Impact of a Health Empowerment Programme on Self-Care Enablement and Health Outcomes of Working Poor Families in Hong Kong

Abstract

Context: Individuals from working-poor families often experience worse health outcomes and health-related quality of life (HRQoL) from limited access to healthcare and poorer self-care. Health empowerment, a process of improving control over the decisions affecting one’s health through education and motivation, is a potential method to enhance health of the working-poor. Objectives: To determine whether a community-based health empowerment programme (HEP) could improve self-care and health outcomes among adults of low SES. Human Subject Review: This project was approved by the University of Hong Kong—the Hospital Authority Hong Kong West Cluster IRB, Reference number: UW 12-517. Design: Prospective cohort study. Setting: The HEP was conducted in Tung Chung, a developing satellite residential area on an outlying island where healthcare services are limited. Participant inclusion criteria were: 1) at least one working family member; 2) at least one child studying in grade 1-3; and 3) a monthly household of <75% Hong Kong’s median monthly household income. Intervention: The intervention group received the HEP consisting of free annual health assessments and the health literacy and enablement programme, which included health literacy seminars, nutrition workshops, healthy cooking kitchens, dancing gyms and rope skipping courses. Doctors, nurses or dietitians were present to explain health problems, advise and refer to appropriate healthcare or social services. Participants were followed-up for 5-years and compared to adults from similar socioeconomic background (control group). Outcome Measures: The primary outcome was self-care enablement, measured using the Patient Enablement Instrument (PEI). Secondary outcomes include HRQoL measured by Short-Form 12 Health Survey Version 2 (SF-12v2), mental health measured by Patient Health Questionnaire-9 (PHQ-9) and physical health outcomes including blood pressure, fasting glucose, lipid profile and waist-to-hip-ratio. Anticipated Results: We anticipate that the intervention group will show greater improvements in self-care enablement, HRQoL, mental and physical outcomes after 5 years compared to the control group. Conclusions: Our findings will demonstrate the effect of community-based health empowerment programmes on self-care capacity, wellbeing, physical and mental health among individuals of low socioeconomic status.