Healthy Diet, Mental Health Wellness
Conditions
Keywords
social support, weight management, emotional support, online support groups, eating behavior, mental health, informational support
Brief summary
The goal of this study is to test the effect of informational and emotional social support (via nutrition education, mental health support, and/or baking classes) through two different communication modalities (online vs. mixed mode / hybrid) on physical and mental health outcomes Our research questions are the following. 1. Does an online social support program that provides informational and emotional support improve diet, anthropometry, and mental health? 2. Does a mixed-mode social support program that provides informational, emotional support through both online and face-to-face mode improve diet, anthropometry, and mental health? 3. Is a mixed mode social support program more effective in improving outcomes? Does meeting the group members face-to-face change the dynamics of online communication? If yes, what are the mechanisms? Are there differences in the following outcomes by communication modality? 1. Online bonding 2. Group identity 3. Quality of relationship
Detailed description
Study design: Randomized controlled trial 1. Study description Filipino Migrant Domestic workers (MDWs) working in Hong Kong will be eligible to apply. The investigators will advertise in Newspapers and Facebook commonly read by Filipino MDWs in Hong Kong. The investigators will recruit 400 MDWs over two phases and randomly assign them across three arms, T1) mixed-mode social support program; T2) Online social support program; and C) Control. Online social support program will be delivered through WhatsApp group chat. MDWs will self-fill surveys at Caritas office, but surveys will be assisted by survey enumerators as a group. 2. Logistics Due to administrative constraints delivering interventions to 400 participants at the same time, the investigators will deliver interventions over two cohorts. Cohort 1 (\ 200 participants) * Oct 31st-Dec 18th 2022 Baseline survey * Jan 8th-March 18th 2023 Intervention (10 weeks) * March 26th -April 16th 2023 Follow-up survey Cohort 2 (\ 200 participants) * Feb 5th-March 19th 2023 Baseline survey * March 20th-May 27th Intervention (10 weeks) * May 28th - June 25th follow-up survey Note 1: The investigators will enroll participants until the scheduled date for baseline survey or until the investigators recruit target sample size, whichever comes earlier. Note 2: The investigators will keep the intervention design exactly the same for cohort 1 and cohort 2, and will not analyze data until data collection for both cohort 1 and cohort 2 is complete. Cohort 1 and cohort 2 will be analyzed as one sample. 3. Statistical analysis model - Estimation of treatment effect In this section, the investigators outline the basic estimation approach to measuring the effect of the treatments on various outcomes. Our basic treatment effects specification estimates the following equation: y= β₀ + β₁T1 + β₂T2+ β₃X+ ε where y is the outcome of interest. T1 and T2 are dummy variables equal to 1 if the participant was randomly assigned to the T1 and T2 group, respectively, and 0 otherwise. β₁ and β₂ represent the effect of being assigned to the specific treatment arm. X is a vector of baseline outcome and individual's characteristics including age, marital status, years working as migrant domestic workers, level of education, received food allowance. ε is an error term. The primary outcome variable, y, include nutrition knowledge, perceived social support, healthy diet, stress, anxiety, and depression. To compare the difference between T1 and T2, we will use F-test coefficient of equality.
Interventions
BEHAVIORALT1: Mixed mode social support group
This group will receive programs in both online and off-line setting. There will be one face-to-face group session to get to know participant's peer group members. After the in-person group meeting, participants will meet in WhatsApp group. In WhatsApp group, facilitator will provide the following program 1. In person get to know your group member activities 2. Nutrition information through WhatsApp 3. Tips and advice to maintain good mental health through WhatsApp 4. Motivational messages through WhatsApp 5. Reminder through WhatsApp 6. In-person baking class x 1 session
BEHAVIORALT2: Online mode social support group
This group will receive the same program as mixed mode social support group. The key differences would be delivery of all program components online. 1. Online get to know your group member activities 2. Nutrition information through WhatsApp 3. Tips and advice to maintain good mental health through WhatsApp 4. Motivational messages through WhatsApp 5. Reminder through WhatsApp 6. Online baking class x 1 session through WhatsApp
Sponsors
Hong Kong University of Science and Technology
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
Baseline survey, follow-up survey, and anthropometry measurement will be collected through assessor masked to assignment details.
Intervention model description
The investigators are providing informational and emotional social support (nutrition, mental health, baking classes) through two different communication modalities (online vs. mixed mode) whose effects will be contrasted against each other and a third, control, condition. Treatment 1: Mixed-mode social support group Treatment 2: Online social support group Control: No intervention
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
Yes
Inclusion criteria
* Filipino * Migrant domestic worker working in Hong Kong
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety (change) | Change from baseline mental health at approximately 3-6 months. | Screen for anxiety using DASS-21 questionnaire, survey questionnaire, score range (0-42), higher score means worse outcome |
| Stress (change) | Change from baseline mental health at approximately 3-6 months. | Screen for stress using DASS-21 questionnaire, survey questionnaire (score range (0-42), higher score means worse outcome |
| Nutrition knowledge score (change) | Change from baseline nutrition knowledge at approximately 3-6 months. | Questions to test nutrition knowledge, survey questionnaire (score range 0-17, higher score means better outcome) |
| Healthy diet practices (change) | Change from baseline diet practices at approximately 3-6 months. | Questions adapted from starting the conversation (STC) food frequency instrument, scale range 0-50, higher score means better outcome, survey questionnaire |
| Perceived social support (change) | Change from baseline perceived social support at approximately 3-6 months. | Participant's perceived social support score, scale adapted from Oslo social support scale (OSSS-3), survey questionnaire, higher score means better outcome. |
| Depression (change) | Change from baseline mental health at approximately 3-6 months. | Screen for depression using DASS-21 questionnaire, survey questionnaire, score range (0-42), higher score means worse outcome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peer pressure | measured at end-line only (3-6 months after baseline survey) | 10 questions: 5 point scale (strongly agree to strongly disagree), survey questionnaire |
| Self-efficacy (change) | Change from baseline self-efficacy at approximately 3-6 months. | four questions, General self-efficacy scale (GSE) survey questionnaire, score range 0-30, higher score means better outcome |
| Body mass index (change) | Change from baseline BMI at approximately 3-6 months. | kg/m2, anthropometry measurements |
| Waist-to-hip ratio (change) | Change from baseline waist-to-hip ratio at approximately 3-6 months. | waist circumference (cm) /hip circumference (cm), anthropometry measurements |
| Waist-to-stature ratio (change) | Change from baseline waist-to-stature ratio at approximately 3-6 months. | Waist circumference (cm)/Height (cm), anthropometry measurements |
| Group identity | measured at end-line only ( 3-6 months after baseline survey) | 4 questions: 5 point scale (strongly agree to strongly disagree) , survey questionnaire |
| Online bonding | measured at end-line only (3-6 months after baseline survey) | 10 questions: 5 point scale (strongly agree to strongly disagree), survey questionnaire |
Other
| Measure | Time frame | Description |
|---|---|---|
| Weight (change) | Change from baseline weight at approximately 3-6 months. | measured in kg |
| Stress (change) | Change from baseline at approximately 3-6 months. | Created dummy variable (moderate or above) from stress score using DASS-21 questionnaire, survey questionnaire |
| Anxiety (change) | Change from baseline at approximately 3-6 months. | Created dummy variable (moderate or above) from anxiety score using DASS-21 questionnaire, survey questionnaire |
| Depression (change) | Change from baseline at approximately 3-6 months. | Created dummy variable (moderate or above) from depression score using DASS-21 questionnaire, survey questionnaire |
| Hip circumference (change) | Change from baseline hip circumference at approximately 3-6 months. | measured in cm |
| Waist circumference (change) | Change from baseline waist circumference at approximately 3-6 months | measured in cm |
Countries
Hong Kong
Contacts
Primary ContactYaeeun Han
Outcome results
None listed