The main purpose of this study was to develop a Rasch Measurement Physical Fitness Scale (RMPFS) based on physical fitness indicators routinely used in Hong Kong primary schools. A total of 9,439 records of students' performances on physical fitness indicators, retrieved from the database of a Hong Kong primary school, were used to develop the Rasch scale. Following a series of iterative Rasch analyses that adopted the 'data should fit the model' approach, four physical fitness indicators (such as 6-min run, 9-min run, 1-min sit-ups, and dominant handgrip) were successfully calibrated to form the RMPFS. The RMPFS and its scale indicators showed fit to the Rasch model sufficient for the intended purposes of measuring the overall fitness of children. The overall physical fitness measure reflects children's fitness on three key core components of physical fitness - cardio-respiratory fitness, muscular endurance, and muscular strength. Advantages of the RMPFS are discussed, and recommendations for future research follow. The findings of this study provide a better knowledge basis for interpreting children's physical fitness assessment results.
[Copyright of Measurement in Physical Education & Exercise Science is the property of Routledge. Full article may be available at the publisher’s website:
http://dx.doi.org/10.1080/1091367X.2011.590772]

Background: Strengthening primary care is key to Hong Kong's ongoing health system reform. Primary care remains unregulated, private sector dominated and financed mainly out-of-pocket. This study sought to examine the association between patients' socioeconomic status (SES), source of health payments and the quality of primary care they accessed to inform policy discussions. Methods: Data was collected from 1,994 respondents in a stratified random telephone survey with a 68% response rate, using the validated primary care assessment tool (PCAT). Education, household-income and type of housing were selected as indicators of SES. Multivariable ordinal logistic regression models were created to examine associations between indicators of SES and scores of quality. Results: Higher household-income was most significantly associated with better experiences of quality. Respondents with HK$ 15000-39999(USD1934-5158) and HK$ 40000(USD5159) and above were 47%(OR 1.47, 95% CI 1.10-1.96) and 2 times (OR 2.07, 95% CI 1.38-3.09) more likely to experience better quality than the lowest-income group respectively. Income group HK$ 40000(USD5159) and above was 84% more likely to have better utilization (OR 1.84, 95% CI(1.21-2.78), and 2 times more likely to receive better comprehensiveness (OR 1.90, 95% CI 1.26-2.87). Patients who used only private insurance were 80%(OR 1.80, 95% CI 1.20-2.68) more likely to experience better quality than those who paid out-of-pocket. Conclusions: Our results show that the quality of primary care experienced in HK tended to be higher for those who had higher income and private insurance, and were able to pay out-of-pocket for the care. This indicated that the inequality in primary care is likely to be related with the private dominated primary care system in Hong Kong. More public responsibility on primary health care should be sought for in HK and similar contexts to reduce the inequality in primary care.
[Copyright of BMC Health Services Research

Background: Hong Kong has a tripartite healthcare system, where western medicine provided in both public and private sectors coexist with Chinese medicine practice. The purpose of this study is to measure fragmentation of ambulatory care experienced by the non-institutionalized population aged 15 and over in such a tripartite system, thus shed light on the ongoing primary care reform.
Methods: This is a cross-sectional secondary data analysis using the Thematic Household Survey, which was conducted by the Hong Kong Census and Statistics Department during November 2009 to February 2010 to collect territory-wide health-related information. Among 18,226 individuals with two or more ambulatory visits during the past 12 months before interview, we grouped each visit into one of the three care segments-public western, private western and Chinese medicine. Two individual-level measures were used to quantify longitudinal fragmentation of care across segments over the one-year period: Most Frequent Provider Continuity Index (MFPC) and Fragmentation of Care Index (FCI). Both are analyzed for distribution and subgroup comparison. A Tobit model was used to further examine the determinants of fragmentation.
Results: More than a quarter of individuals sought care in two or all three segments, with an average MFPC of 65% and FCI of 0.528. Being older, female, married, unemployed, uninsured, or born in mainland China, with lower education, lower income, higher number of chronic conditions or poorer health were found to have experienced higher fragmentation of care. We also found that, fragmentation of care increased with the total number of ambulatory care visits and it varied significantly depending on what segment the individual chose to visit most frequently-those chose private western clinics had lower FCI, compared with those chose public western or Chinese medicine as the most frequently visited segment.
Conclusions: Even measured at healthcare segment level, people

明白了青少年的成長和發展，令我們更加容易了解青少年健康問題多源自其本身的行為。保持青少年健康不能只靠灌輸健康知識，要為青少年制定健康的模式，健康教育也要融入健康的行為。這是要從社會、客觀環境和心理的層面出發，並從基層、第二和第三層推行。基層醫療預防工作可利用健康促進學校的模式推行。而第二及第三層的防預性策略，我們需要構想具創意的策略，由此需要在一個適合青少年的環境下，制定以青少年為目標，以問題為源，及注重其效果的、全面性的和綜合多專業的協調方案。這些策略必須要倚重實據來檢討其成效。
Understanding adolescent growth and development allows us to appreciate why they behave or act in a particular manner. Unhealthy behaviors and actions taken by adolescents would directly hamper their health status. Health education should incorporate elements that cultivate healthy behavior. These elements may be found in social, environmental and psychological arenas and are equally applicable at the primary, secondary and tertiary prevention levels. The concept of Health Promoting Schools could be adopted for primary health prevention. For secondary and tertiary prevention, these would require the adoption of a problem orientated, solution focused, holistic and collaborative approach for a targeted audience in an adolescent sensitive environment. The outcome evaluation for these strategies should be evidence-based.
[Copyright of Journal of Youth Studies is the property of The Hong Kong Federation of Youth Groups at http://yrc.hkfyg.org.hk/]