A Randomized Controlled Trial of a Positive Family Holistic Health Intervention for Probationers in Hong Kong: A Mixed-Method Study

Agnes Y-K Lai, Shirley M-M Sit, Carol Thomas, George O-C Cheung, Alice Wan, Sophia S-C Chan, Tai-Hing Lam, Agnes Y-K Lai, Shirley M-M Sit, Carol Thomas, George O-C Cheung, Alice Wan, Sophia S-C Chan, Tai-Hing Lam

Abstract

Introduction: Probationers, offenders with less serious and non-violent offences, and under statutory supervision, have low levels of self-esteem and physical health, and high level of family conflict, and poorer quality of family relationships. This study examined the effectiveness of the existing probation service and the additional use of a positive family holistic health intervention to enhance physical, psychological, and family well-being in probationers and relationships with probation officers. Methods: Probationers under the care of the Hong Kong Social Welfare Department were randomized into a care-as-usual control group (CAU), a brief intervention group (BI) receiving two 1-h individual sessions [of a brief theory-based positive family holistic health intervention integrating Zero-time Exercise (simple and easy-to-do lifestyle-integrated physical activity) and positive psychology themes of "Praise and Gratitude" in the existing probation service], or a combined intervention group (CI) receiving BI and a 1-day group activity with family members. The outcomes were physical activity, fitness performance, self-esteem, happiness, anxiety and depression symptoms, life satisfaction, quality of life, family communication and well-being, and relationships with probation officers. Self-administered questionnaires and simple fitness tests were used at baseline, 1-month and 3-month follow-up. Linear mixed model analysis was used to compare difference in the changes of outcome variables among groups, adjusted of sex, age, and baseline values. Focus group interviews were conducted. Thematic content analysis was used. Results: 318 probationers (51% male) were randomized into CAU (n = 105), BI (n = 108), or CI (n = 105) group. CAU showed enhanced physical activity, fitness performance and psychological health, and family communication with small effect sizes (Cohen's d: 0.19-0.41). BI and CI showed further improved physical activity, family communication and family well-being (Cohen's d: 0.37-0.70). Additionally, CI reported greater improvements in the relationships with probation officers than CAU with a small effect size (Cohen's d: 0.43). CI also reported greater increases in physical activity and family communication than BI with small to moderate effect sizes (Cohen's d: 0.38-0.58). Qualitative feedbacks corroborated the quantitative findings. Conclusion: Our trial provided the first evidence of the effectiveness of probation service and the additional use of an innovative, relatively low-cost, theory-based brief positive family holistic health intervention. This intervention may offer a new model for enhancing probation service. Trial Registration: The research protocol was registered at the National Institutes of Health (identifier: NCT02770898).

Keywords: Zero-time exercise; community-based; family communication; physical activity; positive psychology; probationer; theory-based.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Lai, Sit, Thomas, Cheung, Wan, Chan and Lam.

Figures

FIGURE 1
FIGURE 1
The conceptual framework of the family holistic health intervention.
FIGURE 2
FIGURE 2
The study flow chart.
FIGURE 3
FIGURE 3
The between –group difference in the changes in physical activity at 1- and 3-month follow-up in three groups: Intention-to-treat analysis.
FIGURE 4
FIGURE 4
The between–group difference in the changes in family communication at 1- and 3-month follow-up in three groups: Intention-to-treat analysis.
FIGURE 5
FIGURE 5
The between–group difference in the changes in family well-being and relationship with probation officers at 1- and 3-month follow-up in three groups: Intention-to-treat analysis.

References

    1. Akers R. L., Jennings W. G. (2019). The Social Learning Theory of Crime and Devianc. Cham: Springer.
    1. Center for Substance Abuse Treatment (2005). Substance Abuse Treatment for Adults in the Criminal Justice System. Rockville, MD: Substance Abuse and Mental Health Services Administration (US).
    1. Chou K. L., Chi I. (2001). Stressful life events and depressive symptoms: social support and sense of control as mediators or moderators? Int. J. Aging Hum. Dev. 52 155–171. 10.2190/9c97-lca5-ewb7-xk2w
    1. Chui W. H. (2003). Experiences of probation supervision in Hong Kong: listening to the young adult probationers. J. Crim. Justice 31 567–577.
    1. Chui W. H. (2004). Adult offenders on probation in Hong Kong: an exploratory study. Br. J. Soc. Work 34 443–454.
    1. Chui W. H., Chan H. C. (2013). Juvenile offenders’ perceptions of probation officers as social workers in Hong Kong. J. Soc. Work 14 398–418. 10.1177/1468017313478291
    1. Comfort M. (2016). “A Twenty-Hour-a-Day Job”: the impact of frequent low-level criminal justice involvement on family life. Ann. Am. Acad. Pol. Soc. Sci. 665 63–79. 10.1177/0002716215625038
    1. Creswell J. W., Clark V. L. P. (2017). Designing and Conducting Mixed Methods Research. Thousand Oak, CA: Sage publications.
    1. De Lude B., Mitchell D., Barber C. (2012). The Probationer’s perspective on the probation officer-probationer relationship and satisfaction with probation. Fed. Probat. J. 76 36–39.
    1. Diener E., Emmons R. A., Larsen R. J., Griffin S. (1985). The satisfaction with life scale. J. Pers. Assess. 49 71–75.
    1. Emmons R., McCullough M. (2003). Counting blessing versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. J. Pers. Soc. Psychol. 84 377–389. 10.1037//0022-3514.84.2.377
    1. Galvin K. M., Braithwaite D. O., Bylund C. L. (2015). Family Communication: Cohesion and Change. New York, NY: Routledge.
    1. Ho H. C., Mui M. W. K., Wan A., Yew C. W. S., Lam T. H. (2019). Happy family kitchen movement: a cluster randomized controlled trial of a communirt-based family holistic health intervention in Hong Kong. J. Happ. Stud. 21 15–36. 10.1007/s10902-018-00071-w
    1. Ho H. C., Mui M. W.-K., Wan A., Yew C. W.-S., Lam T. H. (2020). A cluster randomized controlled trial of a positive physical activity intervention. Health Psychol. 39:667.
    1. Jeon J. Y., Kim I. O., Yeon P. K., Shin W. S. (2021). The physio-psychological effect of forest therapy programs on juvenile probationers. Int. J. Environ. Res. Public Health 18:5467. 10.3390/ijerph18105467
    1. Jones C. J., Rikli R. E., Beam W. C. (1999). A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res. Q. Exerc. Sport 70 113–119. 10.1080/02701367.1999.10608028
    1. Kerekes N., Fielding C., Apelqvist S. (2017). Yoga in correctional settings: a randomized controlled study. Front. Psychiatry 8:204. 10.3389/fpsyt.2017.00204
    1. Kolb D. A. (2015). Experiential Learning: Experience as the Source of Learning and Development. Upper Saddle River, NJ: Pearson Education Ltd.
    1. Kroenke K., Spitzer R. L., Williams J. B., Löwe B. (2009). An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics 50 613–621. 10.1176/appi.psy.50.6.613
    1. Lai A. Y. K., Lam E. Y. W., Fabrizo C., Lee D. P. K., Wan A. N. T., Tsang J. S. Y., et al. (2020). A community-based lifestyle-integrated physical activity intervention to enhance physical activity, positive family communication, and perceived health in deprived families: a cluster randomized controlled trial. Front. Public Health 8:434. 10.3389/fpubh.2020.00434
    1. Lai A., Stewart S. M., Wan A. N. T., Shen C., Ng C. K. K., Kwok L. T., et al. (2018). Training to implement a community program has positive effects on health promoters: JC FAMILY Project. Transl. Behav. Med. 8 838–850. 10.1093/tbm/iby070
    1. Lai A., Stewart S., Wan A., Thomas C., Tse J., Ho D., et al. (2019). Development and feasibility of a brief Zero-time exercise intervention to reduce sedentary behaviour and enhance physical activity: a pilot trial. Health Soc. Care Commun. 27 e233–e245. 10.1111/hsc.12728
    1. Lai Y., Lam T., Wan N. (2019). JC FAMILY project: development and feasibility of a pilot trial of a 15-minute zero-time exercise community-based intervention to reduce sedentary behaviour and enhance physical activity and family communication in older people. Ageing Sci. Ment. Health Stud. 27 e233–e245.
    1. Lam C. L., Eileen Y., Gandek B. (2005). Is the standard SF-12 health survey valid and equivalent for a Chinese population? Qual. Life Res. 14 539–547. 10.1007/s11136-004-0704-3
    1. Lam W. W., Fielding R., McDowell I., Johnston J., Chan S., Leung G. M., et al. (2012). Perspectives on family health, happiness and harmony (3H) among Hong Kong Chinese people: a qualitative study. Health Educ. Res. 27 767–779. 10.1093/her/cys087
    1. LeBlanc A. G., Janssen I. (2010). Difference between self-reported and accelerometer measured moderate-to-vigorous physical activity in youth. Pediatr. Exerc. Sci. 22 523–534. 10.1123/pes.22.4.523
    1. Lyubomirsky S., Lepper H. S. (1999). A measure of subjective happiness: preliminary reliability and construct validation. Soc. Indic. Res. 46 137–155. 10.1017/sjp.2017.8
    1. Macfarlane D., Lee C., Ho E., Chan K., Chan D. (2007). Reliability and validity of the Chinese version of IPAQ (short, last 7 days). J. Sci. Med. Sport 10 45–51. 10.1016/j.jsams.2006.05.003
    1. Morash M., Kashy D. A., Smith S. W., Cobbina J. E. (2015). The effects of probation or parole agent relationship style and women offenders’ criminogenic needs on offenders’ responses to supervision interactions. Crim. Justice Behav. 42 412–434.
    1. Morse J. M., Field P. A. (1995). Qualitative Research Methods for Health Professionals. New York, NY: Sage Publications.
    1. Nan H., Ni M. Y., Lee P. H., Tam W. W., Lam T. H., Leung G. M., et al. (2014). Psychometric evaluation of the Chinese version of the subjective happiness scale: evidence from the Hong Kong FAMILY Cohort. Int. J. Behav. Med. 21 646–652. 10.1007/s12529-014-9389-3
    1. Newman T. J., Alvarez M. A. G., Kim M. (2017). An experiential approach to sport for youth development. J. Exp. Educ. 40 308–322. 10.1177/1053825917696833
    1. Newton R. (1989). Review of tests of standing balance abilities. Brain Injury 3 335–343. 10.3109/02699058909004558
    1. Peterson C., Seligman M. (2004). Character Strengths and Virtues: A Handbook and Classification. Washington, DC: American Psychological Association.
    1. Piercy K. L., Troiano R. P., Ballard R. M., Carlson S. A., Fulton J. E., Galuska D. A., et al. (2018). The physical activity guidelines for Americans. JAMA 320 2020–2028.
    1. Rosenberg M. (1965). Rosenberg self-esteem scale (RSE). Accept. Commit. Ther. Meas. Pack. 61:18.
    1. Seligman M., Flourish P. (2012). “A visionary new understanding of happiness and well-being,” in Flourish, ed. Selligman M. (New York, NY: Free Press; ), 1–368. 10.1007/978-94-007-4414-1_1
    1. Sexton T., Turner C. W. (2010). The effectiveness of functional family therapy for youth with behavioral problems in a community practice setting. J. Fam. Psychol. 24 339–348. 10.1037/a0019406
    1. Sfendla A., Malmström P., Torstensson S., Kerekes N. (2018). Yoga practice reduces the psychological distress levels of prison inmates. Front. Psychiatry 9:407. 10.3389/fpsyt.2018.00407
    1. Silsbury Z., Goldsmith R., Rushton A. (2015). Systematic review of the measurement properties of self-report physical activity questionnaires in healthy adult populations. BMJ Open 5:e008430.
    1. Sin N. L., Lyubomirsky S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. J. Clin. Psychol. 65 467–487. 10.1002/jclp.20593
    1. Skinner G. C. M., Farrington D. P. (2020). A systematic review and meta-analysis of offending versus suicide in community (non-psychiatric and non-prison) samples. Aggress. Violent Behav. 52:10 1421.
    1. Sloas L., Lerch J., Walters S., Taxman F. S. (2020). Individual-level predictors of the working relationship between probation officers and probationers. Pris. J. 100 709–725. 10.1177/0032885520968242
    1. Smilkstein G. (1978). The family APGAR: a proposal for a family function test and its use by physicians. J. fam. Pract. 6 1231–1239.
    1. Social Welfare Department (2021). Probation Service. Available online at: (accessed June 25, 2021).
    1. Sonstroem R. J., Morgan W. P. (1989). Exercise and self-esteem: rationale and model. Med. Sci. Sports Exerc. 21 329–337.
    1. Strauss R. S., Rodzilsky D., Burack G., Colin M. (2001). Psychosocial correlates of physical activity in healthy children. Arch. Pediatr. Adolesc. Med. 155 897–902. 10.1001/archpedi.155.8.897
    1. Thomas P. A., Liu H., Umberson D. (2017). Family relationships and well-being. Innov. Aging 1:igx025.
    1. Tuominen P. P. A., Raitanen J., Husu P., Luoto R. M., Kujala U. M. (2020). Relationship between mothers’ enjoyment and sedentary behavior and physical activity of mother–child dyads using a movement-to-music video program: a secondary analysis of a randomized controlled trial. BMC Public Health 20:1659. 10.1186/s12889-020-09773-4
    1. Wangmo T., Handtke V., Bretschneider W., Elger B. S. (2018). Improving the Health of older prisoners: nutrition and exercise in correctional institutions. J. Correct. Health Care 24 352–364. 10.1177/1078345818793121
    1. Ware J. E., Jr., Kosinski M., Keller S. D. (1996). A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med. Care 34 220–233. 10.1097/00005650-199603000-00003

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