Capacity building workshops for lay health promoters to implement the large scale community-based fitter FAMILY project in Hong Kong

Abstract

Purpose:Under FAMILY: A Jockey Club Initiative for a Harmonious Society, we trained lay volunteers to be health promoters and role models to help social service workers in delivering the large community-based 'Fitter Family Project'(FFP) to enhance physical activity, well-being and neighbourhood cohesion in a relatively deprived district in Hong Kong. We examined the feasibility and acceptability of our train-the-ambassador workshops(TTAs) and the effects on the health promoters(trainees), and the FFP participants. Methods:Zero-time Exercise(ZTEx) includes simple movements and stretching while sitting, standing or walking. We designed the four–sh;session(8 hours) TTAs using ZTEx as a foot-in-the-door approach to increase physical activity, reduce sedentary behaviour, and build capacity for community programme implementation. After training, trainees helped the implementation and acted as role models for the community participants. Repeated measures analysis of variance and Friedman test were used to compare the parametric and non-parametric data, respectively. Qualitative data were analysed using thematic content analysis. Results: Twenty-eight trainees participated in the TTT workshops with enthusiasm. At 3-month follow up, trainees reported improvements in knowledge and attitude towards engaging in ZTEx regularly, increased ZTEx and moderate physical activity, and reduced sitting time, with small to medium effect size (Cohen's d: 0.42 - 0.61). Objectively measured grip strength and balance improved (Cohen's d: 0.58 - 0.61) and perceived health and happiness scores increased (Cohen's d: 0.56), with medium effect size. Trainees helped the implementation of community programme for 953 participants from 672 families. The community participants reported increased ZTEx, and improved fitness performance, neighbourhood cohesion and family well-being, with small to medium effect size at 3-month follow-up. All the improvements above were statistically significant. Eleven trainees attended the 1-year focus group interview, and the qualitative feedbacks supported the 3-month quantitative findings. Conclusions:This brief and innovative TTT has shown the feasibility and satisfactory outcomes of using ZTEx and role modelling approach for training lay health promoters to reduce their sedentary behaviour, enhance physical activity and fitness, and improve well-being. They also contributed to the successful implementation of the community programme which benefited many participants. This could be a new model for capacity building for large scale community-based projects.