Co-Creation and Impacts of a Suicide Prevention Video.

Background: Youth suicide has become an emerging public health challenge globally. In this study we leveraged the power of social media to better engage the youth population. Aims: We aimed to investigate the impacts of promoting suicide prevention through social media and evaluate the co-creation process of the project with a popular YouTuber in Hong Kong. Method: A YouTube suicide prevention short film was co-produced by the YouTuber and the research team. We examined the co-creation process using thematic analysis, and analyzed the YouTube video statistics and the data collected from the online survey and public comments. Results: The short film brought positive perceived changes in the audience's suicide prevention knowledge, attitude, and behaviors. Three facilitating factors and one challenge of the co-creation process were identified. The short film statistics and demographics of the audience were also extracted and analyzed. Limitations: There was a small sample size and a lack of a control group in this study. Conclusion: Suicide prevention promotion by the YouTuber was promising. This study demonstrates the effectiveness in promoting suicide prevention via social media and provides a framework for future studies to evaluate similar forms of collaborations.

A Digital Game and School-Based Intervention for Students in Hong Kong: Quasi-Experimental Design.

BACKGROUND: In Hong Kong, with an increasing number of children experiencing mental health issues, there is a need to not only develop innovative interventions but also develop comprehensive prevention interventions so as to reduce their anxiety symptoms and enhance their emotional management and interpersonal relationships. OBJECTIVE: The aim of this study was to determine the effectiveness of The Adventures of DoReMiFa, an integration model of the cognitive-behavioral approach and positive psychology by using digital game-based and school-based mental health enhancement intervention to magnify the social and emotional health and well-being of the school children in Hong Kong aged 9 to 11 years. METHODS: A quasi-experimental design method was used to evaluate this digital game and school-based intervention. The Adventures of DoReMiFa was piloted in 4 primary schools where students were allocated to either an intervention or a control group. The participants were assessed at pre- and postintervention with a 6-month follow-up measuring their mental health knowledge, levels of anxiety symptoms, positive and negative thinking, perspective-taking, and self-esteem. RESULTS: A total of 459 primary school students from 4 primary schools participated in the study. The response rate on the questionnaires answered on the Web was up to 85.1% (391/459). Compared with the control group, the intervention group was found to have significant association with improved mental health knowledge at the time immediately after the intervention (beta=.46; P=.01) and in the 6-month postintervention period (beta=.66; P<.001); for perspective-taking, the intervention group had exhibited a significant improvement 6 months after the completion of the universal program (beta=1.50; P=.03). The intervention, however, was found not to be effective in reducing the rates of anxiety symptoms and negative thinking among the participating students. CONCLUSIONS: The Adventures of DoReMiFa, an integration of a digital game-based and school-based mental health enhancement intervention, was shown to be effective in elevating the knowledge of mental health and promoting perspective-taking in the primary school students of Hong Kong. Although there was insufficient evidence to support a reduction in symptoms of anxiety and negative automatic thoughts, the overall results were still encouraging in that a preventive effect was found, indicating that the program has the potential to enhance the mental well-being of schoolchildren. It also suggests that knowledge enhancement may not necessarily lead to behavior change, and more focused effort may be needed to achieve the translation. The implications and limitations of this study and suggestions for future research were also discussed.

Exploring the use of telephone helpline pertaining to older adult suicide prevention: A Hong Kong experience.

BACKGROUND: Older adults usually have a higher suicide rate than the general population. There are helpline services provided to older adults but limited studies have examined the suicidal risks among the users, and how those services could be used as a platform to engage older adults in suicide prevention. METHODS: In regard to elderly suicide prevention, this study explored the potential usefulness and relevance of a telephone helpline service in Hong Kong, which had 106,583 users during 2012-2015. An estimation on the suicide rates of the users was made and compared with the general older adult population in Hong Kong. The users' suicide risks and their associated factors were assessed by survival analyses and an estimation system on the users' suicide mortality likelihood was also tested. RESULTS: The suicide rates of both male and female users were more than two times higher than the general older adult population in Hong Kong. The users' risks of suicides were greater at the early period of using the service; men, living alone, and having a history of mental illnesses were also associated with increased risks. Based on the identified factors, an estimation system was developed with a sensitivity of 0.73 and specificity of 0.54. LIMITATIONS: A secondary data analysis. CONCLUSIONS: By identifying a suicide risk profile and distinct telephone calling pattern among the users, early detection and a warning system should be implemented to allow timely intervention to reduce the number of older adult suicides in the community.

Associations of relative income deprivation with perceived happiness and self-rated health among the Hong Kong Chinese population.

OBJECTIVES: To investigate the association of relative income deprivation (RID) with perceived happiness and self-rated health in Hong Kong. METHODS: We measured RID on Yitzhaki indices constructed using multiple reference groups and used multilevel ordinal logistic regression models to assess its linkages with the two outcomes, using data from 6272 respondents from a large-scale representative household survey. RESULTS: Among the overall population, increased RID was found to be consistently associated with reduced perceived happiness, even after adjusting for respondents' level of absolute income and other socio-demographic covariates; however, there were no consistent associations between RID and self-rated health. In subgroup analysis, we observed significant linkages between RID and self-rated health only among men, the middle and older age ranges, and among those with less education and those not engaged in economic activities. CONCLUSIONS: Our findings suggest that RID is adversely associated with perceived happiness. However, its negative linkage with self-rated health is less clear. The weak tie between RID and self-rated health may relate to the Hong Kong context, where the public health system is relatively equitable and has multiple pro-poor health policies.