title: Neighbourhood environment, physical activity, quality of life and depressive symptoms in Hong Kong older adults: a protocol for an observational study.
abstract: BACKGROUND
  The neighbourhood environment can assist the adoption and maintenance of an active lifestyle and affect the physical and mental well-being of older adults. The psychosocial and behavioural mechanisms through which the environment may affect physical and mental well-being are currently poorly understood.
  
  
  OBJECTIVE
  This observational study aims to examine associations between the physical and social neighbourhood environments, physical activity, quality of life and depressive symptoms in Chinese Hong Kong older adults.
  
  
  METHODS
  An observational study of the associations of measures of the physical and social neighbourhood environment, and psychosocial factors, with physical activity, quality of life and depressive symptoms in 900 Hong Kong older adults aged 65+ years is being conducted in 2012-2016. The study involves two assessments taken 6 months apart. Neighbourhood walkability and access to destinations are objectively measured using Geographic Information Systems and environmental audits. Demographics, socioeconomic status, walking for different purposes, perceived neighbourhood and home environments, psychosocial factors, health status, social networks, depressive symptoms and quality of life are being assessed using validated interviewer-administered self-report measures and medical records. Physical functionality is being assessed using the Short Physical Performance Battery. Physical activity and sedentary behaviours are also being objectively measured in approximately 45% of participants using accelerometers over a week. Physical activity, sedentary behaviours, quality of life and depressive symptoms are being assessed twice (6 months apart) to examine seasonality effects on behaviours and their associations with quality of life and depressive symptoms.
  
  
  BACKGROUND
  The study received ethical approval from the University of Hong Kong Human Research Ethics Committee for Non-Clinical Faculties (EA270211) and the Department of Health (Hong Kong SAR). Data are stored in a password-protected secure database for 10 years, accessible only to the named researchers. Findings will be submitted for publication in peer-reviewed journals.
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.
authors.forename: Ester
authors.initials: E
authors.lastname: Cerin
authors.affiliation: Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
authors.forename: Cindy H P
authors.initials: CH
authors.lastname: Sit
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
authors.forename: Casper J P
authors.initials: CJ
authors.lastname: Zhang
authors.affiliation: Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia Institute for Health & Ageing, Australian Catholic University, Melbourne, Victoria, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Barnett
authors.affiliation: Elderly Health Service, Department of Health, The Government of Hong Kong Special Administrative Region, Hong Kong, China.
authors.forename: Martin M C
authors.initials: MM
authors.lastname: Cheung
authors.affiliation: Department of Geography, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
authors.forename: Poh-Chin
authors.initials: PC
authors.lastname: Lai
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
authors.forename: Janice M
authors.initials: JM
authors.lastname: Johnston
authors.affiliation: Elderly Health Service, Department of Health, The Government of Hong Kong Special Administrative Region, Hong Kong, China.
authors.forename: Ruby S Y
authors.initials: RS
authors.lastname: Lee
mesh_terms: D061725:Accelerometry; D000368:Aged; D002681:China / Q000208:ethnology; D002985:Clinical Protocols; D003863:Depression / Q000208:ethnology*; D004779:Environment Design; D015444:Exercise / Q000502:physiology*; D006304:Health Status; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D018670:Monitoring, Ambulatory; D011788:Quality of Life; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012621:Seasons; D057185:Sedentary Behavior; D012944:Social Support; D016138:Walking / Q000706:statistics & numerical data
keywords: Accelerometer; Chinese; EPIDEMIOLOGY; health; social support; walkability