| Author: | Tian, Kun |
| Title: | Social work to improve health literacy among rural older adults with chronic diseases : a practical exploration in Guizhou province, China |
| Advisors: | Bai, Xue (APSS) |
| Degree: | DSW |
| Year: | 2025 |
| Department: | Department of Applied Social Sciences |
| Pages: | 1 volume (unpaged) : color illustrations |
| Language: | English |
| Abstract: | Background: With China's rapidly ageing population and limited access to healthcare resources in rural areas, improving health literacy among older adults with chronic diseases has become an urgent public health concern. In regions such as rural Guizhou, these challenges are further exacerbated by cultural and structural barriers. This study aims to evaluate the effectiveness of social work interventions in enhancing health literacy among older adults with chronic illnesses in Y Community, Guizhou Province. Methods: This study employed a two-phase explanatory sequential mixed-methods design. The first phase was a six-month, three-arm randomised controlled trial (RCT). A total of 120 rural older adults aged 65 and above with chronic diseases were recruited (118 included in the final analysis) and randomly assigned to a comprehensive intervention group (SWIG, n=39), an Educational Resource Group (ERG, n=39), and a control group (CG, n=40). Data were collected through structured questionnaires (covering health knowledge, behaviours, the SF-12v2 Health Survey, and a social support scale), in-depth interviews, and Photovoice. The intervention was guided by the Health Belief Model (HBM) and Social Support Theory (SST). The SWIG group received comprehensive social work services, including casework, group work, and community work, while the ERG group received only basic health education materials. Results: Mixed designed ANOVA and Generalised Estimating Equations (GEE) analyses revealed that the comprehensive intervention group (SWIG) achieved significant positive outcomes post-intervention. Their health knowledge level showed a substantial improvement (partial η² = .787), and they demonstrated significantly better results than the other two groups (p < .05) in adopting healthier behaviours, such as increased physical activity, regular health check-ups, and smoking cessation, as well as in perceived family and community support. While their physical health status (PCS) showed a trend of improvement, changes in mental health status (MCS) and alcohol consumption did not reach statistical significance. Notably, the ERG group, which received only health education, experienced a significant decrease in satisfaction with community resource support post-intervention. Qualitative analysis identified three core mechanisms for the success of SWIG: (1) transforming abstract knowledge into actionable, personal wisdom; (2) reinventing family and community support networks; and (3) responding to and alleviating participants' deep-seated psychological and emotional distress. Conclusion: A structured, multidimensional social work intervention model can effectively improve the health literacy and some health outcomes of rural older adults with chronic diseases in China. This study confirms that a simple, knowledge-infusion educational approach is not only of limited effectiveness but may even have negative consequences by failing to meet the expectations it raises. The key to a successful intervention lies in systemic empowerment that synchronously promotes individual cognitive construction and the enhancement of social support networks. The findings of this study provide a replicable practice model for primary health promotion work in resource-limited areas. |
| Rights: | All rights reserved |
| Access: | restricted access |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 8671.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 2.57 MB | Adobe PDF | View/Open |
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