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Objective This study evaluated the validity of self-reported smartphone usage data against objectively-measured smartphone usage data by directly tracking the activities in the participants’ smartphone among Chinese adolescents and young adults in Hong Kong.Methods A total of 187 participants were recruited (mean age 19.4, 71.7% female) between 2017 and 2018. A smartphone usage tracking app was installed on all participants’ smartphone for 7 consecutive days. After the 7-day monitoring period, they completed a selfadministered questionnaire on smartphone usage habits.Results Although the correlation between self-reported and objectively-measured total smartphone usage time was insignificant (ρ=-0.10, p=0.18), in three out of the four usage domains were positively and significantly correlated, namely social network (ρ=0.21, p=0.005), instant messaging (ρ=0.27, p

The prevalence rate of substance misuse is high among people with mental illnesses. This study adopted an individualized structured relapse prevention program (SRPP) by using an integrative motivational interviewing (MI) and cognitive behavioral therapy (CBT) approach for people with dual diagnosis, i.e., substance use disorder (SUD) comorbid with mental illnesses, in a Chinese population. This study assessed the feasibility of the SRPP and its preliminary effects to provide directions for future wide-scale trials. The program consisted of eight one-to-one interviews conducted weekly. Each interview lasted 1 h. MI was scheduled in the first session, followed by six sessions of CBT and a final session for concluding remarks. The high recruitment and retention rates of the participants indicated that the SRPP was feasible in Hong Kong. Preliminary results reflected a significant increase in self-efficacy to abstain from substance misuse and a decrease in the psychiatric symptoms among the participants with SUD. These effects were sustained 3 months after the intervention. A large sample size and the inclusion of a control group are warranted in future trials to determine the causal relationship between treatment and effect.

Background Laughter Yoga (LY) is a group-based intervention involving simulated laughter, gentle stretching, rhythmic breathing and meditation. There is some limited evidence that LY reduces depressive symptoms over the short term. However, the quality of previous LY studies is poor and none involved working-aged people with a clinical diagnosis of depression. Therefore, this study aimed to investigate the feasibility and potential efficacy of LY for improving residual mood, anxiety and stress symptoms in adults diagnosed with depression. Methods Fifty participants were randomised to the group LY intervention (n = 23) consisting of eight sessions over four weeks, or treatment-as-usual (n = 27). Participants completed the Depression Anxiety Stress Scale and the Short Form 12 item Health Survey at baseline (T0), post-intervention (T1) and at 3 months follow-up (T2). LY participants also completed a Client Satisfaction Questionnaire (CSQ8) at T1 and eleven participated in individual qualitative interviews at T2. Results The LY group had statistically greater decreases in depression and improvements in mental health related quality of life compared to the control group from T0 to T1. The CSQ8 scores indicated a favourable level of satisfaction with the LY intervention. The qualitative interviews highlighted aspects of the intervention that were effective and those requiring modification. Limitations Limitations include the small sample size and treatment-as-usual control group. Conclusions A full scale RCT of LY could be feasible if some modifications were made to the protocol/intervention. The intervention may be effective to improve depression and mental health related quality of life immediately post intervention.

We studied the association between objectively measured smartphone usage and objectively measured sleep quality and physical activity for seven consecutive days among Hong Kong adolescents and young adults aged 11-25 years (n = 357, 67% female). We installed an app that tracked the subjects' smartphone usage and had them wear an ActiGraph GT3X accelerometer on their wrist to measure their sleep quality and physical activity level. Smartphone usage data were successfully obtained from 187 participants (52.4%). The participants on average spent 2 h 46 min per day on their smartphone. Multilevel regression showed that 1 min of daytime smartphone usage was associated with 0.07 min decrease in total sleeping time that night (p = .043, 95% confidence interval [CI]: -0.14, -0.003). Broken down for different usage purposes, 1 min of daytime social network usage and games and comics was associated with a 0.28 (p = .02, 95% CI: -0.52, -0.04) min and 0.18 min (p = .01, 95% CI: -0.32, -0.04) decrease in total sleeping time that night, respectively. One minute of daytime smartphone usage was associated with an increase of 4.55 steps in the number of steps (p = .001, 95% CI: 1.77, 7.34) on the next day. To conclude, time spent on a smartphone in the daytime was associated with total sleeping time that night and number of steps the next day, but was not associated with sleep efficiency, wake after sleep onset and moderate-to-vigorous-intensity activity (MVPA) among Hong Kong adolescents and young adults.

Background The adequate fit of an N95 respirator is important for health care workers to reduce the transmission of airborne infectious diseases in the clinical setting. This study aimed to evaluate whether adequately sealed N95 respirators may provide consistent protection for the wearer while performing nursing procedures. Methods Participants were a group of nursing students (N = 120). The best fitting respirator for these participants was identified from the 3 common models, 1860, 1860S, and 1870+ (3M), using the quantitative fit test (QNFT) method. Participants performed nursing procedures for 10-minute periods while wearing a backpack containing the portable aerosol spectrometers throughout the assessment to detect air particles inside the respirator. Results The average fit factor of the best fitting respirator worn by the participants dropped significantly after nursing procedures (184.85 vs 134.71) as detected by the QNFT. In addition, significant differences in particle concentration of different sizes (>0.3, >0.4, >1.0, and >4.0 µm) inside the respirator were detected by the portable aerosol spectrometers before, during, and after nursing procedures. Conclusions Body movements during nursing procedures may increase the risk of face seal leakage. Further research, including the development of prototype devices for better respirator fit, is necessary to improve respiratory protection of users.

Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration with which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices) are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762). Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.

Vaccination against AH1N1pdm09 infection (human swine infection, HSI) is an effective measure of preventing pandemic infection, especially for high-risk groups like children between the ages of 6 months and 6 years. This study used a cross-sectional correlation design and aimed to identify predicting factors of parental acceptance of the HSI vaccine (HSIV) and uptake of the vaccination by their preschool-aged children in Hong Kong. A total of 250 parents were recruited from four randomly selected kindergartens. A self-administered questionnaire based on the health belief framework was used for data collection. The results showed that a number of factors significantly affected the tendency toward new vaccination uptake; these factors included parental age, HSI vaccination history of the children in their family, preferable price of the vaccine, perceived severity, perceived benefits, perceived barriers, and motivating factors for taking new vaccines. Using these factors, a logistic regression model with a high Nagelkerke R2 of 0.63 was generated to explain vaccination acceptance. A strong correlation between parental acceptance of new vaccinations and the motivating factors of vaccination uptake was found, which indicates the importance of involving parents in policy implementation for any new vaccination schemes. Overall, in order to fight against pandemics and enhance vaccination acceptance, it is essential for the government to understand the above factors determining parental acceptance of new vaccinations for their preschool-aged children.

An integrated adolescent curriculum on health and development (ADH) was implemented in a pre-service nursing programme in a university.This study examined the efficacy of an ADH curricular framework in improving the competency variables of student nurses in delivering ADH services.The design of the study was quasi-experimental with the systematically designed ADH training curriculum as an intervention. Pre- and post-tests incorporating an experimental group and a control group for a sample of 101 student nurses were used.Reports from 50 student nurses in the experimental group indicated that there was a significant increase from the pre-test to the post-test phase in the total score for the variables in the ADH Competency Checklist (Z=-5.71, p0.001) and its four subscales: the professional development subscale (Z=-5.37, p0.001), the psychosocial and physical well-being subscale (Z=-5.66, p0.001), the health behaviours and lifestyles subscale (Z=-5.07, p0.001), and the identity and reproductive health subscale (Z=-4.86, p0.001). Significant changes were detected in the ADH competency variables for the control group in the post-test phase.The findings reveal that the systematic integration of ADH in the nursing curriculum had the positive impact of increasing the competency of student nurses for the examined variables.

Background Substance use among adolescents has caused worldwide public health concern in recent years. Overseas studies have demonstrated an association between adolescent self-esteem and substance use, but studies within a Chinese context are limited. A study was therefore initiated to: (1) explore the 30 days prevalence of substance use (smoking, drinking, and drugs) among male and female adolescents in Hong Kong; (2) identify the significant associations between multidimensional self-esteem and gender; and (3) examine the relationship between multi-dimensional self-esteem and substance use. Methods A self-esteem scale and the Chinese version of the global school-based student health survey were adopted. A total of 1,223 students were recruited from two mixed-gender schools and one boys’ school. Results Among females, there was a lower 30-day prevalence of cigarette, alcohol, and drug use. They also had significantly higher peer and family self-esteem but lower sport-related self-esteem. Body image self-esteem was a predictor of alcohol use among females, while peer and school self-esteem were predictors of drug use among males. Conclusions In summary, the findings demonstrated the influence of self-esteem to the overall well-being of adolescents. Schools could play a role in promoting physical fitness and positive relationships between adolescents and their peers, family, and schools to fulfill their physical and psychological self-esteem needs.

Competition for scarce clinical placements has increased requiring new and innovative models to be developed to meet the growing need. A participatory action research project was used to provide a community nursing clinical experience of involvement in parent education. Nine Hong Kong nursing students self-selected to participate in the project to implement a parenting program called Parenting Young Children in a Digital World. Three project cycles were used: needs identification, skills development and program implementation. Students were fully involved in each cycle's planning, action and reflection phase. Qualitative and quantitative data were collected to inform the project. The overall outcome of the project was the provision of a rich and viable clinical placement experience that created significant learning opportunities for the students and researchers. This paper will explore the student's participation in this PAR project as an innovative clinical practice opportunity. © 2013 Elsevier Ltd.

A collaborative endeavor was initiated between a Hong Kong school of nursing and a school of health in Guangzhou to develop a prevention-focused community nursing educational program. The collaboration aims were to increase the ability and confidence of Guangzhou nurses in performing their community healthcare roles and to train local community health nursing trainers in Guangzhou. The collaborating parties participated in a series of review for planning the teaching team, the taught subjects in the curriculum, the education approach, the student assessment and the train the trainer scheme for the program. The program was developed after the review, planning and implementation phases. This collaboration provided the groundwork for the education of community nurses in Guangzhou and developed local trainers in community health nursing; it enhanced understanding of the present status of community health nursing for both the school of health and the students; and it provided a reference for others that may collaborate with institutions in the People's Republic of China to initiate or strengthen educational programs to build up community health nursing.

Families caring for a chronically-ill child are known to experience a significant degree of stress that often is not fully understood by health professionals. The purpose of this study was to examine, cross culturally, the experience of families caring for children with chronic conditions both in terms of the impact on their lives and the nature of the support received. The responsibility of caring for a child with a chronic condition had considerable impact on family life in both groups, with the disturbance to harmony possibly being felt more keenly in the Hong Kong group. Effective communication with parents was seen in both countries as key for effective practice. Expectations of health services differed between cultures. Implications can be drawn for the design of future health services addressing the specific health needs of families with children with chronic illness.

Objectives To explore the impact of the Lushan earthquake on the schoolchildren's health and learning environment after 2 months of the earthquake and to collect children health information and identify school environmental health risks. Methods This was an explorative single-case study. The case was defined as the two primary schools affected by the earthquake on 20th April, 2013 and relocated in a rebuilt temporary classroom. This study collaborated with Department of Social Work, Sichuan Agricultural University located in Ya'an. With the support from the above social work station, 448 school-age children from the affected Majun and Gonghe primary schools were invited to participate in this study from July 1 to 2, 2013. Finally, 187 children participated. Data were collected through structured questionnaire, field observation and the social work station's report and analyzed by using descriptive analysis and qualitative content analysis. Results One hundred and eighty-seven school-age children participated in this study. Participants' demographic characteristics showed that around half of the subjects (89; 47.6%) were male. Majority were aged 10 or above (114; 61%) and in grades 4–6 (108; 57.7%), whereas only 7% (13) were preschool children. Near three quarters (134.0; 71.7%) children were not living with their parents. School environmental health risks were identified including public health and school building risks. Conclusions One hundred and eighty-seven school-age children in two primary schools were involved in this study. Baseline data for children's health status were obtained and the school health risks were identified. The findings suggested that it would be vital to develop collaborative care and service learning model to enhance children health and school safety in a disaster-prone community.

Background Internet addiction (IA) among adolescents has become a global health problem, and public awareness of it is increasing. Many IA risk factors relate to parents and the family environment. This study examined the relationship between IA and parenting approaches and family functionality. Methods A cross-sectional study was conducted with 2021 secondary students to identify the prevalence of IA and to explore the association between adolescent IA and familial variables, including parents’ marital status, family income, family conflict, family functionality, and parenting approaches. Results The results revealed that 25.3 % of the adolescent respondents exhibited IA, and logistic regression positively predicted the IA of adolescents from divorced families, low-income families, families in which family conflict existed, and severely dysfunctional families. Interestingly, adolescents with restricted Internet use were almost 1.9 times more likely to have IA than those whose use was not restricted. Conclusions Internet addiction is common among Chinese adolescents in Hong Kong, and family-based prevention strategies should be aligned with the risk factors of IA.

Background Young children are using digital technology (DT) devices anytime and anywhere, especially with the invention of smart phones and the replacement of desktop computers with digital tablets. Although research has shown that parents play an important role in fostering and supporting preschoolers’ developing maturity and decisions about DT use, and in protecting them from potential risk due to excessive DT exposure, there have been limited studies conducted in Hong Kong focusing on parent-child DT use. This study had three objectives: 1) to explore parental use of DTs with their preschool children; 2) to identify the DT content that associated with child behavioral problems; and 3) to investigate the relationships between approaches adopted by parents to control children’s DT use and related preschooler behavioral problems. Methods This exploratory quantitative study was conducted in Hong Kong with 202 parents or guardians of preschool children between the ages of 3 and 6 attending kindergarten. The questionnaire was focused on four aspects, including 1) participants’ demographics; 2) pattern of DT use; 3) parenting approach to manage the child’s DT use; and 4) child behavioral and health problems related to DT use. Multiple regression analysis was adopted as the main data analysis method for identifying the DT or parental approach-related predictors of the preschooler behavioral problems. Results In the multiple linear regression model, the ‘restrictive approach score’ was the only predictor among the three parental approaches (B:1.66, 95% CI: [0.21, 3.11], p