The Kwai Tsing Safe Community & Healthy City – 6 Years' Experience
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Community Engagement for Health TheThe KwaiKwai TsingTsing SafeSafe CommunityCommunity && HealthyHealthy CityCity –– 66 YearsYears’’ ExperienceExperience C B Chow Cluster Clinical Coordinator (Community Health) KWC YH Chow, Adela Lai, Alan Lee, Alan Chow, et al Kwai Tsing Safe Communty and Healthy City Association KwaiKwai TsingTsing DistrictDistrict KwaiKwai TsingTsing DistrictDistrict 8.60% 9.70% 3.20% 50 8.10% 40 41.1 24% 30 31.9 % 20 15.4 10 11.6 0 46.40% 0-14 15-34 35-64 65+ No Schooling Primary Secondary Matriculation Non-degree course Degree Cours 22 sq km • 75% living in public housing estate • 21 housing estates • 35 secondary schools • 41 primary schools • 67 kindergartens • 1 higher education institute • 1 acute general hospital Population: • 1 psychiatric hospital 490,000 • 43 nursing homes Kwai Tsing District 6th densely populated (21800 persons per km2) Divided into 5 districts Kwai Tsing - Industry • Contains almost 2/3 of Hong Kong’s heavy industries – Container terminals – Cement industry – Chemical industry – Ship repair and construction – Oil tanks SystemSystem && SurveillanceSurveillance forfor aa SafeSafe CommunityCommunity Evidence of Program Indicators for International Safe Communities • Infrastructure: • Based on partnership and collaborations, governed by a cross- sectional group that is responsible for safety promotion in their community • Injury Surveillance: • Document the frequency and causes of injuries • Programs: • Long-term, sustainable, covering both genders and all ages, environments, and situations • Targeted at high-risk groups and environments • Promote safety for vulnerable groups • Evaluation: • Assess programs, processes and the effects of change • Networks: • Ongoing participation in national and international Safe Cmmunities networks (WHO Collaborating Centre on Community Safety Promotion, http://www.phs.ki.se/csp/who_safe_communities_indicators_en.htm, May 2002) ObjectivesObjectives • To promote a safety culture through partnerships and integration of resources • To coordinate resources in Kwai Tsing District to implement comprehensive and systematic safety promotion, education and researches • To share experience and contribute to International Safe Community network under World Health Organization KwaiKwai TsingTsing SafeSafe CommunityCommunity Inaugurated in October 2000 15 major government departments, 4 education institutes and 8 private organizations TargetsTargets • To reduce injuries by 30% in 5 years • To be accredited by WHO as Safe Community in 2 years DatabaseDatabase • AEIS – Accident & Emergency Information System • CDARS – Hospital admissions • Child abuse registry of SWD • Traffic accident database – Police • Crime rate – Police • Fire outbreaks – Fire Services Department • Ad hoc surveys PilotPilot StudyStudy onon FallFall InjuriesInjuries • Survey was conducted at AED of PMH July 2000 • To investigate incident rate, causes and characteristics • 107 cases were interviewed in four weeks • 24 student volunteers recruited for data collection . • Pamphlets, questionnaires were designed and issued 30 20 % 10 0 0-10 11-20 21-40 41-60 61-70 71+ Percentage 2481724918Age Age Distribution of Fall Injuries PublicPublic AttitudesAttitudes towardstowards HealthHealth andand SafetySafety • Survey on awareness on occupational safety and health in May 2000 • 452 respondents were interviewed by telephone 8 6 Score 4 2 0 Air Tr a f f i c Heart Occup. Home Me ntal Food Cancers Quality Accidents Attacks Accident Accidents Illne ss Poisoning Average Score 6.33 6.08 5.59 5.28 5.1 4.7 4.15 4.05 Health and Safety Issues SurveySurvey onon HospitalHospital StaffStaff’’ss AttitudeAttitude towardstowards HealthHealth andand SafetySafety • To explore the attitude of hospital staff towards work safety and its relationship • Self- administered questionnaires on April 01 • Response rate was 48% (1448 staff) SurveySurvey onon HospitalHospital StaffStaff’’ss AttitudeAttitude towardstowards HealthHealth andand SafetySafety 70% 60% 50% 40% 30% 20% 10% 0% Arthri Stres GI Res p. Visio Heari Other tis/LB s probl probl Skin n ng s P /head em em Administrative 40% 40% 20% 30% 0 0 20% 0 Medic al 41% 41% 18% 45% 18% 9% 2% 5% Nurs ing 60% 60% 38% 41% 16% 6% 3% 3% Allied Health 47% 47% 26% 23% 16% 11% 4% 2% Clerical 41% 41% 28% 30% 9% 24% 10% 8% Supporting 58% 58% 22% 16% 10% 12% 10% 7% SurveySurvey onon TeenagersTeenagers’’ AttitudeAttitude towardstowards SafetySafety andand RiskRisk TakingTaking BehaviourBehaviour • Survey to find out prevalence of risk behaviours and health status of youth • 6147 schoolchildren participated (1026 primary and 5121 secondary school students) • Questionnaire based on Youth Risk Behaviour Surveillance and Wessex Healthy Schools Award Scheme Students evaluation Questionnaire SurveySurvey onon TeenagersTeenagers’’ AttitudeAttitude towardstowards SafetySafety andand RiskRisk TakingTaking BehaviourBehaviour Primary students Secondary students • 6% carried weapons to • 7% carried weapons to school and being threatened school and 4% being • 25% reported property being threatened stolen or damaged • 25% reported property being • 13% complained being stolen or damaged sexually harassed • 17% complained being • 25% found to have sexually harassed depressive symptoms • 40% found to have • 9.8% had suicidal thoughts depressive symptoms • 3% tried cough syrup and • 18.9% had suicidal thoughts 2% sniffing organic solvent • 1% tried cough syrup and 2% sniffing organic solvent CentralCentral HubHub forfor CommunityCommunity HealthHealth ResourcesResources –– with funding from Yuen Yuen Institute • Co-ordinating Office • Venues for meeting, education talks, • Models, activities facilities and equipment to demonstrate safety CentralCentral HubHub forfor CommunityCommunity HealthHealth ResourcesResources Models, facilities and equipment to demonstrate safety KwaiKwai TsingTsing SafeSafe CommunityCommunity andand HealthHealth CityCity AssociationAssociation Made up of key members from Steering and Working Committees To identify To initiate major health changes by and safety issues pooling community resources and efforts To collect and raise funds Age Mechanism Estate – Child -Fall 2002 -Fire - Youth -Traffic - Elderly -Crime Safe -Violence Setting & - Home Healthy - School School Means Workplace -Road 2003 -Safety education 2004 -Safety promotion - Elderly home -Skill training – - Work place Emergency, CPR -Ambassador HospitalizedHospitalized ChildChild andand YouthYouth InjuriesInjuries inin KwaiKwai TsingTsing 600 500 400 300 Number 200 100 0 1997 1998 1999 2000 2001 Year 0-4 yr 5-9 yr 10-14 yr 15-19 yr 20-24 yr HospitalizedHospitalized AdultAdult InjuriesInjuries inin KwaiKwai TsingTsing 500 400 300 Number 200 100 0 1997 1998 1999 2000 2001 Year 25-29 yr 30-34 yr 35-39 yr 40-44 yr 45-49 yr 50-54 yr 55-59 yr 60-64 yr HospitalizedHospitalized ElderlyElderly InjuriesInjuries inin KwaiKwai TsingTsing 400 350 300 250 200 150 No of episodes of No 100 50 0 1997 1998 1999 2000 2001 Year 65-69 yr 70-74 yr 75-79 yr 80-84 yr 85+ yr Kwai Tsing Healthy City Inaugurated in January 2002 SteeringSteering && WorkingWorking CommitteesCommittees 葵青安全社區及健康城市協會董事會 葵青安全社區及健康城市協會督導委員會 Board of Directors Steering Committee 行政會 Executive Committee 安健屋邨委員會 葵青區傷害監察專責委員會 Safe & Healthy Estate Subcommittee KT Injury Surveillance Subcommittee 安健學校委員會 CIIF 及青衣健康中心委員會 Safe & Healthy School Subcommittee CIIF & TY Community Health Centre Subcommittee 安健約章委員會 葵青社區照顧互動網委員會 Safety & Health Charter Subcommittee KT Community Care Network Subcommittee KwaiKwai TsingTsing SafeSafe CommunityCommunity && HealthyHealthy CityCity AssociationAssociation •• FoundedFounded inin AugustAugust 20022002 •• ToTo sustainsustain thethe workwork ofof HealthyHealthy CityCity && SafeSafe CommunityCommunity •• AsAs aa NGONGO andand notnot forfor profitprofit •• AcceptAccept DonationDonation •• ApplyApply forfor researchresearch && developmentdevelopment fundsfunds •• ReduceReduce redred tapestapes andand proceduresprocedures •• WorkWork accordingaccording toto MemorandumMemorandum && ArticlesArticles Designated to be the 73rd Safe Community on 18 March 2003 NewNew CollectiveCollective IdentityIdentity z ‘A common bond was forged between the hospital staff and society at large’… z ‘This new communal spirit was further promoted by the mass media which for once began to serve a constructive purpose by informing the public … of the methods of coping with it in everyday living.’ (Leo Ou-Fan Lee,2003). SpiritualSpiritual AppreciationAppreciation z Solidarity, resilience •Setting up hotlines and emergency z Open expressions of services appreciation to the •Mobilizing volunteers to distribute frontline healthcare facemasks and disinfectants, measure body temperature for the public in MTR workers, family members. Helping underprivileged people to clean up their homes Serving single elderly z Tributes to the heroic persons in the community of homes for professionalism of the the elderly frontline health care workers z Mutual support, peace of mind 認 識 及 預 防 流 感 CommunityCommunity DiagnosisDiagnosis •• ConductedConducted byby thethe ChineseChinese UniversityUniversity ofof HongHong KongKong duringduring 10/0310/03 –– 3/043/04 •• InterviewedInterviewed 685685 residentsresidents •• ConductedConducted 55 FocusFocus GroupGroup meetingsmeetings •• OverallOverall satisfiedsatisfied withwith thethe facilitiesfacilities •• ConcernsConcerns onon nightnight drifters,drifters, neighborhood,neighborhood, environmentalenvironmental hygiene,hygiene, exerciseexercise