Training to implement a community program has positive effects on health promoters: JC FAMILY Project.

To ease the shortage of professionals, lay volunteers were trained to become health promoters and role models for a large community program to enhance physical activity, well-being, and neighborhood cohesion in socioeconomically disadvantaged groups in Hong Kong. This study aimed to examine the effects on health promoters (trainees) and the feasibility and acceptability of capability-building train-the-trainer workshops (TTTs) using Zero-time Exercise (ZTEx) to implement a community program for about 1,000 participants. A four-session (totally 8 hours) TTT introduced an evidence-based ZTEx intervention to enhance physical activity and well-being, and build capacity for community program implementation. Twenty-eight trainees actively participated in the TTT. Twenty-five and 21 trainees completed the 1- and 3-month questionnaires, respectively. Eleven trainees attended the 1-year focus group interview. Repeated measures analysis of variance and Friedman test were used to compare the parametric and nonparametric data, respectively. Qualitative data were analyzed using thematic content analysis. The trainees reduced their sedentary behavior and improved their interpersonal communication skills, knowledge, and attitude toward ZTEx, grip strength, balance, and perceived well-being. The community participants reported improvements in neighborhood cohesion and grip strength. The 1-year qualitative results supported the 3-month quantitative findings. This brief and innovative TTT affirmed the feasibility of using ZTEx and the role modeling approach for lay health promoters to reduce sedentary behavior and enhance physical activity, fitness, and well-being. They then contributed to the successful implementation of community programs that benefited many. This study provides a new model for building capacity for health promotion in the community.

The association between adolescents' depressive symptoms, maternal negative affect, and family relationships in Hong Kong: cross-sectional and longitudinal findings.

This study investigated the bidirectional relationships of adolescents' and maternal mood, and the moderating effect by gender and perceived family relationships on these relationships. Data were obtained from 626 adolescent-mother dyads and follow-up data were collected one year later from a subset. Adolescents reported their depressive symptoms, and their mothers reported their negative affect. Adolescents described their perception of family relationships. Maternal negative affect and adolescents' depressive symptoms were significantly correlated at baseline. This association was moderated by gender and family relationships. The association was stronger in mother-daughter compared to mother-son dyads. In families where relationships were reported to be poor, adolescent depressive symptoms were uniformly high, regardless of maternal negative affect. However, in families where relationships were good, maternal negative affect was associated with higher adolescents' depressive symptoms. In longitudinal analyses, adolescents' mood at baseline was found to relate to maternal negative affect at follow-up. Family relationships at baseline were also associated with adolescents' depressive symptoms at follow-up. However, there was no prediction from maternal negative affect at baseline to adolescents' depressive symptoms at follow-up. Gender and quality of family relationships did not moderate the longitudinal relationships between adolescents' depressive symptoms and maternal negative affect in either direction.

Does smoking affect hospital use before death? A comparison of ever- and never-smokers in the last years of life.

BACKGROUND: Given the apparent greater use of health care services by smokers and predictions of higher costs for a never-smoking population, we aimed in this study to determine whether the acute hospital costs in the last years of life of never- and ever-smokers differed before death using a database of the decedents in 1 year in Hong Kong. OBJECTIVES: To compare the acute hospital use of ever- and never-smoker decedents. METHODS: The data on cause of death, personal characteristics, and public hospital discharges were linked for all decedents in 1998 in Hong Kong. The incidence rate ratio was used to compare, for ever- and never-smokers, the number of days spent in an acute hospital over the prior 7 years. Analyses were done using specific and all cause mortality, adjusted for sex, lifestyle factors, and life expectancy. RESULTS: Compared with never-smokers who died of the same condition, ever-smokers who died of chronic obstructive pulmonary disease used 28% more acute hospital bed days and those dying of smoking-related cancer 9% fewer. These differences cancelled out over the case-mix of deaths with no net difference in acute bed day use by smoking status for all-cause mortality. CONCLUSIONS: There was no difference in acute hospital bed days in the last years of life of ever- and never-smokers but some differences by cause of death. Reducing smoking in this population will not increase acute hospital use.