Zero-time Exercises For Families: The Hong Kong Jockey Club Family Project

Abstract

Physical activity and reducing sedentary behavior have significant health benefits. Successful interventions are scarce and physical inactivity remains a major problem worldwide. We propose “Zero-time Exercise” (ZTEx) as a new approach to promote physical activity, family exercise and well-being in Phase Two of The Hong Kong Jockey Club FAMILY project which aims to promote FAMILY Health, Happiness and Harmony (3Hs). We use a public health approach and positive psychology to promote FAMILY Holistic Health, and collaborate with government and many NGOs to design, implement and evaluate many simple and low-cost community based projects which are evidence-based and evidence-generating, for thousands of participants across ages. (See www.family.org.hk, or YouTube for details). ZTEx are easy, enjoyable and effective (3Es) that can be done with zero time, zero money and zero equipment (3 Zeros) by anybody, anytime and anywhere (3As). ZTEx are simple movements and stretches that can be done while sitting, standing and walking. We have done many presentations and workshops, and found most of the participants admit that they do not have enough physical activity and exercise, although they understand the harms of physical inactivity, and want to be healthier and fitter. We use ZTEx as “a foot-in-the-door approach” to motivate people with sedentary behaviour, and those who do not exercise regularly to start exercising and integrate ZTEx into daily life with their family members. We have conducted different simple and brief workshops on ZTEx in collaboration with several NGOs in different community settings. In June 2015, we were invited by Hong Kong Department of Health to add ZTEx to its series of health talks to older people in all 18 districts for the local Estate Management Advisory Committees of public housing estates. The total duration of the talk was 60 minutes and we were given about 15 minutes in the middle. During June 2015 to Feb 2016, we conducted 18 "mini-workshops", which were the shortest of all our workshops on ZTEx, for 556 residents in public housing estates. During the presentations, we briefly introduced ZTEx to the participants, and invited them to act immediately (such as raising both legs above ground, and do foot pedaling while sitting, and standing on one leg). We encouraged the participants to share what they have learnt and do ZTEx with their family members. We assessed the responses and behavior changes of the participants during and after the workshops, and at two-week follow up by telephone interview. Results (preliminary): Most of the participants were actively involved, enjoyed the session and showed great appreciation. 228 participants (88% female, 66% age ≥ 60 years old, 56% with primary education) completed the interview before the workshops. The evaluation after the workshops (n=150) showed significant improvements in the mean scores of knowledge (4.9 to 5.3, p=0.001, scores ranged from 1 to 6) of and self-efficacy (4.8 to 5.3, p<0.001) to perform ZTEx; and the intention (4.8 to 5.3, p<0.001) and confidence (4.4 to 5.0, p<0.001) to encourage their family members to perform ZTEx. The two-week follow up (n=79) showed significant increases in the practice of ZTEx of the participants (3.1 to 4.8 days in a week, p<0.001), encouraging their family members to perform ZTEx (1.7 to 2.4 days in a week, p=0.014), and their perceived personal (5.5 to 6.3, p=0.017, ranged from 0 to 10) and family health (7.3 to 7.8, p=0.011). Conclusion: These results suggest that ZTEx is an enjoyable and effective innovative approach to enhance physical activity in older people, which would be an easy behavioural change to be integrated into daily family life.