Global prevalence of physical activity for children and adolescents; inconsistencies, research gaps, and recommendations: a narrative review

Abstract Background One of the strategic actions identified in the Global Action Plan on Physical Activity (PA) 2018–2030 is the enhancement of data systems and capabilities at national levels to support regular population surveillance of PA. Although national and international standardized surveillance of PA among children and adolescents has increased in recent years, challenges for the global surveillance of PA persist. The aims of this paper were to: (i) review, compare, and discuss the methodological inconsistencies in children and adolescents’ physical activity prevalence estimates from intercontinental physical activity surveillance initiatives; (ii) identify methodological limitations, surveillance and research gaps. Methods Intercontinental physical activity surveillance initiatives for children and adolescents were identified by experts and through non-systematic literature searches. Prevalence of meeting PA guidelines by country, gender, and age were extracted when available. A tool was created to assess the quality of the included initiatives. Methods and PA prevalence were compared across data/studies and against the methodological/validity/translation differences. Results Eight intercontinental initiatives were identified as meeting the selection criteria. Methods and PA definition inconsistencies across and within included initiatives were observed, resulting in different estimated national prevalence of PA, and initiatives contradicting each other’s cross-country comparisons. Three findings were consistent across all eight initiatives: insufficient level of PA of children and adolescents across the world; lower levels of PA among girls; and attenuation of PA levels with age. Resource-limited countries, younger children, children and adolescents not attending school, with disability or chronic conditions, and from rural areas were generally under/not represented. Conclusions There are substantial inconsistencies across/within included initiatives, resulting in varying estimates of the PA situation of children and adolescents at the global, regional and national levels. The development of a new PA measurement instrument that would be globally accepted and harmonized is a global health priority to help improve the accuracy and reliability of global surveillance.

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Policy Evaluation Network (PEN): Protocol for systematic literature review examining the evidence for impact of school policies on physical activity

HRB Open Research ◽

10.12688/hrbopenres.13089.1 ◽

2020 ◽

Vol 3 ◽

pp. 62

Author(s):

Kevin Volf ◽

Liam Kelly ◽

Enrique García Bengoechea ◽

Blathin Casey ◽

Anna Gobis ◽

...

Keyword(s):

Physical Activity ◽

Literature Review ◽

Systematic Literature Review ◽

Policy Evaluation ◽

Physical Inactivity ◽

Action Plan ◽

Relative Reduction ◽

Global Action ◽

The Impact ◽

Global Action Plan

Introduction: Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity attributes an estimated 9% to this figure. Global responses have included the sustainable development goals and the global action plan on physical activity. Both point to policy action in physical activity (PA) to address change, yet the impact of policy is unknown. The protocol described outlines a systematic literature review that will be undertaken by the Policy Evaluation Network to address this knowledge gap. Protocol: This review of school PA policies is the first of seven planned reviews. The seven best investments for promotion of population PA identified in the Toronto Charter (whole-of-school programmes, transport policy, urban design policy, primary health care policy, public education policy, community programmes and sport programmes) will form the basis of these reviews. Seven individual scientific literature searches across six electronic databases, using key concepts of policy, PA, evaluation and a distinct concept for each area will be conducted. This will be supplemented with a search of the reference list of included articles. Methodological quality will be assessed and overall effectiveness for each included study will be described according to pre-determined categories. Conclusions: The review will provide policy makers with a list of policy statements and corresponding actions which the evidence has determined impact on PA directly or indirectly. By collating the evidence, and demonstrating the depth of the science base which informs these policy recommendations, this review will provide guidance to policymakers to use evidence-based or evidence-informed policies to achieve the 15% relative reduction in physical inactivity as defined by the ‘Global Action Plan on Physical Activity’. Registration: PROSPERO CRD42020156630 (10/07/2020).

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Results From the Mozambique 2016 Report Card on Physical Activity for Children and Adolescents

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0526 ◽

2016 ◽

Vol 13 (s2) ◽

pp. S213-S217 ◽

Cited By ~ 5

Author(s):

António Prista ◽

Timoteo Daca ◽

Francisco Tchonga ◽

Eduardo Machava ◽

Cremildo Macucule ◽

...

Keyword(s):

Physical Activity ◽

Children And Adolescents ◽

Rural Areas ◽

Sport Participation ◽

Report Card ◽

Activity Levels ◽

Sedentary Behaviors ◽

Urban Centers ◽

Organized Sport ◽

Available Information

Background:This article describes the procedures and development of the 2016 Mozambican Report Card on Physical Activity for Children and Adolescents.Methods:Following the procedures adopted in 2014 for that year’s report card, comprehensive searches on new data related to indicators of physical activity (PA) were done. A committee composed of physical activity and sports specialists graded each indicator consistent with the process and methodology outlined by the Active Healthy Kids Canada Report Card model.Results:Nine indicators of PA were graded. Compared with 2014 there were several differences which were caused by changes in the country as well as a more effective evaluation from the committee. The following grades were assigned: Overall Physical Activity Levels, C; Organized Sport Participation, F; Active Play, D; Active Transportation, C; Schools, D; Community and the Built Environment, F; and Government, F. Sedentary Behaviors and Family and Peers were graded Incomplete due to the lack of available information.Conclusions:The decline of the PA habits in urban centers reported in 2014 are accentuated and is influencing the rural areas in several ways. At present, there is no strategy or effective action from authorities to reverse this negative trend.

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Applicability of the Fels questionnaire on physical activity of children in rural areas of Bosnia and Herzegovina

Journal of Health Sciences ◽

10.17532/jhsci.2020.1072 ◽

2020 ◽

Author(s):

Vedran Đido ◽

Aida Pilav ◽

Marijan Marjanović ◽

Jenny Phillips ◽

Deana Švaljug ◽

...

Keyword(s):

Public Health ◽

Physical Activity ◽

Children And Adolescents ◽

Bosnia And Herzegovina ◽

Rural Areas ◽

Cross Sectional Study ◽

School Students ◽

Cross Sectional ◽

Measurement Protocol ◽

General Instrument

Introduction: Insufficient physical activity is one of the leading public health problems in the world, but also in Bosnia and Herzegovina. Modern civilization is characterized by a significant decrease in physical activity, and the number of people whose lifestyle can be called sedentary has never been higher, which is especially emphasised among children and adolescents. Aim of the study is to examine public health significance of physical activity on the occurrence and the degree of obesity in children and adolescents in primary and secondary schools and to determine the applicability of the Fels questionnaire on physical activity of children in rural areas of Bosnia and Herzegovina. Methods: We used a transversal research method of a cross-sectional study at a one-time point, and for obtaining results we used the Fels physical activity questionnaire for children and measurement protocol. Results: 276 primary and secondary school students in two cities participated in this survey. Respondents in Busovača are more physically active than their peers in Sarajevo. One-third of the total number of respondents is overweight and obese, and respondents in Sarajevo are significantly more nourished than their peers in Busovača. The Fels questionnaire is conditionally applicable, especially in rural areas. Conclusion: This study confirmed that the Fels questionnaire for assessing the level of physical activity for children and young people, which is the general instrument for research of physical activity in children, is too generalized because it is based on a homogeneous urban population.

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“Getting Ireland Active”—Application of a Systems Approach to Increase Physical Activity in Ireland Using the GAPPA Framework

Journal of Physical Activity and Health ◽

10.1123/jpah.2020-0864 ◽

2021 ◽

pp. 1-10

Author(s):

Joseph J. Murphy ◽

Fiona Mansergh ◽

Marie H. Murphy ◽

Niamh Murphy ◽

Benny Cullen ◽

...

Keyword(s):

Physical Activity ◽

Systems Approach ◽

Action Plan ◽

Good Practice ◽

Participatory Action ◽

Policy Documents ◽

Active Systems ◽

Strategic Objective ◽

Global Action ◽

Practice Gaps

Physical activity (PA) promotion is a complex challenge, with the Global Action Plan on Physical Activity (GAPPA) endorsing a systems approach and recommending countries assess existing areas of progress which can be strengthened. This paper reports a process facilitating a systems approach for identifying current good practice and gaps for promoting PA in Ireland. Elements of participatory action research were enabled through 3 stages: (1) aligning examples of actions from Irish policy documents (n = 3) to the GAPPA, (2) workshop with stakeholders across multiple sectors, and (3) review of outputs. Data collected through the workshop were analyzed using a deductive thematic analysis guided by the GAPPA. The policy context in Ireland aligns closely to the GAPPA with the creation of Active Systems the most common strategic objective across policy documents. Forty participants (50% male) took part in the systems approach workshop, which after revision resulted in 80 examples of good practice and 121 actions for greater impact. A pragmatic and replicable process facilitating a systems approach was adopted and showed current Irish policy and practices align with the GAPPA “good practices.” The process provides existing areas of progress which can be strengthened, as well as the policy opportunities and practice gaps.

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Physical activity and the built environment: perceptions of policy-makers in Oman

Health Promotion International ◽

10.1093/heapro/daz066 ◽

2019 ◽

Vol 35 (4) ◽

pp. 762-770

Author(s):

Ruth M Mabry ◽

Huda Al Siyabi ◽

Muhssen Kannan ◽

Amal Al Siyabi

Keyword(s):

Physical Activity ◽

Built Environment ◽

Action Plan ◽

Active Travel ◽

Intersectoral Collaboration ◽

Political Commitment ◽

Structured Interviews ◽

Urban Planning And Design ◽

Global Action ◽

Negative Perceptions

Abstract The prevalence of physical activity is low in the Sultanate of Oman. The built environment is a key barrier to physical activity in the region. Our aim is to examine urban planners’ perceptions of the relevance and feasibility of the proposed urban planning and design interventions in the draft WHO technical package on physical activity. Semi-structured interviews were conducted with 11 professionals using a pre-tested interview guide. Interviews were audio-recorded and transcribed. Content analysis based on the socio-ecological framework (policy, physical, socio-cultural and information environment) was used to identify the perceived urban design challenges and solutions. Urban sprawl due to haphazard urban and transport design, limited accessibility to parks and sports facilities, negative perceptions about active travel and limited understanding of physical activity were key challenges identified by interviewees. Participants suggested strengthening governance through policy and intersectoral collaboration, improving community design and accessibility to parks, considering the needs of diverse populations and improving knowledge and attitudes of physical activity as priority when adapting the WHO technical package to Oman. Mid-level managers prioritized three interventions from the package: the need for political commitment and capacity building on how the built environment can promote physical activity, a national political on physical activity that promotes a safe infrastructure for active transport, and accessibility to sports and recreational facilities. Negative perceptions of active travel and cultural expectations that constrain mobility requires a society-wide paradigm shift, the first objective of the WHO global action plan.

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Physical Activity Is an Opportunity for the Health of Nations: What Should We Do Next?

Praxis ◽

10.1024/1661-8157/a003061 ◽

2018 ◽

Vol 107 (17-18) ◽

pp. 943-949 ◽

Cited By ~ 1

Author(s):

Boris Gojanovic

Keyword(s):

Physical Activity ◽

Action Plan ◽

Local Level ◽

Well Being ◽

World Health ◽

Challenges And Opportunities ◽

Global Action ◽

Health Organization ◽

Declaration Of Geneva ◽

Global Action Plan

Abstract. Physical activity provides huge opportunities for the health of nations. Understanding this, the World Health Organization has published a Global Action Plan which aims to provide member states with a framework for action, namely to create active societies, people, environments and systems. The target is set at a 15 % reduction in physical inactivity levels by 2030. We explore in this paper some of the challenges and opportunities that come with it, and give the practitioner some real-world opportunities for relevant action at the local level, as well as for their patients, staying true to the Physician’s Pledge (Declaration of Geneva): “I will attend to my own health, well-being, and abilities in order to provide care of the highest standard.”

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The impact of short-term incentives on physical activity in a UK behavioural incentives programme

npj Digital Medicine ◽

10.1038/s41746-019-0164-3 ◽

2019 ◽

Vol 2 (1) ◽

Cited By ~ 2

Author(s):

Cother Hajat ◽

Ali Hasan ◽

Shaun Subel ◽

Adam Noach

Keyword(s):

Physical Activity ◽

Relative Risk ◽

Large Scale ◽

Action Plan ◽

Short Term ◽

Risk Of Mortality ◽

Global Action ◽

Physical Activity Recommendations ◽

The Impact

Abstract This observational study investigates whether the provision of ongoing short-term-incentives for verified physical activity increases and sustains levels of physical activity. We compared UK members at baseline (years 1 and 2) prior to Vitality’s Active Rewards (VAR) intervention commencing (year 3) and follow-up (year 4) for verified, self-reported (encompassing additional physical activities), mortality relative risk and satisfaction with physical activity. Members were categorised into low-active, medium-active and high-active by tertiles of baseline physical activity. Of 11,881 participants, 6477(54.5%) were male, with mean age 39.7(SD 9.8) years. At follow-up, annual active days had increased by 56% overall [60.8(59.7–61.9)–94.8(93.0–96.5)]; 554% in low-active [8.5(8.3–8.7)–47.1(44.7–49.5)]; 205% in medium-active [39.8(39.4–40.2)–81.4(78.7–84.1)] and 17% in high-active members [131.7(129.9–133.5)–153.7(150.7–156.7)] (all p < 0.001). Annual weeks of attaining international physical activity recommendations increased by 19% overall [22.2(42.8%)–26.4(50.8%)] and by 316% for low-active members [4.9(9.5%)–15.5(29.8%)]. Self-reported active minutes/week increased by 45% overall [1423(139.4–145.2)–207.0(201.8–212.3)] and 712% in low-active members [20.1(19.3–21.0)–143.2(134.6–151.9)]. Happiness with exercise levels also increased from 1985(49.4%) to 3414(84.9%) members (all p < 0.001). The relative risk of mortality from a lack of physical activity reduced by 7% for low-active members [from 0.99 to 0.92], 5% for medium-active [0.94–0.89] and 3% for high-active [0.89–0.86](p < 0.001) and by 0.02% for each additional year of age (p = 0.02). This large-scale, real-world, short-term-incentives intervention led to a dramatic increase in physical activity which was sustained for, and still increasing after, two years. If applied at broader level, this approach could considerably aid progress towards WHO targets in its Global Action Plan for Physical Activity.

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Hitting the Target but Missing the Point? Modelling Health and Economic Impacts of Different Approaches to Meeting the Global Action Plan for Physical Activity Target

Sports Medicine ◽

10.1007/s40279-020-01398-2 ◽

2021 ◽

Author(s):

Anja Mizdrak ◽

Ding Ding ◽

Christine Cleghorn ◽

Tony Blakely ◽

Justin Richards

Keyword(s):

Physical Activity ◽

Healthcare System ◽

Action Plan ◽

World Health ◽

Absolute Amount ◽

Relative Reduction ◽

Uncertainty Interval ◽

Life Years ◽

Global Action ◽

Global Action Plan

Abstract Background The World Health Organization launched the Global Action Plan for Physical Activity (GAPPA) in 2018, which set a global target of a 15% relative reduction in the prevalence of physical inactivity by 2030. This target, however, could be acheived in various ways. Methods We use an established multi-state life table model to estimate the health and economic gains that would accrue over the lifetime of the 2011 New Zealand population if the GAPPA target was met under two different approaches: (1) an equal shift approach where physical activity increases by the same absolute amount for everyone; (2) a proportional shift approach where physical activity increases proportionally to current activity levels. Findings An equal shift approach to meeting the GAPPA target would result in 197,000 health-adjusted life-years (HALYs) gained (95% uncertainty interval (UI) 152,000–246,000) and healthcare system cost savings of US$1.57b (95%UI $1.16b–$2.03b; 0% discount rate). A proportional shift to the GAPPA target would result in 158,000 HALYs (95%UI 127,000–194,000) and US$1.29billion (95%UI $0.99b–$1.64b) savings to the healthcare system. Interpretation Achieving the GAPPA target would result in large health gains and savings to the healthcare system. However, not all population approaches to increasing physical activity are equal—some population shifts bring greater health benefits. Our results demonstrate the need to consider the entire population physical activity distribution in addition to evaluating progress towards a target.

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Physical activity promotion in the age of climate change

F1000Research ◽

10.12688/f1000research.23764.1 ◽

2020 ◽

Vol 9 ◽

pp. 349 ◽

Cited By ~ 1

Author(s):

Karim Abu-Omar ◽

Peter Gelius ◽

Sven Messing

Keyword(s):

Physical Activity ◽

Mass Communication ◽

Global Climate ◽

Action Plan ◽

Physical Activity Promotion ◽

World Health ◽

Activity Promotion ◽

Climate Action ◽

Global Action ◽

Climate Crisis

The importance of the global climate crisis requires linking physical activity promotion and climate action. This article provides a first overview of interconnections between physical activity promotion and climate action, potential synergies and discrepancies, aiming to stimulate further discussion about this topic. The analysis is based on the World Health Organization’s Global Action Plan on Physical Activity 2018-2030 (GAPPA). The GAPPA covers five perspectives that are of particular relevance with respect to potential links with climate policy: (1) Infrastructures supporting active transport, (2) green spaces and recreational/exercise facilities, (3) exercise programs, (4) mass communication campaigns and mass participation events, and (5) training of professionals. Our analysis demonstrates a considerable alignment between strategies for physical activity promotion and efforts for the reduction of greenhouse gas emissions. However, in some of the areas, this alignment could still be improved. Additionally, more climate-conscious policies, research and surveillance need to be developed in the field of physical activity promotion.

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Physical Activity Is an Opportunity for the Health of Nations: What Should We Do Next?

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2018/17 ◽

2018 ◽

Vol 66 (3) ◽

Keyword(s):

Physical Activity ◽

Action Plan ◽

Local Level ◽

Well Being ◽

World Health ◽

Challenges And Opportunities ◽

Global Action ◽

Health Organization ◽

Declaration Of Geneva ◽

Global Action Plan

Physical activity provides huge opportunities for the health of nations. Understanding this, the World Health Organization has published a Global Action Plan which aims to provide member states with a framework for action, namely to create active societies, people, environments and systems. The target is set at a 15% reduction in physical inactivity levels by 2030. We explore in this paper some of the challenges and opportunities that come with it, and give the practitioner some real-world opportunities for relevant action at the local level, as well as for their patients, staying true to the Physician’s Pledge (Declaration of Geneva): “I will attend to my own health, well-being, and abilities in order to provide care of the highest standard.”

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