The Effects of a Tele-health Program

Physical activities of the older adults will be measured by the Chinese version of the Physical Activity Scale for the Elderly. The PASE-C is a 12-items scale estimating the frequency and intensity of older adults' lifestyle physical activities with three types of physical activities (leisure-time activity: 5 items; household activity: 6 items; work-related activity: 1 item) during the previous 7-day period. The total score is computed by the multiplication on the time spent (recorded as never, seldom: 1-2 days per week, sometimes: 3-4 days per week, and often: 5-7 days per week) or participation (yes/no) on each activity by items weights, and summarize all the items. Higher scores mean higher frequency and intensity of physical activities.

Balance will be assessed using the Berg functional balance scale. It is a 14-item scale designed to measure balance of the older adult in a community setting. The scores of the scale range from 0 to 56, with higher the score, better the balance

Cognition status will be measured by the Chinese version of the Mini-Mental State Examination. The Mini mental state examination contains questions in seven domains, such as temporal and spatial orientation, word encoding, attention and calculation, word recall, language, and visual constructive capacity. The scores of scale range from 0 to 30, with higher scores indicate better cognitive status

Short-term memory will be assessed using the digit span forward test. It consists of the presentation of a list of numbers, which should be correctly repeated in a forward order immediately after their presentation. Higher scores mean better short-term memory.

Loneliness will be assessed using the UCLA Loneliness Scale. Each participant will be asked the following three questions: "How often do you feel that you lack companionship?", "How often do you feel left out?" and "How often do you feel isolated from others?". Each question had three options to reflect the frequency:1 = Hardly ever, 2 = Some of the time, and 3 = Often). The values for each question will be summed to get a loneliness score ranging from 3 to 9, with higher values indicating greater loneliness.

Social isolation will be measured by the two subscales of the 6-item Lubben Social Network Scale-6. Each subscale score ranges from 0 to 15, with lower score indicating greater isolation.

Quality of life will be measured by SF-12v2, which has been translated, validated and proven reliable for use among the Hong Kong Chinese population. Score 50 is a norm globally. Higher score means better quality of life.

Depression will be measured by the Chinese version of the Geriatric Depression Scale. The scale ranges from 0-12, with higher score indicates higher depression level.

Self-efficacy will be assessed using the Chinese version of the General Self-Efficacy Scale. It is a ten-item scale measuring a broad and stable sense of personal competence to deal efficiently with a variety of stressful situations. The C-GSE measures the strength dimension of self-efficacy on a four-point Likert scale. Scores are summed to give a total range from 10 to 40; higher scores represent greater self-efficacy.

Social connectedness will be assessed using the Social Connectedness Scale-Revised. The SCS-R, like its predecessor, measures social connectedness as a psychological sense of belonging or, more specifically, as a cognition of enduring interpersonal closeness with the social world in toto. The scale consists of 20 items (10 positive and 10 negative) rated on a 6-point Likert scale with higher scores represent better social connectedness

Attitude towards elderly will be assessed using Kogan's (1961) Attitude toward Old People scale. The Attitude toward old people scale consists of 34 items grouped into two factors that assess positive and negative attitudes toward old people. Kogan's attitude toward old people consisted of 3 domains: personal appearance, resemblance, and the nature of interpersonal relations across age generations. The scores of the scale range from 34 to 204, with higher scores mean better attitude towards elderly

Life satisfaction will be assessed using the satisfaction with life scale (SWLS).It is a 5-item scale designed to measure global cognitive judgments of one's life satisfaction (not a measure of either positive or negative affect). Participants will indicate how much they agree or disagree with each of the 5 items using a 7-point scale that ranges from 7 strongly agree to 1 strongly disagree. Higher scores indicate better life satisfaction

Community involvement will be assessed by asking the participants their number of hours involved in elderly services six months after the completion of the program. Higher hours represent better community involvement

Recruitment rate will be obtained by asking the participant their working status at 6 months after the completion of the program. More people recruited to elderly service work, better the recruitment rate