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Tag: The Education University of Hong Kong

EdUHK App Helps Change Eating Habits

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The Hong Kong SAR Government’s 2018-19 Health Behaviour Survey showed that around 96% of residents aged 15 or over consumed less than five portions of fruit and vegetables per day. Added to this, almost 10% of these people ate processed meat at least once a day, on average. The World Health Organisation states that an unhealthy diet and lack of physical activity are leading global risks to health, and its member states have agreed to halt the rise of diabetes and obesity in adults, teenagers, and of overweight children by 2025.

With this in mind, Dr Louisa Chung Ming-yan at the Department of Health and Physical Education of The Education University of Hong Kong and her team have developed the eDietary Platform, an app for users to record their diet and monitor what they eat and drink. “To change eating habits, we can’t merely deliver lectures on nutrition. We need a record of scientific facts,” explained Dr Chung.

Users input their dietary record onto the app. Any food not already on the list can be added by simply uploading a photo. The app then gives users a bespoke nutrition report, taking into account personal details such as age, gender, height and weight.

The project team was awarded funding by the Food and Health Bureau under the Health Care Promotion Scheme. Through the feedback received, researchers found that using the eDietary app made younger adults more capable of matching food products to categories. Participants therefore understand how to reduce the risk of health problems and vulnerability to diseases and are encouraged to develop their own eating plan in terms of food and portion size change. In testing, the complete switch to healthy eating took 12 weeks.

As a start, the app has already been downloaded over 4,500 times to date, and its effectiveness was trialled in a study on how the use of such technology enhances the eating behaviour of young adults. “We formulated and tested the theory on eating behaviours when people monitor their diets online,” said Dr Chung. People who have used the app have noted that it makes them realise the importance of enjoying healthy food. “It has encouraged me to develop the habit of recording my daily intake,” said one. They suggested that the app could be used by young adults and children, as it helps youngsters learn about food classification, nutrients and quantities.

EdUHK research promoting sustainable tourism development in Sichuan Nature Reserve and Hong Kong

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The UNESCO-listed Wolong National Nature Reserve, a prime habitat for the endangered panda, was badly damaged by the 2008 Sichuan earthquake. To rebuild the reserve into an ecologically sustainable area, Dr Lewis Cheung Ting-on, Associate Professor at the Department of Social Sciences, The Education University of Hong Kong (EdUHK), and his research team devised two unique accreditation systems for the ecotourism industry, one for tourism businesses and one for ecotour guides, as part of the regulations for the tourism development in the ecologically sensitive reserve.

The guidelines included holistic recommendations for ecotourism planning, activities, infrastructure and marketing. In 2016, the local administration in Wolong implemented the recommendations in full. This was the first regional ecotourism certification programme in a protected area in China and it has had a positive influence on the ecotourism development in other protected areas in the mainland and in Taiwan.

The aims of the project, involving researchers from EdUHK, The University of Hong Kong, and The Chinese University of Hong Kong, were to (a) investigate the ecotourism resources of the reserve, (b) formulate ecotourism development guidelines for the reserve, (c) provide training and organise public forums for residents and government officials, and (d) design two ecotourism accreditation systems, one for tourism businesses and one for eco-tour guides.

The project has had a multi-faceted impact on the reserve, replacing the previously unhealthy approach to development with eco-friendly practices, thus improving ecotourism development in the reserve and other parts of China regarding local policy and professional practices, raising awareness of the value of ecotourism and the importance of maintaining a healthy environment;  boosting the local economy by identifying new sustainable tourism services and products, and providing increased income for small businesses and jobs for local residents;  reducing business costs through reduced energy use and water consumption and less waste, and enhancing ecological conservation in the area and preventing the degradation of the precious panda habitat.

Once the new policy was implemented, the number of tourists visiting the reserve surged from less than 1,000 a year before 2014 to over 350,000 annually by 2017.

Ecotourism development requires the understanding, input and support of the local community, so Dr Cheung’s team organised two public forums in the reserve to get residents’ views on the ecotourism development guidelines and to introduce the development plans and certification systems to businesses and guides.

They also organised a two-day training workshop on the guidelines and the accreditation systems for residents, business owners and government officials. These efforts resulted in greater awareness of the importance of saving water and electrical power, reducing the use of disposable items, and waste segregation.

A public forum on the same topic was organised at EdUHK, which helped raise the public’s understanding in Hong Kong of the reserve’s reconstruction and how the HKSAR Government’s donation was used. Dr Cheung’s work has also changed public perceptions through extensive media coverage, reaching audiences of millions in the mainland and Hong Kong.

EdUHK’s innovative ways to test hearing

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The Education University of Hong Kong (EdUHK) audiology experts have found improved ways to test the hearing of the young and elderly through technological innovation.

Mandarin spoken word-Picture IDentification test in noise-Adaptive, or MAPID-A, is an award-winning computerised testing system that assesses young children’s speech recognition in noisy environments.

“It helps frontline professionals, including speech therapists, audiologists, special needs educators, educational and clinical psychologists, to assess the abilities of children with special educational needs in environments with different types and directions of noise,” said Dr Kevin Yuen Chi-pun, project leader and Director of The Education University of Hong Kong’s (EdUHK) Integrated Centre for Wellbeing.

By using MAPID-A, three-year-old children can be reliably tested in just four minutes on average. An assessment tool with such a short testing time for young children has not previously been available in the Chinese-speaking communities and is very scarce globally. The system can be used clinically in hearing clinics, hospitals and schools to investigate young children who have concerns in listening; especially in noisy environments.

MAPID-A can identify children at risk from subtle communication disorders and those who may have transient or permanent hearing impairments. For children who are found to have permanent hearing impairments and need to use hearing devices, the system can compare how they perform compared to their normal-hearing peers, and discover if their current hearing device is giving optimal benefits.

The innovation is based on the concept of signal-to-noise ratio (SNR) between speech signals and interfering noise, such as engines, fans or multiple people speaking. “MAPID-A appears to be a promising clinical tool that, with its high sensitivity and test-retest reliability, helps clinicians quickly and more confidently evaluate young children’s speech recognition in noisy environments,” said Dafannas Tam Yiu-ting, clinical audiologist at Hong Kong Children’s Hospital.

Dr Yuen and his team assessed a girl with profound hearing impairment using different types of noise and from various directions. The girl’s mother said MAPID-A was unique among the many hearing tests her daughter had experienced. “It is extremely important for us to understand her hearing situation in everyday life with noises. The whole test is very user-friendly. It allows young children to interact through games,” the girl’s mother explained.

Dr Anna Kam Chi-shan, Associate Professor at the Department of Special Education and Counselling of EdUHK has developed an award-winning mobile app to help the elderly test their hearing at home, thus avoiding the cost and inconvenience of visiting a clinic.

“The clinic testing machines are bulky, complicated, and must be operated by a medical professional. Most importantly, the test has to be performed in a soundproof booth. By using noise-cancelling headphones, this new test can be done in most quiet places. Our app also simulates background noise to examine speech recognition in difficult environments, so as to detect auditory processing difficulties which often reveal the very early stages of dementia,” explained Dr Kam.

The app has proven to be of great help, “I can’t hear very well now that I’m older,” said one user.

“But it was costly and difficult for me to monitor my situation in the past. Now I can check any time I want.”

EdUHK research boosting equal access to quality education through blended learning

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Research by Professor Lim Cher Ping, Chair Professor of Learning Technologies and Innovation at The Education University of Hong Kong, has significantly contributed to pedagogical and technological innovations in higher education institutions (HEIs), especially in the Asia-Pacific region. He has developed a framework for HEIs to drive and support blended learning to improve access to quality higher education.

The framework has been disseminated by UNESCO (Asia-Pacific) to ministries of education and HEIs in Asia-Pacific countries. It has been adopted and implemented by ministries and universities in Sri Lanka, Cambodia, South Korea, Mongolia and the mainland. The research has provided HEIs with a framework and self-assessment tool to analyse and revise their existing blended learning practices and policies to enhance student learning engagement and outcomes.

By adopting a sociocultural and historical perspective for mixed-method case studies across different education settings, Professor Lim’s research has generated three key principles: (1) in information and communication technologies (ICT) -enabled learning environments, teachers are the key to organising activities for learning; (2) at the institutional or system level, a holistic approach has to be adopted by education leaders to drive and support ICT-enabled practices with the aim of improving access to quality education; and (3) given the pivotal roles of teachers and institutions in ICT-enabled learning environments, the capacity of those institutions, education leaders and teachers has to be built on.

These key principles have generated more than 5,500 citations since 2001.

The above have laid the groundwork for Professor Lim’s applied research; first, the development of a framework for education institutions to adopt ICT for quality teaching and learning. The framework was later redeveloped to focus on the capacity building of HEIs to drive, sustain, and scale up their blended learning practices with eight strategic dimensions: vision and philosophy; curriculum; professional learning; learning support; infrastructure, facilities, resources and support; policy and institutional structure; partnerships; and research and evaluation.

A self-assessment tool for all eight dimensions was developed for the HEIs to conduct a needs and situation analysis of their existing state of blended learning. This allowed them to identify gaps and set targets for blended learning to better equip them to formulate and implement strategies for sustaining and scaling blended learning in their programmes and courses.

Professor Lim has won funding from UNESCO, international research organisations, education foundations and the University Grants Committee (UGC) of Hong Kong for his studies in blended and online learning. His framework was used in 2015 as an analytical lens to examine how nine universities in Australia, Malaysia, Singapore, South Korea, Thailand, and the mainland drove and supported blended learning based on the eight dimensions.

The experiences of these universities were compiled in a book, published and disseminated by UNESCO and served as a policy advocacy and planning tool for educational ministries, policy organisations, and universities. The late Dr Gwang-Jo Kim, Director of UNESCO (Asia-Pacific), described the book as a “valuable approach” to achieve the United Nations’ Sustainable Development Goal 4 of equitable and inclusive quality education, and lifelong learning for all.

The framework was implemented by UNESCO International Centre for Higher Education Innovations (funded by Shenzhen Fund-In-Trust) at the Royal University of Phnom Penh (RUPP) in Cambodia and Colombo University in Sri Lanka. This implementation and partnership have led to the establishment of the Centre of Excellence for Higher Education Teaching and Learning Innovations at RUPP with the support of EdUHK under the World Bank Higher Education Improvement Project.

Professor Lim’s assessment tool has further enabled partnerships between RUPP and the provincial universities of Syay Rieng and Battambang. The tool allowed senior managers to identify their HEI’s existing capacity and provide the evidences to formulate a strategic plan for closing the urban-rural education quality gap across the three universities.

The framework was also disseminated by Professor Han Xibin of the Institute of Education, Tsinghua University, to more than 500 mainland Chinese partner HEIs, where it has met a positive response and helped students overcome challenges such as low literacy levels and low self-learning skills to achieve a 100% pass rate in a course after using blended learning. Professor Lim Cheolil from Seoul National University has also adopted the framework for use by Korean universities.

Professor Lim’s grassroots approach towards professional learning as part of the framework has had significant impact in Hong Kong as well, through his co-leadership of the UGC-funded Blended & Online Learning & Teaching (BOLT) project. In collaboration with four other local universities, the project has demonstrated its potential to achieve a paradigm shift in higher education teacher professional learning and the enhancement of learning and teaching in Hong Kong. Specifically, evaluation of participants in BOLT project demonstrated raised awareness of effective use of blended learning, and also higher competence development across ranges of technological, content, and pedagogical knowledge domains.

Professor Lim’s research on boosting equal access to quality education through blended learning was rated 4-star (outstanding impacts in terms of their reach and significance) in the recent Research Assessment Exercise 2020. To learn more about the impact case study, please click here.

EdUHK Policy research contributes information for Health Care reforms in Mainland China and Hong Kong

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The healthcare systems of the mainland and Hong Kong face similar challenges of spiralling costs in the face of increasing demand from a more prosperous and ageing population and a surge in non-communicable diseases. Hong Kong government reforms aim to reduce the burden on the overstretched public healthcare system.

The public policy research by Dr Alex He Jingwei, Associate Professor and Associate Head (Research and Development) at the Department of Asian and Policy Studies, The Education University of Hong Kong, has contributed to knowledge informing large-scale reforms in both mainland China and Hong Kong and generated public debate.

His work provided a significant reference in a major government-supported reform blueprint for the mainland’s healthcare system, much of it now being implemented in the State Council’s 13th Five-Year Plan (2016-2020), engagement with policymakers, and media engagement in mainland China and Hong Kong, reaching an audience of at least a billion people.

In the past decade, healthcare costs in China have grown 5 to 10 percentage points higher than GDP growth. Without reforms, healthcare costs are expected to increase five-fold by 2035 and account for over 9% of GDP, up from 5.6% in 2014. Therefore, Dr He’s research has focused on healthcare costs and sustainability in Hong Kong and mainland China.

He has conducted research across three main areas which have played an important role in informing both policy and the public debate: (1) doctor-patient relationships in mainland China; (2) healthcare governance in mainland China; and (3) private health insurance in Hong Kong.

In a survey of 506 doctors in Shenzhen, Dr He found that when the doctor-patient relationship was poor, doctors were more likely to practice “defensive medicine”, involving over-prescription of drugs and diagnostic tests to avoid liability and future medical disputes. These practices have had a negative impact on the healthcare system’s capacity and sustainability.

In his research on healthcare governance in mainland China, Dr He identified how the limited capacity of the social health administration impeded policy reforms, in particular practices desired by policymakers for cost-effective strategic and third-party purchasing of health care funded by universal social health insurance. While the government set up a broad network for social health insurance, poor administrative capacity has prevented the desired outcomes, such as cost containment. He developed further insights into healthcare in mainland China through a comparative review of health financing reforms in Hong Kong and Singapore.

In Hong Kong, spending on healthcare is predicted to take up as much as 27% of the government budget by 2033, as the population ages and relies on the public service for about 90% of inpatient care. Dr He has conducted research to inform the planning of health financing and long-term care reforms by conducting surveys on the public’s attitude to the government’s preferred policy option for voluntary healthcare insurance and their willingness to pay for private insurance.

Dr He’s research in mainland China has improved understanding of areas of the healthcare system that need reform and has had a significant impact on policy design and implementation. A blueprint for reforms, from the high-profile study conducted for the World Bank, the World Health Organisation, and the Chinese Government, “Healthy China: Deepening Health Reform in China, Building High-Quality and Value-Based Service Delivery”, cited six of his articles, making him one of the most extensively cited researchers informing the study. The report has been highly valued by the Chinese government as an important reference for health policy and reform, as evidenced by Liu Yandong, Vice Premier of the State Council of China.

In Hong Kong, Dr He’s studies informed policy debate, having an impact on government and industry understanding of public attitudes to health finance reform, and informing policy making. A senior policymaker at the Food and Health Bureau invited him to present and discuss the findings of his research on voluntary health insurance. Dr He was also invited to brief the Hong Kong Federation of Insurers, a key stakeholder in health financing reform.

Dr He has contributed to improving public awareness of health-reform options through extensive media engagement in Hong Kong and mainland China. His research on the doctor-patient relationships and broad health policy reform options achieved local and international media attention, reaching an audience of more than one billion.

For the full article of the impact case study, please visit here.

E-learning journal co-edited by EdUHK’s professor ranked first for six consecutive years

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The Internet and Higher Education, co-edited by Professor Lim Cher Ping, Chair Professor of Learning Technologies and Innovation at The Education University of Hong Kong, who took over as Editor-in-Chief in 2015, was ranked first again in the e-learning category for the sixth consecutive year (2015 to 2020), according to the latest SCImago Journal Rank.

Under the Education category, the journal has been ranked consistently in the top 15. The 2021 Journal Citation Reports of Clarivate Analytics showed that the journal was ranked fifth by the Journal Impact Factor (7.178) in the Education and Educational Research category, and was ranked second by the Journal Citation Indictor (5.01) in the same category.

EdUHK Dr Winnie Lam’s online evidence-based assessment system for student group activities

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Undergraduate students usually need to collaborate with others to complete various types of group projects. However, it is not easy to distribute the work evenly among the group members, and some members are even called “free riders” because of their small contributions to the project.

As a result, teachers usually receive complaints at the end of the semester on this issue. In view of this, Dr Lam Wai-man at the Department of Mathematics and Information Technology of The Education University of Hong Kong developed an Online Evidence-based Assessment System called GMoodle for collaborative learning.

Instead of assessing the final outcome, the process of collaboration is recorded. Students can keep track of the progress of individuals and their group members in GMoodle. Whereas teachers can make use of the progress report to set assessment criteria and identify free riders.

As it is not easy to ensure all students are actively and equally contributed and collaborate with each other in group projects, this system can provide an objective measure to reflect the actual contribution and activeness of each student. It is also useful for students to review their learning goals.

Besides, each student has an individual GMoodle account to store their own learning activities. Once they have logged in the platform, they can view their contribution scores and compare theirs with the average in class to understand their learning progress is on track or not. Most importantly, students can make use of the discussion forum, chat room and Wiki report to create a proactive collaborative learning environment.

GMoodle has been recognised for its innovation and creativity. It obtained the Silver Medal and Special Award – Special Inventor Award in the International Invention Innovation Competition in Canada in 2019. Riding on the success, Dr Lam invited other external parties to collaborate for further development and improvement of the platform.

Future developments in the pipeline include incorporating AI and data mining to customise learning materials, applying to multi-disciplinary courses, adding more collaborative tools, adding co-teaching features, and launching in secondary schools.

EdUHK Scholar studies COVID-19-related stress and mental health problems of parents

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COVID-19 not only threatens people’s physical health, but also creates disruption in work and social relationships. Parents experience additional strain resulting from extra childcare responsibilities. This is even more pronounced with parents of children with developmental disorders, which calls for the need for increased parenting support services and family-friendly policy initiatives in Hong Kong.

Dr Randolph Chan Chun-Ho, Associate Head and Assistant Professor at the Department of Special Education and Counselling, The Education University of Hong Kong (EdUHK) conducted a study to (1) investigate and compare the prevalence of COVID-19-related stress and mental health problems between parents of children with developmental disorders and those of children with typical development, and (2) examine the association of COVID-19-related stress with mental health problems.

In May 2020, the study recruited 129 parents of 8-to-10-year-olds, with either developmental disorders or typical development, from 12 mainstream primary schools in Hong Kong.

It was found that close to 75% of the parents indicated that their work and social lives had been significantly disrupted because of the social-distancing measures in Hong Kong. When schools were closed, children had to stay at home, meaning parents had to reorganise childcare. Nearly two-thirds of the parents reported significant difficulty in taking care of their children and experienced strain trying to balance the demands of childcare and work. More than half of the parents expressed concern about the risk of them and their children being infected with COVID-19.

The findings showed that parents of children with developmental disorders are at greater risk of parenting stress than parents of children with typical development. The parents of children with developmental disorders showed more severe symptoms of depression and anxiety than their counterparts. 25% of them met the criteria for clinical depression, and 13.7% met the criteria for generalised anxiety disorder. Parenting stress during the COVID-19 pandemic explained heightened levels of mental health problems among parents of children with developmental disorders as compared to parents of children with typical development.

Given the elevated risk of parenting stress and mental health problems observed among parents of children with developmental disorders, the study recommends timely positive parenting support to reinforce parent-child relationships, alleviate parents’ psychological distress, and help them cope with health worries and parenting stress. In addition to parenting programmes to enhance competence and efficacy, web-based skills programmes can be offered to parents who are in need of professional support and guidance. Online counselling and support group services, and family friendly policies can also help parents have a more balanced life during this critical time.

The research has been published in Journal of Autism and Developmental Disorders, please visit here for details.

EdUHK Scholar co-authors article published in Nature Climate Change

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A team of leading climate social scientists, including a chair professor at The Education University of Hong Kong (EdUHK), argues that influential studies that attempt to quantify different countries’ “fair shares” of climate action have put forward a biased and oversimplified view of what is primarily a political and ethical discussion.

The Perspective piece, “Ethical choices behind quantifications of fair contributions under the Paris Agreement,” published in the pre-eminent academic journal Nature Climate Change, comes as the world’s governments are expected to release new national plans for climate action ahead of climate negotiations later this year in Glasgow, Scotland, and defend them as “fair and ambitious”.

One of the article’s co-authors is Professor Paul G. Harris, Chair Professor of Global and Environmental Studies in the Department of Social Sciences at EdUHK, who has spent three decades conducting research and writing about climate justice and governance.

The piece evaluates a selection of recent effort-sharing studies to determine whether they are explicit about the ethical choices underlying their analyses. Reviewing sixteen studies that quantify equitable effort sharing between countries under the Paris Agreement, the authors find that nearly two-thirds (10 studies) present themselves as neutral or value-free, despite being limited to a small and biased subset of ethical perspectives on effort-sharing that tend to favour wealthier countries.

“It is widely assumed that climate change is a technical or political problem. It is more accurate to conceive of it as a normative problem in which disagreements about what is just, fair and equitable crowd out co-operation on social and technological solutions,” said Professor Harris.

Sivan Kartha, Senior Scientist at the Stockholm Environment Institute added, “Studies that incorrectly purport to be neutral and objective are not just misleading, they can even be harmful. In this case, they can set unrealistic expectations about what countries might be expected to contribute to a global climate effort. Even if it’s not intentional, one can imagine the problems caused by a body of literature with a consistent bias toward wealthier and against poorer countries.”

In particular, the ‘grandfathering’ of emissions, where countries argue their status as high emitters is a justification for continued high emissions, should not be included in equity assessments of global climate action. This is a key source of the systematic bias in favour of wealthier, higher emitting countries.

Other studies claim objectivity by averaging a spectrum of equity approaches, commonly choosing a subset that excludes important ethical concepts. For instance, when many analyses quantify a country’s capacity to allocate resources to a global climate effort, they routinely treat a dollar earned by a poor citizen as wholly equivalent to a dollar earned by a rich citizen.

Many indicators ranking nations’ efforts to address climate change “say they’re about equity, but there’s still a systematic bias in favour of the biggest historical polluters. As we review efforts in the ‘global stocktake’ of the Paris Agreement, these kinds of indicators must be transparent.  Otherwise, they are anti-equity,” said Timmons Roberts, Professor of Environmental Studies and Sociology at Brown University and Director of the Climate Social Science Network.

“Studies should be explicit about the ethical and moral implications of their underlying assumptions, and equity assessments of countries’ climate action must be based on ethically defensible principles, such as responsibility, capacity and need,” said Dr Kate Dooley, Research Fellow at the University of Melbourne and lead author of the study.

Professor Harris added: “This article helps to reinforce what we already know from other aspects of life: reliance on statistical indicators can result in potentially unjust outcomes. It’s more important than ever to view the ethical challenges of climate change holistically and qualitatively.”

The authors propose new guidelines that emphasise transparency in communicating the ethical underpinnings of assessments of climate action and suggest guidelines for developing policy-relevant — but not ethically neutral — equity research, which includes studies of equitable distribution of climate efforts should not claim value-neutrality; analysis needs to ensure that the losses of those who are potentially marginalised remain clearly visible, and analytical work should aim to inform rather than supplant the political process.

EdUHK scholar develops intervention to promote health and fitness

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Urbanisation, technological advances, and increasing convenience in everyday life have restricted the amount of physical exercise most people engage in, resulting in major public health concern. This persistent and growing health-related problem calls for an acute need to develop an intervention programme that can effectively promote physical activities, not only at the individual level but also at the family, community, and citywide levels.

Whether positive psychology concepts can be integrated with health-promotion behaviours among families had largely been unknown until researchers in Hong Kong developed a positive physical activity (PPA) intervention. This has been made possible by using the positive psychology concepts of joy, gratitude, and savouring to promote Zero-Time Exercise (ZTEx) (which involves integrating simple physical activities into everyday life) and improve physical fitness in Hong Kong families.

Dr Henry Ho Chun-yip, Assistant Professor at the Department of Psychology of The Education University of Hong Kong (EdUHK), together with other researchers and healthcare professionals, worked with different stakeholders during the study, including the government, social service organisations and schools. A cluster randomised controlled trial was conducted with 1,983 participants in 1,467 families in Hong Kong. Data were collected using structured questionnaires and physical fitness assessments before the intervention and in follow-ups one and three months after the trial.

Social workers and teachers of the participating organisations and schools were trained to design and implement the community programmes. The training workshop was delivered by clinical psychologists, registered social workers, registered nurse, and academic researchers to comprehensively cover the contents of positive psychology, physical activity, programme design and programme evaluation.

The study measured the self-reported frequency of ZTEx both alone and with family members and assessed balance and endurance as indicators of physical fitness. It found that PPA intervention was effective in increasing ZTEx with both groups in each time periods, and in improving balance and endurance in the three-month follow-up.

Semi-structured focus groups added in-depth insights into the participants’ motivational, interpersonal and affective experiences. The findings showed that PPA intervention is a cost-effective way to improve physical activity and fitness and that a community-based collaborative approach was successful in engaging community stakeholders in an active and fruitful partnership for programme development.

The findings support the proposition that health promotion behaviour is maintained when the participants experience positive emotions during the activities. Through the application of positive psychology, the participants associated ZTEx with feelings of enjoyment, which nurtured unconscious motives for this health promotion behaviour, thus leading to a successful lifestyle change and improved physical fitness.

This study has important implications for Hong Kong, where 71% of adults did not meet the WHO physical activity recommendations.