Community Health Campaign: Fitter Families Project

In 2011, United Nations (UN) addressed the prevention and control of four non-communicable diseases (NCDs: cancer, cardiovascular disease, chronic respiratory disease, and diabetes mellitus) worldwide. The UN, in its Political Declaration, recognized the critical importance of reducing the exposure to the common modifiable risk factors for NCDs, namely, tobacco use, unhealthy diet, physical inactivity, and the harmful use of alcohol. In Hong Kong, NCDs are responsible for more than 85% of all deaths and most of these are preventable. FAMILY Project Cohort Study (2014) also found that 88.6% of Hong Kong people had inadequate vegetable and fruit intake, 70.6% had inadequate physical exercise, 26.4% were overweight and 5.4% were obese. Hong Kong, being the most westernized and developed city of China, can take a leading role in promoting and implementing the UN Political Declaration.

Families worldwide have been undergoing rapid changes with macro, social and economic trends. Demographic shifts, economic upheavals, changing societal norms and values, immigration across national borders and migration within nations are creating new and altered structures, processes and relationships within families. The increasingly complex and diverse family structure contributes to concerns regarding the well-being of families in Hong Kong, including their health, happiness and harmony (FAMILY 3Hs). Family life and health education should be strengthened to meet the increasing needs of promoting healthy lifestyle among Hong Kong families. The results from the baseline findings of FAMILY Project Cohort Study (2014) revealed that only 27.9% of the participants considered themselves to be 'happy', while 15.6% of the participants were classified as 'unhappy'. Nearly one-third (30.7%) of the participants reported having experienced at least one stressful life event in the previous year due to heavier workload (10.8%), serious health problems of a family member (6.8%), worsening financial situation (6.2%), health problems of oneself (5.1%), or death of a family member (4.7%). Furthermore, more than half of the participants (52.5%) reported having some source of dyadic conflicts with family members. In response to these changes in the contexts and nature of the family, the Fitter Families Project (FFP) with a focus on "FAMILY Holistic Health", will be conducted in order to increase the awareness of the importance of FAMILY 3Hs.

There are several definitions of family health. On the functional level, the terms family health, family functioning, and healthy family are often used interchangeably. Family health has been described as complex system, interactions, relationships and processes with the potential to enhance both well-being and the entire household's health, and routines in the family may affect family health. Despite the different perspectives in the definitions, family health should be holistically defined, encompass both wellness and illness variables and focus on the interactive, developmental, functional, psychosocial, and health processes of family experience. Therefore, family health may be described as a dynamic process that maintains or changes the relative state of well-being, including elements of family systems, such as biological, psychological, spiritual, and sociocultural aspects. Hence, the FFP focuses on "FAMILY Holistic Health" which is to emphasize a more comprehensive and wide reaching aim and includes physical, mental and social health and well-being.

Over the past six years, the FAMILY project has been working on community-based projects to promote FAMILY 3Hs. Since 2010, the Christian Family Service Centre (CFSC) in collaboration with the School of Public Health of the University of the Hong Kong (HKU) implemented a community-based Learning Families Project (LFP) to promote family health, happiness and harmony (3Hs). As a component of the FAMILY Project, the LFP had built up an effective practice model through collaboration among various project partners and showed good evidence of effectiveness in developing a learning culture in the families, enhancing family communication time and quality, increasing neighborhood cohesion and resilience and promoting FAMILY 3Hs. Therefore, the FFP is developed based on the strong foundation of the LFP in the previous years. In view of the health challenges locally and globally, the new phase of FAMILY project will put more emphasis on health in the upcoming three years. Following the theme on FAMILY 3Hs, the FFP focuses on family holistic health with emphasis on the interaction and integration of both physical and psychosocial health.

In Hong Kong, most 'health projects' only focus on individual's physical health and usually separate physical from mental or psychosocial health. This new project focuses not only on individuals' health but on the whole family and holistic health. The investigators strive to help family members influence each other to have better holistic health. The focus on family is a new and unique concept which is an innovative, long-term and highly sustainable approach at the community level. With the involvement of family members, Hong Kong families can develop and change their lifestyles which impact on families' health. The investigators will use a family-focused approach and adopt a holistic perspective to design a sustainable family holistic health intervention model in the community to meet the global health challenges identified by UN.