Thinking the unthinkable: physical activity behavioral change and propensity for rehearsal in Chinese children

Abstract

The continued surge in childhood obesity rates globally has created much impetus for

researchers to develop intervention strategies effective in changing physical activity behavior

during childhood. Despite such interest there has been limited success, and very rarely have

cross-cultural applicability of these initiatives been considered. This thesis begins with an

examination of the applicability of a Western-modeled school-based intervention, America

on the Move, using pedometers and point-of-choice prompts in an attempt to change the

walking behavior of Chinese Hong Kong children (Chapter 2). To achieve this, the

intervention mapping protocol was followed. The process comprised three studies. First, health messages prompting walking behaviors were developed and tested for motivational

properties. Second, two piezoelectric pedometers were validated for our target population,

and finally, a 7-week pilot of the intervention using the validated health messages and

pedometers was implemented and evaluated among 8-12 year old Chinese Hong Kong

children.

The second part of the thesis took the unexpected results of the pilot intervention and

explored how a goal-related psychological construct, emotional rehearsal, which has been

associated with dysregulated health behaviors, may contribute to these. This part commences

with an overview of the conceptualization of rehearsal and presentation of a conceptual

model between stress and dysregulated health behavior mediated by the propensity for

rehearsal (Chapter 3). Three studies were then undertaken to examine the relationship

between rehearsal and dysregulated physical activity behavior. First, a Chinese version of the

Rehearsal Scale for children (RSC-C) measuring propensity of rehearsal in children was

adapted and validated for use in the subsequent two studies (Chapter 4). The second study

investigated the existence of pedometer reactivity and how this might interact with propensity

for rehearsal (Chapter 5). Lastly, the relationship between rehearsal and child health was

examined through an assessment of the propensity for rehearsal and central adiposity status.

Taken together, results of these empirical studies show promise in supporting the

proposition that the effectiveness of intervention strategies may be culturally bound via the

propensity for rehearsal and its link with cardiovascular health. Limitations of this thesis and

future research directions are explored in the final chapter.