Key determinants (Ecological/Environmental Model) associated with being highly or moderately active in Hong Kong residents

Abstract

Psychosocial factors as well as features of the built environment can be important determinants of our physical activity (PA) habits. Self-efficacy and social support from others, neighbourhoods aesthetics, proximity to commercial destinations and recreational facilities are often correlated with walking for transport, leisure-time PA and total PA. PURPOSE: As most studies have been undertaken in low density Occidental urban areas, the aim was to use an ecological model to examine which characteristics of neighbourhoods common in a high density Asian city might contribute to enhancing the levels of PA of it residents. METHODS: A total of 348 residents were recruited from 32 selected neighborhoods (balance of high/low walkability and high/low socio-economic status, SES), aged 18-65 years (42.2% male). Adopting an ecological model of PA, residents completed a self-report questionnaire on the perceived neighborhood characteristics (NEWS-A); residential housing quality (BEQQ); PA habits (IPAQ-long); psychosocial factors; and perceived health (SF-12). Multinomial logistic regressions determined the ecological factors contributing to the odds of being highly or moderately active vs. low active. RESULTS: In our summary model, (i) three factors were associated with higher odds of being moderately active (v low active): college/university graduate (1.75 Odds Ratio (OR), p=0.02), barriers to PA (1.39 OR, p=0.05); overall self-efficacy (1.21 OR, p<0.01); whilst (ii) four factors were associated with the odds of being highly active (v low active): litter/social disorder (0.56 OR, p=0.05), overall self-efficacy (1.21 OR, p=0.02); overall support from family (1.14 OR, p=0.02), overall support from friends (1.17 OR, p<0.01). CONCLUSIONS: The associations seen in an ultra-dense Asian city are not too dissimilar those reported in less dense Western cities, but surprisingly neither area walkability, nor area SES, nor most perceived neighborhood characteristics were associated with being in a higher PA category. Having high self-efficacy and social support remain important factors for Hong Kong residents to gain adequate levels of PA.