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

Abstract

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.