Social Work Engagement and Empowerment Model for Youth Internet Users in Hong Kong - a Quasi-Experimental Design

Background:

The use of the Internet has been unprecedented in the 21st century and has become one of the social work intervention strategies for youth with social withdrawal and other at-risk behaviors, in additional to those mainstream services that emphasize on contact-in-reality. Evaluation of such online youth services is of a high priority in developing evidence-based practice, and, has funding implications. This study aims to examine the effects of social work online-engagement and empowerment model in alleviating level of emotional distress and social withdrawal among online youth clients.

Methods:

A quasi-experimental design was used to compare the effect of engagement and empowerment between the intervention group of 182 youth clients recruited from three non-profit social service organizations and a reference group of 191 youths recruited from a territory-wide prevalence survey on Internet use of a representative sample (N=1,010). Emotional distress, social withdrawn behavior, social support, and behavioral problems were assessed for both groups at baseline (T₀), two-month (T₁) and nine-month (T₂). A repeated measure regression model was used to detect statistical significance on time effect and group effect, with an additional interaction model between time and group, to test on each outcome indicator.

Results:

There were no significant differences in the demographic backgrounds between the intervention and the reference groups. The mean age and the gender ratio (M:F) of the intervention group were 19.24 years old and 1:1, and were 19.63 and 1:1.39 for the reference group.

Emotional distress was found to have improved significantly. The changes in emotional distress measured by General Health Questionnaire (GHQ12) over time within both the intervention and reference groups was statistically significant (χ²=46.10, p<0.001). For the intervention group, the negative signs of the estimated regression parameters for the interaction term of time x group indicated that the GHQ12 scores had significantly improved (reduced emotional distress) over time (T₁: β=-2.30, Z=-4.54, p<0.001; T₂: β=-4.50, Z=-6.77, p<0.001).The intervention group had a significantly higher prevalence of social withdrawal measured by a checklist of social withdrawn signs; prominent decrease in such behavior was observed in this group from T₀ to T₂, with a statistical significance in the interaction term for time x group (χ²=6.28, p=0.043). Withdrawal behaviors had remained low and stable in the reference group. There was no significant effect shown on other outcome indicators.

Conclusions:

The results showed promising signs that youth with emotional distress and social withdrawn problems may benefit from outreach social work intervention online. With the increasing popularity of Internet use and decreasing age of Internet users, online engagement and empowerment type of social work practice have to be based on empirical evidence, with on-going development and standardization for future funding implications. Limitation: No causal effect could be detected, as this study was not a randomized controlled trial and the reference group engaged in relatively less at-risk behaviors. Future studies on a larger sample with random assignment across different age groups are recommended.