Development of a culturally sensitive client-centered elder abuse intervention in Hong Kong : a mixed method study

Abstract

Elder abuse remains a critical yet underreported challenge in aging societies like Hong Kong, where interventions must balance safety with cultural values of familial harmony. This three-phase mixed-methods study developed and evaluated a culturally sensitive client centered intervention model. Phase 1 involved a scoping review of global elder abuse interventions. Core components identified included multidisciplinary collaboration, victim empowerment, and systemic resource coordination. Phase 2 engaged 32 frontline professionals in focus groups to adapt these components to the Hong Kong context. Participants emphasized proactive risk detection through community networks, strategies to balance autonomy with safety, and integrating trauma-informed care with practical assistance. Informed by findings from Phases 1 and 2, an 8-session case management intervention program was developed. Delivered individually by social workers, sessions focused on psychological well-being through trauma-informed coping strategies, enhancing self-efficacy, strengthening social support networks and health planning. Phase 3 of this study tested the feasibility of this program with a sample of 40 older adults screened positive for abuse risk in community screening. Pre-post analyses using paired-sample t-tests (SPSS 27) showed this intervention demonstrated statistically significant improvements. Upon completing the 8-session intervention program, participants reported reduced abuse severity (p < .05), enhanced psychological well-being (p < .05), and strengthened social support (p < .001). Importantly, participants found the intervention acceptable, commending its non-confrontational approach and cultural relevance. Many noted it provided meaningful support without pressuring them to sever family ties, a critical concern in Hong Kong’s familial loyalty-driven context. This study highlights the potential of culturally sensitive, community-driven strategies for prevention of elder abuse. By incorporating trauma-informed practices with localized resource coordination, the model addresses Hong Kong’s unique challenges, where reluctance to report abuse often stems from cultural norms. The feasibility findings underscore the model’s promise as a scalable foundation. Future research should explore digital adaptations to broaden accessibility and test cross-cultural applicability. By prioritizing both safety and relational cohesion, this study advances equitable protection for aging populations globally.