Authors (including presenting author) :
Chan YK(1), Yeung FL(1), Chu WM(1), Wong YC(1), Lee PY(2), Chu WY(1), Lui HL(1), Ng TW(1), Wong BC(1), Cheng SYR(1), Ng YS(1)
Affiliation :
(1) Department of Family Medicine and Primary Health Care, NTWC, (2) Ambulatory Care Centre, NTWC
Keyword 1: :
Lifestyle medicine
Keyword 2: :
Nurse-led care
Keyword 3: :
Preventive care
Keyword 4: :
Self-care empowerment
Keyword 5: :
Primary care innovation
Introduction :
Hong Kong faces a rapidly ageing population and a high burden of chronic non-communicable diseases, contributing to rising Hospital Authority Family Medicine Clinic (FMC) attendances and increasing pressure on treatment-oriented care models. In alignment with HA’s strategic shift towards people-centred, prevention-oriented, community-based and nurse-led care, a lifestyle medicine–based preventive coaching model was developed to address modifiable risk factors at pre-disease and early-risk stages.
Objectives :
To evaluate the effectiveness and service efficiency of a nurse-led lifestyle medicine coaching model in improving self-care behaviours and managing growing primary care service demand.
Methodology :
A quasi-experimental pre–post pilot study with intervention and control groups was conducted in NTWC FMCs. 40 participants per arm were recruited through routine screening, comprising adults without established diabetes and hypertension. Priority was given to individuals with limited access to preventive care, supporting risk-based and equitable allocation of preventive services. The intervention comprised brief nurse-led lifestyle coaching and prescribing across six domains: nutrition, physical activity, restorative sleep, stress management, social connection, and avoidance of risky substances. Coaching was supported by SMART (Specific, Measurable, Achievable, Relevant and Time-bound) goal-setting tools, cue cards, digital reminders and referral to District Health Centres. Outcomes were measured using standardised lifestyle measures over an 8-week period and delivered within existing FMC workflows without additional manpower.
Result & Outcome :
Baseline demographic characteristics and initial lifestyle assessment scores were comparable between the intervention and control groups. Compared with controls (n=40), the intervention group (n=40) demonstrated significant and clinically meaningful improvements. Diet quality increased from 25.0 to 31.0 (p < .001), with marked increases in fruit and vegetable intake and reductions in refined, sugary, and fried foods (all p < .001). Moderate-to-vigorous physical activity increased from 0 to 90 minutes/week (p < .001), and attainment of WHO physical activity recommendations rose from 12.5% to 55.0%. Modest improvements were observed in sleep quality and social wellbeing (p < .05), while substance use and mood were less responsive. The pilot was delivered without additional staffing and demonstrates potential to reduce future consultation intensity and downstream chronic disease burden. This nurse-led lifestyle medicine coaching model is effective, feasible and scalable within HA primary care. By strengthening self-care at early risk stages, the model supports preventive care delivery, workforce optimisation and sustainable management of growing primary care service demand.
