Introduction: Influenza illness is considered to be associated with high mortality, morbidity and economic loss. Numerous studies and mathematical simulations are conducted to understand the disease pattern, transmission dynamics, and psychosocial response of the population; however, little is known about the health seeking behavior of patients after the onset of respiratory infection symptoms. Respiratory infections exert substantial burden on the health care system of Hong Kong, therefore in addition to detecting the disease early, it is necessary to understand health care utilization behavior of the population. This information will not only benefit to formulate public health policies, it will also improve the preparedness plan to deal with future pandemics. Objective: To examine the influence of factors such as gender, age, education and occupation on the health seeking behavior of Hong Kong citizens and to understand the magnitude of health care utilization by the patients with respiratory infections. Method: This study is based on the data from a large randomized controlled trial of 703 households comprising of 2,586 individuals. Bi-weekly telephone contact was established with these households to assess the health seeking behavioral response of the individuals with respiratory infection episodes separately for laboratory confirmed influenza, and two other clinically defined infection episodes that are influenza like illness (ILI) and acute respiratory infection (ARI) episodes. Descriptive analyses were performed to assess the health care utilization within various health care delivery institutions. Multivariable logistic regression models were applied to determine the association of demographic factors with the health seeking behavior of individuals with respiratory infection episodes. Fischer exact test was used to analyze the association of promptness of health care contact with ARI and ILI episodes. Multivariable logistic regression model was used to analyze the association of demographic factors of ILI patients with early health care contact. Results: The results showed that seeking health care varied by the severity of illness and characteristics of the patients/ parents. As compared with the patients of ARI (non-ILI) episodes, higher proportion of ILI patients sought medical care and among all the health care delivery systems, private health care delivery system was attended by majority of the patients. Individuals with ILI episodes more likely to seek health care were male patients by 66% (Crude OR 1.66; 95% CI 1.01-2.77), and children below 10 years by 219% (Crude OR 3.19; 95% CI 1.30-7.79). Within the group of laboratory confirmed influenza patients, adjusted odds ratio showed male patients 243% more likely to seek health care (Adjusted OR 3.43; 95% CI 1.01-11.63). Unemployed ILI adult patients were less likely to seek medical care (Crude OR 0.39; 95% CI 0.15-0.98), and employed ARI (non-ILI) patients were 52% more likely to attend medical care (Crude OR 1.52; 95% CI 1.10-2.08). Health care contact within 24 hours of onset of symptoms was significantly associated with ILI patients (OR 1.85; 95% CI 1.33-2.59; p-value 0.0003) showing that patients with febrile ARI were more likely to seek early health care rather than patients with afebrile ARI. Conclusion: The differences in the health seeking behavior demonstrated in this study indicate inequalities in the health care services utilization. Higher and earlier utilization of health care services by patients with ILI episodes during low influenza activity period might result in the overburdening of the health care system. In order to address these issues, policy makers should have a clear understanding of populations’ preventive and enabling factors to seek health care, perceptions of the risk of disease, self-care behaviors and health education levels. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Social Work / Master / Master of Social Work

Siu, Hon Kei. / "November 2011." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 80-88). / Abstracts in English and Chinese; appendix in Chinese. / Thesis/Assessment Committee --- p.1 / Abstract --- p.2 / Content --- p.5 / Acknowledgements --- p.7 / Introduction --- p.8 / Background --- p.12 / Defining continuity of care --- p.12 / Measuring continuity of care --- p.14 / Effects of continuity of care --- p.15 / Factors affecting the continuity of care --- p.16 / Health care system in Hong Kong --- p.18 / Health care service charges in public and private sectors in Hong Kong --- p.19 / Primary care service in public and private sector --- p.21 / Health status and health seeking behaviours of Hong Kong people --- p.22 / Summary --- p.22 / Objectives --- p.24 / Methods --- p.25 / Target population --- p.25 / Sample size --- p.25 / Data collection --- p.26 / Preparation of questionnaire --- p.26 / Questionnaire in detail --- p.27 / Ethics issue --- p.32 / Statistical analysis --- p.32 / Results --- p.38 / Survey findings --- p.38 / Detailed analysis - respondents claimed that they needed a family doctor --- p.44 / Detailed analysis - respondents claimed that they had a family doctor --- p.46 / Discussion --- p.50 / Limitations of the study --- p.50 / Strengths of the study --- p.51 / Discussion of the findings --- p.52 / Implications --- p.59 / Conclusion --- p.62 / Tables and figures --- p.64 / Appendix --- p.75 / Bibliography --- p.80

Tang, Shing Tung. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 114-126). / Abstracts in English and Chinese; some appendixes in Chinese. / Chapter Chapter 1: --- Introduction --- p.1 / Chapter Chapter 2: --- Background --- p.5 / HPV Vaccination and Cervical Cancer --- p.5 / Overview of HPV Vaccination in the West and Asia --- p.6 / Chapter Chapter 3: --- Literature Review --- p.9 / Applying the Theory of Planned Behavior in Vaccination Context --- p.9 / Effects of Mass and Interpersonal Communication --- p.22 / Relationship between Mass and Interpersonal Communication --- p.33 / Differential Effects of Mass and Interpersonal Communication --- p.39 / Chapter Chapter 4: --- Methodology --- p.45 / Participants and Procedure --- p.45 / Measures --- p.49 / Chapter Chapter 5: --- Results --- p.54 / Model Fit and Adjustments --- p.54 / Testing the Alternative Model --- p.56 / Evaluating Individual and Contextual Predictors --- p.59 / Examining the Context-to-intention Pathways --- p.60 / Summary of Findings --- p.61 / Chapter Chapter 6: --- Discussion --- p.63 / Comparing the Proposed and Alternative Model --- p.63 / Evaluating the TPB in Vaccination Context --- p.65 / Evaluating Mass and Interpersonal Communication as Contextual Predictors --- p.73 / Further Exploration on the Differential Effects --- p.76 / Theoretical Contributions and Practical Implications --- p.80 / Chapter Chapter 7: --- Limitations and Directions for Future Research --- p.85 / Limitations --- p.85 / Directions for Future Research --- p.90 / Chapter Chapter 8: --- Conclusion --- p.93 / Appendix --- p.96 / References --- p.114

by Au-Yeung Kit Mei. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves 219-232). / Abstracts in English and Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / Abstract (Chinese Version) --- p.v / Table of Contents --- p.vii / List of Figures --- p.xiii / List of Tables --- p.xv / List of Abbreviations --- p.xxviii / Chapter CHAPTER ONE: --- INTRODUCTION / Chapter 1.1 --- Health-related Transition in Hong Kong and Their Implications --- p.1 / Chapter 1.2 --- "Eating Habits, Lifestyle and Health of Hong Kong Children" --- p.1 / Chapter 1.2.1 --- Affluent Diet --- p.1 / Chapter 1.2.2 --- Poor Diet Habits --- p.2 / Chapter 1.2.2.1 --- Low Breastfeeding Rate --- p.2 / Chapter 1.2.2.2 --- Breakfast Skipping --- p.4 / Chapter 1.2.2.3 --- Increased Eating Out --- p.5 / Chapter 1.2.2.4 --- Quality of School Lunch --- p.6 / Chapter 1.2.2.5 --- Snacking Habits --- p.7 / Chapter 1.2.3 --- Physical Inactivity --- p.8 / Chapter 1.2.4 --- Childhood Obesity Prevalence and Trend --- p.9 / Chapter 1.2.5 --- Health Implications and Consequences --- p.10 / Chapter 1.2.6 --- Children's Eating and Physical Activity Habit Formation --- p.13 / Chapter 1.2.6.1 --- Parental Influences --- p.13 / Chapter 1.2.6.2 --- Influence of School Environment and Healthy Food Availability --- p.14 / Chapter 1.2.6.3 --- Media Influences --- p.15 / Chapter 1.3 --- Prevention Rather than Management --- p.15 / Chapter 1.3.1 --- Good Habit Establishment is Essential When Young --- p.16 / Chapter 1.3.2 --- Need for Comprehensive Health or Nutrition Education --- p.17 / Chapter 1.3.3 --- Brief Review of Nutrition Education Research in Other Nations --- p.17 / Chapter 1.3.4 --- Nutrition / Health Education in Hong Kong --- p.21 / Chapter 1.3.4.1 --- Government and Community Promotion --- p.21 / Chapter 1.3.4.2 --- Nutrition and Physical Activity in Primary School Syllabus --- p.22 / Chapter 1.3.4.3 --- Barriers --- p.23 / Chapter 1.4 --- Rationale of This Study --- p.24 / Chapter 1.4.1 --- Project Background: Multidisciplinary Advisory Committee Composition --- p.24 / Chapter 1.4.2 --- Objectives of this Project --- p.24 / Chapter 1.4.3 --- Theoretical Framework --- p.25 / Chapter 1.4.4 --- Research Design and Hypothesis --- p.26 / Chapter CHAPTER TWO: --- METHODOLOGY / Chapter 2.1 --- Target Subjects --- p.27 / Chapter 2.2 --- Sample --- p.27 / Chapter 2.2.1 --- Gaining Access To Subjects --- p.27 / Chapter 2.2.2 --- Sample Selection --- p.29 / Chapter 2.3 --- Questionnaires Development and Data Collection --- p.30 / Chapter 2.3.1 --- Questionnaire Design --- p.30 / Chapter 2.3.1.1 --- Students' Questionnaire --- p.31 / Chapter 2.3.1.2 --- Parents' Questionnaire --- p.32 / Chapter 2.3.1.3 --- Pre-testing --- p.32 / Chapter 2.3.1.4 --- Student Helper Training --- p.33 / Chapter 2.3.1.5 --- Reliability and validity of measures --- p.33 / Chapter 2.4 --- Intervention --- p.34 / Chapter 2.4.1 --- Intervention Activities and Curriculum Design --- p.34 / Chapter 2.4.2 --- Intervention Materials Development and Pre-testing --- p.39 / Chapter 2.5 --- Evaluation --- p.39 / Chapter 2.5.1 --- Outcome Evaluation --- p.39 / Chapter 2.5.1.1 --- Data Management --- p.39 / Chapter 2.5.1.2 --- Statistics --- p.40 / Chapter 2.5.1.3 --- "Knowledge,Attitude and Behavior Scores of Students" --- p.40 / Chapter 2.5.2 --- Process Evaluation of Program Materials and Activities During the Intervention --- p.41 / Chapter 2.6 --- Ethics --- p.44 / Chapter CHAPTER THREE: --- RESULTS / Chapter 3.1 --- Response Rate --- p.45 / Chapter 3.2 --- Baseline Characteristics of Students and Parents in Pre-intervention Survey --- p.46 / Chapter 3.2.1 --- General Sociodemographic Characteristics --- p.46 / Chapter 3.2.2 --- Breastfeeding --- p.58 / Chapter 3.2.3 --- Healthy Diet Pyramid and General Healthy Eating Awareness --- p.63 / Chapter 3.2.4 --- Healthy Breakfast --- p.67 / Chapter 3.2.5 --- Healthy Eating Out --- p.73 / Chapter 3.2.6 --- Healthy School Lunch --- p.79 / Chapter 3.2.7 --- Healthy Snacking --- p.82 / Chapter 3.2.8 --- Family Dietary Habits --- p.88 / Chapter 3.2.9 --- Physical Activity --- p.97 / Chapter 3.2.10 --- Summary Profile of the Subjects at Pre-intervention Survey --- p.109 / Chapter 3.3 --- Outcome Evaluation --- p.114 / Chapter 3.3.1 --- General Sociodemographic Characteristics of Students and Parents in Post-intervention survey --- p.114 / Chapter 3.3.2 --- Breastfeeding --- p.117 / Chapter 3.3.3 --- Healthy Diet Pyramid and General Healthy Eating Awareness --- p.122 / Chapter 3.3.4 --- Healthy Breakfast --- p.125 / Chapter 3.3.5 --- Healthy Eating Out --- p.130 / Chapter 3.3.6 --- Healthy School Lunch --- p.134 / Chapter 3.3.7 --- Healthy Snacking --- p.138 / Chapter 3.3.8 --- Family Dietary Habits --- p.144 / Chapter 3.3.9 --- Physical Activity --- p.150 / Chapter 3.3.10 --- "Changes in Students' Knowledge, Attitudes and Behavior With Respect to Healthy Eating and Physical Activity" --- p.157 / Chapter 3.3.11 --- Summary Profile of the Subjects at Post-intervention Survey --- p.162 / Chapter 3.4 --- Parents' Evaluation of Program Materials and Activities --- p.166 / Chapter 3.5 --- Teachers' Evaluation of Program Materials and Activities --- p.174 / Chapter 3.5.1 --- Breastfeeding Evaluation --- p.175 / Chapter 3.5.2 --- Program Evaluation: Other FUN-IN-SEVEN Themes --- p.181 / Chapter CHAPTER FOUR: --- DISCUSSION / Chapter 4.1 --- Implication of Findings --- p.193 / Chapter 4.2 --- Strengths and Limitations of the Study --- p.210 / Chapter 4.3 --- Major Difficulties Encountered in Launching Nutrition Promotion in Schools --- p.213 / Chapter 4.4 --- Implications and Recommendations for Meeting the Challenges to Improving Hong Kong Primary Students Nutrition and Physical Activity Habits --- p.214 / Chapter CHAPTER FIVE: --- CONCLUSION --- p.218 / References --- p.219 / Appendices / Chapter AI --- Students' questionnaire (Chinese version) --- p.233 / Chapter AII --- Students' questionnaire (English version) --- p.238 / Chapter BI --- Visual aids (Chinese version) --- p.251 / Chapter BII --- Visual aids (English version) --- p.258 / Chapter CI --- Parents' questionnaire (Chinese version) --- p.265 / Chapter CII --- Parents' questionnaire (English version) --- p.273 / Chapter DI --- Introductory letter (Chinese version) --- p.281 / Chapter DII --- Introductory letter (English version) --- p.283 / Chapter EI --- Consent form (Chinese version) --- p.285 / Chapter EII --- Consent form (English version) --- p.286 / Chapter F --- Principal/teacher questionnaire --- p.287 / Chapter G --- Background information of the partner schools --- p.289 / Chapter H --- Summary of materials and activities of FUN-IN-SEVEN Programme (Chinese version) --- p.291 / Chapter KI --- "Programme materials, pamphlets/brochures and photographs of some activities" --- p.292 / Chapter LI --- Parents' evaluation (Chinese version) --- p.370 / Chapter LII --- Parents' evaluation (English version) --- p.372 / Chapter MI --- Teachers' breastfeeding evaluation (Chinese version) --- p.373 / Chapter MII --- Teachers' breastfeeding evaluation (English version) --- p.375 / Chapter NI --- Teachers' programme evaluation (Chinese version) --- p.377 / Chapter NII --- Teachers' programme evaluation (English version) --- p.381 / Chapter P --- Socioeconomic background information of partner schools --- p.385

by Wan Cheuk Wing. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves p. 166-183). / Abstracts in English and Chinese. / Acknowledgements --- p.i / Abstract --- p.ii-iii / Abstract (Chinese Version) --- p.iv / Table of Contents --- p.v-xi / List of Figures --- p.xii / List of Tables --- p.xiii-xxiii / List of Abbreviations --- p.xxiiv / Chapter CHAPTER ONE: --- INTRODUCTION / Chapter 1.1 --- "Socioeconomic, dietary and epidemiological transformation" --- p.1 / Chapter 1.1.1 --- Low breastfeeding rate --- p.3 / Chapter 1.1.2 --- Breakfast skipping --- p.6 / Chapter 1.1.3 --- Popularity of eating out --- p.8 / Chapter 1.1.4 --- Lack of school lunch surveillance or policy --- p.10 / Chapter 1.1.5 --- Frequent unhealthy snack consumption --- p.11 / Chapter 1.1.6 --- Physical inactivity --- p.12 / Chapter 1.2 --- "Childhood and Adolescent obesity determinants, trends and consequences" --- p.13 / Chapter 1.3 --- "Physiological, psychosocial and economic determinants of childhood and adolescent obesity" --- p.16 / Chapter 1.4 --- Adolescence - Critical period of habit development --- p.17 / Chapter 1.4.1 --- "Factors affecting eating and physical activity patterns: peers, television and the school environment" --- p.18 / Chapter 1.5 --- The education system in Hong Kong and United States --- p.20 / Chapter 1.5.1 --- Principles of effective nutrition curriculum development --- p.23 / Chapter 1.6 --- Study Design and Theoretical Approach of study --- p.23 / Chapter CHAPTER TWO: --- METHODOLOGY / Chapter 2.1 --- Target Population Determination --- p.28 / Chapter 2.2 --- Recruitment & Geographical Distribution of Schools --- p.28 / Chapter 2.2.1 --- Familiarization with School Background --- p.30 / Chapter 2.3 --- Focus groups --- p.31 / Chapter 2.4 --- "Questionnaire Development, Instrument Design and Pre-testing" --- p.32 / Chapter 2.4.1 --- Questionnaire Development --- p.32 / Chapter 2.4.2 --- Socio-demographic --- p.33 / Chapter 2.4.3 --- Breastfeeding --- p.33 / Chapter 2.4.4 --- "Dietary - Healthy Diet Pyramid, Healthy Breakfast, Healthy Lunch, Healthy Snack, Healthy Eating Out" --- p.33 / Chapter 2.4.5 --- Physical Activity --- p.34 / Chapter 2.4.6 --- Pretesting --- p.35 / Chapter 2.4.7 --- Sampling Method --- p.35 / Chapter 2.4.8 --- Student Helpers Training --- p.36 / Chapter 2.4.9 --- Data Collection --- p.37 / Chapter 2.4.10 --- Fun-In-Seven Logo --- p.37 / Chapter 2.5 --- Intervention Program --- p.38 / Chapter 2.5.1 --- Planning the Intervention Programs - Health Committee Establishment --- p.38 / Chapter 2.5.2 --- "Intervention Activities, Curriculum Design and Implementation" --- p.39 / Chapter 2.6 --- Evaluations --- p.45 / Chapter 2.6.1 --- Process Evaluation --- p.45 / Chapter 2.6.2 --- Outcome Evaluation --- p.45 / Chapter 2.7 --- Data Management --- p.46 / Chapter 2.7.1 --- Data Processing --- p.46 / Chapter 2.7.2 --- Statistics --- p.46 / Chapter 2.7.3 --- Data Analysis --- p.47 / Chapter CHAPTER THREE: --- RESULTS / Chapter 3.1 --- Participation rate of the study --- p.52 / Chapter 3.2 --- Pre-intervention survey results --- p.52 / Chapter 3.2.1 --- General sociodemographic characteristics of students --- p.52 / Chapter 3.2.2 --- Self-evaluated nutrition scores --- p.53 / Chapter 3.2.3 --- Breastfeeding --- p.55 / Chapter 3.2.4 --- Healthy Diet Pyramid --- p.61 / Chapter 3.2.5 --- Healthy breakfast awareness and practices --- p.64 / Chapter 3.2.6 --- "Eating out knowledge, attitudes and practices" --- p.68 / Chapter 3.2.7 --- Healthy Lunch --- p.73 / Chapter 3.2.8 --- Snack patterns --- p.77 / Chapter 3.2.9 --- Physical Activity --- p.81 / Chapter 3.2.10 --- Summary Profile of the Secondary Students in the Pre-intervention Survey --- p.92 / Chapter 3.3 --- Outcome evaluation --- p.95 / Chapter 3.4 --- Post-intervention Survey --- p.95 / Chapter 3.4.1 --- General sociodemographic characteristics of students --- p.95 / Chapter 3.4.2 --- Changes in self-rated nutrition knowledge --- p.96 / Chapter 3.4.3 --- Intervention effects on of breastfeeding knowledge and attitudes --- p.97 / Chapter 3.4.4 --- Healthy Diet Pyramid and healthy eating awareness --- p.104 / Chapter 3.4.5 --- Breakfast --- p.109 / Chapter 3.4.6 --- Eating Out --- p.113 / Chapter 3.4.7 --- Lunch --- p.117 / Chapter 3.4.8 --- Snacking --- p.121 / Chapter 3.4.9 --- Physical Activity --- p.128 / Chapter 3.4.10 --- "Changes in students' knowledge, attitude, and behavior after the intervention programme" --- p.140 / Chapter 3.5 --- Summary Profile of the Secondary Students in the Post-intervention Survey --- p.145 / Chapter CHAPTER FOUR: --- DISCUSSION / Chapter 4.1 --- Impacts of Fun-in-Seven programmes --- p.150 / Chapter 4.1.1 --- Breastfeeding --- p.150 / Chapter 4.1.2 --- Healthy Diet Pyramid --- p.151 / Chapter 4.1.3 --- Healthy Breakfast --- p.152 / Chapter 4.1.4 --- Lunch --- p.153 / Chapter 4.1.5 --- Snacking --- p.155 / Chapter 4.1.6 --- Physical Activity --- p.156 / Chapter 4.2 --- Strengths of the intervention programme --- p.157 / Chapter 4.3 --- Limitations and problems encountered --- p.159 / Chapter 4.4 --- Recommendations for further improvement --- p.161 / Chapter CHAPTER FIVE: --- CONCLUSION --- p.165 / References --- p.166-180 / Appendices / Chapter A --- Questionnaire for Teacher/Principal (English version) --- p.181-183 / Chapter B --- Secondary School Background Information (English version) --- p.184-195 / Chapter CI --- Questionnaire (Chinese version) --- p.196-209 / Chapter CII --- Questionnaire (English version) --- p.210-224 / Chapter D --- Pamphlets for seven themes (Chinese and English versions) --- p.225-257 / Chapter E --- Worksheets & Certificates (Chinese and English versions) --- p.258-283 / Chapter F --- Activities photos (English version) --- p.284-288 / Chapter G --- Summary of materials and activities of each theme in Fun-in-Seven (Chinese version) --- p.289 / Chapter HI --- Breastfeeding and Physical Activity Process Evaluation Questionnaire (Chinese version) --- p.290-291 / Chapter HII --- Breastfeeding and Healthy Diet Pyramid Process Evaluation Questionnaire (English version) --- p.292-294 / Chapter JI --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (Chinese version) - School 1" --- p.295-299 / Chapter JII --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (English version)" --- p.300-305 / Chapter KI --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (Chinese version) - School 2" --- p.306-309 / Chapter KII --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (English version) ´ؤ School 2" --- p.310-313 / Chapter LI --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (Chinese version) ´ؤ School 3" --- p.314-317 / Chapter LII --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (English version) ´ؤ School 3" --- p.318-322 / Chapter MI --- Teacher's Outcome Evaluation Form (Chinese version) ´ؤ School --- p.323-324 / Chapter MII --- Teacher's Outcome Evaluation Form (English version) 一 School --- p.325-327 / Chapter NI --- Teacher's Outcome Evaluation Form (Chinese version) ´ؤ School --- p.328-329 / Chapter NII --- Teacher's Outcome Evaluation Form (English version) - School --- p.330-332 / Chapter PI --- Teacher's Outcome Evaluation Form (Chinese version) - School --- p.333-334 / Chapter PII --- Teacher's Outcome Evaluation Form (English version) 一 School --- p.335-337 / Chapter QI --- Health Ambassador's Outcome Evaluation Form (Chinese version) --- p.338-339 / Chapter QII --- Health Ambassador's Outcome Evaluation Form (English version) --- p.340-341