Research and Projects

End-of-life communication practices in Hong Kong

Principal Investigator: Dr Margo Turnbull

About the research: Communication is an important part of the work people do in all care services. This research project is exploring how training, mentoring and education can be improved to support the communication skills of end-of-life care workers. The research is aimed at all people working in end-of-life care services in Hong Kong (including social workers, volunteers, clinicians). This research is funded by a grant from the University Grants Council of Hong Kong. All research activities will be conducted in Chinese.

Target participants: Adults working in end-of-life care settings in Hong Kong (either in paid or unpaid/volunteer posts).

Research activities: An anonymous, online survey which takes 10-15 minutes to complete. Once the survey is completed, participants can claim a HKD $50 supermarket voucher. Participants can also volunteer to join a short interview after the survey. After the interview, participants will receive a HKD $100 supermarket voucher.

Link to survey:

QR code:


Dr Margo Turnbull, Email:

Dr Carol Yu, Email: 

Publications: <click here>

Research and Projects 研究項目

Global health needs have changed markedly in recent decades. The greatest threat to the health of previous generations was posed by infectious diseases such as malaria and tuberculosis. Scientific advances and population changes, however, now present the world and the Asia Pacific Region with new and different challenges. Global populations are ageing rapidly with significant implications for health. Hong Kong’s 2011 census results indicated that the population aged 60 and over nearly doubled in the previous two decades. In 2011, 1 351 000 people in Hong Kong (that is, 19.2% of the population) were aged 60 or over. By 2039, that figure is projected to grow to nearly three million. Such population shifts have occurred alongside changes in the structure of families and communities. As people are living longer, rates of chronic and non-communicable diseases have increased. Family and community support networks have also changed and now governments and society more generally are having to think about how future health needs can be supported equitably and efficiently. The work of IRCAHC aims to address these contemporary concerns through research that is closely linked to policy and practice so as to support effective future planning.

If you are interested in working with IRCAHC or in receiving updates about our research and training, please email Professor Bernadette Watson.





如果您有興趣與我們合作、或接收我們最新的研究和培訓資訊,請發送電子郵件給Bernadette Watson教授

Current research 目前的研究

Using cues and heuristics to test responses of older Hong Kong residents to digital health promotion messages 

The use of digital health messaging has grown exponentially as a result of restrictions associated with the Covid-19 health crisis. Limitations on access to older and at-risk populations as part of Covid-19 risk management has increased the widespread implementation of digital technologies associated with health promotion and health literacy for this group of people. This research project will look at key dimensions of health messaging that influence understanding and compliance with advice including the use of organisational branding to build trust, visual representation of an authority figure involved in message delivery, personal relevance to the target audience and conversational style of information presentation.  

Research team: Margo Turnbull (PI); Co-Is: Bernadette Watson, Dr Simon Chow (CUHK), Dr Alice Yau (HKU)  

Leveraging ‘uncertainty’ during a health crisis: A comparative analysis of the speeches of four international political leaders during the first 6 months of 2020

Speeches given by political leaders during a time of crisis are important tools in the management of uncertainty and public anxiety. The Covid-19 health crisis has been shaped by constant uncertainty in relation to the novel coronavirus (SARS-Cov-2) itself, infection routes and mortality rates. This project will analyse speeches made by leaders in Australia, Hong Kong, New Zealand and the United Kingdom during the first six months of the health crisis. In this context, political speeches are viewed as texts constructed by a variety of contributors (e.g. the speaker, experts, speech writers) rather than examples of spontaneous or naturalistic speech. The findings of this research will contribute new knowledge to the fields of political and health communication by exploring and evaluating how uncertainty was used to encourage compliance with politically-driven health and infection control directives.

Research team: Dr Margo Turnbull (PI); Co-Is: Prof. Bernadette Watson, Dr Blair Ying Jin

Click here for more information of this project or contact Dr Margo Turnbull.

Community disruption, collective trauma and recovery

The notion of collective trauma refers to the community-level effects of events that cause widespread social disruption over an extended period of time. Protest movements and population health crisis are examples of such potentially traumatic events. Previous research has focused on collective trauma in the context of natural disasters such as bushfires, floods, or civil war. The collective trauma associated with prolonged social unrest such as that seen in Hong Kong in recent months, and the disruption and uncertainty caused by the current global health crisis, have not yet been studied in detail or in close temporal proximity to key events. The experiences of The Hong Kong Polytechnic University – a community of more than 30, 000 students and staff – over the last six months offer a novel opportunity to study collective trauma and recovery within a culturally and linguistically diverse university community. We initiated a multi-method research study (human research ethics reference: HSEARS20191122001) in the weeks immediately following the protest related events at PolyU in November 2019. Research activities were undertaken in either English, Cantonese or Mandarin Chinese depending on individual preferences. Early analysis has highlighted a number of important themes which warrant further investigation in relation to community-level recovery following large-scale disruption such as social unrest and population health emergencies.

Research Team (in alphabetical order):

For inquiries about this research, please contact Margo at or Blair at

Lung cancer stigma

Lung cancer is the fifth most commonly diagnosed cancer globally and contributes 1 in 5 cancer deaths. In particular, the increase of lung cancer in women has seen it overtake breast cancer as the most significant threat to life, yet the advocacy and support for lung cancer has yet to catch up. Adding to this picture, lung cancer patients, more so than other cancer patients, feel stigmatised by their disease, and this increases psychological distress. Evidence for lung cancer stigma has been reported in patients in the UK, North America, and Australia. However, this phenomenon has not been examined in Asia until now. Although in Western Educated Industralised Rich Democratic (WEIRD) cultures smoking has declined since the late twentieth century, elsewhere declines have been less steep or rates have even increased. Asian cultures have seen slow declines or even increases, especially in women.

This research entitled Cultural Communication Perspectives on moralization as a predictor of lung cancer stigma represents a collaboration between FH and FHSS at PolyU with Griffith University in Australia. Our project is based on a model of stigma developed by Occhipinti and colleagues that focuses on people’s perceptions of smoking. In many cultures, smoking is seen as a violation of morality and we believe that these perceptions may drive lung cancer stigma. Our project is gathering evidence for this effect in Hong Kong SAR and Australia using both quantitative methods from psychology and methods such as discourse analysis from communication research. The investigators from Griffith University are Associate Professor Stefano Occhipinti, and Professor Liz Jones. From PolyU they are Associate Professor Andy Cheng (check spelling) from Rehabilitation Sciences and Professor Bernadette Watson Director of IRCAHC

For more information, please visit

Patient safety and adverse events prevention

This research foregrounds the importance of intergroup relations and the roles of cultural norms in the hospital system. In the proposed project, the International Research Centre for the Advancement of Health Communication (IRCAHC) builds on work conducted in Australia and the USA. In this new project, we systematically examine how hospital cultural norms in Hong Kong influence the way health professionals perceive communication with colleagues and the relationship of these norms with safe patient care. We will also investigate how health professionals describe communication behaviours that led to adverse patient events. The principal investigator of this two-phase project is Professor Bernadette Watson, Director of the IRCAHC and Ms. Ivy Wu is the Research Assistant.

Current Progress

In Phase 1 we wrote a report comprising secondary data from Risk Alert and Annual Reports on Sentinel and Serious Untoward Events issued by the Hong Kong Hospital Authority from 2007 to 2017. Only incidents documented in both the Risk Alert newsletters and the annual reports were analyzed. The report identifies the role of communication in sentinel events and serious untoward events that occurred in Hong Kong over the past decade and establishes which events are most common in the hospital setting. The report also offers recommendations to ensure better patient care from the perspective of communication, which mirror the Root Cause Analysis panel’s recommendations but highlight issues around communication specificity. This phase is now complete and a publication detailing this work is in preparation.

Phase 2 involved semi-structured interviews with health professionals at Hong Kong public hospitals, which explored their perspectives on barriers and facilitators in patient care. We particularly focused on the role of communication, leadership and hospital norms based on the knowledge obtained from Phase 1. We interviewed 69 participants, representing a diverse range of health professions, disciplines and levels of seniority. Transcription and data analysis is in progress.

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Completed research

Using wireless technologies in health communication: Using mHealth to promote safety in the home amongst Hong Kong elders

Recent technological advances have seen the emergence of mHealth technologies (i.e. the use of mobile and wireless technologies) as important tools in health promotion such as the dissemination of health-related information. While these technologies may be considered as more popular and widely used among younger adults, it has been proved by recent studies (e.g. Shen et al., 2018) to be effective tools to engage the elderly population, particular people who are disadvantaged and less capable to participate in more traditional health promotion activities, in learning health behaviors. Given the global trend of the aging population, the increasing use of some high-tech gadgets (e.g. smart phones and tablets), and the age-related differences in individual behaviors of using these technologies, the center is interested in identifying the use of mHealth tools among HK elders and the impact of these tools on promoting health behaviors and health literacy. Rather than developing an app or a program, we are piloting a way of investigating how older HK residents may use a smart phone or tablet in learning health behaviors and risk prevention (i.e. falls at home). The center is now at the final stage negotiation with a local elderly center. We intend to include some focus group interviews to see participants’ perceptions on health information on mHealth technologies. Themes and patterns of the data will also be analyzed. The project involves interdisciplinary effort with experts from psychology, linguistics, and health communication. The expected outcome promises contributions to the knowledge of health promotion, safety, and digital communication.

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Visualising communication: using natural language processing tools to analyse Chinese data sets

Communication in health care is complex and involves ongoing and dynamic interactions between people. Although health-related information can be shared across a range of modalities, such as electronically or in print, conversations between people remain a key element of health communication. Conversation can be differentiated from other modes of communication in terms of the involvement of multiple people as well as its dynamic nautre. As conversation unfolds meaning is generated and shared, as people begin to discuss a shared topic.

Recent developments in Natural Language Processing (NLP), a sub-field of computer science concerned with analyzing and understanding human language (Hirschberg & Manning, 2015), have seen the increasing use of computer programs to process conversational data and supplement other methods of qualitative and quantitative analysis. Discursis, one such NLP tool, has been used successfully in recent studies of healthcare. Although Discursis and other NLP tools may be theoretically able to process non-alphabetic input, most published work to date has reported on the analysis of data sourced in or translated to alphabetic. IRCAHC has been researching how Discursis can be used to analysis data written in Chinese characters. This is important as vital communication information can be lost through the process of translation.

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