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Background: This study aims to investigate the effect of two interventions (verbal advice and comic books) on health literacy and medication compliance among older adults living in 15 public estates in Hong Kong. Methods: This is a two-phase multi-site quasi-experimental study with a pre-and-post design with four measurement points (T1–T4). In both phases, the two interventions were conducted by trained medical/nursing/pharmacy students. Two home visits were carried out in each phase. After the baseline measurement at Time 1 (T1), students verbally advised the older adult participants on how to read, understand, and interpret information on drug labels and how to store drugs properly. A post-assessment was conducted at T2. One year later, another pre-assessment was conducted at T3, and then students used a comic book to educate the older adults. A post-assessment was carried out at T4 after the use of the comic book. Health literacy was measured using the 24-item Chinese Health Literacy Scale for Chronic Care and medication compliance was measured using the Medication Compliance, Knowledge and Storage scale. Generalised Linear Mixed Models were used. Results: A total of 165 subjects were included. The majority (60.6%) were female, aged from 67 to 96. About half (47.3%) had received no formal education. Controlling for age and cognition, there was a significant increase in health literacy after the use of the comic book (coefficient = 2.742, p = 0.001). There was also a significant improvement in medication compliance (total score) (coefficient = −1.018, p < 0.001), reduced knowledge deficiency (coefficient = −0.236, p < 0.05), and reduced storage problems (coefficient = −0.293, p = 0.001) after using comic books. Conclusion: Comic books are a good strategy to improve the health literacy level and medication compliance of community-dwelling older adults.

Purpose: This study evaluated the potential effectiveness of a tablet-based, volunteer-led intervention (Lok Chi In-home Training) for cognitively impaired older people in improving cognitive and emotional health. Method: A one-group pretest and posttest design was adopted, involving 57 community-dwelling older people with cognitive impairments (Montreal Cognitive Score between 13 and 22, without neuropsychiatric behavioral problem). Trained volunteers performed eight in-home training sessions using a tablet to facilitate. Outcome measures include cognitive function, depression, activity of daily living, and instrumental activity of daily living. Results: A paired sample t test indicated that after receiving Lok Chi In-home Training, participants showed significantly large improvements on cognitive ability, moderate improvements on depression, and small improvements on instrumental activity of daily living. Conclusions: This study demonstrated the feasibility and potential benefits of Lok Chi intervention for improving cognition and emotion.

Objective:Community dwelling older adults with mild cognitive impairment (MCI) encounter challenges in many daily activities including medication taking. With inadequate health literacy, many of them have difficulty in understanding the instructions on drug labels and make decision on medication taking. This study aims to assess the effect of two interventions, verbal advice plus educational leaflet (VAEL) and comic books (CB), on medication taking among persons with MCI. Methods:This is a two-year multi-site longitudinal study with pre-and-post design and four-point measures (Time 1, 2, 3, and 4). Subjects were aged 60 or above, scored <22 in Chinese version of the Montreal Cognitive Assessment (MoCA), and were taking ≥ 2 drugs regularly. Health literacy was measured by the 24-item Chinese Health Literacy for Chronic Care (CHLCC) and medication adherence was measured by the 8-item Morisky Medication Adherence Scale (MMAS). Generalized Linear Mixed Models (GLMM) and Generalized Estimating Equation (GEE) were used. Results:Among the 131 subjects, the majority (62%) were females and mean age was 82.5 (SD 6.5). One-third of them received primary education (31%). Controlling age, there was a significant increase in CHLCC scores after the use of CBs (T4-T3: coefficient=2.742, p=0.003; T4-T1: coefficient=5.073, p=0.014). On the other hand, comparing to the baseline at T1 and controlling age, the chance of moving MMAS level one level higher than its original level at T4 was high (O.R.=3.316, S.E. 0.2979, 95% CI 0.650-1.747, p<0.001). Similar improvement in MMAS level was observed at T3 and T2. Conclusion:The two interventions (VAEL and CBs) seem to be a good strategy to improve health literacy and medication adherence among community dwellers with MCI. More research is warranted to support medication taking in this specific population.