教育局
小學校本課程發展組
2016年 9月24日
< 分享嘉賓 >
陳作耘醫生
（香港兒科基金主席）
陳永生校長
（國際基督教優質音樂中學暨小學）
柴瑞恩主任
（香港扶幼會則仁中心學校）
Adolescent Health in Hong Kong 2016 Update
Dr. Chok-wan CHAN
Chairman, Joint Committee for Promotion of Child Health in Hong Kong Board Chairman, Hong Kong Pediatric Foundation
President, International Paediatric Association (2007 to 2010)
6/10/2016
Outlines of My Talk
• Concept of Global Child Health
• Adolescent Health in Hong Kong
• Youth Issues for Hong Kong
• The Child Health Policies for Hong Kong
• The Way Ahead
Child Health
• The Child (0 to 18 Years – United Nations) covering Fetus, Newborn, Childhood and Adolescence
• Sectors (Medical, Social and Education)
• Domains (Family, School, Community)
• Definitions
– Freedom from Diseases (1946)
– A state of physical, social, mental and spiritual well-being (1988)
– Attainment of highest potential in life and development (2008)
6/10/2016
Continuum of Care
Mother
Newborn
Child Under 5 Child 5 - 11
Adolescent
Child Health
Providers: (Transdisciplinary Team)
• Healthcare Professionals – Medical Doctors
– Nurses / Midwives
– Allied Health Professionals
• Social workers
• Education – teachers, health nurses
• Others
6/10/2016
United Nation (UN) Convention on the Rights of the Child 1989
• Equity
• Quality
• Rights
• Welfare
• Protection
• Others
Adolescent Health Service in Hong Kong
6/10/2016
At mid-2014,
the population of Hong Kong was 7.24 million
– 0–14 years 804 400 people 11.1%
– 15–24 years 835 200 people 11.5%
Around 20% of Hong Kong population are children and youth
Census and Statistics Department Website: http://www.censtatd.gov.hk
Organization of Child & Adolescent Health Service in Hong Kong
Organization Hospital
Authority (Public Service)
Department of Health
Private doctor Social Welfare Dept
Health Education
Health Surveillance 100%
Immunization 90% 10%
School health services 100%
Adolescent health ½
Child Assessment ½
Primary medical care 5% 5% 90%
Secondary & tertiary care 90% 10%
Rehabilitation
6/10/2016
Majority of primary health care is provided in private setting but preventive care is mainly provided in the public health system
Adolescent Health Service (HA)
• Adolescent Medical Center (QEH) started in 1995
• Adolescent service gradually set up in many pediatric units
– Out-patient adolescent service:
– In-patient admission: up to 18 yrs (2002)
Chronic illness
Eating disorders
Psychosomatic disorders
Drug overdose/abuse
Sexual/physical abuse
Behavioural and emotional problems
6/10/2016
Student Health Service D epartment of Health
• Target at
– primary school P1-6 (aged 6-11 yrs) &
– secondary school S1-7 (aged 12-18 yrs) students
• Provide comprehensive and preventive health
screening for physical and psychological health
Health Program at Student Health Center
Screening for Secondary School Students
– Obesity – Scoliosis
– Mental Health
6/10/2016
• Outreach service set up in 2001
• For secondary school students, parents & teachers
• Basic Life Skills Training
– emotion and stress management, interpersonal communications – smoking, drinking and substance abuse, healthy lifestyle
http://www.studenthealth.gov.hk/english/resources/resources_bl/files/shs_lefleat.pdf
Hong Kong Society for Adolescent Health (HKSAH)
• A multidisciplinary society set up in 2006
• Members including doctors, nurses, social workers, occupational therapists, physiotherapists, clinical psychologists and other youth workers
• The Society is committed to improving the physical and psychological health and well-being of
adolescents and to enabling adolescents to develop
and realize their potential
6/10/2016
New Health Challenges
for Children and Adolescents in 21
stCentury
• Non-communicable diseases and Chronic illnesses
– Unhealthy life style
– Exposure to environmental toxins – Risk exposure
• e-Era
– Overwhelming information from cyber world with new sets of social values and culture
– Overuse of electronic media leading to new health hazards
• Increasing mental health problems
– Competitive world – Academic stress
– Parental expectation
• Inequity (poverty, physical insufficiency, learning disability)
Common Mental Health Issues in Adolescents
• Suicide
• Self-harm behaviour
• Psychosis
• Depression
• Panic attack
• Eating disorder
• Psychosomatic disorder
Suicide (WHO Mortality Database in 2012)
• A major global public health issue
• Every year, about a million suicidal cases are recorded
• Global age-standardized suicide rate of 11.4 / 100 000 persons per year (>50% cases occur in Asia)
• For youths between 15 to 29 years of age, suicide accounted for 8.5% of all deaths & ranked 2
ndleading cause of death
(WHO, 2014)• 2/3 of suicidal cases did not receive any mental health care in the year before their deaths
6/10/2016
Youth Suicide Rate in Hong Kong (10-19 years)
Year 1981-2012
Students at breaking point: Hong Kong announces emergency measures after 29 suicides
since the start of the academic year 2015/2016
• High-pressure education system in Hong Kong
• Virtual world in the internet and lack of interpersonal skills
• The new generation has less resilience against stresses and problems
• Lack of Family Support
– both parents have to work, so having less quality time interacting with their children
6/10/2016
Professional and Public Education
on Adolescent Health on 23-26 Apr. 2016 organized by HKPS and HKPF
• Multidisciplinary Seminar
– Review and update on the hot topics on adolescent health
• Professional Forum on HPV
– Update on recent evidences on HPV vaccine for adolescents
• Adolescent Health Survey and Press Conference
– Health Literacy
– Risk Behaviour
Sing Pao
「香港中學生健康素養及高危健康行為狀況調查」
新聞發佈會
• 情緒問題嚴重 六成稱不開心 27%中學生擬自殘自殺
27/4/2016《成報》
• Suicidal Thoughts of Students Uncovered 27/4/2016 The Standard
6/10/2016
調查：六成學生有情緒病先兆
• 26/4/2016 《Now新聞》
Online Survey on
Health Literacy & Risk Behaviours of Hong Kong Secondary School Students
THE HONG KONG
PAEDIATIC SOCIETY THE HONG KONG
PAEDIATRIC FOUNDATION
Methodology
Survey
background To understand the level of health literacy and risk behavior of Hong Kong secondary school students so as to provide relevant public health education Survey duration 17 March, 2016 - 10 April,2016
Target audience Secondary school students Methodology Questionnaire
Total number of
respondents 1,685
Respondent profile
6/10/2016 Valid Sample : 1,685
Gender Percentages
Male 39.47%
Female 60.53%
有效樣本: TBC
Grade Percentages
Form 1 21.84%
Form 2 13.83%
Form 3 31.10%
Form 4 13.95%
Form 5 18.87%
Form 6 0.42%
Valid Sample : 1,685
78% of secondary school students think they are healthy
48% are not satisfied with their body shape and weight
In the past 6 months,
62% felt sad or cried for no reason
63% encountered sleeping disorders
6/10/2016 Valid Sample : 1,685
62%
63%
62%
72%
27 % had considered harming themselves or committing suicide in the past 6 months
27%
8% had been cyber bullied in the past year, - 40% of them felt depressed and
- 18% wanted to commit suicide
6/10/2016 Valid Sample : 1,685 Valid Sample: 141
Health Literacy 健康素養
HE35% think that they are not kids anymore, they could search information in the web
for self treatment when feeling sick
6/10/2016 Valid Sample : 1,685
35%
Do you agree/ disagree with the following statement？
66%
prefer to handle health issues by searching information from internet instead of seeking medical help Top 3: 1) Weight management, 2) mental health problems and3) acne/skin care problems
66%
79% think that recommendation from medical professionals are reliable
34% think that online information is reliable
6/10/2016 Valid Sample : 1,685
34%
40%
consider that even without doctor’s prescription, they can still try other remedies38%
consider their friends’ experiences are more reliable than doctors’ recommendations38%
29%
28%
Do you agree/ disagree with the following statements?
40%
Examples of
Inadequate Health Literacy
Among Young People
Less than 40% of secondary school students know
that teenagers should receive HPV vaccine (39%) and
meningococcal vaccine(20%) for their own protection
41% refuse to be vaccinated even if
the government provides free HPV vaccine
No, Yes, 41%
59%
If the government provides HPV vaccine, will you vaccinate it?
6/10/2016
Valid Samples : 1,685
Valid Sample: 694
Reasons for not vaccinating HPV vaccine indicate inadequate health literacy in youngsters
• Many youngsters do not understand the benefit of vaccination
• Taking HPV vaccine as an example
• 41% expressed refusal on HPV vaccination even if the government provides it free
• Reasons includes
• “Don’t want to be vaccinated for no reason”
• “The vaccine is useless”
• “Only for female while I am not”
• This shows health literacy among youngsters is inadequate
=> miss the chance to protect their long-term health
Mental health problems, low health literacy and yet
high prevalence of self-management of health issue among HK
secondary school students may lead to disastrous consequences
6/10/2016
• Almost 30% of secondary school students have considered harming themselves or committing suicide in the past 6 months
• 65% has mental health concerns
• Many considered handling health issues by themselves by searching information from internet instead of seeking medical help when sick
• Nearly 40%consider their friends’ experiences are more reliable than doctors’
recommendations
• Despite they perceive recommendation by medical professionals are trustworthy
• Yet, count on on-line information and recommendations from friends over doctors
• If they handle health issues inappropriately, result can be disastrous
DR. CHARLES E. IRWIN, JR.
DIRECTOR OF THE DIVISION OF ADOLESCENT &
YOUNG ADULT MEDICINE & DIRECTOR OF HEALTH POLICY IN THE DEPARTMENT OF PEDIATRICS AT THE UNIVERSITY OF CALIFORNIA,
SAN FRANCISCO (UCSF)
IRIS LITT VISITING PROFESSOR ON ADOLESCENT HEALTH RESEARCH 2016
Comments made at the Press Conference
as a world expert on Adolescent Health
• Globally, mental health disorders (especially depression) are the number one cause of disease burden on adolescents.
• Increasing adolescents and young adults are gaining their information from web-based sources of information or through chat rooms that discuss a number of health issues.
• These new sources of gaining information on health and well-being provide both opportunities and risks for reaching young people.
Opportunities
– E.g. adolescents can recognize mental health disorders in their peers and recommend their peers to seek appropriate health care
Risks
– E.g. eating disorders websites to promote dieting & abnormal eating
6/10/2016
• We need to engage schools, community groups, health
professionals, media, business sector and the government to
educate and support our young people to develop adequate health literacy and identify appropriate and useful health information
• Successful example: Tobacco campaigns
• We need to extend these activities beyond tobacco and provide
similar approaches to both health promoting and damaging issues
How to identify mental health problems in youngsters?
– Teenagers during this period are struggling for physical, cognitive, psychological as well as self-esteem development
– Teenage behaviours are often affected by physical changes, peer relationships, high risk behaviours, environmental factors, and social trends
It is important to identify the underlying causes for their emotional and behavioural issues
6/10/2016
Adolescent is a period of rapid behavioral, cognitive and brain development, teenagers are prone to emotional and behavioral challenges
How to evaluate internet information and resources?
Is the source credible? Information in a journal or on the Web should have an identifiable source or an author. If the information is medical, credibility is
generally enhanced if it is provided by a medical institution, an entity that brings together medically knowledgeable professionals, or a government health agency.
Accuracy of information Try to determine whether the information is supported by evidence from scientific studies, other data or expert opinion.
Judge whether the information is mere personal experience or supported by a few cases
Analyze whether the information is based on evidence from a study, on expert opinion or is it merely the opinion of the writer, especially when obtaining information through instant messaging, internet forums, chat rooms and bulletins.
Is the information up-to- date?
Given that health information is constantly changing as new discoveries are made, it is important to make sure that the information is current.
Is there a conflict of interest?
Be aware of any commercial element or product related information that has been included in the health information. This may not fully reflect the real situation or there may be biased information. Analyze if the information is fair and objective.
Comments on Government’s Actions for Youth Suicide
• Committee on Prevention of Student Suicides
Set up at the end of March 2016
Chaired by Professor Paul Yip, Director of the Centre for Suicide Research and Prevention at the University of Hong Kong
Members comprising schools, parents, youth and student representatives;
professionals from the healthcare and social welfare sectors, and representatives of different government bureaus and departments
Only a psychiatrist and a clinical psychologist were involved
No pediatricians or primary healthcare workers
Only reactive to recent suicidal cases but no long term strategic plans on adolescent health
6/10/2016
Suggestions from HKPS and HKPF
1. Build up Core Value in Life
Encourage young people to identify personal interests and to develop one’s own talents rather than focusing on materialistic enjoyment or academic achievements
Life education for youngsters to review the value and goals in life
2. Training on resilience and positive youth development
Workshops or games to train up resilience
Training on problem solving skills and stress coping
3. Training on health literacy
Advocate the concept on Preventive Health Care to have early identification and intervention of any health issues
Empower young people to have self-identification and identification of peers who have mental health issues and refer them to seek professional help
Teach the skills on searching for reliable and correct health information and applying the information for making health decisions
Suggestions from HKPS and HKPF
4. Establish multiple channels to listen to youth voices
Channels at schools
Channels at families
Channels from peers
Channels from communities
Channels from professionals
5. Support parents to have effective communication with youth
Workshop for parents and youth to train up communication skills and enhance understanding of each other
6. Use of media for dissemination of positive messages and life stories and for training on health information literacy
6/10/2016
Youth Suicide is only the tip of an iceberg There are many other emerging youth
problems
Poverty
Young people (15-24 yrs) in receipt of CSSA accounting for 5.4% of the population
Youth living in low-income households increased from 16.1% in 2005 to 17.5% in 2011
Youth unemployment
2-5 times greater than overall population
In 2013, unemployment rates for 15-19 year-olds (17.8%) and 20-24 year-olds (8.3%)
Substance abuse
Duration of undetected substance abuse increases among youngsters
Use of methylamphetamine (Ice) and cocaine has been rising in the recent few years
Housing issue
Education issue
Major Adolescent Health Issues in Hong Kong
• Social movements
• Youth suicides
• Substance abuse
• Social problems – Housing
– Employment
– National identity issues
6/10/2016
Underlying Root Causes
• Pressure from study
• Lack of core values for existence
• Pressure of life and work
• Too much concern on materialistic enjoyment
• No spiritual target in life
Solutions
• Re-establishment of Core Value in Life for Youth
• Revamp the whole education system in Hong Kong
• Start Health School Nurse system at schools
• A child-friendly community for youth health
• A Child Health Policy for Hong Kong
• A Children's Commissioner for Hong Kong
6/10/2016
A CHILD-CENTERED
COMPREHENSIVE CHILD HEALTH POLICY IS
NEEDED
Reality of Children in Hong Kong
6/10/2016
Be successful from the beginning Environmental
pollution
Enormous pressure from school
Pressure from parents
No time for playing and
sleeping
Economic Perspective
Prevention Early
Intervention
Cost- effective
An effective health policy should follow this framework
Study indicates that early intervention can save up to 75% of health costs that
will be needed later in life
In the past 3 years (from 2012), the Hong Kong Pediatric Society and the Hong Kong Pediatric Foundation focus on
Child Health Policy
HKPS and HKPF gathered over hundreds of healthcare professionals, economists, educators and social welfare
professionals to review the child health problems in our community and develop the first ever
Child Health Policy Proposal for Hong Kong
6/10/2016
Policy priorities in different perspectives
Medical
Nursing and Allied Health
Youth’s voice Social Education
Environmental
Parents
6/10/2016
The Children's Commission
• As advised by the United Nations Committee on the Rights of the Child
• To supervise, implement, assess and measure outcome deliverables of the Child Health Policy
• It should be chaired by a Children's Commission who will look after the welfare and advocacy issues of the children
• It should be above-bureau and should be financially independent of government bureaus
• The policy should be implemented across different government
departments with appropriate resource allocation and holistic approach
• Together with the establishment of a Children’s Commission to investigate, monitor and implement the policy
Indicator Value World
Ranking
Median (Average) Age 43.22 years 7th
Life Expectancy (Male) 81.16 years 1st
Life Expectancy (Female) 87.23 years 2nd Total Fertility Rate 1.214 children/woman Lowest Infant Mortality Rate 1.688 deaths/1,000 live births Lowest Under Five Mortality 2.432 deaths/thousand Lowest
Hong Kong Population Indicators
6/10/2016
World Population Prospects - Global demographic estimates and projections by the United Nations
Health Statistics for Hong Kong best in the world
• Lowest Childhood Statistics
(Infant Mortality and Below-5 Mortality)
• Highest Literacy Rate
• Highest Longevity Rate
• Highest Gross Domestic Product
World Happiness Report 2016
• Hong Kong only ranks the 75 th happiest among 156 countries
• 2013 – 64 th in the world
6/10/2016United Nations (UN) Sustainable Development Solutions Network (SDSN)
Something has to be done for our children in Hong Kong
before it is too late!
Conclusions
• Children make up 20% of our population but represent 100% of our future!
• Integrated Child Health (Medical, Social, Education and others) is essential for their attainment of
highest potential in life
• We need a Joint Powerful Voice for our Children
• A Child Health Policy and a Children's Commissioner are urgently in need for HK
• Goal for Child Health - “Healthy Youth for Healthy World!”
6/10/2016
Visit our Website for more information at hkpf.org.hk
Thank you for your attention!
Dr. Chok-wan CHAN
不一樣的學習體驗 不一樣的生命歷程
陳永生校長
國際基督教優質音樂中學暨小學
6/10/2016
不一樣的音樂教育 學習音樂的意義
音樂教育的重要性，
是在培育人類一顆美善的心靈 鈴木鎮一
6/10/2016
不一樣的音樂教育 音樂對人的影響
• 音樂是上帝給人類最美的恩賜，它可使人 完全離開愁煩的重擔，又可排除惡念和迷 惑，又可振奮人心。
除神學外，音樂是最值得推動的
馬丁路德
不一樣的音樂教育 你也可以享受音樂
6/10/2016
• Edvard Grieg - Morning Mood (Peer Gynt Suite No. 1, Op. 46)
• Händel Messiah - Hallelujah Chorus
• Jules Massenet - Meditation from Thais for
Violin and Piano
不一樣的價值取向
每位孩子都是有價值的
神就照著自己的形像造人，
乃是照著他的形像造男造女。
創1:27 各樣美善的恩賜和各樣全備的賞賜都是從上 頭來的，是眾光之父那裡降下來的。
雅各書1:17
6/10/2016
不一樣的價值取向 愛裡沒有懼怕
• 愛裡沒有懼怕，愛既完全，就把懼怕除去。
約翰一書4:18
不一樣的價值取向
讓孩子進入豐盛的生命
• 我來了，是要叫人得生命，並且得的更豐盛 約翰福音10:10
6/10/2016
服務
• 本地社區
• 澳門
• 泰南
不一樣的學習體驗 學習階段的更新
6/10/2016
學習階段的更新
Restore Junior Section G.1-G.4 (6-9歲)
Return Middle Section G.5-G.8 (10-13歲)
Revive
Senior
Section
G.9-G.12
(14-17歲)
不一樣的學習體驗 你也可以夢想成真
6/10/2016
柴瑞恩 (訓輔主任–小學部)
6/10/2016
自 尊
08-09 09-10 10-11 11-12 12-13
安全感
盡本份、
展所能、
建和諧
真英雄、
欺不容、
和諧校園樂融融 和諧約章 和諧校旗、班旗
Twemlow, BMSB
和平戰隊 和諧約章 和諧校旗、班旗
BMSB 彩
虹 計 劃
獨特感
盡本份 尋「寶」之旅 真英雄聯繫感 (師生關係)
集體相 v1 集體相 v2 Puzzle 1, 2, 3
集體相 集體相
和平戰隊 並肩作戰 二人三足 併桌上課 集體相
大 家 落
互 勉 計 劃
能力感
盡本份、展所能 計劃
真英雄 武林 盛會
大本型 完成任務
勁 爆
方向感
與社工定行為目標 與社工定行為目標升級英雄升級 與社工定行為目標
升官階 與社工定行為目標
自 治
選擇
選擇權／爭取 真彩 虹 計 劃
減少獎罰
減少留堂班日數取消說話篇 白表、紅表、後果
領導才能
風紀、班長、班委員、小士多、笑容哥哥、展所能 計劃增加內在動機
提升集隊形象 閱兵片段 集隊片段自 個人
自我管理自尊 自治 自立 框架
自 尊
08-09 09-10 10-11 11-12 12-13
自 治
選擇
選擇權／爭取自 立
自尊 自治 自立 框架
6/10/2016
自 尊
08-09 09-10 10-11 11-12 12-13
自 治
選擇 選擇權／爭取
減少獎罰
減少留堂班日數取消說話篇 白表、紅表、後果
自 立
自尊 自治 自立 框架
自 尊
08-09 09-10 10-11 11-12 12-13
自 治
選擇 選擇權／爭取
減少獎罰
減少留堂班日數取消說話篇
白表、紅表、後果
領導才能
風紀、班長、班委員、小士多、笑容哥哥、展所能 計劃自 立
自尊 自治 自立 框架
6/10/2016
自 尊
08-09 09-10 10-11 11-12 12-13
自 治
選擇 選擇權／爭取
減少獎罰
減少留堂班日數取消說話篇
白表、紅表、後果
領導才能 風紀、班長、班委員、小士多、笑容哥哥、展所能 計劃 增加內在動機
提升集隊形象 閱兵片段 集隊片段自 立
自尊 自治 自立 框架
自 尊
08-09 09-10 10-11 11-12 12-13
彩 虹 計 劃
勁爆
自 治
真 彩 虹 計 劃
自 立
自尊 自治 自立 框架
6/10/2016
有用的人—陳國榮
路要自己走—秀蘭瑪雅
謝謝 !
6/10/2016
