Non Communicable DiseasesNCT06889792
Prevent Non-communicable Diseases Through Screening and Educating Emergency Department Attendees to Adopt Healthy Lifestyles
A study testing Theory of planned behaviour, Foot-in-the-door technique and Self-determination theory in people with Non Communicable Diseases and Health-risk Behaviours, run by Chinese University of Hong Kong at 1 site in Hong Kong.
Trial summary
Objective: To examine the effectiveness of a general health promotion intervention based on self-determination theory in proactively helping emergency department (ED) attendees to adopt healthy lifestyles. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non Communicable Diseases, Health-risk Behaviours
- What is being tested?
- Theory of planned behaviour, Foot-in-the-door technique and Self-determination theory
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,172 participants
- Where
- 1 siteHong Kong
- Study dates
- 10 Jun 2025to 31 Jan 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- being aged ≥18 years old Chinese
- being triaged as semi-urgent (level 4) or non-urgent (level 5) and discharged home on the same day after receiving medical attention
- having at least one health risk behaviour (tobacco use, harmful alcohol consumption, unhealthy diet, and physical inactivity)
- owning a smartphone and having an ability to use instant messaging applications (e.g. WhatsApp or WeChat).
Who cannot join
- having a poor cognitive state or mental illness
- being diagnosed with NCDs and undergoing regular follow-ups in outpatient clinics
- participating in another related study
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Hong Kong1 site, 1 recruiting
- Recruiting
The Nethersole School of Nursing, The Chinese University of Hong Kong
Hong Kong
Ho Cheung William Li, PhD, +85239430889 ext. williamli@cuhk, williamli@cuhk.edu.hk
About this study
Official title: A Proactive Approach to Prevent Non-communicable Diseases Through Screening and Educating Emergency Department Attendees to Adopt Healthy Lifestyles: A Randomised Clinical Trial
Objective: To examine the effectiveness of a general health promotion intervention based on self-determination theory in proactively helping emergency department (ED) attendees to adopt healthy lifestyles.
Hypothesis to be tested: A general health promotion intervention based on self-determination theory will be effective in helping people adopt healthy lifestyles.
Read more
Design and subjects: The investigators will conduct a randomised controlled trial involving 1,172 ED attendees from five major acute care hospitals in Hong Kong.
Instruments: A behavioural risk factor questionnaire will be used to identify participants' health risk behaviours and document their blood pressure and body mass index. The EuroQoL 5-Dimension 5-level will be used to assess participants' quality of life.
Interventions: Participants in the intervention group will receive a brief health warning and advice on health-risk behaviours. In addition, participants will be asked about their priority in engaging in healthy lifestyles. Moreover, participants will receive WhatsApp/WeChat messages during the first 6 months as a reminder to adhere to their desired healthy lifestyle and a link to a 1-minute video relevant to their selected healthy lifestyle. Participants in the control group will receive brief advice on adopting healthy lifestyles through regular text messages.
Main outcome measures: The number of healthy lifestyles adopted at 6 months. Data analysis and expected results: SPSS for Windows will be used for quantitative data analysis. A significantly higher proportion of participants in the intervention group will adopt healthy lifestyles and exhibit better quality of life than those in the control group at 6 and 12 months.
Read the detailed description
Study design An assessor-blinded, multicentre RCT with a two-group between-subjects design will be used following the Consolidated Standards of Reporting Trial.
Setting The proposed project will be conducted at the EDs of five major acute care hospitals in different clusters in Hong Kong.
Recruitment At the EDs The investigators has obtained ethical approval from the institutional review boards of the five hospitals. All potential participants will be approached by emergency nurses before being discharged from the EDs. These nurses will provide potential participants with a leaflet detailing the nature, purpose, design, procedures, and potential benefits and risks of the study. Subsequently, the emergency nurses will refer the potential participants to the RA. Informed written consent will be obtained from all participants. Participants will be assured that their participation will be voluntary, with no prejudice attached to refusal, and that the information provided by them will be kept confidential. A baseline assessment will be performed using questionnaires. Then, participants will be informed that participants will receive a telephone call from an RA within 3 days to evaluate their potential health-risk behaviours and provide them with appropriate health advice to adopt healthy lifestyles. In addition, the participants will be provided a Practical Resource Hub for Healthy Life leaflet containing information on various applications, including (i) 'Move Your Body', (ii) 'Eat Healthy', (iii) 'Live Alcohol Free', and (iv) 'Stay Away from Tobacco', which were developed by the Hong Kong Department of Health
Intervention
- Intervention group Brief intervention via telephone (within 3 days after visiting the ED) The participants will receive a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) model, which was originally developed for primary-care tobacco cessation. This intervention includes the following steps: (1) Ask about and assess health-risk behaviours; (2) Warn about the high morbidity and mortality risks associated with health-risk behaviours; (3) Advise on adopting healthy lifestyles to improve the participant's health; (4) Refer to hotline services, such as those for smoking cessation and alcohol treatment or the nearest district health centre to follow up their health status; and (5) Do it again if participants have not adopted a healthy lifestyle at follow-ups. For the advice step, the RA will ask about the participants' priority in engaging in a desired health-related lifestyle based on their responses in the behavioural risk factor questionnaire. The participants will also be asked to choose a goal that the participants consider most attainable, such as quitting or reducing smoking, consuming more vegetables or less fatty foods or sugary drinks, performing more exercise, or reducing alcohol consumption. Although the participants will be encouraged to adopt aspects of a healthy lifestyle sequentially, the participants will have the option to adopt them simultaneously if the participants feel confident in doing so. Each participant will receive a brief (approximately 5 minutes) individual intervention providing health advice on their selected lifestyle goal. The entire intervention will last approximately 10 minutes and may be extended if necessary. At the end of the telephone call, the participant will be informed that the RA will assist them in achieving their health-related goals throughout the study by sending messages via WhatsApp/WeChat. Follow-up booster intervention (up to 6 months) During the first 6 months of the proposed project, the RA will send WhatsApp/WeChat messages approximately once a week to remind the participants to adhere to their desired health-related lifestyle. Instant messaging via mobile applications was found to be effective in enhancing treatment compliance. In addition, during the first week, the RA will send participants a link via WhatsApp/WeChat to a 1-minute video developed by the research team comprising content relevant to their selected health-related lifestyle. Four separate 1-minute videos will be compiled, each focusing on a different healthy lifestyle. These videos will indicate the health hazards of continuing this health risk behaviour and the benefits of adopting a healthy lifestyle. Moreover, the RA will encourage the participants to watch the video and ask any questions regarding the video content via WhatsApp/WeChat. One advantage of using videos to deliver instant health advice messages is the use of sound and images, which can elicit emotions, enhance understanding of abstract concepts, and improve the retention of new information through auditory, visual, and verbal stimulation. Moreover, the delivered content can be viewed by the participants at their convenience and own pace. Follow-up assessment of behavioural changes at 3, 6, and 12 months The success of the participants in achieving their targeted health-related lifestyle will be assessed through phone calls at 3, 6, and 12 months. If the participants report the successful adoption of a healthy lifestyle, the RA will encourage them to adopt another healthy lifestyle. Then, the RA will provide participants with brief healthcare advice (approximately 5 minutes) and send via WhatsApp/WeChat another 1-minute video focused on their newly chosen and desired health-related lifestyle.
- Control group Participants will receive a brief telephone intervention based on the AWARD model from the trained RA, similar to that delivered to the intervention group. However, the RA will only advise the participants to adopt a healthy lifestyle. In addition, the RA will send regular SMS messages to participants at a frequency similar to that used for the intervention group. However, these messages will contain only general health advice. In addition, the participants will receive follow-up outcome assessments at the same schedule as that followed in the intervention group.
- Conditions
- Non Communicable Diseases, Health-risk Behaviours
- Being tested
- Theory of planned behaviour, Foot-in-the-door technique, Self-determination theory, Follow-up booster intervention, Practical Resource Hub for Healthy Life leaflet
- Keywords
- Health-risk Behaviours, Non Communicable Diseases, Emergency Department
- Medical subject headings
- Noncommunicable Diseases, Emergencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Theory of planned behaviourOther
This theory holds that an intention to engage in a health-related behaviour is determined by the proximal factors of attitudes, subjective norms, and perceived behavioural control. Attitudes represent individuals perceived likelihood of performing and appraisal of the consequences of performing a health-promoting behaviour. Subjective norms are the social pressure perceptions to either perform or not perform a health-promoting behaviour. Finally, perceived behavioural control is an individual's perception of control regarding performing the behaviour.
Foot-in-the-door techniqueOther
The foot-in-the-door technique, which was introduced by Freeman and Fraser, emphasises the notion that individuals who initially comply with a small, easy request are more likely to later comply with a larger request. Compliance with the first request or target increases the individual's confidence and alters their self-perceived capability and willingness regarding further requests or targets. This technique can facilitate the recruitment process and enhance compliance.
Self-determination theoryOther
According to self-determination theory, behavioural regulation is more autonomous when it is internalised, as opposed to being regulated by external factors. Compared with external regulation, autonomous regulation is associated with increased self-efficacy, greater behavioural persistence, longer-term behavioural changes and more positive health behaviour. Autonomy is another influential determinant of behaviour that is emphasised by freedom of choice. There is some evidence that people who have greater autonomy demonstrating greater competence and self-efficacy in achieving behavioural change compared with those with less autonomy. As a result, increased autonomy will facilitate a gradual change in risky behaviours.
Our intervention aims to first change the participants' attitudes and their subjective norms through risk communication. Using foot-in-the-door technique and self-determination theory, it will then increase participants' willingness to adopt a healthy lifestyle.
Follow-up booster interventionOther
Staff will send WhatsApp/WeChat messages approximately once a week to remind the participants to adhere to their desired health-related lifestyle for the first 6 months. In addition, during the first week, the RA will send participants a link via WhatsApp/WeChat to a 1-minute video developed by the research team comprising content relevant to their selected health-related lifestyle. Four separate 1-minute videos will be compiled, each focusing on a different healthy lifestyle. These videos will indicate the health hazards of continuing this health risk behaviour and the benefits of adopting a healthy lifestyle. Moreover, the RA will encourage the participants to watch the video and ask any questions regarding the video content via WhatsApp/WeChat.
Practical Resource Hub for Healthy Life leafletOther
The participants will be provided a Practical Resource Hub for Healthy Life leaflet containing information on various applications, including (i) 'Move Your Body', (ii) 'Eat Healthy', (iii) 'Live Alcohol Free', and (iv) 'Stay Away from Tobacco', which were developed by the Hong Kong Department of Health
a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) modelOther
The participants will receive a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) model : (1) Ask about and assess health-risk behaviours; (2) Warn about the high morbidity and mortality risks associated with health-risk behaviours; (3) Advise on adopting healthy lifestyles to improve the participant's health; (4) Refer to hotline services, such as those for smoking cessation and alcohol treatment or the nearest district health centre to follow up their health status; and (5) Do it again if participants have not adopted a healthy lifestyle at follow-ups.
| Study group | Role | What they receive |
|---|---|---|
| WhatsApp/WeChat with video | Experimental | Participants in the intervention group will receive a brief health warning and advice on health-risk behaviours. In addition, they will be asked about their priority in engaging in healthy lifestyles. Moreover, participants will receive WhatsApp/WeChat messages during the first 6 months as a reminder to adhere to their desired healthy lifestyle and a link to a 1-minute video relevant to their selected healthy lifestyle. Receives: Other: Theory of planned behaviour; Other: Foot-in-the-door technique; Other: Self-determination theory; Other: Follow-up booster intervention; Other: Practical Resource Hub for Healthy Life leaflet; Other: a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) model |
| Placebo | Placebo comparator | Participants in the control group will receive brief advice on adopting healthy lifestyles through regular text messages. Receives: Other: Practical Resource Hub for Healthy Life leaflet; Other: a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) model |
What is being measured
The primary outcome is the main question the study is designed to answer.
The composite event rate of adopting at least one of the four healthy lifestyles at 6 months.
The composite event rate of adopting at least one of the four healthy lifestyles at 6 months which is measured by using a behavioural risk-factor questionnaire. The higher rate of adopting at least one of the four healthy lifestyles indicate the more successful to help emergency department attendees to adoption of a healthy lifestyle and lead healthier lives.
Measured: from baseline to 6 months
Secondary outcomes (3)
The composite event rate of adopting at least one of the four healthy lifestyles adopted at 12 months
The composite event rate of adopting at least one of the four healthy lifestyles adopted at 12 months which is measured by using a behavioural risk-factor questionnaire. The higher rate of adopting at least one of the four healthy lifestyles indicate the more successful to help emergency department attendees to adoption of a healthy lifestyle and lead healthier lives.
Measured: from baseline to 12 months
Improvement in health-related quality of life at 6 months
Participants' change of health-related quality of life between baseline and 6-month follow-ups will use EuroQol 5-level scale (EQ-5D-5L) to measure the quality of life. It consists of two part. The first part has 5 questions and each question has choices 1 to 5. Large number means a worse outcome in the first part. The second part has one question which is a scale of 0 to 100. Large number means a better outcome in the second part.
Measured: from Baseline to 6 months
Improvement in health-related quality of life at 12 months
Participants' change of health-related quality of life between baseline and 12-month follow-ups will use EuroQol 5-level scale (EQ-5D-5L) to measure the quality of life. It consists of two part. The first part has 5 questions and each question has choices 1 to 5. Large number means a worse outcome in the first part. The second part has one question which is a scale of 0 to 100. Large number means a better outcome in the second part.
Measured: from baseline to 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Mar 2025
- Study start10 Jun 2025
- Primary completion30 Jun 2027 (estimated)
- Study completion31 Jan 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Non Communicable DiseasesStudies of the same condition, open and under way.
- More trials run by Chinese University of Hong KongThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 1,172 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Chinese University of Hong Kong
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Li Ho Cheung William, Chinese University of Hong Kong
- Investigators
- Ho Cheung William Li, PhD, Principal investigator, The Nethersole School of Nursing, CUHK
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06889792
- Sponsor's protocol ID
- HMRF22230351
- Status last verified
- Jan 2026
- First submitted
- 17 Mar 2025
- Last updated
- 29 Jan 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The relevant anonymized patient level data, full dataset, technical appendix, and statistical code are available on reasonable request. The approval from the Principal Investigator for the purpose of data use is required.
Publications
Li WHC, Wong EL, Xia W, Chen H, Tsui SH, Chan YC, Cheung KY, Leung YF, Ho LKL, Choi KC, Chung OJ. A proactive approach to prevent non-communicable diseases through screening and educating emergency department attendees to adopt healthy lifestyles: Study protocol for a pragmatic, multicenter, randomized controlled trial. PLoS One. 2025 Jul 3;20(7):e0327558. doi: 10.1371/journal.pone.0327558. eCollection 2025.
PubMed 40608754
Study at a glance
From the registry record, last updated by the sponsor on 29 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Proactive Approach to Prevent Non-communicable Diseases Through Screening and Educating Emergency Department Attendees to Adopt Healthy Lifestyles: A Randomised Clinical Trial
- ClinicalTrials.gov ID
- NCT06889792
- Acronym / sponsor ID
- HMRF22230351
- Conditions
- Non Communicable Diseases, Health-risk Behaviours
- Keywords
- Health-risk Behaviours, Non Communicable Diseases, Emergency Department
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 1,172 participants (estimated)
- Lead sponsor
- Chinese University of Hong KongUniversity, hospital or other
- Study start
- 10 Jun 2025 (actual)
- Primary completion
- 30 Jun 2027 (estimated)
- Study completion
- 31 Jan 2028 (estimated)
- First posted
- 21 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Objective: To examine the effectiveness of a general health promotion intervention based on self-determination theory in proactively helping emergency department (ED) attendees to adopt healthy lifestyles.
Hypothesis to be tested: A general health promotion intervention based on self-determination theory will be effective in helping people adopt healthy lifestyles.
Design and subjects: The investigators will conduct a randomised controlled trial involving 1,172 ED attendees from five major acute care hospitals in Hong Kong.
Instruments: A behavioural risk factor questionnaire will be used to identify participants' health risk behaviours and document their blood pressure and body mass index. The EuroQoL 5-Dimension 5-level will be used to assess participants' quality of life.
Interventions: Participants in the intervention group will receive a brief health warning and advice on health-risk behaviours. In addition, participants will be asked about their priority in engaging in healthy lifestyles. Moreover, participants will receive WhatsApp/WeChat messages during the first 6 months as a reminder to adhere to their desired healthy lifestyle and a link to a 1-minute video relevant to their selected healthy lifestyle. Participants in the control group will receive brief advice on adopting healthy lifestyles through regular text messages.
Main outcome measures: The number of healthy lifestyles adopted at 6 months. Data analysis and expected results: SPSS for Windows will be used for quantitative data analysis. A significantly higher proportion of participants in the intervention group will adopt healthy lifestyles and exhibit better quality of life than those in the control group at 6 and 12 months.
Detailed description
Study design An assessor-blinded, multicentre RCT with a two-group between-subjects design will be used following the Consolidated Standards of Reporting Trial.
Setting The proposed project will be conducted at the EDs of five major acute care hospitals in different clusters in Hong Kong.
Recruitment At the EDs The investigators has obtained ethical approval from the institutional review boards of the five hospitals. All potential participants will be approached by emergency nurses before being discharged from the EDs. These nurses will provide potential participants with a leaflet detailing the nature, purpose, design, procedures, and potential benefits and risks of the study. Subsequently, the emergency nurses will refer the potential participants to the RA. Informed written consent will be obtained from all participants. Participants will be assured that their participation will be voluntary, with no prejudice attached to refusal, and that the information provided by them will be kept confidential. A baseline assessment will be performed using questionnaires. Then, participants will be informed that participants will receive a telephone call from an RA within 3 days to evaluate their potential health-risk behaviours and provide them with appropriate health advice to adopt healthy lifestyles. In addition, the participants will be provided a Practical Resource Hub for Healthy Life leaflet containing information on various applications, including (i) 'Move Your Body', (ii) 'Eat Healthy', (iii) 'Live Alcohol Free', and (iv) 'Stay Away from Tobacco', which were developed by the Hong Kong Department of Health
Intervention
- Intervention group Brief intervention via telephone (within 3 days after visiting the ED) The participants will receive a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) model, which was originally developed for primary-care tobacco cessation. This intervention includes the following steps: (1) Ask about and assess health-risk behaviours; (2) Warn about the high morbidity and mortality risks associated with health-risk behaviours; (3) Advise on adopting healthy lifestyles to improve the participant's health; (4) Refer to hotline services, such as those for smoking cessation and alcohol treatment or the nearest district health centre to follow up their health status; and (5) Do it again if participants have not adopted a healthy lifestyle at follow-ups. For the advice step, the RA will ask about the participants' priority in engaging in a desired health-related lifestyle based on their responses in the behavioural risk factor questionnaire. The participants will also be asked to choose a goal that the participants consider most attainable, such as quitting or reducing smoking, consuming more vegetables or less fatty foods or sugary drinks, performing more exercise, or reducing alcohol consumption. Although the participants will be encouraged to adopt aspects of a healthy lifestyle sequentially, the participants will have the option to adopt them simultaneously if the participants feel confident in doing so. Each participant will receive a brief (approximately 5 minutes) individual intervention providing health advice on their selected lifestyle goal. The entire intervention will last approximately 10 minutes and may be extended if necessary. At the end of the telephone call, the participant will be informed that the RA will assist them in achieving their health-related goals throughout the study by sending messages via WhatsApp/WeChat. Follow-up booster intervention (up to 6 months) During the first 6 months of the proposed project, the RA will send WhatsApp/WeChat messages approximately once a week to remind the participants to adhere to their desired health-related lifestyle. Instant messaging via mobile applications was found to be effective in enhancing treatment compliance. In addition, during the first week, the RA will send participants a link via WhatsApp/WeChat to a 1-minute video developed by the research team comprising content relevant to their selected health-related lifestyle. Four separate 1-minute videos will be compiled, each focusing on a different healthy lifestyle. These videos will indicate the health hazards of continuing this health risk behaviour and the benefits of adopting a healthy lifestyle. Moreover, the RA will encourage the participants to watch the video and ask any questions regarding the video content via WhatsApp/WeChat. One advantage of using videos to deliver instant health advice messages is the use of sound and images, which can elicit emotions, enhance understanding of abstract concepts, and improve the retention of new information through auditory, visual, and verbal stimulation. Moreover, the delivered content can be viewed by the participants at their convenience and own pace. Follow-up assessment of behavioural changes at 3, 6, and 12 months The success of the participants in achieving their targeted health-related lifestyle will be assessed through phone calls at 3, 6, and 12 months. If the participants report the successful adoption of a healthy lifestyle, the RA will encourage them to adopt another healthy lifestyle. Then, the RA will provide participants with brief healthcare advice (approximately 5 minutes) and send via WhatsApp/WeChat another 1-minute video focused on their newly chosen and desired health-related lifestyle.
- Control group Participants will receive a brief telephone intervention based on the AWARD model from the trained RA, similar to that delivered to the intervention group. However, the RA will only advise the participants to adopt a healthy lifestyle. In addition, the RA will send regular SMS messages to participants at a frequency similar to that used for the intervention group. However, these messages will contain only general health advice. In addition, the participants will receive follow-up outcome assessments at the same schedule as that followed in the intervention group.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| WhatsApp/WeChat with video | Experimental | Other: Theory of planned behaviour, Other: Foot-in-the-door technique, Other: Self-determination theory, Other: Follow-up booster intervention, Other: Practical Resource Hub for Healthy Life leaflet, Other: a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) modelParticipants in the intervention group will receive a brief health warning and advice on health-risk behaviours. In addition, they will be asked about their priority in engaging in healthy lifestyles. Moreover, participants will receive WhatsApp/WeChat messages during the first 6 months as a reminder to adhere to their desired healthy lifestyle and a link to a 1-minute video relevant to their selected healthy lifestyle. |
| Placebo | Placebo comparator | Other: Practical Resource Hub for Healthy Life leaflet, Other: a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) modelParticipants in the control group will receive brief advice on adopting healthy lifestyles through regular text messages. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- being aged ≥18 years old Chinese
- being triaged as semi-urgent (level 4) or non-urgent (level 5) and discharged home on the same day after receiving medical attention
- having at least one health risk behaviour (tobacco use, harmful alcohol consumption, unhealthy diet, and physical inactivity)
- owning a smartphone and having an ability to use instant messaging applications (e.g. WhatsApp or WeChat).
Key exclusion criteria (3 listed)
- having a poor cognitive state or mental illness
- being diagnosed with NCDs and undergoing regular follow-ups in outpatient clinics
- participating in another related study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Theory of planned behaviourThis theory holds that an intention to engage in a health-related behaviour is determined by the proximal factors of attitudes, subjective norms, and perceived behavioural control. Attitudes represent individuals perceived likelihood of performing and appraisal of the consequences of performing a health-promoting behaviour. Subjective norms are the social pressure perceptions to either perform or not perform a health-promoting behaviour. Finally, perceived behavioural control is an individual's perception of control regarding performing the behaviour. | Other | WhatsApp/WeChat with video |
| Foot-in-the-door techniqueThe foot-in-the-door technique, which was introduced by Freeman and Fraser, emphasises the notion that individuals who initially comply with a small, easy request are more likely to later comply with a larger request. Compliance with the first request or target increases the individual's confidence and alters their self-perceived capability and willingness regarding further requests or targets. This technique can facilitate the recruitment process and enhance compliance. | Other | WhatsApp/WeChat with video |
| Self-determination theoryAccording to self-determination theory, behavioural regulation is more autonomous when it is internalised, as opposed to being regulated by external factors. Compared with external regulation, autonomous regulation is associated with increased self-efficacy, greater behavioural persistence, longer-term behavioural changes and more positive health behaviour. Autonomy is another influential determinant of behaviour that is emphasised by freedom of choice. There is some evidence that people who have greater autonomy demonstrating greater competence and self-efficacy in achieving behavioural change compared with those with less autonomy. As a result, increased autonomy will facilitate a gradual change in risky behaviours. Our intervention aims to first change the participants' attitudes and their subjective norms through risk communication. Using foot-in-the-door technique and self-determination theory, it will then increase participants' willingness to adopt a healthy lifestyle. | Other | WhatsApp/WeChat with video |
| Follow-up booster interventionStaff will send WhatsApp/WeChat messages approximately once a week to remind the participants to adhere to their desired health-related lifestyle for the first 6 months. In addition, during the first week, the RA will send participants a link via WhatsApp/WeChat to a 1-minute video developed by the research team comprising content relevant to their selected health-related lifestyle. Four separate 1-minute videos will be compiled, each focusing on a different healthy lifestyle. These videos will indicate the health hazards of continuing this health risk behaviour and the benefits of adopting a healthy lifestyle. Moreover, the RA will encourage the participants to watch the video and ask any questions regarding the video content via WhatsApp/WeChat. | Other | WhatsApp/WeChat with video |
| Practical Resource Hub for Healthy Life leafletThe participants will be provided a Practical Resource Hub for Healthy Life leaflet containing information on various applications, including (i) 'Move Your Body', (ii) 'Eat Healthy', (iii) 'Live Alcohol Free', and (iv) 'Stay Away from Tobacco', which were developed by the Hong Kong Department of Health | Other | Placebo, WhatsApp/WeChat with video |
| a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) modelThe participants will receive a brief intervention using the Ask, Warn, Advise, Refer and Do-it- again (AWARD) model : (1) Ask about and assess health-risk behaviours; (2) Warn about the high morbidity and mortality risks associated with health-risk behaviours; (3) Advise on adopting healthy lifestyles to improve the participant's health; (4) Refer to hotline services, such as those for smoking cessation and alcohol treatment or the nearest district health centre to follow up their health status; and (5) Do it again if participants have not adopted a healthy lifestyle at follow-ups. | Other | Placebo, WhatsApp/WeChat with video |
Primary outcome
The composite event rate of adopting at least one of the four healthy lifestyles at 6 months.
Time frame: from baseline to 6 months
The composite event rate of adopting at least one of the four healthy lifestyles at 6 months which is measured by using a behavioural risk-factor questionnaire. The higher rate of adopting at least one of the four healthy lifestyles indicate the more successful to help emergency department attendees to adoption of a healthy lifestyle and lead healthier lives.
3 secondary outcomes
The composite event rate of adopting at least one of the four healthy lifestyles adopted at 12 months
Time frame: from baseline to 12 months
Improvement in health-related quality of life at 6 months
Time frame: from Baseline to 6 months
Improvement in health-related quality of life at 12 months
Time frame: from baseline to 12 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jan 2026.
- Derived from this study: PubMed 40608754Li WHC, Wong EL, Xia W, Chen H, Tsui SH, Chan YC, Cheung KY, Leung YF, Ho LKL, Choi KC, Chung OJ. A proactive approach to prevent non-communicable diseases through screening and educating emergency department attendees to adopt healthy lifestyles: Study protocol for a pragmatic, multicenter, randomized controlled trial. PLoS One. 2025 Jul 3;20(7):e0327558. doi: 10.1371/journal.pone.0327558. eCollection 2025.
- Individual participant dataSharing planned: Yes. The relevant anonymized patient level data, full dataset, technical appendix, and statistical code are available on reasonable request. The approval from the Principal Investigator for the purpose of data use is required.
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Compare Oral Itraconazole and Standard Care Versus Standard Care Alone in Patients With Non-cystic Fibrosis Related Bronchiectasis With Chronic Aspergillus Infection in Reducing Bronchiectasis Exacerbations
Bronchiectasis, Bronchiectasis Adult
RecruitingPhase 2
CMV-MVA Triplex Vaccination in HLA-Matched Related Stem Cell Donors for the Prevention of CMV Infection in Patients Undergoing Hematopoietic Stem Cell Transplant
Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Ho Cheung William Li, PhD principal investigator
The Nethersole School of Nursing, CUHK
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Theory of planned behaviour, Foot-in-the-door technique and Self-determination theory in people with Non Communicable Diseases and Health-risk Behaviours, run by Chinese University of Hong Kong at 1 site in Hong Kong.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 29 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Ho Cheung William Li, PhD (+85239430889, williamli@cuhk.edu.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The composite event rate of adopting at least one of the four healthy lifestyles at 6 months. (time frame: from baseline to 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06889792, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jan 2026.