Qualified and consenting participants living in two of four districts were assigned to an IG by ballot; while participants lived in the other two districts were assigned to a CG. All subjects in the IG were separated into small groups based on their convenience and given a 4-week TOAP intervention. The subjects in the CG received normal routine care and were not visited between assessments. The study was approved by the Institutional Review Board of the Taipei City Hospital. Participants were given detailed information about study procedures and written consent was obtained.