Janet Wing Hung Sit

1. Stroke is a significant threat to global public health, with approximately 94 million people having experienced stroke worldwide (Feigin et al., 2025). While advances in medical treatments have ...

Background: Stroke survivors often encounter difficulties in managing psychosocial health after returning to the community. However, there is limited understanding of their experiences in managing psychosocial health, particularly the strategies they adopted and the challenges they encountered. Objectives: This study explored the experiences of stroke survivors after returning to the community, particularly psychosocial experiences and the strategies adopted for managing psychosocial health. Methods: Semistructured and individual interviews were conducted with participants recruited from community centres and support groups using convenience sampling. Adult stroke survivors living in the community and being able to communicate in Chinese were eligible to participate in this study. Interview data were analysed using thematic analysis with MAXQDA 2020. Results: Twenty‐six participants were interviewed. Three main themes were identified, including (1) setbacks and struggles in regulating emotions, (2) dilemmas in engaging in social activities, and (3) strategies adopted for managing psychosocial health. Conclusion: This study revealed that although survivors have experienced stroke for many years, they still encountered challenges in interacting with others, participating in social activities, and receiving social support. To support psychosocial health following stroke, it is necessary to help them rebuild self‐confidence through various strategies, such as mutual encouragement, being adaptive, and staying positive. In particular, such strategies are suggested to be tailored into group‐based programmes with components of creative expression, support, and motivation, thereby supporting psychosocial health following stroke in the community.

An assessor-blinded randomized controlled trial was conducted to assess the effect of a culturally tailored low-glycaemic index (GI) dietary educational intervention on body mass index and cardiometabolic risks for Chinese people with obesity in Hong Kong. A total of 166 Chinese adults in Hong Kong with obesity were randomized to the intervention group (n = 83) or the control group (n = 83). The intervention group received the culturally sensitive low-GI dietary educational intervention based on the health belief model, consisting of an educational booklet, one individual interactive educational session, and three follow-up telephone calls. The control group received general advice on a healthy diet, including a pamphlet, one individual education session, and three follow-up telephone calls. Outcome measures included body mass index, cardiometabolic risk factors, dietary intake variables, and sense of satiety. Data collection was conducted at baseline and post-intervention at 12 weeks. A generalized estimating equation model was used to compare the difference in changes in outcome variables between groups. Compared with the control group, the intervention group exhibited a significant reduction in dietary glycaemic load (β = −6.963, P = 0.026) at post-intervention. No significant effects were found on other outcomes. A 12-week culturally tailored and health belief model-based low-GI dietary educational intervention significantly reduced the dietary glycaemic load and showed the feasibility of the low-GI dietary intervention in Chinese adults in Hong Kong with obesity. A longer intervention period and follow-up might be required to achieve improvements in reducing cardiometabolic risk factors in people with obesity. ClinicalTrials.gov: NCT04152213

A randomized controlled trial was conducted to examine the effects of a home-based music-paced physical activity programme guided by Information-Motivation-Strategy (IMS) model and Self-determination theory on exercise-related outcomes for patients with coronary heart disease (CHD) after cardiac rehabilitation (CR). A total of 130 patients with CHD from a regional CR centre in Hong Kong were recruited and randomly allocated into intervention (n = 65) or control groups (n = 65). The intervention group received theory-guided practical sessions on performing prescribed home-based physical activity with individualized synchronized music, and follow-up telephone calls. The primary outcome was exercise capacity. Secondary outcomes included exercise self-efficacy, physical activity level, and exercise self-determination. Data were collected at baseline, 3 months, and 6 months after study entry. The generalized estimating equations model was used to assess the intervention effects. Patients with CHD in the intervention group demonstrated significantly greater improvements in exercise capacity at 3 months [β = 35.68, 95% confidence interval (CI) 2.69–68.68, P = 0.034] and significantly improved exercise self-efficacy at 6 months (β = 3.72, 95% CI 0.11–7.32, P = 0.043) when compared with the control group. However, no significant group differences were found in physical activity level and exercise self-determination. The study findings provide evidence on an innovation on improving the exercise capacity and exercise self-efficacy of patients with CHD. The music-paced physical activity guided by the IMS model and Self-determination theory requires further investigation on its long-term effects in future studies. ChiCTR-IOR-17011015.

Aims and Objectives: The study aimed to identify factors associated with participation in Phase II cardiac rehabilitation and to assess patient perceptions towards the usage of technologies in cardiac rehabilitation.Background: Despite efforts to promote utilisation of cardiac rehabilitation (CR), participation among patients remains unsatisfactory. Little is known of patient decision to participate Phase II CR in a multi‐ethnic country.Design: A cross‐sectional study design.Methods: A consecutive sampling of 240 patients with coronary heart disease completed Coronary Artery Disease Education Questionnaire (CADE‐Q) II, Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS) and Cardiac Rehabilitation Barriers Scale (CRBS).Results: Seventy per cent of patients (mean age 60.5 [SD = 10.6] years, 80.8% male) participated in phase II cardiac rehabilitation. Self‐driving to cardiac rehabilitation centres, higher barriers in perceived need/health care and logistical factors were significantly associated with decreased odds of participation. Patients with more barriers from comorbidities/functional status, higher perceived social support from friends, and anxiety were more likely to participate. Chinese and Indians were less likely to participate when compared with Malays. More than 80% of patients used both home and mobile broadband internet, and 72.9% of them would accept the usage of technologies, especially educational videos, instant messenger, and video calls to partially replace the face‐to‐face, centre‐based cardiac rehabilitation approach.Conclusion: Several barriers were associated with non‐participation in phase II cardiac rehabilitation. With the high perceived acceptance of technology usage in cardiac rehabilitation, home‐based and hybrid cardiac rehabilitation may represent potential solutions to improve participation.Relevance to clinical practice: By addressing the barriers to cardiac rehabilitation, patients are more likely to be ready to adopt health behaviour changes and adhere to the cardiac rehabilitation programme. The high perceived acceptance of using technologies in cardiac rehabilitation may provide insights into new delivery models that can improve and overcome barriers to participation.

The urban–rural gap in cervical cancer screening uptake is a significant public health consideration. Educational interventions are commonly adopted to promote cervical cancer screening among females in rural areas; however, the characteristics and effectiveness of these educational interventions remain unclear. In this review, we aimed to identify the characteristics of educational interventions used in rural populations and to evaluate the effects of these interventions on cervical cancer screening-related outcomes. Seven English databases were searched in January 2022. Randomized controlled trials (RCTs) and quasi-experimental studies were included. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Randomized Controlled Trials and the JBI Critical Appraisal Checklist for Quasi-Experimental Studies were used for quality appraisal. RevMan 5.4 software was used for the meta-analysis. A narrative synthesis was conducted in instances where a meta-analysis was inappropriate. Three RCTs and seven quasi-experimental studies conducted in six countries were included. A social cognitive theory-based framework, the community setting, group sessions, healthcare professional-led approaches, and culture-tailored materials were implemented in the educational interventions for cervical cancer screening. The educational content mainly included basic information on cervical cancer screening, psychological issues, barriers and strategies to overcome them, and locally available resources. Educational interventions increased the knowledge and uptake of cervical cancer screening in the rural population. However, the studies only evaluated the short-term effects of these educational interventions, with the cervical screening behavior only being assessed in one instance for each participant. Educational interventions promote cervical cancer screening among females in rural areas. Theory-driven, community-involved, group-based, and healthcare professional-led approaches should be prioritized in the application of educational interventions in rural populations. Both the short- and long-term, influences of educational interventions on the cervical cancer screening behavior of females in rural areas need to be recognized.