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Project Details
Funding Scheme : General Research Fund
Project Number : 14619720
Project Title(English) : A Cluster Randomized Controlled Trial of School-based Physical Activity Intervention on Mental Health and Risk Behaviours in Adolescents with Special Educational Needs 
Project Title(Chinese) : 校本體力活動干預對有特殊教育需要青少年的心理健康和危險行為的集群隨機對照研究 
Principal Investigator(English) : Prof Sit, Cindy Hui-ping 
Principal Investigator(Chinese) :  
Department : Dept of Sports Science & Physical Education
Institution : The Chinese University of Hong Kong
Co - Investigator(s) :
Prof A-Nicitopoulos , Kelly
Prof Ho, Tin Hung, Rainbow
Prof Wong, Stephen Heung-sang
Panel : Humanities, Social Sciences
Subject Area : Education
Exercise Year : 2020 / 21
Fund Approved : 791,930
Project Status : On-going
Completion Date : 31-12-2023
Abstract as per original application
(English/Chinese):
Mental health problems such as anxiety and depression are the leading disease burden, affecting up to 20% of adolescents globally. Mental health problems are associated with risk behaviours such as school dropouts, aggression, suicidal ideation and suicide. Evidence indicates that adolescents with special educational needs (SEN) such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) have poorer mental health and higher risk behaviours than those with typical development. More than half of all mental health problems emerge during adolescence and continue into adulthood, so early effective interventions are therefore important. Little is known about the associations of physical activity with reduced mental health problems and risk behaviours in adolescents with SEN. Recently, our research team has conducted a pilot school-based physical activity intervention in this group and found immediate positive effects on increased physical activity and reduced anxiety, depression and suicidal ideation. We also found that physical activity was strongly associated with resilience, an ability to overcome obstacles and achieve positive outcomes in the face of diversity and life stresses. Future research is needed to determine whether improved mental health can translate into decreases in risk behaviours in the longer term. Grounded in the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) framework, this study is the first cluster randomized controlled trial (RCT) to examine the effects of a school-based physical activity intervention on the mental health and risk behaviours of adolescents with SEN. It is also the first study to use salivary cortisol as a biomarker of stress in Hong Kong adolescents with SEN. Based on a power calculation, 240 adolescents with SEN in twelve Hong Kong secondary mainstream schools will be cluster randomized allocated into either a 12-week physical activity intervention or a control condition. Measurements of mental health and risk behaviours will be conducted at (i) baseline, (ii) post-intervention (immediately after 12-week intervention), (iii) 3-month after post-intervention, and (iv) 12-month after post-intervention. This cluster RCT brings experts in physical activity interventions together, and the findings will assist educators and education and healthcare policy makers to develop early treatment strategies and to introduce school-based health promotion practices for adolescents with SEN. In the longer term, our aim is to develop a territory-wide school-based physical activity policy (lunchbreak “exercise-snack” program) in mainstream schools in Hong Kong.
心理健康問題如焦慮及抑鬱是主要的疾病負荷,影響全球多達20%的青少年。心理健康問題與危險行為相關,例如輟學、攻擊性行為、企圖自殺及自殺。證據顯示有特殊教育需要青少年(如注意力不足/過度活躍症、自閉症)的心理健康較一般青少年為差,而危險行為則較高。多於一半以上的心理健康問題於青春期出現,並持續到成年期,因此早期有效的干預是非常重要。對於有特殊教育需要的青少年,體力活動與減少心理健康問題及危險行為的關聯知之甚少。最近,我們的研究小組開展一項針對有特殊教育需要青少年的校本體力活動試驗,結果發現體力活動干預對增加體力活動,減少焦慮、抑鬱和企圖自殺有正面的影響。我們也發現體力活動與心理彈性密切相關,心理彈性是一種在面對多樣的生活壓力時,具有克服障礙及取得積極結果的能力。我們需要進行進一步的研究以確定改善心理健康是否可以長遠地降低危險行為。這項研究以國際健康功能與身心障礙分類系統-兒童和青少年版(ICF-CY)為理論框架,首次採用集群隨機對照的方法檢驗校內體力活動干預對有特殊教育需要青少年的心理健康和危險行為的影響。這也是香港首個採用唾液皮質醇來檢測有特殊教育需要青少年的壓力研究。根據統計功效計算,香港十二所主流中學的240名有特殊教育需要的青少年將以群組形式被隨機分為12週的體力活動干預組和控制組。心理健康和危險行為的評估將分別於(i)基線、(ii)干預後12週、(iii)干預後3個月、以及(iv)干預後12個月進行。這項集群隨機對照研究將會集多位體力活動干預專家之合作,研究結果將幫助教育工作者和教育、醫療保健政策制定者訂立早期干預政策,並為有特殊教育需要的青少年引入校本健康促進活動。長遠來看,我們的目標是在香港主流學校制定以全港學校為基礎的體力活動政策(午休「運動零食」計劃)。
Research Outcome
Layman's Summary of
Completion Report:
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  SCREEN ID: SCRRM00542