Publications by authors named "Kee Lee Chou"

Background: Caregiver stress can pose serious health and psychological concerns, highlighting the importance of timely interventions for family caregivers of people with dementia. Single-session mindfulness-based interventions could be a promising yet under-researched approach to enhancing their mental well-being within their unpredictable, time-constrained contexts. This trial will evaluate the effectiveness and feasibility of a blended mindfulness-based intervention consisting of a single session and app-based follow-up in reducing caregiver stress.

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Background: Loneliness is a prevalent and alarming issue among older adults that requires effective interventions. While randomised controlled trials have been commonly undertaken to explore reduction in loneliness, there is a growing recognition that a comprehensive treatment strategy involving multiple interventions may yield better outcomes. Therefore, this study aims to develop and identify a two-stage adaptive intervention that combines telephone-delivered behavioural activation (Tele-BA) and mindfulness techniques (Tele-MF) to reduce loneliness in older adults in Hong Kong.

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Objective: In this three-armed RCT, we tested the effects of a telephone-delivered wisdom enhancement narrative therapy-based intervention (Tele-NT) and a telephone-delivered empathy-focused intervention (Tele-EP) in reducing loneliness against an active control group that received regular call (ACG) at the 4-week follow-up assessment.

Design, Setting, Intervention, And Participants: To evaluate the effects of the interventions on loneliness, we randomized 287 older adults based in Hong Kong, ages 65 to 90, into Tele-NT (N = 97), Tele-EP (N = 95), or ACG (N = 95).

Measurement: The primary outcome was loneliness, calculated using the De Jong Gierveld Scale and the UCLA Loneliness Scale.

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Importance: Older adults are particularly vulnerable to loneliness and its physical and psychosocial sequelae, but scalable interventions are lacking, especially during disasters such as pandemics.

Objective: To compare the effects of layperson-delivered, telephone-based behavioral activation and mindfulness interventions vs telephone-based befriending on loneliness among at-risk older adults.

Design, Setting, And Participants: This assessor-blinded, 3-arm randomized clinical trial screened Chinese older adults through household visits and community referrals from April 1, 2021, to April 30, 2023, in Hong Kong.

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Background: Poverty, as a risk factor for loneliness, has been understudied, and there is a need to gain a better understanding of the relationship between poverty examined by material deprivation and loneliness among older adults in Hong Kong. It also aimed to explore the possible mediation and moderation effects of social support, social networks, neighborhood collective efficacy, and social engagement in the link between material deprivation and loneliness.

Methods: 1696 Chinese older adults aged 60 years and above (M = 74.

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Background: Interventions to reduce loneliness in older adults usually do not show sustained effects. One potential way to combat loneliness is to offer meaningful social activities. Volunteering has been suggested as one such activity - however, its effects on loneliness remain to be tested in randomized controlled trials (RCT).

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Objective: To determine the beneficial effects of volunteering as lay counselor via telephone on own loneliness, social network engagement, perceived social support, stress, anxiety, and depressive symptoms among Chinese older adults in Hong Kong during the COVID-19 pandemic. DESIGN, SETTING, INTERVENTION, AND PARTICIPANTS: "Helping Alleviate Loneliness in Hong Kong Older Adults" (HEAL-HOA), a dual randomized controlled trial, was implemented to test effects of telephone-based psychosocial interventions delivered by older-adult volunteers for low-income lonely older adults. To evaluate the effects of volunteering on loneliness, we randomized 375 individuals ages 50-70 into a volunteering condition versus an active control (psychoeducation with social gatherings).

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Background: Family caregiver interventions are essential to support dementia caregiving. However, such interventions are typically complex and consist of multiple components. Existing evidence rarely delineates the effectiveness and interactions between individual components.

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Objectives: Family caregivers of people with dementia (FC-of-PWD) suffer from a high level of stress and depressive symptoms, which usually require different interventions at different stages. Although some standalone interventions such as behavioural activation (BA) and mindfulness practice (MP) have been shown to be potentially effective at reducing depressive symptoms, the best sequence and combination of these interventions for caregivers are unknown. This study aims to develop and identify a two-stage adaptive intervention with prespecified rules guiding whether, how or when to offer different interventions initially/over time to reduce depressive symptoms in FG-of-PWD.

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A social pension, regarded as a reliable source of income, has the potential to significantly influence the overall wellbeing of vulnerable older adults. This study aimed to extend the understanding of the effects of social pension expansion beyond its economic impacts to encompass recipients' health status. Using three-wave data from a representative sample of older adults, we employed a quasi-experimental assessment model to evaluate the impact of a recent social pension expansion in Hong Kong on health-related consumption and health outcomes among older adults.

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Despite the soaring demand for long-term care (LTC) services in aging societies, dedicated risk-pooling mechanisms are largely absent. Private insurance has been advocated but the market remains small. This study seeks to unravel this paradox through an empirical study in Hong Kong, a super-aging society.

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Depressive symptomatology is associated with caregiver burden and poor health outcomes among dementia caregivers. Scholars called for a paradigm shift to focus on positive aspects of caregiving, in particular, meaning making during the caregiving journey. This study draws on the meaning making model and a generation perspective to predict depression among dementia caregivers from two generations, including Baby Boomers who were born between 1946 and 1964 and Generation X who were born between 1965 and 1980, using a configuration approach.

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Poverty indicators such as income-based poverty, material deprivation, asset-based poverty, and expenditure-based poverty each carries an aspect of economic deprivation. This current study examined and compared the unique effects of each poverty dimension on life satisfaction during old age. We measured four poverty indicators-life satisfaction, social resources, physical health, and mental well-being-in a three-wave sample of older Hong Kong adults ( = 563).

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Background: It is well-documented that socioeconomic status (SES) and academic performance in school-aged children are closely related. However, little is known about how the three core executive functions (EFs), inhibition, working memory, and cognitive flexibility, mediate the association between the two. Moreover, most previous studies examined SES disparities in Western countries, how such disparities in EF and academic performance manifest in the Chinese context, where a distinctive EF profile and learning experience are observed, remains uncertain.

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The need for family-friendly policies to balance work and life demands is growing. Many studies have addressed how family-friendly policies relate to a variety of employees' work attitudes and behavioral outcomes, but not how they (positively or negatively) affect them, especially the affective components of family-friendly policies that provide "felt" support to an employee. To fill this gap, this study adopts a moderated mediating mechanism to analyze how affective components of family-friendly policies impact employees' attitudes and behaviors through signaling and social exchange theory.

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Rationale: Depression should be investigated not only as a psychiatric symptom but also as a social issue. This research responds to recent calls and contributes to an understanding of the role played by social factors in the route toward the development of depressive symptoms.

Objective: Our aim was to elaborate on the impact of poverty on depressive symptoms among Hong Kong's older people.

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There is a stark contrast between rising long-term care (LTC) demands and limited financing capacity in many ageing societies. Despite the theoretical potential of private insurance in LTC financing reforms, the reality is that the market remains remarkably underdeveloped. This study adopts a novel two-phase approach to quantitatively examine the market demand for private long-term care insurance (LTCI) in Hong Kong, one of the world's super-ageing societies.

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Long-term volunteering has been associated with better physical, mental, and cognitive health in correlational studies. Few studies, however, have examined the longitudinal benefits of volunteering with randomized experimental designs (e.g.

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Introduction: Educators and policymakers promote political participation in young people as a means to strengthen the legitimacy of democracy. Creative social media use has grown in popularity in the digital age; however, this creative usage still receives inadequate attention in the literature-particularly its association with political participation.

Method: This study collected three-wave panel data from a sample of young people living in Hong Kong (56.

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Background And Objectives: Volunteering has consistently been associated with better mental, physical, and cognitive health in older adulthood. However, the volunteering rate of older adults in Hong Kong is much lower than in Western countries. Few studies have examined whether interventions can be effective in motivating older adults to volunteer in Hong Kong.

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Background: Volunteering could be a win-win opportunity for older adults: Links between volunteering and societal improvements as well as older adults' own health and longevity are found in several observational studies. RCTs to increase volunteering in older adults are however sparse, leaving the question of causality unanswered. This study protocol describes a theory-based social-cognitive intervention with multiple behavior change techniques to increase volunteering among community-dwelling older adults in Hong Kong.

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Retirees without annuities in Hong Kong confront longevity and investment risks. Despite these risks, there is very limited uptake of annuities. This study identifies product and consumer characteristics that are associated with the demand for annuities in Hong Kong.

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The role of social exclusion in depressive symptoms in older people has not been examined systematically. This study examines the associations of social exclusion, income poverty, and financial strain with depressive symptoms and evaluates the moderating effect of social support in the link between social exclusion and depressive symptoms. Our sample consisted of 850 older people (65 years old or above) in Hong Kong randomly selected through a household survey.

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Despite the potential of private insurance in financing long-term care (LTC), its coverage remains rather limited. This study is built on a comprehensive framework to examine the demand for LTC insurance in Hong Kong, a rapidly aging Asian society. A telephone survey was conducted in 2016 to collect data that formed a sample of 1,474 middle-aged and older adults.

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Objectives: Examine the association of income poverty and material deprivation with depression in old age.

Methods: Our data contains a survey of 1,959 older Chinese adults in Hong Kong. We used the Geriatric Depression Scale - Short Form to assess their depressive symptoms.

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