Neighborhood Built Environment and Physical Activity in Primary Schoolchildren in Hong Kong

The purposes of this thesis were to, first, develop a useful instrument for measurement of perceived neighborhood environment in Hong Kong children, and second, to examine the relationship between the neighborhood built environment and physical activity (PA) behaviors of children in Hong Kong. Three stepwise studies were conducted to address these purposes.;In the first study (Chapter 2), five nominal group technique (NGT) groups were conducted among 34 children aged 10-11 years from four types of neighborhoods varying in socio-economic status and household density in Hong Kong. In each NGT group, environmental items were generated by children in response to the question "What neighborhood environment do you think would increase or decrease your willingness to do PA?" Items were prioritized based on the number of votes that they received from children, which served as an indicator of their importance to PA. Sixteen unique environmental items, which were perceived by children as the most important factors influencing their PA, were identified. These PA-related environmental attributes were believed to be relevant to both the Hong Kong context and the children. The findings of this study could be used to develop or complement instruments that measure children's perceived neighborhood environment in Hong Kong.;The second study (Chapter 3) developed a comprehensive questionnaire assessing perceived neighborhood environment for Chinese children in Hong Kong, namely, the Neighborhood Environment Walkability Scale for Chinese Children (NEWS-CC). The development of the NEWS-CC was based on the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) with incorporation of selected items identified in the first study. The test-retest reliability and factorial validity of the NEWS-CC were examined by intraclass correlation coefficients (ICCs) and confirmatory factor analysis, respectively, in a sample of 953 children in the 4th to 6th grades from seven local primary schools.;The third study (Chapter 4) examined how perceived and objective neighborhood environment were related to children's PA behaviors among 1279 children in the 4th to 6th grades from nine local primary schools. For the self-reported PA of boys, perceived aesthetics was positively related to overall and non-school PA. For the objective PA of boys, shorter distance to nearest recreation ground and longer distance to attended school were related to more weekday overall MVPA and more weekday non-school MVPA; meanwhile, perceived walking facilities was negatively related to weekend overall MVPA. For the self-reported PA of girls, shorter distance to nearest park/garden and living in neighborhoods with higher household income were related to increased non-school PA. For the objective PA of girls, distance to nearest recreation ground was negatively associated with weekday overall MVPA; by contrast, distance to attended school had a positive association with weekday non-school MVPA, and distance to nearest park/garden was positively related to weekend overall MVPA. (Abstract shortened by UMI.).