Development and reliability of a scale of physical activity-related informal social control for parents of Chinese pre-schoolers

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Parent-perceived neighbourhood environment, parenting practices and preschool-aged children physical activity and screen time: a cross-sectional study of two culturally and geographically diverse cities

Background: Preschool-aged children’s physical activity (PA) and screen time (ST) are important health-related behaviours likely influenced by PA opportunities, parental perceptions of neighbourhood safety and parenting practices pertaining to PA and ST. How these factors interact to impact on young children’s PA and ST, and whether their effects are generalisable across cultures and geographical location is not known. This study addressed these knowledge gaps by conducting pooled analyses of comparable data from two culturally and geographically diverse samples – Chinese parent-child dyads from an ultra-dense city (Hong Kong, China) and Latino parent-child dyads from a low-density city (Houston, USA). Methods: The analytical sample consisted of 164 Hong Kong Chinese and 84 US Latino parent-child dyads with data on socio-demographic characteristics, parent-perceived neighbourhood destinations and facilities for children’s PA, physical and social safety-related neighbourhood attributes, PA-related parenting practices and child’s ST and accelerometer-assessed PA. Generalised linear models with robust standard errors accounting for neighbourhoodlevel clustering were used to estimate associations and interaction effects. Results: Hong Kong Chinese children accumulated less PA than US Latino children, although the latter had more ST. Hong Kong Chinese parents reported more parenting practices promoting inactivity. Neighbourhood PA opportunities were positively related to children’s PA only if parental perceptions of neighbourhood safety were favourable, and the associations of physical neighbourhood environment characteristics with children’s PA and ST depended on PA-related parenting practices. Community cohesion was positively related to children’s PA and negatively related to ST, while parental promotion of ST was positively associated with children’s ST. Correlates of children’s PA and ST did not differ by city. Conclusions: The substantial diferences in activity patterns between Hong Kong Chinese and US Latino preschoolaged children observed in this study are likely due to a combination of cultural and built environmental factors. However, the fact that no between-city differences in correlates of PA and ST were detected indicates that both populations of children are equally affected by parent-perceived neighbourhood environmental characteristics and parenting practices. Overall, this study highlights the importance of considering how various individual-, home- and neighbourhood physical and social factors interact to influence young children’s health-promoting activity levels

Brief advice and active referral for smoking cessation services among community smokers: a study protocol for randomized controlled trial

Abstract Background Most smokers do not use smoking cessation (SC) services although it increases successful quits. Passive referral providing SC information to smokers is commonly used in SC studies. Little was known about active referral in the community setting. This study aims to motivate community smokers to quit by brief SC advice using a validated AWARD model (Ask, Warn, Advise, Refer and Do-it-again) that adjunct with active referral of smokers to various SC services in Hong Kong. Methods/Design This is a single-blinded, parallel three-armed cluster randomized controlled trial (RCT) with two treatment groups of (1) brief SC advice using the AWARD model, active referral to SC services plus a referral card and a health warning leaflet (active referral group) and (2) brief SC advice using AWARD model and health warning leaflet (brief advice group) and a control group receives general very brief advice with a self-help booklet. A total of 1291 smokers will be recruited from 66 clusters (recruitment sessions) with 22 will be allocated to each of the two intervention and one control groups. SC ambassadors will be trained for delivering the interventions and conducting telephone follow-up. The primary outcomes are self-reported 7-days point prevalence (PP) abstinence at 3 and 6 months follow-up. Intention-to-treat principle and multi-level regressions will be used for data analysis. Discussion This is the first RCT on assessing a model combining brief advice and active referral to SC services among community smokers. The results will inform the practices of SC services and intervention studies. Trial registration NCT02539875 (ClinicalTrials.gov registry; registered retrospectively on 22 July 2015

What Drives Animal Fluency Performance in Cantonese-Speaking Chinese Patients with Adult-Onset Psychosis?

Among the numerous studies investigating semantic factors associated with functioning in psychotic patients, most have been conducted on western populations. By contrast, the current cross-sectional study involved native Cantonese-speaking Chinese participants. Using the category fluency task, we compared performance between patients and healthy participants and examined clinical and sociodemographic correlates. First-episode psychosis patients (n = 356) and gender- and age-matched healthy participants (n = 35) were asked to generate as many ‘animals’ as they could in a minute. As expected, patients generated fewer correct responses (an average of 15.5 vs. 22.9 words), generated fewer clusters (an average of 3.7 vs. 5.4 thematically grouped nouns), switched less between clusters (on average 8.0 vs. 11.9 switches) and, interestingly, produced a larger percentage of Chinese zodiac animals than healthy participants (an average of 37.7 vs. 24.2). However, these significant group differences in the clusters and switches disappeared when the overall word production was controlled for. Within patients, education was the strongest predictor of category fluency performance (namely the number of correct responses, clusters, and switches). The findings suggest that an overall slowness in patients may account for the group differences in category fluency performance rather than any specific abnormality per se

Development of measures for the study of environmental neighborhood and family determinants of physical activity in Hong Kong preschoolers

abstractHuman PerformanceDoctoralDoctor of Philosoph

Parental practices encouraging and discouraging physical activity in Hong Kong Chinese preschoolers

Background: Regular participation in physical activity (PA) can help reduce the risk of overweight/obesity. Parental practices related to PA are modifiable determinants of preschoolers\u27 PA that are still not well understood, especially in non-Western cultures. This qualitative explorative study aimed to identify parental practices encouraging or discouraging PA in Hong Kong preschoolers. Methods: Nominal Group Technique (NGT) sessions (n = 45; 6 to 9/group), complemented by a focus group (n = 6) and individual interviews (n = 12), were conducted with primary caregivers (mainly parents) of Hong Kong preschoolers to investigate what parents do to encourage (4 groups) and discourage (2 groups) PA in children. The groups were stratified by low and high neighborhood socioeconomic status. Results: Participants generated 21 and 16 items describing practices encouraging and discouraging preschoolers\u27 PA, respectively. Parental provision of instrumental, motivational, and conditional support were thought to encourage child\u27s PA, while parental safety concerns, focus on academic achievement, lack of time and resources, and promotion of sedentary behaviors were thought to discourage child\u27s PA. Conclusions: Several parental practices that were deemed to encourage or discourage Hong Kong preschoolers\u27 PA were identified. These can assist with development of a culturally sensitive scale of PA parenting practices and inform future quantitative research

Validity of a scale of neighbourhood informal social control relevant to pre-schoolers' physical activity: A cross-sectional study

Childhood physical activity (PA) is important for health across the lifespan. Time pre-schoolers spend outdoors, which has been associated with more PA, is likely influenced by parents' perception of neighbourhood informal social control relevant to pre-schoolers' PA, defined as the willingness of neighbours to intervene to ensure social order and a safe community environment for young children's active play. To advance measurement of this construct, we assessed factorial and construct validities of the PA-related neighbourhood informal social control scale for parents of pre-schoolers (PANISC-PP). In 2013–2014, Hong Kong primary caregivers (n=394) of 3–5-year-old children completed a socio-demographic questionnaire, the preliminary version of the PANISC-PP, and self-report measures of theoretical neighbourhood correlates of PA-related neighbourhood informal social control (perceived signs of physical and social disorder, community cohesion, perceived stranger danger, risk of unintentional injury and traffic safety). The fit of the data to an a priori measurement model of the PANISC-PP was examined using confirmatory factor analyses. As the a priori model showed inadequate fit to the data, the factor structure was re-specified based on theoretical considerations. The final measurement models of the PANISC-PP showed acceptable fit to the data and consisted of three correlated latent factors: "General informal supervision", "Civic engagement for the creation of a better neighbourhood environment" and “Educating and assisting neighbourhood children”. The internal reliability of the subscales was good (Cronbach'sαvalues 0.82–0.89). Generalised additive mixed models indicated that all subscales were positively associated with community cohesion and scores on the subscale "Educating and assisting neighbourhood children" were related in the expected direction to all indicators of traffic and personal safety, supporting construct validity of the PANISC-PP. This study suggests that the PANISC-PP is a reliable and valid instrument for assessing parents’ perceived neighbourhood informal social control related to pre-schoolers' PA

Development of physical activity-related parenting practices scales for urban Chinese parents of preschoolers: confirmatory factor analysis and reliability

Background: 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. Methods: 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. Results: 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). Conclusion: 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

Measures of environmental correlates of physical activity for urban Chinese preschool-aged children: development and reliability

We adapted/developed and examined the test–retest reliability and internal consistency of eight parent-report measures of home and neighborhood environmental correlates of physical activity appropriate for Chinese preschool-aged children and their parents/primary caregivers living in densely populated urban environments. This study consisted of a qualitative (cognitive interviews) and a quantitative (test–retest reliability) component. Chinese versions of the measures were pilot-tested on 20 parents of Hong Kong preschool-aged children using cognitive interviews. Measures were then administered to 61 parents twice, 1 week apart. Test–retest reliability and internal consistency were computed. Except for two items, the test–retest reliability of items and scale summary scores ranged from moderate to excellent. The internal consistency of the measures exceeded recommended minimal values (Cronbach’s α >.70). The parent-report measures examined in this study are potentially appropriate for use in investigations of environmental correlates of the physical activity of Chinese preschool-aged children living in densely populated urban environments. However, their predictive validity with respect to Chinese preschool-aged children’s physical activity needs to be assessed in future studies