID-19 Information Sharing: Sociodemographic Differences and Associations with Family Communication Quality and Well-Being in Hong Kong

Family support through the sharing of information helps to shape and regulate the health and behaviours of family members, but little is known about how families are sharing COVID-19-related information, or about its associations with family communication quality and well-being. We examined the associations of COVID-19 information sharing methods with sociodemographic characteristics, the perceived benefits of information communication and technology (ICT) methods, and family communication quality and well-being in Hong Kong. Of 4852 respondents (53.2% female, 41.1% aged over 55 years), the most common sharing method was instant messaging (82.3%), followed by face-to-face communication (65.7%), phone (25.5%) and social media (15.8%). Female sex (adjusted prevalence ratio (aPR) 1.09), older age (aPRs 1.14&ndash;1.22) and higher household income (aPR 1.06) (all p &le; 0.04) were associated with instant messaging use, while post-secondary education was associated with face-to-face (aPR 1.10), video call (aPR 1.79), and email (aPR 2.76) communications (all p &le; 0.03). Each ICT sharing method used was associated with a higher likelihood of both reported benefits (aPRs 1.26 and 1.52), better family communication quality and family well-being (adjusted &beta;s 0.43 and 0.30) (all p &le; 0.001). We have first shown that COVID-19 information sharing in families using both traditional methods and ICTs, and using more types of methods, was associated with perceived benefits and better family communication quality and well-being amidst the pandemic. Sociodemographic differences in COVID-19 information sharing using ICTs were observed. Digital training may help enhance social connections and promote family well-being

Digital inequalities in health information seeking behaviors and experiences in the age of web 2.0: A population-based study in Hong Kong.

BackgroundInequalities in health information seeking behaviors (HISBs) using mass media and internet websites (web 1.0) are well documented. Little is known about web 2.0 such as social networking sites (SNS) and instant messaging (IM) and experiences of HISBs.MethodsWe surveyed representative Hong Kong Chinese adults (N = 10143, 54.9% female; 72.3% aged 25-64 years) on frequency of HISBs using traditional sources, internet websites, SNS (e.g., Facebook, Twitter), and IM (e.g., WhatsApp, WeChat) and experiences measured using Information Seeking Experience Scale. Adjusted prevalence ratios (aPRs) for HISBs and experiences by sociodemographic and health-related characteristics were yielded using multivariable Poisson regression with robust variance estimators. aPRs for experiences by HISBs using internet websites, SNS, and IM adjusting for sociodemographic and health-related characteristics were also yielded.ResultsBeing female, higher educational attainment, not smoking, and being physically active were associated with HISBs using any source (all PConclusionsWe identified correlates of web-based health information seeking and experiences in Hong Kong Chinese adults. Providing greater access to and improved information environment of web 2.0 to the target groups may help address digital inequalities

Data_Sheet_1_Association of family wellbeing with forwarding and verifying COVID-19-related information, and mediation of family communication quality.docx

ObjectiveWe assessed the associations of family wellbeing with verifying and subsequently forwarding COVID-19-related information to family members and the mediating effect of the quality of family communication on these associations among Chinese adults in Hong Kong.MethodsUnder the Jockey Club SMART Family-Link Project, we conducted an online population-based survey, using Family wellbeing Scale and questions related to the family communication quality and forwarding and verifying COVID-19 information. Data were collected from 4,891 adults in May 2020. Prevalence estimates of forwarding and verifying COVID-19 information were weighted by sex, age, and education of the general population, and their associations with family wellbeing (ranged 0–10) were analyzed using generalized linear models with mutual adjustment. Their interactive effects on family wellbeing and the mediating effects of family communication quality were examined.ResultsIn total, 53.9% of respondents usually/always forwarded COVID-19 information related to their family, 68.7% usually/always verified it before forwarding, and 40.9% did both. Greater family wellbeing was associated with usually/always forwarding [adjusted β (95% CI): 0.82 (0.72–0.92)] and usually/always verifying [0.43 (0.32–0.55)] (both P ConclusionForwarding COVID-19 information to family, verifying such information, and especially doing both, were associated with greater family wellbeing, being strongly mediated by the quality of family communication. Individuals should be encouraged to verify COVID-19-related information before forwarding it to family members amidst the COVID-19 pandemic.</p

Data_Sheet_1_Development and evaluation of two brief digital health promotion game booths utilizing augmented reality and motion detection to promote well-being at a gerontechnology summit in Hong Kong.PDF

BackgroundThe acceleration of population aging calls for simple and effective interventions catered for older people. Gerontechnology, the combination of gerontology and technology, can promote quality of life in older adults. However, public health-related events incorporating information communication technology (ICT) for older people have seldom been evaluated.ObjectiveWe reported the development and evaluation of two simple and brief digital health promotion games hosted at the annual Hong Kong Gerontech and Innovation Expo cum Summit (GIES) in 2018 and 2019 to promote well-being.MethodsTwo game booths (Dinosaur Augmented Reality photo-taking in 2018, Sit-and-Stand fitness challenge in 2019) were designed by our interdisciplinary team. Four gaming technologies were employed: augmented reality, chroma key (green screen), motion detection and 3D modeling. Immediately after the game, we administered a brief questionnaire survey to assess participant satisfaction, happiness and perceived benefits, and collected qualitative data through observations and informal interviews.ResultsMajority of 1,186 and 729 game booth participants in 2018 and 2019, respectively, were female (73.4% and 64.7%) and older adults (65.5 and 65.2%). Overall satisfaction toward the game booths was high (4.64 ± 0.60 and 4.54 ± 0.68 out of 5), with females and older adults reporting higher scores. Average personal and family happiness of participants in 2018 were 8.2 and 8.0 (out of 10). 90.3 and 18.4% of participants in 2019 chose one or more personal (e.g. enhance healthy living habits 62.4%, enhance personal happiness 61.6%) and family (e.g. enhance family happiness 15.6%, improve family relationships 10.8%) benefits of the game booth, respectively. Participants showed enthusiasm toward the technologies, and pride in their physical abilities in the fitness challenge.ConclusionOur report on the development and evaluation of brief game interventions with ICT showed high satisfaction and immediate perceived benefits in community participants. Females and older adults reported higher satisfaction. Simple tools measuring happiness and perceived benefits showed positive results. Older adults were receptive and enthusiastic about the new technologies. Our findings can inform researchers and organizers of similar events. More research on simple and enjoyable ICT interventions is needed to attract older adults and promote their well-being.Trial registrationThe research protocol was registered at the National Institutes of Health (Identifier number: NCT03960372) on May 23, 2019.</p

Use of Information and Communications Technology in Family Services and Its Perceived Benefits amid the COVID-19 Pandemic in Hong Kong—Jockey Club SMART Family-Link Project

Introduction: We examined information and communications technology (ICT) use in family services and its perceived benefits and barriers amid the COVID-19 pandemic in Hong Kong. Methods: We invited all family service social workers of 12 NGOs to complete an anonymous online questionnaire in May 2020 (Part A) and a management representative from each NGO to provide written feedback on ICT use in January 2021 (Part B). Results: In Part A, of 255 respondents (response rate: 67.3%), perceived ICT use in conducting programmes, groups, casework and preventive family programmes showed net increases of 33.9–54.5%; perceived ICT use in different work processes showed net increases of 18.8–48.6%. The three most common perceived benefits were “providing another option to service users” (74.2%), “more convenient service” (60.2%) and “maintaining normal service” (59.7%). In Part B, 12 management representatives consistently reported positive impacts of ICT use on family services. They shared actionable strategies (e.g., ICT skill-related training) and concerns about data privacy and management. Conclusions: ICT use in family services markedly increased amid the COVID-19 pandemic in Hong Kong. It helped make the services more accessible especially when the pandemic restricted face-to-face services

Measurement of the W±ZW^{\pm}Z boson pair-production cross section in pppp collisions at s=13\sqrt{s}=13 TeV with the ATLAS Detector

The production of $W^{\pm}Z$ events in proton--proton collisions at a centre-of-mass energy of 13 TeV is measured with the ATLAS detector at the LHC. The collected data correspond to an integrated luminosity of 3.2 fb$^{-1}$. The $W^{\pm}Z$ candidates are reconstructed using leptonic decays of the gauge bosons into electrons or muons. The measured inclusive cross section in the detector fiducial region for leptonic decay modes is $\sigma_{W^\pm Z \rightarrow \ell^{'} \nu \ell \ell}^{\textrm{fid.}} = 63.2 \pm 3.2$ (stat.) $\pm 2.6$ (sys.) $\pm 1.5$ (lumi.) fb. In comparison, the next-to-leading-order Standard Model prediction is $53.4^{+3.6}_{-2.8}$ fb. The extrapolation of the measurement from the fiducial to the total phase space yields $\sigma_{W^{\pm}Z}^{\textrm{tot.}} = 50.6 \pm 2.6$ (stat.) $\pm 2.0$ (sys.) $\pm 0.9$ (th.) $\pm 1.2$ (lumi.) pb, in agreement with a recent next-to-next-to-leading-order calculation of $48.2^{+1.1}_{-1.0}$ pb. The cross section as a function of jet multiplicity is also measured, together with the charge-dependent $W^+Z$ and $W^-Z$ cross sections and their ratio