Improving Family Holistic Health in Probationers

Improving Family Holistic Health in Probationers- a Mixed Methods Evaluation

Evaluating the impact of probation on probationers is necessary for both effective practice of probation officers and their assessment of the success of their work. At present, there are limited studies that have evaluated the impact of probation services on probationers and their family. There are even fewer studies that have examined interventions on probationers' well-being and family relations in a Chinese society. Compared with the general population, probationers are associated with poorer mental (e.g., depression, lower levels of self-esteem, high level of stress) and physical health, and often experience higher levels of family conflict, and poorer quality of family relationships. Given the vulnerabilities, there is a need to strengthen and promote healthy lifestyle and enhance individual and family well-being among probationers. As part of the FAMILY project, the current study focuses on "FAMILY Holistic Health" which emphasizes a comprehensive approach to improving physical, mental, and social health and well-being. This project will be conducted as a pilot project in the Social Welfare Department (SWD) in the Eastern District of Hong Kong. Interventions will be delivered to promote and enhance probationer's wellbeing, as well as enhancing FAMILY 3Hs (Happiness, Health, and Harmony). Training programs will be provided to probation officers and/or workers of SWD in order to equip them with knowledge and skills in implementing health-related family intervention programs.

Study Overview

• Status: Completed
• Conditions: Self-esteem; Family Relationship; Self-efficacy
• Intervention / Treatment: Behavioral: Family Holistic Health

Detailed Description

To enhance individual and family well-being among probationers, family life and health education, including the skills and knowledge for physical exercise, healthy family functioning, strong communication skills, healthy interpersonal relationships, and positive self-esteem, should be strengthened and promoted. Based on the strong foundation of the FAMILY projects conducted by our research team in the past years, this project seeks to promote "FAMILY holistic health" for targeted families (i.e. probationers). The holistic health interventions are interactive and designed for behavioral changes to enhance individual well-being and encourage positive and sustainable health actions among family members. Thus, it is expected ultimately that the participants and their family members could enhance their family happiness, health, and harmony (3Hs). In sum, the project has the following contributions:

1. Strengthen evidence-based practice Hong Kong probation-related topics are scarcely studied. There is a need for rigorous studies to build and strengthen evidence-base for probation services. This study will be one of the first studies to evaluate the effectiveness of probation services on individual well-being and family well-being utilizing a mixed-methods approach.
2. Stakeholder engagement Stakeholders will be engaged throughout the research process. This promotes co-learning and empowering process, builds on strengths and resources within the community, and integrates knowledge and intervention for the mutual benefit of all partners.
3. Train-the-trainer program Training will be provided to probation officers and/or workers at the Social Welfare Department. The result of this train-the-trainers program is that front-line service workers will increase and enhance their knowledge and skills to independently and effectively carry out interventions. Probation officers will act as role models for probationers and continue to implement our knowledge and techniques in their future interventions.

• Study Type: Interventional
• Enrollment (Actual): 463
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Hong Kong, China
    • The University of Hong Kong

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Be an existing probationer with 6 months of term remaining
• Reading and writing abilities for questionnaire completion
• Have family members that are based in Hong Kong (the rationale is that one of the secondary outcome is to improve family relations)
• Probationer does not have a developmental or intellectual disability
• Probationer aged 13 and above (the rationale is that youth under 12 years of age may not have the cognitive ability to complete questionnaires)

Exclusion Criteria:

• Sexual offenders
• Drug offenders

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Brief Intervention; The brief intervention is individual focus and consists of three main components, which include enhancing the individual personal attributes such as participant's knowledge, values, and behaviors related to physical exercise. Second, the intervention will promote changes in behavioral attributes by providing opportunities and experience in goal setting, skills development in physical exercise and self-monitoring. Finally, the brief intervention promotes family relations and well-being by encouraging individuals to share their knowledge and increase physical activities with other family members. The brief intervention will be delivered by the probation officer during regular monthly consultation.	Behavioral: Family Holistic Health; Interventions for probationers will aim to promote physical and psychosocial health, family relationships and Family 3H (happiness, harmony and health).
Experimental: Combined Intervention; Participants allocated to the combined intervention will receive the individual brief intervention and participate in a community group program. The components in the brief intervention will also be reinforced in the group program. The group nature is designed to create an environment that is supportive of physical exercise, through role models, peer support, and encourages families to exercise with probationers.	Behavioral: Family Holistic Health; Interventions for probationers will aim to promote physical and psychosocial health, family relationships and Family 3H (happiness, harmony and health).
No Intervention: Care-as-usual; Participants allocated to Care-as-usual arm will receive their usual services. Participants will be offered the combined interventions upon completion of 3-months follow up assessment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in Individual well-being (self-esteem, self-efficacy)	Individual well-being will be assessed by the Rosenberg Self-esteem Scale.	T1 (baseline), T2 (one month follow-up), T3 (three months follow-up)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical health	Physical health will be assessed by the SF-12v2 health survey.	T1 (baseline), T2 (one month follow-up), T3 (three months follow-up)
Psychosocial health	Psychosocial health will be assessed by the SF-12v2 health survey.	T1 (baseline), T2 (one month follow-up), T3 (three months follow-up)
Behaviours on physical exercise (Adapted version of IPAC)	Theme-related behaviours will be assessed by behavioural indicators.	T1 (baseline), T2 (one month follow-up), T3 (three months follow-up)
Family health, happiness and harmony (3Hs)	Family 3Hs will be assessed by the family well-being scale.	T1 (baseline), T2 (one month follow-up), T3 (three months follow-up)
Family relations	Family relations will be assessed by the family APGAR scale.	T1 (baseline), T2 (one month follow-up), T3 (three months follow-up)
Satisfaction towards the program (Self-generated satisfaction scale)	Satisfaction towards the program will be assessed by a program evaluation measure.	T1 (baseline), T2 (one month follow-up), T3 (three months follow-up)

Collaborators and Investigators

• Sponsor: The University of Hong Kong

Publications and helpful links

General Publications

• Lai AY, Sit SM, Thomas C, Cheung GO, Wan A, Chan SS, Lam TH. A Randomized Controlled Trial of a Positive Family Holistic Health Intervention for Probationers in Hong Kong: A Mixed-Method Study. Front Psychol. 2021 Dec 7;12:739418. doi: 10.3389/fpsyg.2021.739418. eCollection 2021.

Study record dates

Study Major Dates

• Study Start: July 1, 2015
• Primary Completion (Actual): March 1, 2017
• Study Completion (Actual): July 1, 2017

Study Registration Dates

• First Submitted: November 23, 2015
• First Submitted That Met QC Criteria: May 10, 2016
• First Posted (Estimate): May 12, 2016

Study Record Updates

• Last Update Posted (Actual): May 4, 2018
• Last Update Submitted That Met QC Criteria: May 3, 2018
• Last Verified: May 1, 2018

More Information

Terms related to this study

• Keywords: well-being; physical exercise; evidence-based; probation; family well-being
• Other Study ID Numbers: UW 15-249

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED