Efficacy of a transtheoretical model intervention to improve college students\u27 physical activity engagement: a pilot randomized controlled trial

Recent reports have indicated the severity of physical inactivity. Few previous interventions have adopted randomized controlled trials (RCT) for the promotion of college students’ physical activity (PA) in Hong Kong. The aim of this pilot study is to test the efficacy of a Transtheoretical Model (TTM)-based intervention to enhance college students’ PA behaviour. Twenty-five healthy, sedentary student volunteers (16 male and 9 females) were recruited and randomly allocated to the TTM-based experimental group (n=12) or the control group (n=13). The treatment intervention group underwent fitness training and TTM-based counselling, while the control group received fitness training only. The fitness training for both groups lasted for 4 weekly sessions at a campus fitness facility. All participants wore a pedometer. Daily pedometer counts were recorded into the PA log as a direct-measured PA engagement. Direct-measured fitness outcomes and self-reported health outcome measurements were assessed before and after the 4-week intervention. Data were analysed to distinguish the intervention group from the control group. The initial results of this pilot study could be said to support the TTM-based behaviour intervention for PA promotion in Hong Kong college settings. Randomization was found to be successful and the instrumentation was effective with certain limitations. Due to the small and varied group size, the effectiveness of the intervention seemed inconclusive and too negligible to declare. Finally, based on discussion of the results and findings, recommendations have been drawn to inform the upcoming study at community level and future PA intervention practices

Effects of a transitional palliative care model on patients with end-stage heart failure: a randomised controlled trial

Objective To examine the effects of home-based transitional palliative care for patients with end-stage heart failure (ESHF) after hospital discharge. Methods This was a randomised controlled trial conducted in three hospitals in Hong Kong. The recruited subjects were patients with ESHF who had been discharged home from hospitals and referred for palliative service, and who met the specified inclusion criteria. The interventions consisted of weekly home visits/telephone calls in the first 4 weeks then monthly follow-up, provided by a nurse case manager supported by a multidisciplinary team. The primary outcome measures were any readmission and count of readmissions within 4 and 12 weeks after index discharge, compared using Ï ‡ 2 tests and Poisson regression, respectively. Secondarily, change in symptoms over time between control and intervention groups were evaluated using generalised estimating equation analyses of data collected using the Edmonton Symptom Assessment Scale (ESAS). Results The intervention group (n=43) had a significantly lower readmission rate than the control group (n=41) at 12 weeks (intervention 33.6% vs control 61.0% Ï ‡ 2 =6.8, p=0.009). The mean number (SE) of readmissions for the intervention and control groups was, respectively, 0.42 (0.10) and 1.10 (0.16) and the difference was significant (p=0.001). The relative risk (CI) for 12-week readmissions for the intervention group was 0.55 (0.35 to 0.88). There was no significant difference in readmissions between groups at 4 weeks. However, when compared with the control group, the intervention group experienced significantly higher clinical improvement in depression (45.9% vs 16.1%, p<0.05), dyspnoea (62.2% vs 29.0%, p<0.05) and total ESAS score (73.0% vs 41.4%, p<0.05) at 4 weeks. There were significant differences between groups in changes over time in quality of life (QOL) measured by McGill QOL (p<0.05) and chronic HF (p<0.01) questionnaires. Conclusions This study provides evidence of the effectiveness of a postdischarge transitional care palliative programme in reducing readmissions and improving symptom control among patients with ESHF. Trial registration number HKCTR-1562; Results