A Community-Based Intervention Program to Enhance Family Communication and Family Well-being: The Learning Families Project in Hong Kong

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Abstract

Background

Family communication is important to maintain family relationships and family well-being. To enhance family communication and family well-being, a community-based “Learning Families Project,” based on the social ecological model was developed in Kwun Tong in Hong Kong, a district with high prevalence of family problems.

Methods

This quasi-experimental study included two nearby government subsidized low-rent housing estates separated by busy main roads, as the intervention [Tsui Ping (South) Estate] and control (Shun Tin Estate) estate. The main intervention was resident training programs, such as talks, day camps, and thematic activities. No program was implemented in the control estate. Participants in the intervention group received assessments before the intervention (T1), immediately after the intervention (T2), and 6 weeks after the intervention (T3). Control group participants were assessed at baseline (March to April 2011) and follow-up (December 2011 to March 2012). Assessments of family communication (time and perceived adequacy) and family well-being (harmony, happiness, and health) at T1 and T3 were obtained in the intervention group to examine within-group changes. In addition, these differences in outcomes in the intervention group were compared with those in the control group to examine the effectiveness of the intervention.

Results

Family communication time and perceived communication adequacy increased significantly in the intervention group ( n = 515) with a small effect size (Cohen effect d: 0.10 and 0.24, respectively). Compared with the control group ( n = 476), the improvements in family communication time and perceived communication adequacy (Cohen effect d: 0.13 and 0.14, respectively), and perceived family harmony and happiness (Cohen effect d: 0.12 and 0.12, respectively) were significantly greater in the intervention group, adjusting for age and education, suggesting the intervention was effective in improving family communication and family well-being. Mediation analysis showed that perceived communication adequacy mediated the effects of the intervention on family harmony [β = 0.10, 95% confidence interval (CI) 0.03, 0.18], happiness (β = 0.12, 95% CI 0.04, 0.20), and health (β = 0.10, 95% CI 0.02, 0.17), adjusting for age and education.

Conclusion

This community intervention based on the social ecological model improved family well-being through improving family communication, which could be an effective target to promote family well-being in other communities.

Trial registration

This study was registered under ClinicalTrials.gov, identifier NCT02851667. URL: https://clinicaltrials.gov/ct2/show/NCT02851667?term=02851667&rank=1.

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Author and article information

Contributors

Chen Shen: URI : http://frontiersin.org/people/u/449844

Sunita M. Stewart: URI : http://frontiersin.org/people/u/293721

Journal

Journal ID (nlm-ta): Front Public Health

Journal ID (iso-abbrev): Front Public Health

Journal ID (publisher-id): Front. Public Health

Title: Frontiers in Public Health

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2296-2565

Publication date (Electronic): 29 September 2017

Publication date Collection: 2017

Volume: 5

Electronic Location Identifier: 257

Affiliations

[1] ¹Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong , Hong Kong, Hong Kong

[2] ²Christian Family Service Center , Kwun Tong, Hong Kong

[3] ³Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas , Dallas, TX, United States

[4] ⁴Li Ka Shing Faculty of Medicine, School of Nursing, The University of Hong Kong , Hong Kong, Hong Kong

Author notes

Edited by: Shane Andrew Thomas, Shenzhen International Primary Health Care Research Institute, China

Reviewed by: Alun Conrad Jackson, Australian Centre for Heart Health, Australia; Jeff Bolles, University of Mount Olive, United States

*Correspondence: Tai Hing Lam, hrmrlth@ 123456hku.hk

Specialty section: This article was submitted to Public Health Education and Promotion, a section of the journal Frontiers in Public Health

Article

DOI: 10.3389/fpubh.2017.00257

PMC ID: 5649187

SO-VID: 24618d74-e340-461c-ac55-35114857cf4d

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 30 June 2017

Date accepted : 11 September 2017

Page count

Figures: 2, Tables: 4, Equations: 0, References: 46, Pages: 9, Words: 6319

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