Angela Leung

• PhD, MHA, BN, RN, FHKAN(Geron)
• Professor at The Hong Kong Polytechnic University

Background: Although much research has been done investigating the roles of social network sites (SNSs) in linking patients and health professionals, there is a lack of information about their uses, benefits, and limitations in connecting health professions only for professional communication. Objective: This review aimed to examine the utilizat...

Background To decrease the burden of diabetes in society, early screening of undiagnosed diabetes and prediabetes is needed. Integrating a diabetes risk score into a mobile app would provide a useful platform to enable people to self-assess their risk of diabetes with ease. Objective The objectives of this study were to (1) assess the profile of D...

Objectives: To examine levels of knowledge about dementia and attitudes towards dementia in low- and middle-income countries (LMICs), identify sources to turn to for help, and explore the relationship between knowledge and attitudes. Methods: This mixed-methods study with both quantitative (a cross-sectional survey) and qualitative (focus group...

Objectives: This paper examines the relationship between health literacy and mental well-being of school staff during distressful times. It examines the mediating roles of work-related stress, health-protective behaviours (i.e., attitudes about vaccination), and sense of coherence in the relationship between health literacy and mental well-being. S...

Vaccine hesitancy is identified as one of the top ten global health threats by the World Health Organization. The emergence of new coronavirus variants and evidence of waning immunity offered by COVID-19 vaccines draw attention to the need for regular vaccinations. This study aimed to understand the people’s hesitancy towards regular COVID-19 vacci...

Background: To strengthen and motivate the nursing workforce, this study explored the relationship between nurses’ self‐efficacy, job embeddedness, and psychological empowerment, and how this relationship varied across three regions in the Guangdong–Hong Kong–Macao Greater Bay Area of China. Methods: A multicenter cross‐sectional study surveyed 380...

Background and objectives Social robots show great potential for delivering home-based aged care and supporting ageing-in-place. This study aims to assess the acceptability of social robots in delivering home care to older adults across seven domains: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportu...

Background Coronary artery disease (CAD) is a major health problem of atherosclerotic cardiovascular (CV) disease and early intervention is regarded important. Given the proven effect of a lifestyle intervention with nursing telephone counselling and mHealth use in health care, yet the comparisons of both support are lacking, this study is proposed...

Background Sense of coherence (SoC) is a core concept of ‘salutogenesis’ in positive psychology, correlated with emotional distress and disease development in adults with chronic disease and older adults. A diversity of non‐pharmacological interventions (NPIs) has been developed to enhance SoC, but research findings are conflicting and the adequacy...

Background Older adults with pre-diabetes face unique health challenges, including limited awareness and resources for disease management. The Salutogenic model of Health focuses on identifying and utilising available resistance resources surrounding people to cope with tension created by stressors. This approach is crucial for this vulnerable popu...

Aim The aim of this study was to explore the factors influencing the retention behaviour of experienced nurses in China, using the capability, opportunity, motivation and behaviour (COM‐B) model as a conceptual framework. Design A qualitative descriptive study based on the COM‐B model. Methods In this qualitative descriptive study, semi‐structure...

Objectives: This study aimed to tailor and pilot a health education program using the PRECEDE-PROCEED model to promote vaccination and enhance self-protective behaviors against COVID-19 in Hong Kong populations. Study design: Quasi-experimental study. Methods: Phases 1-4 of the PRECEDE-PROCEED model were used to identify the needs for COVID-19...

Sense of coherence (SoC) refers to how individuals cope with stress and maintain health, yet its concept remains no consensus about how it is defined and applied in the context of stroke care. This study aims to clarify the concept of SoC by reviewing its applications in various stroke populations and its changes across different stages of stroke....

Abstract Background The World Health Organization (WHO) introduced the Integrated Care for Older People (ICOPE) approach to assist communities in evaluating the intrinsic capacities of older adults and proposing strategies to prevent, mitigate, or reverse declines. This study represents the inaugural attempt to assess intrinsic capacities among old...

Loneliness has become a significant public health issue among community‐dwelling older adults particularly those with multimorbidity. Family caregivers are crucial care resources for dependent older adults living in the community before transitioning to institutional services. However, understanding of their perceptions in supporting older adults w...

Background Family caregivers (FCs) encounter a variety of health problems in older people with chronic illness, necessitating a certain level of health literacy to access, understand, appraise and apply health information and services. This study aimed to develop and validate a scale for measuring health literacy among FCs of older people with chro...

Vaccine hesitancy is one of the top ten threats to global health. Artificial intelligence-driven chatbots and motivational interviewing skills show promise in addressing vaccine hesitancy. This study aimed to develop and validate an artificial intelligence-driven motivational digital assistant in decreasing COVID-19 vaccine hesitancy among Hong Kon...

Background: Community engagement plays a vital role in global immunization strategies, offering the potential to overcome vaccination hesitancy and enhance vaccination confidence. Although there is significant backing for community engagement in health promotion, the evidence supporting its effectiveness in vaccination promotion is fragmented and o...

Background The 2020 national health literacy monitoring revealed that only 8.49% of individuals aged 65–69 years, a segment of the older population, possess adequate health literacy levels, indicating a low level in China. Studies have demonstrated that improving the organizational health literacy of healthcare institutions is a crucial approach to...

Background Providing informal care for individuals with dementia is frequently a challenging and demanding experience that can have detrimental effects on the psychological well-being of caregivers. Regrettably, community-based caregiver services often prove inadequate, highlighting the necessity for innovative approaches to support caregivers. Ai...

Abstract Dementia is a long-term and progressive syndrome that not only influences the person with dementia (PWD) but also the caregiver. However, informal caregivers are not always empathic and understand the symptoms of dementia, leading to destructive caregiving relationships and poor quality of caregiving. VR-based simulation interventions can...

Background Sense of Coherence (SoC) is a core concept of “salutogenesis” in positive psychology, correlated with emotional distress and disease development in older adults with chronic disease (OACD). A diversity of interventions has been developed to enhance SOC, but research findings are conflicting and only a few studies have reviewed the effect...

Objective This study aims to assess the effect of the Blended Gaming COVID-19 Training System (BGCTS) on infection control practices, compliance rates and knowledge of standard precautions among all staff in residential care homes (RCHs). Design: A 2-arm single-blinded cluster randomized controlled trial. Setting: Thirty RCHs were recruited and ran...

The World Health Organization (WHO) proposed the Integrated Care for Older People (ICOPE) approach to guide health systems in better supporting the intrinsic capacity and functional ability of older adults to enable healthy aging (Briggs et al., 2018; de Carvalho et al., 2019). This approach is aligned with Singapore’s Healthier SG initiative, whic...

With the growing number of Parkinson’s disease technological intervention studies available, it is uncertain what and how people with Parkinson’s disease (PWP) respond to these interventions. This systematic review aims to study the user perception and perceived psychosocial gain of technological interventions among the Parkinson’s disease populati...

The World Health Organization (WHO) proposed the Integrated Care for Older People (ICOPE) approach to guide health systems in better supporting the intrinsic capacity and functional ability of older adults to enable healthy aging (Briggs et al., 2018; de Carvalho et al., 2019). This approach is aligned with Singapore's Healthier SG initiative, whic...

Objectives: To examine loneliness in old age and whether intergenerational reciprocity and WHO functional ability predicted loneliness. Methods: Using the China Health and Retirement Longitudinal Study Wave 4 (2018) database (CHARLS), logistic regression models were adopted to investigate the relationships. Results: The prevalence of lonelines...

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 reduci...

The emergence of new coronavirus variants and evidence of waning immunity offered by COVID-19 vaccines draw attention to the need for regular vaccination. Vaccine hesitancy is one of the top ten threats to global health. There is a dearth of knowledge on people’s hesitancy to take regular COVID-19 vaccines. This study aimed to investigate the preva...

Background and Objectives Age‐related hearing loss (ARHL) is the third leading cause of years lived with disability. Connections among ARHL, depressive symptoms, social engagement and cognitive status are increasingly reported but the underlying mechanisms leading to these relationships are largely unknown. Exploring these mechanisms is a worthy go...

Background: Depression is a debilitating disorder affecting individual functioning and increase the global psychiatric mortality rates. The general population nationwide is confronted by the novel coronavirus disease (COVID-19) which causes a spike downturn to individuals’ mental health. Aim: The aim of this study was to examine the prevalence and...

Background: Community engagement plays a vital role in global immunization strategies, offering the potential to overcome vaccination hesitancy and enhance vaccination confidence. Although there is significant backing for community engagement in health promotion, the evidence supporting its effectiveness in vaccination promotion is fragmented and o...

Purpose: The research aimed to examine the effect of a lifestyle intervention program using mobile application versus booklet for adults with metabolic syndrome in Hong Kong. The outcomes comprised body weight (primary outcome), exercise amount, improvement of cardiometabolic risk factors, cardiovascular endurance, perceived stress scale, and exer...

Background Immersive virtual reality (IVR) applications are gaining popularity in health care education. They provide an uninterrupted, scaled environment capable of simulating the full magnitude of sensory stimuli present in busy health care settings and increase students’ competence and confidence by providing them with accessible and repeatable...

Aim Despite the well-documented short to medium-term effectiveness of eHealth (electronic health) secondary prevention interventions on patients with cardiovascular disease (CVD), there is limited empirical evidence regarding long-term effectiveness. This review aims to evaluate the long-term effects of eHealth secondary prevention interventions on...

Background: Family caregivers of people with dementia (FG-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 behavioral activation (BA) and mindfulness practice (MP) have been shown to be potentially effective at reduci...

Background: Social robots have the potential to bring benefits to aged care. However, it is uncertain whether placing these robots in older people's home is acceptable and whether human-robot interactions would occur or not. Methods: Four case studies were conducted to understand the experiences of older adults and family caregivers when humanoi...

Objectives The coronavirus disease 2019 (COVID-19) pandemic developed rapidly, with changing guidelines, misinformation, inaccurate health information and rumors. This situation has highlighted the importance of health literacy, especially among educators. The aims of this study were (i) to assess COVID-19-specific health literacy among school teac...

Background: Caregivers of people with dementia experience high stress levels. Network intervention can effectively improve the mental health of caregivers, which is a very feasible way for dementia caregivers who need help. Objective: The aim was to explore the feasibility and effects of Wechat official account network interventionon family caregiv...

The health and well-being of school leaders during the COVID-19 pandemic have been largely neglected compared to the health and well-being of students and teachers. This study assessed the magnitude of perceived stress and well-being and the associated factors, including number of working hours, work-related sense of coherence (work-SoC), perceived...

As global population ageing persists, understanding older adults' capacity to navigate the financial and healthcare system is essential. This scoping review examines how the concept of financial health literacy (FHL) is described and measured in the existing literature, the factors that may affect it, and its potential outcomes in middle-aged and o...

School teachers have faced many challenges due to the coronavirus disease-2019 (COVID-19) pandemic and public health-related containment measures. Recent studies have demonstrated high levels of stress and mental health issues among school teachers. To better understand teacher well-being and inform practices to support them in the face of the ongo...

Objectives Research on dementia literacy in Chinese societies is still emerging, and this is especially the case among racially minoritized groups. The present study explored the knowledge, causal beliefs, and help-seeking behaviors of South Asian migrants in Hong Kong about dementia. It also investigated existing community barriers related to deme...

Background The World Health Organization (WHO) encourages healthy ageing strategies to help develop and maintain older people’s functional abilities in five domains: their ability to meet basic needs; learn, grow, and make decisions; be mobile; build and maintain relationships, and contribute to society. This scoping review reports the available ev...

Background: While a number of population preventive measures for COVID-19 exist that help to decrease the spread of the virus in the community, there are still many areas in preventative efforts that need improvement or refinement, particularly as new strains of the virus develop. Some of the key issues currently include incorrect and/or inconsist...

To date, we know little about COVID-19-related health literacy among school leaders, particularly in East Asia. The present study aimed to assess the level of COVID-19-related health literacy and associated factors (vaccine hesitancy, self-endangering behaviour, and work satisfaction) among school leaders in Hong Kong. A cross-sectional study of 25...

Background: Hypertension comorbid with metabolic syndrome could increase the development of adverse cardiovascular events. Educational interventions were effective to improve outcomes in patients. Methods: This was a secondary data analysis of participants with hypertension. The original randomized controlled trial aimed to examine the effect of...

Background: Dementia is an emerging public health issue. Growing evidence emerged on the association between social integration and the risk of dementia. However, the magnitude of the association between different aspects of social integration and the risk of dementia is unclear. Methods: Five databases were systematically searched. Newcastle-Ot...

Background Dementia informal caregiving is a global phenomenon. It is well documented that caregivers' psychological health is often affected by busy caregiving schedules. Lawton's two-factor model indicates that caregivers' psychological wellbeing is influenced by caregiving appraisal and other caregiver factors. Our review also identified the sig...

Objective To compare the learning curve of clinicians with different levels of embryo transfer (ET) experience using the ASRM Embryo Transfer Simulator. Design Prospective cohort study Setting Single large university-affiliated IVF Center Patient(s) Participants with three levels of expertise with ET were recruited: “Group 1” (REI attendings), “...

Background Mindfulness-based intervention (MBI), an emotion-focused approach, has been shown promising and sustainable effects on enhancing the well-being of caregivers of patients with dementia (PWD). However, the conventional MBI was quite demanding, had high rates of attrition and inconsistent long-term effect. The social distancing measures int...

Caregiving appraisal is the caregivers’ cognitive evaluation of caregiving stressors. It determines the caregiving outcomes and caregiver health. Dementia caregivers have shown relatively negative caregiving appraisals. However, there is a lack of interventions to improve caregiving appraisal. This study describes the multi-phase process of develop...

Objectives: In 2007, the World Health Organization published a guide on age-friendly cities. However, little is known about interventions that have been implemented to promote age-friendly communities in rural and remote areas. This paper presents the findings from a scoping review undertaken to locate available evidence of interventions, strategi...

Objective: To determine the association of interpregnancy interval on perinatal outcomes and whether this was influenced by mode of conception. Design: Retrospective cohort. Setting: Centers for Disease Control and Prevention's natality national database. Patient(s): Patients who had an index singleton live birth with a preceding live birth....

Background and Objectives Integrating mental activities with physical exercises (e.g., dual-tasking) may potentially improve cognition in older adults and people with mild cognitive impairment (MCI). This study investigated the preliminary efficacy of a new intervention called dual-task Zumba Gold (DTZ) on people with MCI to guide an adequately-pow...

BACKGROUND Immersive virtual reality (IVR) applications are gaining popularity in health care education. They provide an uninterrupted, scaled environment capable of simulating the full magnitude of sensory stimuli present in busy health care settings and increase students’ competence and confidence by providing them with accessible and repeatable...

Background: Although sleep disturbances and insomnia are common among Internally Displaced Persons (IDPs), these disorders remain largely understudied among victims fleeing ethnoreligious genocide. The Insomnia Severity Index (ISI), though a widely used measure of insomnia, has not been translated, cross-culturally adapted, nor validated in common...

Painting is a well-known method for alleviating stress, but it is uncertain whether family caregivers can use an electronic painting platform at home for this purpose. Aim: The aim in this study was to assess the feasibility and acceptability of having family caregivers of persons with dementia (FCPWD) draw electronic paintings using a mobile app...

Leisure activities are essential for family caregivers of loved ones with dementia living in the community, yet these caregivers tend not to engage in them, especially in China, wherein it may have a negative impact on their physical and psychological health. To date, limited knowledge exists regarding underlying reasons that deter these family car...

Background: International guidelines have promoted palliative care (PC) for stroke survivors, but definition and implementation have been less than ideal. This practice gap is more prominent in China, where discussion of death remains taboo. Aim: The aim of this study was to explore the perspectives of PC among caregivers of hospitalized patient...

During the COVID-19 pandemic, there is a growing interest in online information about coronavirus worldwide. This study aimed to investigate the digital health literacy (DHL) level, information-seeking behaviour, and satisfaction of information on COVID-19 among East and South-East Asia university students. This cross-sectional web-based study was...

Abstract Background The World Health Organization (WHO) published the Integrated Care for Older People (ICOPE) framework to guide assessing and promoting intrinsic capacity of older adults. This study, adopting the WHO ICOPE framework, assessed the intrinsic capacity impairment and investigated the relationship among intrinsic capacity, social enga...

Purpose: Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally. This study aimed to examine the preliminary effect of a nurse-led support programme using a mobile application versus nursing telephone advice on patients at risk of CHD living in the community. Patients and methods: A prospective randomized controlle...

STUDY QUESTION Is there a relationship between endometrial compaction and live birth in euploid frozen embryo transfer (FET) cycles? SUMMARY ANSWER Live birth rates (LBRs) were similar in both patients that demonstrated endometrial compaction or no compaction in single euploid FETs. WHAT IS KNOWN ALREADY There has been increasing interest in the...

Background: A majority of persons with dementia in Sweden live in their own homes and are often cared for by family members. Caring for a family member may be a positive experience. It may, however, also be a negative experience as symptoms like disturbing behavior and delusions may be difficult to encounter. The burden of being a family caregiver...

Sleep disturbances are common among family caregivers of people with dementia (PWD). Although behavioral activation (BA) shows potential to improve sleep quality, to date, evidence for this treatment’s feasibility and efficacy for family caregivers of PWD is limited. Therefore, this study pilot-tested an evidence-based BA protocol for improving sle...

Despite the popularity of Zumba dancing, research is scarce about its impact on older adults. Meanwhile, the integration of cognitive tasks with physical exercises, also known as dual tasking, is an evolving strategy to facilitate activities for older adults. This study investigated the perceptions of persons aged ≥55 years on Zumba and its potenti...

On 30 January 2020, the World Health Organization (WHO) declared the current novel coronavirus disease 2019 (COVID-19) as a public health emergency of international concern and later characterized it as a pandemic. New data show that excess body mass and vitamin D deficiency might be related to the disease severity and mortality. The aim of this st...

The needs of the aging populations are putting increasing burden on healthcare particularly in the Western Pacific Region (WPR), which is the home of aging economies such as Hong Kong and Japan alongside rapid increases in older people in low- and middle-income countries (LMICs). However, little is known about the associations between sociodemograp...

This encyclopedia brings together a comprehensive collection of work highlighting established research and emerging science in all relevant disciplines in gerontology and population aging. It covers the breadth of the field, gives readers access to all major sub-fields, and illustrates their interconnectedness with other disciplines. With more than...

Introduction Dementia is a progressive brain degeneration characterized by a progressive deterioration in cognition and independent living capacity (Sobral, Pestana, & Paúl, 2015). Fifty million people are living with dementia globally. This number will be projected to grow to 82 million by 2030 and 152 million by 2050 (Alzheimer's Disease Internat...

PurposeThis pilot study sought to (1) validate the use of a novel technology for single-sperm-cell genome sequencing (Sperm-seq) in infertile men who may not have optimal quantity or quality of sperm for genomic analysis and (2) compare these results to fertile donors.Methods Infertile men undergoing IVF with female partners with a previous history...

Dual-tasking (e.g., enrichment of physical activities with mental exercises) is an innovative strategy to enhance older adults’ cognition. Meanwhile, Zumba is a popular dance program, but research is limited about its utility on older people or those with mild cognitive impairment (MCI). This study assessed the feasibility of a new intervention cal...

(Abstracted from Fertil Steril 2021;116(1):27–35) In vitro fertilization (IVF) has represented the mainstay of infertility treatment globally for many decades and has improved significantly over this time in efficacy and efficiency. Innovation in technology and laboratory practices such as cryopreservation and vitrification in conjunction with clin...

The aim of this study was to examine nurses’ attitudes about the importance of family in nursing care from an international perspective. We used a cross-sectional design. Data were collected online using the Families’ Importance in Nursing Care—Nurses’ Attitudes (FINC-NA) questionnaire from a convenience sample of 740 registered nurses across healt...

Despite the popularity of Zumba in several countries, research is scarce about its impact on older adults. Meanwhile, the integration of cognitive tasks with physical exercises, known as dual-tasking, is an evolving strategy to facilitate activities for older people. This study investigated the perceptions of older adults regarding Zumba and the po...

Caregiving appraisal is a key driver to moderating caregiving outcomes. The caregiving appraisal of informal caregivers of people with dementia requires increased attention. This study aimed to explore the feasibility and acceptability of an evidence‐based bibliotherapy protocol, and test the efficacy on improving caregiving appraisal. A two‐arm pi...

The current study examined the moderating role of socioeconomic status (SES) in the association between digital health literacy (DHL) and psychological well-being of 801 university students in Hong Kong and Macao amid the coronavirus disease-2019 (COVID-19) pandemic. Results showed that DHL and SES were positively associated with psychological well...

Globally, staff, administrators, and community members have devised innovative strategies to maintain quality of life for residents while reducing spread of COVID-19. Although developed as urgent responses to a temporary situation, some innovations could address longstanding quality of life challenges and should, we suggest, be considered for perma...

Purpose This study aimed to examine the preliminary effect, feasibility, and acceptability of a lifestyle intervention program using a mobile application (app) versus the effect of a program using a booklet for adults with metabolic syndrome (MetS). Patients and Methods This trial was conducted in two community centers of Hong Kong. Participants w...

Awareness is one of the first steps in a lifestyle modification process. Since older adults are at a higher risk of hypertension, maintaining low sodium intake is of utmost importance. Yet, it is uncertain if older adults have an awareness of their sodium intake. This study aimed to explore self-perceived sodium intake among older Chinese people an...

Background APOE ε4 is the best-known risk factor for late-onset Alzheimer’s disease (AD). Population studies have demonstrated a relatively low prevalence of APOE ε4 among Chinese population, implying additional risk factors that are Chinese-specific may exist. Apart from ε-alleles, genetic variation profile along the full-length APOE has rarely be...

This an electronic record of the scoping review protocol undertaken by our team.

Sense of community may be shaped by the quality of the physical environment and has potential health implications. Based on a survey of 2,247 community-dwelling middle-aged and older adults living in Hong Kong, we tested the mediation effect of sense of community on the relationship between the quality of the built environment and physical and ment...