Results and SWOT Analysis of the 2022 Hong Kong Report Card on Physical Activity for Children and Adolescents With Special Educational Needs.

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.

Physical Competence, Physical Well-Being, and Perceived Physical Literacy among Older Adults in Day Care Centers of Hong Kong.

In Hong Kong, where the aging problem is inevitable, it is increasingly common for older adults to be admitted to day care centers. However, there has been limited research exploring conceivable indicators of healthy aging among older adults in such settings. The present study investigated the associations among the three indicators (physical competence, physical well-being, and perceived physical literacy) among older adults in day care centers of Hong Kong. A total of 97 participants (aged 60 years old or above) participated in the study from April to July 2021 amid the COVID-19 pandemic. Data on participants' sociodemographic information, physical competence (PC), physical well-being (PWB), and perceived physical literacy (PPL) were collected. Our results showed that the level of PC reached a high level among the participants. Positive correlations were found between PC and PWB and between PPL and PWB (r = 0.22−0.23, p < 0.05). However, PC was not associated with PPL (r = 0.11, p > 0.05). In addition, as a component within PPL, "knowledge and understanding" (KU) was found to be correlated with PC (r = 0.21, p < 0.05) and had a positive and moderate correlation with PWB (r = 0.35, p < 0.01). The results suggest that older adults admitted to day care centers maintain and enhance their physical competence to improve their physical well-being. Greater knowledge and understanding of physical literacy and physical health should be delivered among day care centers considering future development.

The Effects of Exercise Interventions on Executive Functions in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review and Meta-analysis.

BACKGROUND: Both chronic and acute exercise interventions have reported positive effects on executive functions (EFs) in general populations. However, data on changes in EFs in children and adolescents with autism spectrum disorder (ASD) in response to exercise interventions are still unclear. OBJECTIVE: This systematic review and meta-analysis aimed to synthesize available empirical studies concerning the effects of exercise interventions on EFs in children and adolescents with ASD. METHODS: In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the electronic databases CINAHL Complete (via EBSCOhost), SPORTDiscus with Full Text (via EBSCOhost), MEDLINE (via EBSCOhost), Web of Science, ProQuest, and Education Resources Information Center (ERIC; via EBSCOhost) were searched from inception to January 2021. Two authors independently extracted data and conducted a risk-of-bias analysis using the Physiotherapy Evidence Database scale. Randomized controlled trials/quasi-experimental designs that used acute or chronic exercise interventions and assessed EFs through neurocognitive tasks or questionnaires among children and adolescents with ASD were included. In total, 259 articles were identified, of which 15 full texts were independently assessed for eligibility by two authors. In total, 14 articles underwent systematic review, and seven were selected for meta-analysis. RESULTS: Overall, chronic exercise interventions had a small to moderate positive effect on overall EFs in children and adolescents with ASD (g = 0.342; 95% confidence interval [CI] 0.084-0.600; p < 0.01). Regarding domain-specific EFs, chronic exercise interventions had a small to moderate positive effect on cognitive flexibility (g = 0.312; 95% CI 0.053-0.570; p < 0.01) and inhibitory control (g = 0.492; 95% CI 0.188-0.796; p < 0.01). However, our review found a non-significant effect size (g = 0.212; 95% CI - 0.088 to 0.512) on working memory. CONCLUSIONS: Chronic exercise interventions appear to have beneficial effects on overall EFs in children and adolescents with ASD, particularly in relation to cognitive flexibility and inhibitory control.

The impact of exercise interventions concerning executive functions of children and adolescents with attention-deficit/hyperactive disorder: a systematic review and meta-analysis.

BACKGROUND: Previous studies found that exercise interventions have positive effects on executive functions of the general population. However, studies seldom target executive functions of children and adolescents with attention-deficit hyperactivity disorder (ADHD). This study aimed to synthesise empirical studies regarding the effects of exercise interventions on executive functions of children and adolescents with ADHD. METHODS: A systematic search of the relevant literature was conducted in March 2020 through six electronic databases: CINAHL Complete, Eric, MEDLINE, PsychINFO, SPORTDiscus with Full Text, and Web of Science. Randomised controlled trials/quasi-experimental designs that applied exercise interventions and assessed executive functions through neurocognitive tasks among children and adolescents with ADHD were included. Altogether, 314 studies were identified, from which 31 full texts were independently assessed by two authors for eligibility. Finally, 21 studies underwent systematic reviews and 15 were selected for meta-analysis. Data extraction procedures and risk of bias analysis were conducted by two independent authors using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: The findings indicated that exercise interventions improved overall executive functions of children and adolescents with ADHD (SMD = 0.611, 95% CI [0.386 to 0.836], p < 0.01). Exercise interventions had a moderate-to-large positive effect on inhibitory control (g = 0.761, 95% CI [0.376 to 1.146], p < 0.01) and cognitive flexibility (g = 0.780, 95% CI [0.331 to 1.228], p < 0.001). Likewise, during the subgroup analysis, intervention intensity and sessions of exercise (acute vs chronic) significantly moderated exercise intervention rather than intervention type. CONCLUSIONS: Chronic sessions of exercise interventions with moderate intensity should be incorporated as treatment for children with ADHD to promote executive functions.

Physical Activity and Executive Function in Children With ADHD: The Mediating Role of Sleep.

This study examined the mediating role of sleep in the relationship between physical activity and executive function in children with attention deficit hyperactivity disorder (ADHD). Fifty-six children with ADHD were recruited from Shenzhen Children's Hospital. Participants wore an accelerometer for seven consecutive days to measure physical activity and sleep quality. Activity counts were analyzed to measure moderate-to-vigorous physical activity (MVPA). Four sleep parameters, including sleep latency (SL), sleep efficiency, total sleep time, and wake after sleep onset were recorded from the actigraph. Three core executive functions, inhibitory control; working memory (WM); and cognitive flexibility (CF), were assessed from computer-based tasks: the flanker task, and the Tower of London and Trail Making Tests, respectively. The regression results showed that MVPA was negatively associated with SL (-0.169; 95%CI [-0.244, -0.112]). WM (total scores) was positively related to MVPA (0.028, 95%CI [0.008, 0.048]), but negatively related to SL (-0.105, 95%CI [-0.167, -0.030]). CF (part B errors) was negatively associated with MVPA (-0.031, 95%CI [-0.055, -0.005]) and positively correlated with SL (0.184, 95%CI [0.092, -0.260]). The indirect effect of SL was found for MVPA and WM (0.018, 95%CI [0.015, 0.034]), supporting the indirect partial mediation. Similarly, the indirect effect of SL was found between MVPA and CF (-0.031, 95%CI [-0.060, -0.012]), supporting the indirect partial mediation. The mediating role of SL in children with ADHD suggests that the intensity of physical activity plays a key role in linking sleep quality and executive function in this group.

Accelerometer-measured physical activity levels in children and adolescents with autism spectrum disorder: A systematic review.

Associations between physical activity (PA) and health benefits are well documented. Evidence indicates that children and adolescents with autism spectrum disorder (ASD) are less physically active than their typically developing peers. The purpose of this systematic review is to provide a comprehensive summary of the PA levels of children and adolescents with ASD and the associated factors that affect their PA levels by applying a socio-ecological model (SEM). Seven databases (PubMed, CINAHL, SPORTDiscus with Full Text, MEDLINE, EMBASE, ERIC, and PsychINFO) were searched in June 2019 to identify studies examining accelerometer-measured PA and factors affecting the PA levels of children and adolescents with ASD, aged 6-17 years. Two researchers independently screened studies, assessed methodological quality, and summarized relevant data. Twenty-one studies were included in the detailed review. Only 42% of the participants met the PA guidelines (i.e., children and adolescents aged 5-17 years should do at least 60 min of moderate to vigorous PA daily). By applying the SEM, multi-level factors ranging from intrapersonal to community levels that positively or negatively influenced PA levels in children and adolescents with ASD were identified. This review indicates that children and adolescents with ASD have low PA levels, and that there are multi-level factors that affect their PA. There is a pressing need to design effective PA interventions that promote activity accrual in the school, family, and community settings for children and adolescents with ASD.

Assessing factor structure of the simplified Chinese version of Perceived Physical Literacy Instrument for undergraduates in Mainland China.

BACKGROUND: /Objective: To evaluate the factor structure of the simplified Chinese version of "Perceived Physical Literacy Instrument" (PPLI) among Chinese undergraduates. METHODS: The PPLI scale (simplified Chinese version) is based on the original 18-item Cantonese version of PPLI scale, which was first constructed and validated to measure the perceived physical literacy (PL) of physical education (PE) teachers and adolescents in Hong Kong. In this study, 622 undergraduates were randomly split into two subsets. Exploratory factor analysis (EFA) was conducted on the first subset (n = 311) and then confirmatory factor analysis (CFA) was conducted on the second subset (n = 311) for the adapted version based upon the first EFA result. RESULTS: EFA led to an 8-item, 3-factor scale and item loadings ranged from 0.68 to 0.93, Cronbach's alpha ranged from 0.79 to 0.83. CFA showed that the construct factor loading ranged from 0.60 to 0.92, which further confirmed the satisfactory factor validity. CONCLUSION: The PPLI (simplified Chinese version) is a reliable and valid instrument to examine the perceived PL for Chinese undergraduates. Unlike the original Cantonese version of PPLI, PPLI (simplified Chinese version) exactly explore the kernel attributes, namely, motivation, confidence and physical competence, and interaction with the environment, of the concept of PL. Build from this instrument, more studies could explore the potential factors that influence the physical activity level, as well as structure appropriate intervention programs to utilize PL as a standard to evaluate the quality of PE courses or foster lifelong physical activity level, among Chinese young generation.

Results from the Hong Kong's 2018 report card on physical activity for children and youth.

BACKGROUND/OBJECTIVE: The Active Healthy Kids 2018 Hong Kong Report Card provides evidence-based assessment across 12 indicators of physical activity behaviors, sleep, and related community and government initiatives for children and youth. METHODS: The systematic development process provided by the Active Healthy Kids Global Alliance was used. The best available data from the past 10 years were reviewed by a panel of experts. According to predefined benchmarks, letter grades were assigned to 12 indicators (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behaviors, Physical Fitness, Sleep, Family, School, Community and Environment, Government, and Obesity). RESULTS: Three of the five activity behaviors received C- or C grades: Overall Physical Activity (C-), Sedentary Behaviors (C-), and Organized Sport Participation (C). Active Transportation was graded B + . Same to the 2016 Hong Kong Report Card, Active Play could not be graded. School and Government were graded C. Family and Community and Environment was graded D- and B, respectively. Three new indicators were added after the 2016 Report Card and they were graded from C- (Sleep) to D (Physical Fitness) or D- (Obesity). CONCLUSIONS: Children and youth in Hong Kong have low physical activity and physical fitness levels and high sedentary behaviors despite a generally favorable community environment. A high prevalence of obesity and low levels of family support warrant more public health action. Researchers should address the surveillance gap in active play and peer support.

Preservice Teachers' Mindfulness and Attitudes Toward Students With Autism Spectrum Disorder: The Role of Basic Psychological Needs Satisfaction.

Teachers' attitudes toward students with autism spectrum disorder (ASD) are vital predictors of successful inclusive education. Guided by the basic psychological needs theory, this cross-sectional survey aimed to examine the relationships among mindfulness, basic psychological needs satisfaction (basic psychological needs theory-based construct), and attitudes toward including students with ASD among preservice physical education (PE) teachers. A multisection survey form was administered to 211 preservice PE teachers. Path analysis indicated that mindfulness and basic psychological needs satisfaction positively predicted attitudes toward the inclusion of students with ASD. In addition, mindfulness had an indirect effect on attitudes through basic psychological needs satisfaction. The findings provide a preliminary direction for the development of a mindfulness-based intervention program for enhancing preservice PE teachers' attitudes toward the inclusion of students with ASD. The findings also suggest that the basic psychological needs theory is a useful framework for understanding the relationship between mindfulness and attitudes. Future longitudinal or intervention studies are needed to examine whether the findings can be replicated.

Psychometric Properties of the Physical Educators' Self-Efficacy Toward Including Students With Disabilities-Autism Among Chinese Preservice Physical Education Teachers.

Teachers' self-efficacy is a critical predictor for successful inclusive physical education. However, little is known about preservice physical educators' self-efficacy toward teaching students with autism spectrum disorders in China. A sound instrument is necessary to measure their self-efficacy level. This validation study examined the psychometric properties of the Chinese version of the Physical Educators' Self-Efficacy Toward Including Students with Disabilities-Autism. A multisection survey form was administered to preservice physical educators in Mainland China (n = 205) and Hong Kong (n = 227). The results of confirmatory factor analysis confirmed the one-factor model of the scale in the total sample and each of the two samples. Invariance tests across the two samples supported configural and metric invariance but not scalar invariance. The scale scores showed good internal reliability and were correlated with theoretically relevant constructs (i.e., burnout and life satisfaction) in the total sample and subsamples. These findings generally support the utility of the scale for use among Chinese preservice physical educators.

Perceived physical literacy instrument for adolescents: A further validation of PPLI.

BACKGROUND/OBJECTIVE: The purpose of this study is to examine the reliability and validity of "Perceived Physical Literacy Instrument" (PPLI) questionnaire in adolescents. METHODS: Based on physical literacy literature, a 9-item instrument was developed for initial tests. The self-report measure was administered to 1945 adolescents in Hong Kong. Confirmatory factor analysis (CFA) was used to examine a three-factor structure of physical literacy. A chi-square difference test analysed several competing models and compared the results between the proposed models (i.e., a three-factor solution) and other alternative models (i.e., a one-factor or two-factor solution). Furthermore, the measurement invariance across gender groups was examined by using multiple-group confirmatory factor analysis. Mean scores for physical literacy factors were also examined by demographic characteristics. RESULTS: Confirmatory factor analysis (CFA) showed that the construct demonstrated a good fit to the model. For convergent validity, our results, evaluating the factor loading of each items, the values of composite reliability (CR) and the average variance extracted (AVE) of the three factors, revealed that the three-factor validity of physical literacy was satisfactory. The chi-square difference test between models was significant indicating that all the latent variables had satisfactory discriminant validity. Moreover, the findings of measurement invariance showed that the PPLI is invariant across gender. CONCLUSIONS: The PPLI thus appeared to be reliable and valid as a measure of the perceived physical literacy of adolescents. Thus, along with other validated instruments, protocols and research designs, the PPLI could be widely used to test adolescents' self-perception of physical literacy and their own physical and mental health conditions and thereby health. Physical education professionals may thus recommend appropriate intervention programmes for younger generations.

Self-determined motivation and students' physical activity during structured physical education lessons and free choice periods.

OBJECTIVE: Various organizations have suggested that physical education (PE) should play a central role in increasing adolescents' physical activity (PA) levels. The purpose of this study was to examine relationships between students' self-determined motivation and their PA behavior during a structured PE lesson led by their teacher and a free-choice period in which they were not required to be active. METHODS: 528 Hong Kong students (mean age=15.78 years) participated in this study in April and May 2007. Situational Motivation Scale scores were used to form high and low self-determined motivation groups. Students wore a pedometer during a 20-minute structured basketball lesson and a 20-minute free choice period, during which they did not receive instruction. RESULTS: ANOVA revealed that self-determined motivation and PE class environments which provided students opportunities to make choices were related to greater PA. Furthermore, the difference in PA between the high and low self-determined groups was greater in the free-choice condition than the structured lesson, suggesting that self-determined motivation is especially important when students are not supervised. CONCLUSION: Findings indicated that promoting self-determined motivation may be an effective means of ensuring that PE programs are able to increase PA levels, foster self-initiated PA behaviors, and enhance adolescents' health.