「心澄體靜。抗疫工作坊」首份成效研究報告 (英文)

Title

A pilot trial of a brief online body-mind-spirit program to promote positive emotions and psychological well-being during COVID-19

Author
Shirley Man-man Sit*1,3, Patricia Lai-ping Szeto2, Michael Sit-kei Ip2, Hilary Pui-yee Ho1, Man-ping Wang3, Sai-yin Ho1, Tai-hing Lam1, Agnes Yuen-kwan Lai3
Authors' Affiliation
1 School of Public Health, The University of Hong Kong, Hong Kong
2 Caritas-Hong Kong, Hong Kong
3 School of Nursing, The University of Hong Kong, Hong Kong

Background

The COVID-19 pandemic has led to negative emotions in the community. Promotion and support for practicing self-care to enhance personal well-being is greatly needed yet lacking. The body-mind-spirit (BMS) model adopts a holistic approach in promoting the self-connection and care of one’s physical, mental and spiritual needs. Its application is used in primarily remedial contexts to enhance health and well-being, and could be a useful approach to promote positive emotions and psychological well-being among community participants of different age groups during the pandemic.

Objective

We aimed to examine the feasibility of a BMS pilot program in enhancing positive emotions and psychological well-being among Hong Kong adults during the pandemic. We also tested the acceptability of conducting a traditional face-to-face program in an online format, and explored any differences between different sex and age groups.

Methods

The online BMS pilot program was developed with academic-community collaboration and an interdisciplinary team of social work, public health and nursing professionals from Caritas-Hong Kong and the University of Hong Kong and supported by the “Sir Robert Kotewall Professorship in Public Health” fund. The program was implemented starting in October 2020 via a 2-hour online experiential session with three components: i) meridian exercises and physical activity; ii) mindful and healthy eating; and iii) relaxation exercises and arts therapy. Participants were recruited through Caritas Integrated Family Service Centre - Tsuen Wan (East) Facebook and Facebook advertismen, invited to attend a single session workshop, and completed evaluation questionnaires at three time-points: i) at baseline before joining the session; ii) immediately after the session; and iii) one month after the session. We assessed participants’ program satisfaction, and changes in positive (happiness) and negative (stress and symptoms of anxiety and depression) emotions, and health-related behaviours. Positive emotion was measured by the Subjective Happiness Scale (SHS), while negative emotions were measured by the Perceived Stress Scale (PSS-4) and Patient-Health Questionnaire (PHQ-4). Health-related behavioural changes were measured by the number of days per week engaged in different activities. Independent and paired T-tests were used to examine the between-group and within-group differences, respectively. Qualitative evaluation was also conducted via focus group interviews after one-month follow-up.

Results

Up to January 2021, 65 participants (89.2% female, 15.4% aged 55 and above) have joined the program and completed one-month follow-up. Immediately after the session, participants reported satisfaction scores for the overall program and on the use of an online format for the program with mean 8.1 and 7.4 out of 10, respectively, with no significant differences between age group and sex. At one-month follow-up, 75.4% and 69.2% of participants reported sharing the content they learned to family and friends and recommended this program to others, respectively. Participants reported improved positive emotion with higher SHS score (mean 4.0 to 4.4 out of 7, Effect size (ES) = 0.36, P < 0.001) and reduced negative emotions with lower PSS-4 (mean 8.5 to 7.5 out of 16, ES = 0.36, P < 0.001) and PHQ-4 (mean 8.1 to 6.7 out of 12, ES = 0.32, P = 0.001) scores. Participants also reported improvements in health-related behaviours, including increases in days of engaging in i) physical activity, such as stretching or jogging (mean 2.1 to 4.0 days in a week, ES = 0.97); ii) mindful and healthy eating (mean 1.9 to 3.8 days in a week, ES = 0.98), and iii) relaxation exercises, such as meditation (mean 1.8 to 3.9 days in a week, ES = 0.83) (all P < 0.001). Qualitative feedback from participants during the focus group interviews reported increased awareness and use of different BMS components to enhance positive emotions and reduce stress during the pandemic. They expressed enjoyment in learning about BMS and that the components were easy to integrate into their daily lives.

Conclusions

Preliminary results from our ongoing pilot BMS program showed a high satisfaction score among participants of different sex and age groups. Improvements in positive emotions and health-related behaviours, and reduction in perceived stress and symptoms of anxiety and depression suggest the preliminary evidence of the BMS approach to help promote personal well-being. With the pandemic posing obvious challenges for traditional face-to-face workshops, positive results from this pilot trial also suggest the potential for brief online interventions to be conducted as part of community-based preventive mental health promotion efforts.