Introduction
Insufficient physical activity among children and youth is of great concern and has been overlooked in Hong Kong. The Active Healthy Kids Hong Kong was established in 2015 to consolidate evidence-based evaluation of physical activity related indicators for children and youth in Hong Kong. The first Hong Kong Report Card on Physical Activity in 2016 clearly showed a high level of physical inactivity and sedentary behavior for children and youth despite some promising policies in school and community.1 This paper aims to summarize the results of the 2018 Hong Kong Report Card which includes 12 indicators.
Methods
The systematic development process provided by the Active Healthy Kids Global Alliance (https://www.activehealthykids.org/) was used. The 2018 Hong Kong Report Card included 10 core indicators that are common to the Global Matrix 3.0 (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behaviors, Physical Fitness, Family, School, Community and Environment, and Government) and two new indicators (Sleep and Obesity).
The best available data over the past ten years (from March 2009 to February 2018) were consolidated and reviewed by a panel of experts. The search for data sources included published journal articles, government reports (including grant completion reports), manual searches and personal contacts. According to the pre-defined benchmarks, letter grades were assigned to the 12 indicators. The data sources relied upon were national surveys, e.g. “Healthy Exercise for All Campaign – Physical Fitness Test for the Community”2 and “Surveys on Physical Fitness Status of Hong Kong School Pupils”,3 as well as published journal articles from representative samples. Feedback on initial grades was collected from the stakeholder group via a face-to-face meeting and online consultation. The grades were audited by the Active Healthy Kids Global Alliance and then finalized.
Results and Discussion
Grades and rationale for the 2018 Hong Kong Report Card are provided in Table 1 (for the 10 indicators common to Global Matrix 3.0 only) and its cover page is shown in Figure 1. Four of the five behavior indicators grades had either slightly improved (Overall Physical Activity, Organized Sport Participation and Active Transportation) or deteriorated (Sedentary Behaviors) compared with the 2016 grades. The changes were due to newly added data sources and revisions to the grading scheme for Global Matrix 3.0, i.e., more clear-cut benchmarks for plus (+) and minus (-) grades.
Grades and rationales for Hong Kong’s 2018 Report Card
| Indicator | Grades | Rationale |
|---|---|---|
| Overall Physical Activity | C- | Half of 6- to 8-year old children meet the physical activity recommendation, however, the percentage dropped to 30% and 22% at the 1-year and 2-year follow-ups.4 Nearly 90% of adolescents meet the recommendation.5 Less than 10% of adolescents report participation in at least 60 minutes of moderate to vigorous physical activity a day (self-report).2 |
| Organized Sport Participation | C | Half of secondary school students report participation in leisure time sports at least once per week.6 |
| Active Play | INC | No relevant data |
| Active Transportation | B+ | 80% of adolescent boys and 77% of adolescent girls report that they actively travel to school at least once per week.5 52% of primary school children use active travel to/from school at least 5 times per week.7 |
| Sedentary Behaviors | C- | 51% of the youth aged 12-23 years spend no more than 2 hours per day using the Internet.8 52% of primary school children spend less than 2 hours on screen time.9 |
| Physical Fitness | D | Average percentile achieved based on VO2peak for sex and age for 9- to 17-year old children and adolescents is 25.4% for boys and 36.2% for girls. Overall, it is 30.8%.3 |
| Family | D- | 37% of children and 23% of adolescents report family physical activity participation together at least once per week.2 17.3% of fathers and 15.1% of mothers report exercise habits of ≥3 times per week.10 |
| School | C | 77% of primary schools have physical education (PE) class for 70-120 minutes per week.11 70% of schools have a physical activity related policy (28% with documented policy and 42% with undocumented policy).11 |
| Community and Environment | B | 60-79% of parents of youth aged 11-18 years felt that their neighbourhood was safe (low traffic and crime rate).5 The majority of people aged ≥12 years were satisfied with the sport facilities provided by the government (location: 95%, price: 70%, cleanliness: 91%, booking arrangement: 66%, staff services: 79%, and facilities level: 86%).12 |
| Government | C | According to Physical Education Key Learning Area Curriculum Guide (Primary 1 - Secondary 6) of the Education Bureau of the Hong Kong Government: • At the primary level and junior secondary level, schools should allocate 5% to 8% of the total lesson time to General PE; • At the senior secondary level, schools should allocate at least 5% of the total lesson time in General PE through Other Learning Experiences. In addition, PE is an elective subject of the senior secondary curriculum and accounts for 10% of the total lesson time over a course of three years. http://www.edb.gov.hk/attachment/en/curriculum-development/renewal/PE/PE_KLACG_P1-S6_Eng_2017.pdf In the Sports Development section of Hong Kong Chief Executive’s 2017 Policy address, the opening up of School Facilities for Promotion of Sports Development Scheme was mentioned to encourage public sector schools to open up school facilities to sports associations by providing additional subsidies to the schools. This scheme will play an important role in promoting a sporting culture in schools. https://www.policyaddress.gov.hk/2017/eng/policy_ch06.html Leisure and Cultural Services Department (LCSD) of the Hong Kong Government is committed to providing high quality leisure facilities and services to meet the needs of the Hong Kong community. The 2018-19 budget of LCSD is HK$9.09 billion. Among the whole budget, Recreation and Sports accounts for HK$4.18 billion, which has increased by 2.5% based on the 2017-18 original budget. According to the plan, the number of participants in school sports programs and NSAs/sports organizations subvented programs are HK$634,480 and HK$749,250, respectively. http://www.lcsd.gov.hk/en/aboutlcsd/ppr/statistics/leisure.html#fac |
Note: The grade for each indicator is based on the percentage of children and youth meeting a defined benchmark: A+ is 94% to 100%; A is 87% to 93%; A- is 80% to 86%; B+ is 74% to 79%; B is 67% to 73%; B- is 60% to 66%; C+ is 54% to 59%, C is 47% to 53%; C- is 40% to 46%; D+ is 34% to 39%; D is 27% to 33%; D- is 20% to 26%; F is < 20%; INC is Incomplete data.
—Hong Kong’s 2018 Report Card cover.
Citation: Journal of Physical Activity and Health 15, s2; 10.1123/jpah.2018-0468
Similar to 2016, Family was assigned the lowest grade (D-) among the three setting and sources of influence indicators in 2018. Although new data sources have been found, there were no compelling evidence suggesting obvious changes of School and Community and Environment. Since 2016, the government has made efforts in promoting sport culture in schools and increasing financial support for school sports programs. Consequently, the indicator Government Strategies and Investments was graded (C) in the 2018 Report Card. The two new indicators that are not included in Global Matrix 3.0 were graded C- (Sleep) and D- (Obesity). The rationale for them will be described in more detail in Hong Kong’s report card’s full paper.
Although there are some new data sources available for the 2018 Hong Kong Report Card, there are still surveillance gaps, especially for active play (not graded in both the 2016 and 2018 Report Card) and peer support.
Conclusion
Children and youth in Hong Kong have low physical activity and physical fitness levels, and high sedentary behaviors despite a generally favorable community environment. The low level of family support warrant more public health actions. There is a surveillance gap in active play and peer support that researchers should address.
Funding Source
The 2018 Hong Kong Report Card is funded by
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