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 Children’s 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 children’s 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.
Is a Change to Active Travel to School an Important Source of Physical Activity for Chinese Children?
Wendy Y. Huang, Stephen H. Wong, and Gang He
Development of Physical Activity–Related Parenting Practices Scales for Urban Chinese Parents of Preschoolers: Confirmatory Factor Analysis and Reliability
Yi-nam Suen, Ester Cerin, Anthony Barnett, Wendy Y.J. Huang, and Robin R. Mellecker
Valid instruments of parenting practices related to children’s physical activity (PA) are essential to understand how parents affect preschoolers’ PA. This study developed and validated a questionnaire of PA-related parenting practices for Chinese-speaking parents of preschoolers in Hong Kong.
Parents (n = 394) completed a questionnaire developed using findings from formative qualitative research and literature searches. Test-retest reliability was determined on a subsample (n = 61). Factorial validity was assessed using confirmatory factor analysis. Subscale internal consistency was determined.
The scale of parenting practices encouraging PA comprised 2 latent factors: Modeling, structure and participatory engagement in PA (23 items), and Provision of appropriate places for child’s PA (4 items). The scale of parenting practices discouraging PA scale encompassed 4 latent factors: Safety concern/overprotection (6 items), Psychological/behavioral control (5 items), Promoting inactivity (4 items), and Promoting screen time (2 items). Test-retest reliabilities were moderate to excellent (0.58 to 0.82), and internal subscale reliabilities were acceptable (0.63 to 0.89).
We developed a theory-based questionnaire for assessing PA-related parenting practices among Chinese-speaking parents of Hong Kong preschoolers. While some items were context and culture specific, many were similar to those previously found in other populations, indicating a degree of construct generalizability across cultures.
Effects of Fundamental Movement Skills Training on Children With Developmental Coordination Disorder
Jie Yu, Cindy H.P. Sit, Angus Burnett, Catherine M. Capio, Amy S.C. Ha, and Wendy Y.J. Huang
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.
Recent Secular Trends in Child and Adolescent Physical Activity and Sedentary Behavior Internationally: Analyses of Active Healthy Kids Global Alliance Global Matrices 1.0 to 4.0
John J. Reilly, Joel Barnes, Silvia Gonzalez, Wendy Y. Huang, Taru Manyanga, Chiaki Tanaka, and Mark S. Tremblay
Background: We examined recent global secular trends in 5 indicators of child and adolescent physical activity and sedentary behavior (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, and Sedentary Behavior) and 4 influences on these (Family and Peers, School, Community and Environment, and Government). Methods: Active Healthy Kids Global Alliance letter grades (A+ to F) were assigned numbers from 15 to 2, with 0 assigned for missing/incomplete grades. Trends from Active Healthy Kids Global Alliance Global Matrices 1.0 (2014) to 4.0 (2022) were analyzed using linear mixed-effects models with level of economic development and gender inequity considered as potential moderators. Results: Report card grades were generally relatively stable. Trends generally did not differ significantly by level of economic development (except for Active Transportation and Active Play), but gender inequality did significantly moderate trends for most of the indicators, with higher gender inequality associated with more adverse changes in grades. The number of “incomplete” grades decreased over time, but this did not reach statistical significance. Conclusions: While trends varied within and between countries, physical activity and sedentary behaviors, and the influences on these behaviors globally, were relatively stable over the past decade or so, albeit at undesirable levels.
Results and SWOT Analysis of the 2022 Hong Kong Report Card on Physical Activity for Children and Adolescents With Special Educational Needs
Cindy H.P. Sit, Wendy Y.J. Huang, Stephen H.S. Wong, Martin C.S. Wong, Raymond K.W. Sum, and Venus M.H. Li
Background: Following the 2019 Hong Kong Para Report Card, the 2022 Hong Kong Para Report Card aimed to provide an updated and evidence-based assessment for nine indicators related to physical activity in children and adolescents with special educational needs and to assess the results using a SWOT (strengths, weaknesses, opportunities, and threats) analysis. Methods: Using a systematic process, the best available data on nine indicators were searched from the past 10 years and were assessed by a research work group. Letter grades were assigned and considered by stakeholders and auditors. Results: Four indicators were assigned a letter grade (overall physical activity: F [mixed device-measured and self-reported data]; sedentary behaviors: D [device-measured data]; active transportation: D−; government strategies & investment: C+). SWOT analysis highlighted opportunities for facilitating children and adolescents with special educational needs to achieve health recommendations. Conclusion: There were deteriorating trends in physical activity and sedentary behaviors. Effective, multilevel, and cross-sector interventions are recommended to promote active behavior in children and adolescents with special educational needs.
Economic Freedom, Climate Culpability, and Physical Activity Indicators Among Children and Adolescents: Report Card Grades From the Global Matrix 4.0
Eun-Young Lee, Patrick Abi Nader, Salomé Aubert, Silvia A. González, Peter T. Katzmarzyk, Asaduzzaman Khan, Wendy Y. Huang, Taru Manyanga, Shawnda Morrison, Diego Augusto Santos Silva, and Mark S. Tremblay
Background: Macrolevel factors such as economic and climate factors can be associated with physical activity indicators. This study explored patterns and relationships between economic freedom, climate culpability, and Report Card grades on physical activity-related indicators among 57 countries/jurisdictions participating in the Global Matrix 4.0. Methods: Participating countries/jurisdictions provided Report Card grades on 10 common indicators. Information on economic freedom and climatic factors were gathered from public data sources. Correlations between the key variables were provided by income groups (ie, low- and middle-income countries/jurisdictions and high-income countries/jurisdictions [HIC]). Results: HIC were more economically neoliberal and more responsible for climate change than low- and middle-income countries. Annual temperature and precipitation were negatively correlated with behavioral/individual indicators in low- and middle-income countries but not in HIC. In HIC, correlations between climate culpability and behavioral/individual and economic indicators were more apparent. Overall, poorer grades were observed in highly culpable countries/jurisdictions in the highly free group, while in less/moderately free groups, less culpable countries/jurisdictions showed poorer grades than their counterparts in their respective group by economic freedom. Conclusions: Global-level physical activity promotion strategies should closely evaluate different areas that need interventions tailored by income groups, with careful considerations for inequities in the global political economy and climate change.
Results from Hong Kong’s 2018 Report Card on Physical Activity for Children and Youth
Wendy Y. Huang, Stephen H.S. Wong, Cindy H.P. Sit, Martin C.S. Wong, Raymond K.W. Sum, Sam W.S. Wong, and Jane J. Yu
Report Card Grades on the Physical Activity of Children and Youth Comparing 30 Very High Human Development Index Countries
Salomé Aubert, Joel D. Barnes, Nicolas Aguilar-Farias, Greet Cardon, Chen-Kang Chang, Christine Delisle Nyström, Yolanda Demetriou, Lowri Edwards, Arunas Emeljanovas, Aleš Gába, Wendy Y. Huang, Izzeldin A.E. Ibrahim, Jaak Jürimäe, Peter T. Katzmarzyk, Agata Korcz, Yeon Soo Kim, Eun-Young Lee, Marie Löf, Tom Loney, Shawnda A. Morrison, Jorge Mota, John J. Reilly, Blanca Roman-Viñas, Natasha Schranz, John Scriven, Jan Seghers, Thomas Skovgaard, Melody Smith, Martyn Standage, Gregor Starc, Gareth Stratton, Tim Takken, Tuija Tammelin, Chiaki Tanaka, David Thivel, Richard Tyler, Alun Williams, Stephen H.S. Wong, Paweł Zembura, and Mark S. Tremblay
Background: To better understand the childhood physical inactivity crisis, Report Cards on physical activity of children and youth were prepared concurrently in 30 very high Human Development Index countries. The aim of this article was to present, describe, and compare the findings from these Report Cards. Methods: The Report Cards were developed using a harmonized process for data gathering, assessing, and assigning grades to 10 common physical activity indicators. Descriptive statistics were calculated after converting letter grades to interval variables, and correlational analyses between the 10 common indicators were performed using Spearman’s rank correlation coefficients. Results: A matrix of 300 grades was obtained with substantial variations within and between countries. Low grades were observed for behavioral indicators, and higher grades were observed for sources of influence indicators, indicating a disconnect between supports and desired behaviors. Conclusion: This analysis summarizes the level and context of the physical activity of children and youth among very high Human Development Index countries, and provides additional evidence that the situation regarding physical activity in children and youth is very concerning. Unless a major shift to a more active lifestyle happens soon, a high rate of noncommunicable diseases can be anticipated when this generation of children reaches adulthood.
Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries
Salomé Aubert, Joel D. Barnes, Chalchisa Abdeta, Patrick Abi Nader, Ade F. Adeniyi, Nicolas Aguilar-Farias, Dolores S. Andrade Tenesaca, Jasmin Bhawra, Javier Brazo-Sayavera, Greet Cardon, Chen-Kang Chang, Christine Delisle Nyström, Yolanda Demetriou, Catherine E. Draper, Lowri Edwards, Arunas Emeljanovas, Aleš Gába, Karla I. Galaviz, Silvia A. González, Marianella Herrera-Cuenca, Wendy Y. Huang, Izzeldin A.E. Ibrahim, Jaak Jürimäe, Katariina Kämppi, Tarun R. Katapally, Piyawat Katewongsa, Peter T. Katzmarzyk, Asaduzzaman Khan, Agata Korcz, Yeon Soo Kim, Estelle Lambert, Eun-Young Lee, Marie Löf, Tom Loney, Juan López-Taylor, Yang Liu, Daga Makaza, Taru Manyanga, Bilyana Mileva, Shawnda A. Morrison, Jorge Mota, Vida K. Nyawornota, Reginald Ocansey, John J. Reilly, Blanca Roman-Viñas, Diego Augusto Santos Silva, Pairoj Saonuam, John Scriven, Jan Seghers, Natasha Schranz, Thomas Skovgaard, Melody Smith, Martyn Standage, Gregor Starc, Gareth Stratton, Narayan Subedi, Tim Takken, Tuija Tammelin, Chiaki Tanaka, David Thivel, Dawn Tladi, Richard Tyler, Riaz Uddin, Alun Williams, Stephen H.S. Wong, Ching-Lin Wu, Paweł Zembura, and Mark S. Tremblay
Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.
Global Matrix 4.0 Physical Activity Report Card Grades for Children and Adolescents: Results and Analyses From 57 Countries
Salomé Aubert, Joel D. Barnes, Iryna Demchenko, Myranda Hawthorne, Chalchisa Abdeta, Patrick Abi Nader, José Carmelo Adsuar Sala, Nicolas Aguilar-Farias, Susana Aznar, Peter Bakalár, Jasmin Bhawra, Javier Brazo-Sayavera, Mikel Bringas, Jonathan Y. Cagas, Angela Carlin, Chen-Kang Chang, Bozhi Chen, Lars Breum Christiansen, Candice Jo-Anne Christie, Gabriela Fernanda De Roia, Christine Delisle Nyström, Yolanda Demetriou, Visnja Djordjic, Arunas Emeljanovas, Liri Findling Endy, Aleš Gába, Karla I. Galaviz, Silvia A. González, Kylie D. Hesketh, Wendy Yajun Huang, Omphile Hubona, Justin Y. Jeon, Danijel Jurakić, Jaak Jürimäe, Tarun Reddy Katapally, Piyawat Katewongsa, Peter T. Katzmarzyk, Yeon-Soo Kim, Estelle Victoria Lambert, Eun-Young Lee, Sharon Levi, Pablo Lobo, Marie Löf, Tom Loney, José Francisco López-Gil, Juan López-Taylor, Evelin Mäestu, Agus Mahendra, Daga Makaza, Marla Frances T. Mallari, Taru Manyanga, Bojan Masanovic, Shawnda A. Morrison, Jorge Mota, Falk Müller-Riemenschneider, Laura Muñoz Bermejo, Marie H. Murphy, Rowena Naidoo, Phuong Nguyen, Susan Paudel, Željko Pedišić, Jorge Pérez-Gómez, John J. Reilly, Anne Kerstin Reimers, Amie B. Richards, Diego Augusto Santos Silva, Pairoj Saonuam, Olga L. Sarmiento, Vedrana Sember, Mohd Razif Shahril, Melody Smith, Martyn Standage, Gareth Stratton, Narayan Subedi, Tuija H. Tammelin, Chiaki Tanaka, Riki Tesler, David Thivel, Dawn Mahube Tladi, Lenka Tlučáková, Leigh M. Vanderloo, Alun Williams, Stephen Heung Sang Wong, Ching-Lin Wu, Paweł Zembura, and Mark S. Tremblay
Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children’s and adolescents’ (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. Methods: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders’ top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. Results: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. Conclusions: The Global Matrix 4.0 represents the largest compilation of children’s and adolescents’ PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.