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The goal of this study is to test the effect of informational and emotional social support (via nutrition education, mental health support, and/or baking classes) through two different communication modalities (online vs. mixed mode / hybrid) on physical and mental health outcomes
Our research questions are the following.
Does an online social support program that provides informational and emotional support improve diet, anthropometry, and mental health?
Does a mixed-mode social support program that provides informational, emotional support through both online and face-to-face mode improve diet, anthropometry, and mental health?
Is a mixed mode social support program more effective in improving outcomes? Does meeting the group members face-to-face change the dynamics of online communication? If yes, what are the mechanisms? Are there differences in the following outcomes by communication modality?
Study design: Randomized controlled trial
Study description
Filipino Migrant Domestic workers (MDWs) working in Hong Kong will be eligible to apply. The investigators will advertise in Newspapers and Facebook commonly read by Filipino MDWs in Hong Kong. The investigators will recruit 400 MDWs over two phases and randomly assign them across three arms, T1) mixed-mode social support program; T2) Online social support program; and C) Control. Online social support program will be delivered through WhatsApp group chat. MDWs will self-fill surveys at Caritas office, but surveys will be assisted by survey enumerators as a group.
Logistics
Due to administrative constraints delivering interventions to 400 participants at the same time, the investigators will deliver interventions over two cohorts.
Cohort 1 (~200 participants)
Cohort 2 (~200 participants)
Note 1: The investigators will enroll participants until the scheduled date for baseline survey or until the investigators recruit target sample size, whichever comes earlier.
Note 2: The investigators will keep the intervention design exactly the same for cohort 1 and cohort 2, and will not analyze data until data collection for both cohort 1 and cohort 2 is complete. Cohort 1 and cohort 2 will be analyzed as one sample.
Statistical analysis model - Estimation of treatment effect
In this section, the investigators outline the basic estimation approach to measuring the effect of the treatments on various outcomes.
Our basic treatment effects specification estimates the following equation:
y= β₀ + β₁T1 + β₂T2+ β₃X+ ε where y is the outcome of interest.
T1 and T2 are dummy variables equal to 1 if the participant was randomly assigned to the T1 and T2 group, respectively, and 0 otherwise. β₁ and β₂ represent the effect of being assigned to the specific treatment arm. X is a vector of baseline outcome and individual's characteristics including age, marital status, years working as migrant domestic workers, level of education, received food allowance. ε is an error term. The primary outcome variable, y, include nutrition knowledge, perceived social support, healthy diet, stress, anxiety, and depression. To compare the difference between T1 and T2, we will use F-test coefficient of equality.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| T1: Mixed mode social support group | Experimental | This group will receive programs in both online and off-line setting. There will be one face-to-face group session to get to know participant's peer group members. After the in-person group meeting, participants will meet in WhatsApp group. In WhatsApp group, facilitator will provide the following program |
|
| Online social support group | Experimental | This group will receive the same program as mixed mode social support group. The key differences would be delivery of all program components online. |
|
| Control | No Intervention | This is the control group. Control group will only participate in baseline and follow-up survey |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| T1: Mixed mode social support group | Behavioral | This group will receive programs in both online and off-line setting. There will be one face-to-face group session to get to know participant's peer group members. After the in-person group meeting, participants will meet in WhatsApp group. In WhatsApp group, facilitator will provide the following program
|
| Measure | Description | Time Frame |
|---|---|---|
| Nutrition knowledge score (change) | Questions to test nutrition knowledge, survey questionnaire (score range 0-17, higher score means better outcome) | Change from baseline nutrition knowledge at approximately 3-6 months. |
| Perceived social support (change) | Participant's perceived social support score, scale adapted from Oslo social support scale (OSSS-3), survey questionnaire, higher score means better outcome. | Change from baseline perceived social support at approximately 3-6 months. |
| Healthy diet practices (change) | Questions adapted from "starting the conversation (STC)" food frequency instrument, scale range 0-50, higher score means better outcome, survey questionnaire | Change from baseline diet practices at approximately 3-6 months. |
| Stress (change) | Screen for stress using DASS-21 questionnaire, survey questionnaire (score range (0-42), higher score means worse outcome | Change from baseline mental health at approximately 3-6 months. |
| Anxiety (change) | Screen for anxiety using DASS-21 questionnaire, survey questionnaire, score range (0-42), higher score means worse outcome | Change from baseline mental health at approximately 3-6 months. |
| Depression (change) | Screen for depression using DASS-21 questionnaire, survey questionnaire, score range (0-42), higher score means worse outcome | Change from baseline mental health at approximately 3-6 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Body mass index (change) | kg/m2, anthropometry measurements | Change from baseline BMI at approximately 3-6 months. |
| Waist-to-hip ratio (change) | waist circumference (cm) /hip circumference (cm), anthropometry measurements |
| Measure | Description | Time Frame |
|---|---|---|
| Weight (change) | measured in kg | Change from baseline weight at approximately 3-6 months. |
| Waist circumference (change) | measured in cm | Change from baseline waist circumference at approximately 3-6 months |
Inclusion Criteria:
Exclusion Criteria:
Female will be eligible to participate. Participant eligibility is based on self-representation.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yaeeun Han | Contact | +85253004009 | yehan@ust.hk |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hong Kong University of Science of Technology | Recruiting | Hong Kong | Hong Kong |
The investigators will share the study protocol, analysis plan, informed consent form, and study report for up to 5 years after the study is published.
Immediately after the study is accepted for publication, and available for 5 years
Those who want access will be asked to contact the Principal Investigator via email.
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The investigators are providing informational and emotional social support (nutrition, mental health, baking classes) through two different communication modalities (online vs. mixed mode) whose effects will be contrasted against each other and a third, control, condition.
Treatment 1: Mixed-mode social support group Treatment 2: Online social support group Control: No intervention
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Baseline survey, follow-up survey, and anthropometry measurement will be collected through assessor masked to assignment details.
|
| T2: Online mode social support group | Behavioral | This group will receive the same program as mixed mode social support group. The key differences would be delivery of all program components online.
|
|
| Change from baseline waist-to-hip ratio at approximately 3-6 months. |
| Waist-to-stature ratio (change) | Waist circumference (cm)/Height (cm), anthropometry measurements | Change from baseline waist-to-stature ratio at approximately 3-6 months. |
| Self-efficacy (change) | four questions, General self-efficacy scale (GSE) survey questionnaire, score range 0-30, higher score means better outcome | Change from baseline self-efficacy at approximately 3-6 months. |
| Group identity | 4 questions: 5 point scale (strongly agree to strongly disagree) , survey questionnaire | measured at end-line only ( 3-6 months after baseline survey) |
| Online bonding | 10 questions: 5 point scale (strongly agree to strongly disagree), survey questionnaire | measured at end-line only (3-6 months after baseline survey) |
| Peer pressure | 10 questions: 5 point scale (strongly agree to strongly disagree), survey questionnaire | measured at end-line only (3-6 months after baseline survey) |
| Hip circumference (change) | measured in cm | Change from baseline hip circumference at approximately 3-6 months. |
| Depression (change) | Created dummy variable (moderate or above) from depression score using DASS-21 questionnaire, survey questionnaire | Change from baseline at approximately 3-6 months. |
| Anxiety (change) | Created dummy variable (moderate or above) from anxiety score using DASS-21 questionnaire, survey questionnaire | Change from baseline at approximately 3-6 months. |
| Stress (change) | Created dummy variable (moderate or above) from stress score using DASS-21 questionnaire, survey questionnaire | Change from baseline at approximately 3-6 months. |
| ID | Term |
|---|---|
| D005247 | Feeding Behavior |
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D001522 | Behavior, Animal |
| D001519 | Behavior |
| D010549 | Personal Satisfaction |
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