Wendy Y. Huang

Understanding Neighborhood Environment Related to Hong Kong Children’s Physical Activity: A Qualitative Study Using Nominal Group Technique

Background Relationships between the neighborhood environment and children’s physical activity have been well documented in Western countries but are less investigated in ultra-dense Asian cities. The aim of this study was to identify the environmental facilitators and barriers of physical activity behaviors among Hong Kong Chinese children using nominal group technique. Methods Five nominal groups were conducted among 34 children aged 10–11 years from four types of neighborhoods varying in socio-economic status and walkability in Hong Kong. Environmental factors were generated by children in response to the question “What neighborhood environments do you think would increase or decrease your willingness to do physical activity?” Factors were prioritized in order of their importance to children’s physical activity. Results Sixteen unique environmental factors, which were perceived as the most important to children’s physical activity, were identified. Factors perceived as physical activity-facilitators included “Sufficient lighting”, “Bridge or tunnel”, “Few cars on roads”, “Convenient transportation”, “Subway station”, “Recreation grounds”, “Shopping malls with air conditioning”, “Fresh air”, “Interesting animals”, and “Perfume shop”. Factors perceived as physical activity-barriers included “People who make me feel unsafe”, “Crimes nearby”, “Afraid of being taken or hurt at night”, “Hard to find toilet in shopping mall”, “Too much noise”, and “Too many people in recreation grounds”. Conclusions Specific physical activity-related environmental facilitators and barriers, which are unique in an ultra-dense city, were identified by Hong Kong children. These initial findings can inform future examinations of the physical activity-environment relationship among children in Hong Kong and similar Asian cities.

Measures of environmental correlates of physical activity for urban Chinese preschool-aged children: development and reliability

We adapted/developed and examined the test–retest reliability and internal consistency of eight parent-report measures of home and neighborhood environmental correlates of physical activity appropriate for Chinese preschool-aged children and their parents/primary caregivers living in densely populated urban environments. This study consisted of a qualitative (cognitive interviews) and a quantitative (test–retest reliability) component. Chinese versions of the measures were pilot-tested on 20 parents of Hong Kong preschool-aged children using cognitive interviews. Measures were then administered to 61 parents twice, 1 week apart. Test–retest reliability and internal consistency were computed. Except for two items, the test–retest reliability of items and scale summary scores ranged from moderate to excellent. The internal consistency of the measures exceeded recommended minimal values (Cronbach’s α > .70). The parent-report measures examined in this study are potentially appropriate for use in investigations of environmental correlates of the physical activity of Chinese preschool-aged children living in densely populated urban environments. However, their predictive validity with respect to Chinese preschool-aged children’s physical activity needs to be assessed in future studies.

Validity and reliability of questionnaires measuring physical activity self-efficacy, enjoyment, social support among Hong Kong Chinese children

Background Physical activity (PA) correlates have not been extensively studied in Hong Kong children. Objective The aim of this study is to assess the validity and reliability of translated scales to measure PA related self-efficacy, enjoyment and social support in Hong Kong Chinese children. Methods Sample 1 (n = 273, aged 8–12 years) was recruited (May–June, 2013) from two primary schools. Confirmatory factor analyses (CFA) were conducted to assess factorial validity. Criterion validity was assessed by correlating measured constructs with self-reported PA. Cronbachs alpha was computed to assess scale internal consistency. The intraclass correlation coefficient (ICC) was performed to assess scale test–retest reliability. Criterion validity was further examined in Sample 2 (n = 84, aged 8–12 years) from a third school by correlating measured constructs with objectively measured PA collected in September 2013 and February 2014. Results The CFA results supported the one-factor structure of the scales. All PA correlates were significantly (p < 0.01) associated with self-reported PA in Sample 1. Self-efficacy and enjoyment were significantly (p < 0.05) correlated with objectively measured PA in Sample 2. All the scales demonstrated acceptable internal consistency. All ICC values of the scales suggested acceptable test–retest reliability. Conclusion The results provide psychometric support for using the scales to measure PA correlates among Hong Kong Chinese children.

Fundamental movement skills proficiency in children with developmental coordination disorder: does physical self-concept matter?

Abstract Purpose: The purpose of this study was to (1) examine differences in fundamental movement skills (FMS) proficiency, physical self-concept, and physical activity in children with and without developmental coordination disorder (DCD), and (2) determine the association of FMS proficiency with physical self-concept while considering key confounding factors. Method: Participants included 43 children with DCD and 87 age-matched typically developing (TD) children. FMS proficiency was assessed using the Test of Gross Motor Development – second edition. Physical self-concept and physical activity were assessed using self-report questionnaires. A two-way (group by gender) ANCOVA was used to determine whether between-group differences existed in FMS proficiency, physical self-concept, and physical activity after controlling for age and BMI. Partial correlations and hierarchical multiple regression models were used to examine the relationship between FMS proficiency and physical self-concept. Results: Compared with their TD peers, children with DCD displayed less proficiency in various components of FMS and viewed themselves as being less competent in physical coordination, sporting ability, and physical health. Physical coordination was a significant predictor of ability in object control skills. DCD status and gender were significant predictors of FMS proficiency. Conclusions: Future FMS interventions should target children with DCD and girls, and should emphasize improving object control skills proficiency and physical coordination. Implications for Rehabilitation Children with DCD tend to have not only lower FMS proficiency than age-matched typically developing children but also lower physical self-concept. Self-perceptions of physical coordination by children with DCD are likely to be valuable contributors to development of object control skills. This may then help to develop their confidence in performing motor skills. Children with DCD need supportive programs that facilitate the development of object control skills. Efficacy of training programs may be improved if children experience a greater sense of control and success when performing object control skills.

Isotemporal Substitution Analysis for Sedentary Behavior and Body Mass Index.

PURPOSE This study examined the prospective associations of reallocating time spent in different types of sedentary behavior, physical activity, and sleep with body mass index (BMI) in children using isotemporal substitution analysis. METHODS Chinese children in grades 1-3 were recruited to a cohort study in 2009 and were followed up over a 2-yr period. Reports were gathered from the parents on childrens sedentary behavior, sleep duration, and sociodemographic variables. The reported sedentary behavior types were then grouped into three categories: screen time (e.g., watching TV), academic-related activities (e.g., doing homework), and other sedentary behaviors (e.g., sitting and talking). Moderate-to-vigorous physical activity (MVPA) and light-intensity physical activity were assessed by ActiGraph accelerometry (ActiGraph, Pensacola, FL). Isotemporal substitution models were performed to examine the effects of time allocation on BMI. RESULTS A total of 672 children (359 boys, mean age at recruitment = 7.6 yr) who had provided valid accelerometer data for at least one assessment time point were included in the analysis. Controlling for covariates and total behavior time, isotemporal substitution models indicated that the displacement of 30 min·d of other sedentary behaviors with equal amounts of screen time (B = 0.12; 95% confidence interval, 0.04-0.20) or academic-related activities (B = 0.13; 95% confidence interval, 0.04-0.21) was associated with higher BMI. Reallocating 30 min·d of MVPA with each of the sedentary behavior variables resulted in increased BMI. CONCLUSIONS The substitution of screen time or academic-related activities with other sedentary behaviors or MVPA was associated with lower BMI in Chinese children.

Physical Activity Research in Hong Kong From 1987 to 2012: Evidence on Children and Adolescents

A comprehensive understanding of research on the physical activity (PA) of Hong Kong youth is necessary to develop specific and effective intervention strategies. This review summarizes existing evidence in studies on PA among the Hong Kong youth. An electronic literature search was conducted using MEDLINE, SPORTDiscus, ERIC, and HighWire database. Forty-five studies published from 1987 to 2012 were included in this review. The findings are presented in five categories, namely, health benefits of PA, participation in PA, assessment of PA, correlates of PA, and interventions to promote PA. The results indicate that PA among the youth in Hong Kong has attracted concern in the past decade. Specifically, extensive studies focused on the areas of health benefits of PA, participation in PA, and correlates of PA. Research into context-specific correlates of PA and tailored PA promotion programs for the Hong Kong youth is warranted in the future.

Effects of fundamental movement skills training on children with developmental coordination disorder

The purpose of this study was to examine the effects of fundamental movement skills (FMS) training on FMS proficiency, self-perceived physical competence (SPC), physical activity (PA), and sleep disturbance in children with developmental coordination disorder (DCD) compared with children with typical development (TD). A total of 84 children were allocated into either experimental group (DCD[exp], TD[exp]) who received 6 weeks of FMS training or control groups (DCD[con], TD[con]). FMS were assessed using the Test of Gross Motor Development-2, whereas PA was monitored using accelerometers. SPC and sleep disturbance were evaluated using questionnaires. Results showed that the DCD[exp] group had significantly higher scores in FMS and SPC compared with the DCD[con] group at posttest. The DCD[exp] group scored lower in sleep disturbance at follow-up when compared with posttest. It is suggested that short-term FMS training is effective in improving FMS and SPC and reducing sleep disturbances for children with DCD.

Physical Activity and Sedentary Time among Children with Disabilities at School

Purposes Physical activity (PA) is important for the development of children with disabilities, but rarely does this population meet the recommended standards. Schools are salient locations for PA, but little is known about how specific school settings affect the PA of children with diverse disabilities. We assessed PA and sedentary time (ST) of children with disabilities in three school settings (physical education, recess, lunchtime). Methods Participants included 259 children from 13 Hong Kong special schools for five primary disabilities: visual impairments, hearing impairments, physical disabilities, intellectual disabilities, and social development problems. Children wore accelerometers at school for 3 d, and the time (min and %) they engaged in moderate-to-vigorous PA (MVPA) and ST was extracted for each school setting by sex. Analyses included multiple linear mixed models to determine differences in MVPA and ST by sex across disability types, adjusting for body mass index, grade level, and duration in each setting. Results Overall, children spent 70% of their day at school being sedentary and accrued little MVPA (mean, 17 ± 4.2 min daily). Children with intellectual disabilities (severe) had especially low levels of MVPA. All three settings contributed significantly to both MVPA and ST, with recess contributing more to MVPA than physical education or lunchtime. Conclusions This is the first study to examine MVPA and ST among different disability types at school using accelerometry. Given the low levels of PA, this population should receive priority in the development of cost-effective interventions to improve their PA opportunities.

Is a Change to Active Travel to School an Important Source of Physical Activity for Chinese Children

This study investigated the association between a change in travel mode to school and one-year changes in physical activity (PA) among children in Hong Kong. Data from 677 children aged 7-10 years (56% boys) who participated in the Understanding Childrens Activity and Nutrition (UCAN) study were analyzed. During the 2010/11 and 2011/12 school years, the children wore an accelerometer for a week and their parents completed a questionnaire about the childrens modes of travel to school and nonschool destinations. Associations between a change in the mode of travel to school and changes in moderate-to-vigorous PA (MVPA) were determined using linear mixed models, adjusting for covariates. Compared with children who consistently used passive travel modes, a change from passive to active travel to school was positively associated with changes in the percentage of time spent in MVPA (b = 1.32, 95% CI = 0.63, 2.02) and MVPA min/day (b = 10.97, 95% CI = 5.26, 16.68) on weekdays. Similar results were found for weekly MVPA. Promoting active travel to school may help to combat age-related decline in PA for some Chinese children. However, maintaining active travel to school may not be sufficient to halt the decreasing trend in MVPA with age.

Effects of whey protein in carbohydrate-electrolyte drinks on post-exercise rehydration

Abstract The purpose of this study was to examine the effects of different amounts of whey protein in carbohydrate–electrolyte (CE) drinks on post-exercise rehydration. Ten males completed 5 trials in a randomised cross-over design. A 4-h recovery was applied after a 60-min run at 65% VO2peak in each trial. During recovery, the participants ingested a high-carbohydrate CE drink (CE-H), a low-carbohydrate CE drink (CE-L), a high-whey-protein (33 g·L−1) CE drink (CW-H), a medium-whey-protein (22 g·L−1) CE drink (CW-M) or a low-whey-protein (15 g·L−1) CE drink (CW-L) in a volume equivalent to 150% of their body mass (BM) loss. The drinks were provided in six equal boluses and consumed by the participants within 150 min in each trial. After exercise, a BM loss of 2.15% ± 0.05% was achieved. Urine production was less in the CW-M and CW-H trials during recovery, which induced a greater fluid retention in the CW-M (51.0% ± 5.7%) and CW-H (55.4% ± 3.8%) trials than in any other trial (p < .05). The plasma albumin content was higher in the CW-H trial than in the CE-H and CE-L trials at 2 h (p < .05) and 3 h (p < .01) during recovery. The aldosterone concentration was lower in the CE-H trial than in the CW-M and CW-H trials after recovery (p < .05). It is concluded that the rehydration was improved when whey protein was co-ingested with CE drinks during a 4-h recovery after a 60-min run. However, this additive effect was only observed when whey protein concentration was at least 22 g·L−1 in the current study.