Enhancing District Health Center membership among older adults through intergenerational home-based and AI-generated digital interventions: protocol for a pilot cluster randomized controlled trial

Abstract

Background Hong Kong is experiencing rapid population aging, with the population of older adults expected to reach 36.0% by 2046. The rise in life expectancy is often accompanied by increased chronic diseases and mental health challenges. The healthcare system remains heavily focused on tertiary care, leading to increased system burden and suboptimal health outcomes. Strengthening engagement with primary care for older adults, particularly through community-based services such as District Health Centers, is essential for improving long-term health outcomes. This approach promotes early detection, better management of chronic conditions, and prevention of unnecessary hospitalizations. Objective This pilot study aims to evaluate the feasibility, acceptability, and preliminary effectiveness of a hybrid intergenerational home-based and AI-generated digital intervention for increasing the proportion of District Health Center members among older adults in Hong Kong. Methods This is a two-group parallel cluster randomized controlled trial, involving 180 older adults recruited from 6 clusters. Participants will receive home-based DHC intervention by trained students, followed by 1-month of AI-generated digital interventions, including infographics, videos, and messages on the introduction and promotion of DHC, via WhatsApp. The feasibility indicators include recruitment rate, retention rates, dose delivered, dose received, and participant engagement. Acceptability outcomes are workshop and digital intervention satisfaction. The primary outcome is to increase the proportion of District Health Center members. Secondary outcomes include the proportion of participants utilizing DHC, health status, behavioral modifiable risk factors, eHealth literacy, infectious disease prevention behaviors, and feasibility metrics. Data will be collected via surveys at baseline and follow-ups (1, 3, and 6 months). Discussion This proposed pilot study aims to use hybrid intergenerational home-based and AI-generated digital intervention to improve primary healthcare engagement among older adults in Hong Kong. By promoting awareness and utilization of primary healthcare services like District Health Centers, the study seeks to promote healthier aging, improve health outcomes, alleviate hospital strain, and provide a framework for addressing the needs of aging populations. Clinical trial registration https://clinicaltrials.gov/, NCT07252934.