Li William Ho Cheung, Wong Eliza Lai-Yi, Xia Wei, Chen Hong, Tsui Sik-Hon, Chan Yiu Cheung, Cheung Kai Yeung, Leung Yuen Fan, Ho Long Kwan Laurie, Choi Kai Chow, Chung Oi-Kwan Joyce
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
PLoS One. 2025 Jul 3;20(7):e0327558. doi: 10.1371/journal.pone.0327558. eCollection 2025.
Noncommunicable diseases (NCDs) have become the leading contributors to morbidity and mortality worldwide, responsible for 74% of all deaths. The major risk factors that substantially contribute to and significantly increase the risk of dying from NCDs include tobacco and alcohol use, unhealthy diet, and physical inactivity. Proactive prevention strategies are vital in reducing the burden. Presenting at the emergency department (ED) can be an excellent "teachable moment" to intervene for unhealthy behaviors because people seeking medical treatment from doctors at EDs may be more motivated to adopt healthy lifestyles. We aim to examine the effectiveness of a general health promotion intervention based on self-determination theory in helping ED attendees adopt a healthy lifestyle. A randomized clinical trial will be conducted on Chinese adults aged ≥18 years attending the EDs of five major acute care hospitals in Hong Kong. Participants will be randomized 1:1 into intervention and control groups (n = 586 per group). Intervention group will receive a brief telephone intervention using the AWARD (Ask, Warn, Advise, Refer and Do-it-again) model, weekly personalized instant messages and four 1-minute videos focused on the desired behaviors via WeChat/WhatsApp, and follow-up assessments of behavior changes at 3, 6, and 12 months. While control group will receive similar brief intervention which only advises them to adopt a healthy lifestyle, similar number of SMS messages containing only general health advice, and follow-up assessments at same schedule with the intervention group. Outcome measures include the composite event rate of adopting at least one of the four healthy lifestyles at 6 (primary outcome) and 12 months measured by a behavioral risk-factor questionnaire and improvement in health-related quality of life at 6 and 12 months measured by the EuroQoL 5-Dimension 5-level (EQ-5D-5L) questionnaire. Ethical approval has been obtained. This trial is registered at ClinicalTrials.gov on March 17, 2025: NCT06889792.
非传染性疾病（NCDs）已成为全球发病和死亡的主要原因，占所有死亡人数的74%。导致非传染性疾病死亡风险大幅增加的主要风险因素包括烟草和酒精使用、不健康饮食以及身体活动不足。积极的预防策略对于减轻负担至关重要。在急诊科（ED）就诊可能是干预不健康行为的绝佳“教育时机”，因为在急诊科向医生寻求医疗救治的人可能更有动力采取健康的生活方式。我们旨在研究基于自我决定理论的一般健康促进干预措施在帮助急诊科就诊者采取健康生活方式方面的有效性。将对香港五家主要急症医院急诊科中年龄≥18岁的中国成年人进行一项随机临床试验。参与者将按1:1随机分为干预组和对照组（每组n = 586）。干预组将接受使用AWARD（询问、警告、建议、转介和再次行动）模型的简短电话干预、每周个性化即时消息以及通过微信/WhatsApp发送的四个关注期望行为的1分钟视频，并在3个月、6个月和12个月时对行为变化进行随访评估。而对照组将接受类似的简短干预，仅建议他们采取健康的生活方式，数量相似的仅包含一般健康建议的短信，以及与干预组相同时间表的随访评估。结局指标包括通过行为风险因素问卷测量的在6个月（主要结局）和12个月时采用四种健康生活方式中至少一种的复合事件率，以及通过欧洲五维健康量表（EQ - 5D - 5L）问卷测量的在6个月和12个月时健康相关生活质量的改善情况。已获得伦理批准。该试验于2025年3月17日在ClinicalTrials.gov注册：NCT06889792。
