Jacqueline Manuel, left, checks Roselyn Advincule's health indicators during a Hans Kai meeting at the Nor’West Co-Op Community Health in Winnipeg on July 11. Hans Kai is like a book club for your health: A regular group of people meets every week or two to socialize, measure health indicators and do some physical activity together.JOHN WOODS/The Globe and Mail
Last winter was Maricelle Banay's first in Winnipeg and she found it difficult to adjust.
Back home in the Philippines, Banay would go running every night, often with friends and co-workers. But that wasn't an option, she said, when "everything is in ice."
"I was sad because … it was my first Christmas, it was my first New Year, very very far from the country that I came from, and it's totally different here," she said.
So when a friend invited her to join a health program called Hans Kai at their local community centre last November, she decided to go.
At the meeting, Banay found a welcoming group of about 25 people – many of whom were also Filipino – working together to stay active and healthy. Today, she goes every week, and she says she's more health conscious in her everyday life than before.
"There's really a sense of being together," she says.
Hans Kai groups operate much like book clubs, but with a focus on health: Members meet regularly to socialize, take Zumba or belly dancing classes, eat healthy food and measure and keep track of health indicators such as blood pressure and weight. The program originated in Japan after the Second World War as a way for people to monitor their own health amidst a lack of adequate medical services. "Hans Kai" is a Japanese phrase that translates to "group meeting."
Stepping on a scale in front of a room full of people may sound awkward, but it's also a do-it-yourself method of addressing a health issue that time-strapped doctors and unwieldy government agencies have long struggled to address: preventive medicine. Designed around the principle of group accountability, organizers say Hans Kai keeps people healthy by giving them simple tools and advice for maintaining their own well-being.
Though Hans Kai may invite comparisons to programs such as Weight Watchers, there are several key differences. There's no explicit focus on weight loss for Hans Kai – rather, each group has its own focus depending on the needs of the members. There's no charge to join a Hans Kai group, and members aren't sold any special products as part of the program.
The Hans Kai concept was first brought to Canada in 2010 by NorWest Co-Op Community Health in Winnipeg. Now there are 14 in the city and it has spread, with active groups in Quebec, New Brunswick, Nova Scotia and Saskatchewan. A health-care co-op in Victoria is in the process of setting up six groups, and organizers also hope to have new groups up and running in Ottawa later this year.
Hans Kai meetings aren't meant to replace regular checkups or visits to the doctor, says Michelle Kirkbride, who helps train Hans Kai groups at NorWest. Rather, they encourage participants to live a healthy lifestyle so they can catch early warning signs of possible health problems, and have more productive visits with their doctors.
"We have amazing physicians in this country, but they often don't have a huge amount of time to spend with everyone," Kirkbride says. "So this is doing the kind of behind-the-scenes work."
The programs are set up and facilitated by health-care co-ops, who must be members of the Health Care Co-operatives Federation of Canada. The members of a Hans Kai group typically have something in common – while Banay's group is composed of mainly immigrants, for example, there are other groups for people with diabetes or osteoporosis, and even groups for teens in high school.
Groups get eight training sessions from their parent co-op in areas such as health knowledge and how to safely measure blood pressure and blood sugar, but after the training the groups are largely self-directed.
Sonya Bertoncello-May started a twice-weekly Hans Kai group for her United Way office in Winnipeg.
"You get to know your co-workers better," she says, adding that the regular physical activity helps improve productivity. "If companies don't take advantage of it, it's almost like, 'You guys are crazy.' … You'd be foolish not to try it."
Because Hans Kai is relatively new to Canada, there is no published research on its effectiveness. However, researchers at the University of Manitoba have been studying groups in Winnipeg since 2011, and intend to publish a study later this summer. Preliminary results provided by Kirkbride indicate that Hans Kai participants have better social support networks, show improved levels of knowledge about diabetes and nutrition, and can recognize health changes or issues.
Hans Kai has the potential to be a positive addition to the field of preventive medicine, says Randy Fransoo, senior research scientist and associate director of research at the Manitoba Centre for Health Policy at the University of Manitoba. Fransoo, who is not involved in the program, said the benefits could have a network effect, influencing people who don't participate themselves.
"The important thing is it's not just affecting the people who go – they have families and friends, and this is the kind of thing that rubs off," he said. However, he cautioned the program shouldn't be touted as a silver bullet for public health, since many participants may be the kind of people who are more likely to live a healthy lifestyle.
"We have to invest some resources so initiatives like this can reach people who won't step forward on their own," he said.