Zero-time Exercise: A Cluster Randomized Control Trial To Promote Physical Activity, Health, Happiness And Family Harmony Under Hong Kong Jockey Club Family Project

Abstract

Objectives: About half of Hong Kong people are physically inactive. 'Zerotime Exercise' (ZTEx) is a new approach to motivate people to do simple exercises, which need no extra time (zero time ), money or equipment, and suit anybody, anytime and anywhere (3As). This cluster randomized controlled trial examined the effects of a ZTEx community intervention. Methods: All the eight Caritas Integrated Family Services Centres with their respective community participants were randomized into either a physical activity experimental (PA) group or a control group (4 centres per group). We aimed to enhance the PA participants' physical activity by increasing their knowledge, motivation and self‐efficacy about ZTEx through a 2‐hour interactive core session at baseline, a 1.5‐hour booster session at 3 months, and six monthly mobile messages. The control group had healthy diet (HD) intervention with the same methods, number of sessions and duration. Primary outcome was the number of days per week in doing ZTEx. Secondary outcomes were personal health, happiness, and family harmony. Each item allowed response on a 0 to 10 scale ranging from 'not at all healthy/ happy/ harmonious' to 'very healthy/ happy/ harmonious'. We analysed by intentionto‐ treatmethod. Results (preliminary): 673 participants (92% female) with at least one child, were recruited into the PA experimental group (n=357) or HD control group (n=316). Both groups had increased ZTEx [PA group: from 2.3 to 5.0 days/ week (Cohen's d=1.14, p<0.001) at three months, and at six months; HD group: from 2.6 to 3.7 days/week (Cohen's d=0.44, p<0.001) at three months and 3.8 days/week (Cohen's d=0.49, p<0.001) at six months]. Both groups also had better perceived personal health [PA group: from 4.8 to 5.8 and 6.0 units; HD group: from 4.8 to 5.5 and 5.8 units), happiness (PA group: from 5.8 to 6.5 and 6.6 units; HD group: 5.4 to 6.0and 6.3 units), and family harmony (PA group: 6.2 to 6.8 and 6.9 units; HD group: 5.8 to 6.4 and 6.5 units) at three months, and at six months (all p<0.001), respectively. Comparing with the HD control group, the PA experimental group performed more ZTEx by 1.3 days/week (Cohen's d = 0.75, p<0.001), and had greater improvements in perceived personal health by 0.2 unit (Cohen's d =0.21, p=0.007) and family harmony by 0.2 unit (Cohen's d=0.17, p=0.036) at three and six months, adjusting for age, gender, education, income, marital status and their baseline values. Conclusions: Our ZTEx intervention showed preliminary evidence of effectiveness in increasing physical activity, personal health, happiness and family harmony.