Results from Hong Kong’s 2018 Report Card on Physical Activity for Children and Youth

in Journal of Physical Activity and Health

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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.

Table 1

Grades and rationales for Hong Kong’s 2018 Report Card

IndicatorGradesRationale
Overall Physical ActivityC-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 ParticipationCHalf of secondary school students report participation in leisure time sports at least once per week.6
Active PlayINCNo relevant data
Active TransportationB+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 BehaviorsC-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 FitnessDAverage 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
FamilyD-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
SchoolC77% 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 EnvironmentB60-79% 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
GovernmentCAccording 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.

Figure 1
Figure 1

—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 Tin Ka Ping Foundation.

References

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    Huang WY, Wong SH, Wong MC, et al. Results from Hong Kong’s 2016 report card on physical activity for children and youth. J Phys Act Health. 2016;13(11 suppl 2):S169–S175. doi:10.1123/jpah.2016-0302

    • Crossref
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    Leisure and Cultural Services Department, The Government of the Hong Kong Special Administrative Region. Healthy Exercise for All Campaign-Physical Fitness Test for the Community. February 2013. https://www.censtatd.gov.hk/hkstat/sub/sp380.jsp?productCode=FA100265. Accessed June 12, 2018.

    • Search Google Scholar
    • Export Citation
  • 3.

    Education Bureau, The Government of the Hong Kong Special Administrative Region. Surveys on ‘Physical Fitness Status of Hong Kong School Pupils’. 2015–2016. http://www.edb.gov.hk/en/curriculum-development/kla/pe/references_resource/fitness-survey/index.html. Accessed June 12, 2018.

    • Search Google Scholar
    • Export Citation
  • 4.

    Wong SH, Huang WY, He G. Longitudinal changes in objectively measured physical activity differ for weekdays and weekends among Chinese children in Hong Kong. BMC Public Health. 2015;15(1):1310. doi:10.1186/s12889-015-2618-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Cerin E, Sit CH, Wong SH, et al. Understanding the Relative Contribution And Interactive Effects of Psychological, Social and Environmental Correlates of Physical Activity, Sedentary Behaviours and Dietary Behaviours in Hong Kong Adolescents. Final Report of Health and Medical Research Fund (HMRF) Approved Project. 2016. https://rfs2.fhb.gov.hk/app/fundedsearch/projectdetail.xhtml?id=1118. Accessed June 12, 2018.

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  • 6.

    Wong BY, Ho SY, Lo WS, et al. Longitudinal Relations of Perceived Availability of Neighborhood Sport Facilities with Physical Activity in Adolescents: An Analysis of Potential Moderators. J Phys Act Health. 2014;11(3):581–587. doi:10.1123/jpah.2012-0077

    • Crossref
    • PubMed
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  • 7.

    Huang WY, Wong SH, He G. Is a change to active travel to school an important source of physical activity for chinese children? Pediatr Exerc Sci. 2017;29(1):161–168. doi:10.1123/pes.2016-0001

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  • 8.

    Public Opinion Programme, The University of Hong Kong. Youth Survey on Usage of Internet and Social Network Websites. June 8, 2010. https://www.hkupop.hku.hk/english/report/microsoft10/. Accessed June 12, 2018.

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  • 9.

    Huang WY, Wong SH, He G, et al. Isotemporal substitution analysis for sedentary behavior and body mass index. Med Sci Sports Exerc. 2016;48(11):2135–2141. doi:10.1249/MSS.0000000000001002

    • Crossref
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    Yeung DC, Yuan X, Hui SS, et al. Determinants of moderate to vigorous physical activity and obesity in children: a structural equation modeling analysis. World J Pediatr. 2016;12(2):170–176. doi:10.1007/s12519-015-0057-8

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    Department of Health, Education Bureau, Leisure and Cultural Services Department, The Government of the Hong Kong Special Administrative Region. Healthier Lifestyle for Primary School Children. March 27, 2009. https://www.aud.gov.hk/pdf_e/e52ch04.pdf. Accessed June 12, 2018.

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    Census and Statistics Department, The Government of the Hong Kong Special Administrative Region. Thematic Household Survey Report No. 47. Public Views on Education Reform; Public Views on the Provision of Sports Facilities. March 24, 2011. https://www.statistics.gov.hk/pub/B11302472011XXXXB0100.pdf. Accessed June 12, 2018.

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    • Export Citation

If the inline PDF is not rendering correctly, you can download the PDF file here.

Huang is with Department of Physical Education, Hong Kong Baptist University, Hong Kong, China. Stephen Wong, Sit, Sum, and Yu are with Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China. Martin Wong is with the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. Sam Wong is with Physical Fitness Association of Hong Kong, China.

Stephen Wong (hsswong@cuhk.edu.hk) is the corresponding author.
  • 1.

    Huang WY, Wong SH, Wong MC, et al. Results from Hong Kong’s 2016 report card on physical activity for children and youth. J Phys Act Health. 2016;13(11 suppl 2):S169–S175. doi:10.1123/jpah.2016-0302

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Leisure and Cultural Services Department, The Government of the Hong Kong Special Administrative Region. Healthy Exercise for All Campaign-Physical Fitness Test for the Community. February 2013. https://www.censtatd.gov.hk/hkstat/sub/sp380.jsp?productCode=FA100265. Accessed June 12, 2018.

    • Search Google Scholar
    • Export Citation
  • 3.

    Education Bureau, The Government of the Hong Kong Special Administrative Region. Surveys on ‘Physical Fitness Status of Hong Kong School Pupils’. 2015–2016. http://www.edb.gov.hk/en/curriculum-development/kla/pe/references_resource/fitness-survey/index.html. Accessed June 12, 2018.

    • Search Google Scholar
    • Export Citation
  • 4.

    Wong SH, Huang WY, He G. Longitudinal changes in objectively measured physical activity differ for weekdays and weekends among Chinese children in Hong Kong. BMC Public Health. 2015;15(1):1310. doi:10.1186/s12889-015-2618-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Cerin E, Sit CH, Wong SH, et al. Understanding the Relative Contribution And Interactive Effects of Psychological, Social and Environmental Correlates of Physical Activity, Sedentary Behaviours and Dietary Behaviours in Hong Kong Adolescents. Final Report of Health and Medical Research Fund (HMRF) Approved Project. 2016. https://rfs2.fhb.gov.hk/app/fundedsearch/projectdetail.xhtml?id=1118. Accessed June 12, 2018.

    • Search Google Scholar
    • Export Citation
  • 6.

    Wong BY, Ho SY, Lo WS, et al. Longitudinal Relations of Perceived Availability of Neighborhood Sport Facilities with Physical Activity in Adolescents: An Analysis of Potential Moderators. J Phys Act Health. 2014;11(3):581–587. doi:10.1123/jpah.2012-0077

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Huang WY, Wong SH, He G. Is a change to active travel to school an important source of physical activity for chinese children? Pediatr Exerc Sci. 2017;29(1):161–168. doi:10.1123/pes.2016-0001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Public Opinion Programme, The University of Hong Kong. Youth Survey on Usage of Internet and Social Network Websites. June 8, 2010. https://www.hkupop.hku.hk/english/report/microsoft10/. Accessed June 12, 2018.

    • Search Google Scholar
    • Export Citation
  • 9.

    Huang WY, Wong SH, He G, et al. Isotemporal substitution analysis for sedentary behavior and body mass index. Med Sci Sports Exerc. 2016;48(11):2135–2141. doi:10.1249/MSS.0000000000001002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Yeung DC, Yuan X, Hui SS, et al. Determinants of moderate to vigorous physical activity and obesity in children: a structural equation modeling analysis. World J Pediatr. 2016;12(2):170–176. doi:10.1007/s12519-015-0057-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Department of Health, Education Bureau, Leisure and Cultural Services Department, The Government of the Hong Kong Special Administrative Region. Healthier Lifestyle for Primary School Children. March 27, 2009. https://www.aud.gov.hk/pdf_e/e52ch04.pdf. Accessed June 12, 2018.

    • Search Google Scholar
    • Export Citation
  • 12.

    Census and Statistics Department, The Government of the Hong Kong Special Administrative Region. Thematic Household Survey Report No. 47. Public Views on Education Reform; Public Views on the Provision of Sports Facilities. March 24, 2011. https://www.statistics.gov.hk/pub/B11302472011XXXXB0100.pdf. Accessed June 12, 2018.

    • Search Google Scholar
    • Export Citation
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