A randomized controlled trial of the effectiveness of Zero-time Exercise Intervention for the probationers in Hong Kong: Jockey Club FAMILY Project

Abstract

Purpose:Probationers have poorer physical and psychosocial health, and often experience higher levels of family conflict and lower quality of family relationship. 'Zero-time Exercise(ZTEx) is simple movements and stretching while sitting, standing, walking, watching TV or commuting which requires zero time, zero money and zero equipment(3 Zeros) and can be done by anybody, anytime and anywhere(3As). Under FAMILY: A Jockey Club Initiative for a Harmonious Society, this 3-arm randomized controlled trial examined the effectiveness of using ZTEx and family holistic health approach to enhance probationers' ZTEx, physical activity, physical and psychosocial health, family communication(performing ZTEx with family and praising family members) and family well-being(functioning, health, happiness and harmony). Methods:Probationers under the care of Hong Kong Social Welfare Department were randomized into a brief intervention group(Group A), a combined intervention group (brief intervention plus a group session)(Group B) or a care-as-usual group(Group C, control). Self-administered questionnaires and fitness assessment were used at baseline, 1-month and 3-month follow-up. Focus group interviews were conducted. We analysed by intention-to-treat(missing data replaced by baseline values) with adjustment for age, gender and baseline values of outcome variables. Results/findings:318 participants(51% male) were randomised to Group A(n=108), Group B(n=105) or Group C(n=105). Both Group A and B showed significantly greater increase in family communication and functioning with small to medium effect size, compared with Group C(Cohen's d=0.30-0.76). In addition, Group A showed significantly greater increase in family happiness and health scores and marginally significantly greater increase in subjective happiness and family harmony scores than Group C, with small effect size(Cohen's d=0.25-0.31). Group B showed significantly greater increase in moderate and vigorous physical activity and marginally significantly greater improvement in perceived physical health and physical fitness performance than Group C, with small to medium effect size(Cohen's d=0.25-0.61). Qualitative feedbacks supported the quantitative findings. Conclusions:Our findings have shown preliminary evidence that ZTEx with family holistic health approach was an effective intervention to enhance ZTEX and physical activity, promote family communication and improve family well-being. The ZTEx intervention with family holistic health approach should be further developed and tested, and could be a new intervention model in probation and other services.