The 5-year outcomes of a health-empowerment program on low-income children's behaviors and quality of life

Background: This study aims to evaluate the 5-year impact of a Health Empowerment Program (HEP) on mitigating problematic conducts and enhancing the health-related quality of life (HRQOL) among children living in poverty.

Methods: A prospective cohort study (N = 239, Intervention group: n = 124, Comparison group: n = 115) was established with participants recruited between July 2013 and March 2016 and followed until November 2021. During the 5-year study period, children and their parents from the intervention group were invited to join a multi-dimensional HEP. At baseline and follow-up, both intervention and comparison groups were assessed using the Chinese Strengths and Difficulties Questionnaire (SDQ) and Chinese Child Health Questionnaire Parent Form 28 (CHQ-PF28). Multiple linear regressions were conducted to identify changes in outcome variables as the effect of the HEP.

Results: Upon completion of the 5-year follow-up, children in the intervention group showed a larger decline in conduct problems (B = - 0.66, p <.001), hyperactivity inattention (B = - 0.67, p =.005), and total difficulties score (B = - 1.89, p =.002) of SDQ, a greater increase in prosocial behavior of SDQ (B = 0.53, p =.040), and more substantial enhancement in CHQ-PF28's psychosocial summary score (B = 2.75, p =.017) compared to the comparison group.

Conclusions: HEP is effective in mitigating behavioral problems and improving psychosocial HRQOL of children of low-income families, as evident by this 5-year cohort study.

Trial registration: This study received approval (UW 12-517) from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster.