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Stanley Sai-chuen Hui

Promoting regular physical activity has been considered one of the most important aspects of preventive medicine in recent years. This is due to the fact that tremendous evidence has been found about the positive association between increasing physical activity and desirable health effects. Findings have been summarized in a number of review documents; however, most of these reviews emphasize findings retrieved from research conducted in Western countries. Few papers were found to summarize findings in physical activity and health of the Hong Kong Chinese population. Epidemiological studies revealed that there exists distinct diverse health status among different ethnic groups due to culture, beliefs, genetic makeup, health practices, and behaviors in these highly diverse groups. This chapter reviews what is known about the association between physical activity and health in the Chinese population of Hong Kong. Current health issues including coronary heart disease, obesity, diabetes, cancer, osteoporosis, and so on, that are specific to the Hong Kong situation are reviewed. Moreover, findings in physical activity participation levels of Hong Kong adults and children are introduced. Results indicate that the associations between physical activity and health found in the Chinese population of Hong Kong share similar trends as those reported in Western countries. Three quarters of Hong Kong children and adults are not physically active enough to achieve health benefits. The physical activity level for the Hong Kong Chinese population remains low. The need for promotional and intervention programs on physical activity participation is pressing.

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André O. Werneck, Edilson S. Cyrino, Paul J. Collings, Enio R.V. Ronque, Célia L. Szwarcwald, Luís B. Sardinha and Danilo R. Silva

Background: This study describes the levels and patterns of television (TV) viewing in Brazilian adults and investigates associations of TV viewing with hypertension, type 2 diabetes, and heart disease. Methods: Data from the Brazilian Health Survey, a nationally representative survey that was conducted in 2013 (N = 60,202 men and women aged ≥18 y), were used. Information regarding TV viewing, physician diagnoses of type 2 diabetes, hypertension, and heart disease was collected via interview-administered questionnaire. Data on covariables (including chronological age, educational status, skin color, sodium consumption, sugar consumption, tobacco smoking, alcohol consumption, and leisure-time physical activity) were also self-reported. Logistic regression models and population attributable fractions were used for the etiological analyses. Results: The prevalence (95% confidence interval) of >4 hours per day of TV viewing was 12.7% (12.0–13.4) in men and 17.5% (16.8–18.3) in women. Men and women being younger or older, moderately educated, living alone, smoking tobacco, and drinking alcohol were associated with higher reported TV viewing time. Odds ratios (95% confidence interval) revealed that >4 hours per day of TV viewing was associated with type 2 diabetes [male: 1.64 (1.23–2.17) and female: 1.33 (1.09–1.63)], hypertension [male: 1.36 (1.14–1.63) and female: 1.20 (1.05–1.37)], and heart disease [male: 1.96 (1.43–2.69) and female: 1.30 (1.00–1.68)]. Exceeding 4 hours per day of TV viewing was responsible for 6.8% of type 2 diabetes, 3.7% of hypertension, and 7.5% of heart disease cases. Conclusions: Independent of covariates, >4 hours per day of TV viewing was associated with type 2 diabetes, hypertension, and heart disease. High volumes of TV viewing are prevalent and appear to contribute to chronic disease burden.

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Rebecca L. Vivrette, Laurence Z. Rubenstein, Jennifer L. Martin, Karen R. Josephson and B. Josea Kramer


To determine seniors’ beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors.


Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials.


Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers.


An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them.

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Stanley S.C. Hui, Neil Thomas and Brian Tomlinson


The impact of physical activity, aerobic fitness, and body composition on coronary heart disease (CHD) risk factors in Hong Kong Chinese adults has not been previously investigated.


The study surveyed 707 randomly selected middle-age Hong Kong Chinese by telephone for Physical Activity Rating (PAR). Three hundred and sixteen respondents (age: 45.1 ± 8.1 y) participated in subsequent aerobic fitness testing (VO2max) and CHD risk factor screening.


More than 70% of respondents did not have sufficient levels of physical activity. Fifty percent of the men and 19.5% of the women had two or more CHD risk factors. PAR correlated poorly with VO2max and CHD risk factors. VO2max showed significant associations with CHD risk factors. The adjusted odds ratios of having CHD risk factors for unfit participants ranged from 1.11 to 6.61 as compared to fit participants. Obese but fit individuals demonstrated lower odds of CHD risk factors than the obese and unfit individuals. WC was found to be a stronger predictor for CHD risk factors than BMI.


The prevalence of CHD risk factors in middle-age Chinese in Hong Kong was high and was related to levels of aerobic fitness and obesity.

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Lisa M. Stobierski, Shirleeah D. Fayson, Lindsay M. Minthorn, Tamara C. Valovich McLeod and Cailee E. Welch

Clinical Scenario:

Injuries are inevitable in the physically active population. As a part of preventive medicine, health care professionals often seek clinical tools that can be used in real time to identify factors that may predispose individuals to these injuries. The Functional Movement Screen (FMS), a clinical tool consisting of 7 individual tasks, has been reported as useful in identifying individuals in various populations that may be susceptible to musculoskeletal injuries. If factors that may predispose physically active individuals to injury could be identified before participation, clinicians may be able to develop a training plan based on FMS scores, which could potentially decrease the likelihood of injury and overall time missed from physical activities. However, in order for a screening tool to be used clinically, it must demonstrate acceptable reliability.

Focused Clinical Question:

Are clinicians reliable at scoring the FMS, in real time, to assess movement patterns of physically active individuals?

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Rebecca E. Hasson

.A. , Yu , H. , & Brown , E.R. ( 2008 ). Physical activity among adolescents. When do parks matter? American Journal of Preventive Medicine, 34 ( 4 ), 345 – 348 . 10.1016/j.amepre.2008.01.020 Balfour , J.L. , & Kaplan , G.A. ( 2002 ). Neighborhood environment and loss of physical function in

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Abolanle R. Gbadamosi, Alexandra M. Clarke-Cornwell, Paul A. Sindall and Malcolm H. Granat

). Active commuting and cardiovascular risk: A meta-analytic review . Preventive Medicine, 46 ( 1 ), 9 – 13 . PubMed ID: 17475317 doi: 10.1016/j.ypmed.2007.03.006 Harrington , D.M. , Welk , G.J. , & Donnelly , A.E. ( 2011 ). Validation of MET estimates and step measurement using the ActivPAL

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Akio Kubota, Alison Carver and Takemi Sugiyama

.E. ( 2011 ). Measurement of adults’ sedentary time in population-based studies . American Journal of Preventive Medicine, 41, 216 – 227 . PubMed ID: 21767730 doi:10.1016/j.amepre.2011.05.005 10.1016/j.amepre.2011.05.005 Herbolsheimer , F. , Mosler , S. , & Peter , P.R. ( 2016 ). Relationship

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Joowon Lee, Baojiang Chen, Harold W. Kohl III, Carolyn E. Barlow, Chong Do Lee, Nina B. Radford, Laura F. DeFina and Kelley P. Gabriel

Cooper Center Longitudinal Study (CCLS) is an ongoing observational database of patient visits to the Cooper Clinic in Dallas, TX, a preventive medicine practice that began in 1970. The participants were community dwelling and were either self-referred or referred by their employers for preventive health

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Jordan A. Carlson, J. Aaron Hipp, Jacqueline Kerr, Todd S. Horowitz and David Berrigan

SOPARC (System for Observing Play and Recreation in Communities) . Preventive Medicine, 86 , 153 – 166 . PubMed ID: 26946365 doi:10.1016/j.ypmed.2016.02.029 10.1016/j.ypmed.2016.02.029 Eyler , A.A. , Blanck , H.M. , Gittelsohn , J. , Karpyn , A. , McKenzie , T.L. , Partington , S