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Open access

Hannah Wilkie, Martyn Standage, Lauren Sherar, Sean Cumming, Caley Parnell, Adrian Davis, Charlie Foster and Russ Jago

Background:

Regular physical activity improves physical and mental health, yet children’s physical activity levels were low in England’s 2014 Report Card. Within this paper, we update the 2014 Report Card to assess current information for the 9 indicators of physical activity.

Methods:

A search for nationally representative data on 9 indicators of physical activity was conducted and the data were assessed by an expert panel. The panel assigned grades [ie, A, B, C, D, F, or INC (incomplete)] to each indicator based on whether children across England were achieving specific benchmarks. The 2016 Report Card was produced and disseminated.

Results:

The following grades were awarded: Overall Physical Activity Levels: D-; Organized Sport Participation: D; Active Play: INC; Active Transportation: C-; Sedentary Behaviors: INC; Family and Peers: INC; School: B+; Community and the Built Environment: B; Government Strategies and Investment: INC.

Conclusions:

The grades have not improved since the 2014 Report Card and several gaps in the literature are still present. While children’s physical activity levels remain low alongside competing sedentary choices, further national plans and investment with local actions are urgently needed to promote physical activity especially via active play, active transport, and family support.

Open access

Helena Kruusamäe, Merike Kull, Kerli Mooses, Eva-Maria Riso and Jaak Jürimäe

Background:

The 2016 Report Card on Physical Activity for Children and Youth, the first of its kind, aims to set baseline physical activity (PA) indicators using the Active Healthy Kids Global Alliance grading system.

Methods:

A research work group analyzed and selected data for the grade assignment meeting (GAM). During the GAM, 17 leading researchers and policy experts from Estonia assessed the data and assigned grades for each of the 9 PA indicators. In addition, recommendations were provided for further actions to improve the grades.

Results:

Grades from A (highest) to F (lowest) were assigned as follows: 1) Overall PA (F); 2) Organized Sport (C); 3) Active Play [incomplete data (INC)]; 4) Active Transportation (INC); 5) Sedentary Behaviors (F); 6) Family and Peers (C); 7) School (C); 8) Community and the Built Environment (B); and 9) Government (C). An indicator was marked as incomplete (INC) when there was a lack of representative quality data.

Conclusions:

Evidence suggests that PA levels of Estonian children remain very low, despite moderately supportive social, environmental, and regulatory factors. There are many challenges to overcome in supporting and promoting PA of children and youth (eg, cross-sectional cooperation, implementing interventions, changing social norms, empowerment of parents and educational institutions).

Open access

Tuija H. Tammelin, Annaleena Aira, Matti Hakamäki, Pauliina Husu, Jouni Kallio, Sami Kokko, Kaarlo Laine, Kati Lehtonen, Kaisu Mononen, Sanna Palomäki, Timo Ståhl, Arja Sääkslahti, Jorma Tynjälä and Katariina Kämppi

Background:

Finland’s 2016 Report Card on Physical Activity for Children and Youth gathers and translates research results and assesses the status and promotion of physical activity (PA) among Finnish children and youth less than 18 years of age. This article summarizes the results and provides grades for 9 indicators.

Methods:

The working group evaluated the evidence and assigned grades of A (highest, 81% to 100%), B, C, D, or F (lowest, 0% to 20%) for 9 PA indicators using the Active Healthy Kids Canada Report Card development process.

Results:

The grades varied in Finland as follows: 1) Overall PA/fulfillment of recommendations = D, 2) Organized Sport Participation = C, 3) Active Play = C, 4) Active Transportation = B, 5) Sedentary Behaviors = D, 6) Family and Peers = C, 7) School = B, 8) Community and the Built Environment = B, 9) Government = B.

Conclusions:

Despite good policies and programs to promote PA in Finland, children and youth overall PA levels are low, whereas their time spent sedentary is high. More effective interventions, operation models, concrete tools as well as environmental solutions are needed to support the work toward more physically active childhood and youth.

Open access

Reginald Ocansey, Richmond Aryeetey, Seidu Sofo, Alex Nazzar, Margaret Delali, Prince Pambo, Vida Nyawornota, John Nartey and Rachel Sarkwa

Background:

Currently, there is limited evidence on estimates for physical activity (PA) behavior and sedentary behavior (SB) in Ghana. This report card (RC) is intended to increase awareness and sensitivity about issues surrounding PA and SB in Ghana.

Methods:

Data were collected from peer-reviewed literature, graduate students’ theses, physical education and sports documents, and a survey of opinions of stakeholders covering the 10 key RC indicators and benchmarks. The principal investigator harmonized all grades. A consensus meeting of the RC team was held to assign the final grades.

Results:

School and Community grades declined from a D in 2014 to an F in 2016. SB declined from B to D. Family and Active Play were not graded in 2014 and now received an F and a B, respectively. Family and Built Environment were graded F, Active Transportation received a C, and Government and Overall PA were graded D.

Conclusions:

A conscious national investment effort can increase overall PA among children.

Open access

Wendy Yajun Huang, Stephen Heung-Sang Wong, Martin Chi-Sang Wong, Cindy Hui-Ping Sit, Raymond Kim-Wai Sum and Gang He

Background:

Hong Kong’s 2016 Report Card on Physical Activity (PA) for Children and Youth is the first evidence-based synthesis of various indicators related to individual behaviors that contribute to overall PA levels, settings and sources of influence, and strategies and investments in Hong Kong.

Methods:

Following a standardized protocol, currently best available data for Hong Kong youth were collated and evaluated by an expert consensus panel on 9 indicators (5 activity behaviors and 4 influences on these behaviors).

Results:

Less than half of the children and youth met the recommended PA level. As a result, a D grade was given for Overall PA levels. Organized Sport Participation and Active Transportation received grades of C- and B, respectively. Sedentary Behaviors and School scored a C grade. Community and the Built Environment scored a grade of B. Family Influence received as low a score as Overall PA (D). Active Play and Government were not graded due to incomplete data.

Conclusions:

PA levels are low and sedentary behaviors are high for children and youth in Hong Kong. Promising policies exist in schools and features of community and the built environment are favorable. Increasing family support should be emphasized for future PA promotion.

Open access

Tarun Reddy Katapally, Shifalika Goenka, Jasmin Bhawra, Subha Mani, Ghattu V Krishnaveni, Sarah Helen Kehoe, Anjana Sankhil Lamkang, Manu Raj and Kathleen McNutt

Background:

Physical inactivity in children and youth in India is a major public health problem. The 2016 Indian Report Card on Physical Activity for Children and Youth has been conceptualized to highlight this epidemic by appraising behaviors, contexts, strategies, and investments related to physical activity of Indian children and youth.

Methods:

An international research collaboration resulted in the formation of a Research Working Group (RWG). RWG determined key indicators; identified, synthesized, and analyzed existing evidence; developed criteria for assigning grades; and, finally, assigned grades to indicators based on consensus.

Results:

Overall Physical Activity Levels were assigned a grade of C-. Active Transportation and Sedentary Behaviors were both assigned a grade of C. Government Strategies and Investments was assigned a grade of D. Six other indicators, including the country-specific indicator Physical Fitness, were graded as INC (incomplete) due to the lack of nationally representative evidence.

Conclusions:

Based on existing evidence, it appears that most Indian children do not achieve recommended levels of physical activity and spend most of their day in sedentary pursuits. The report card identifies gaps in both investments and research that need to be addressed before understanding the complete picture of active living in children and youth in India.

Open access

Deirdre M. Harrington, Marie Murphy, Angela Carlin, Tara Coppinger, Alan Donnelly, Kieran P. Dowd, Teresa Keating, Niamh Murphy, Elaine Murtagh, Wesley O’Brien, Catherine Woods and Sarahjane Belton

Background:

Physical activity (PA) is a key performance indicator for policy documents in both the Republic of Ireland and Northern Ireland. Building on baseline grades set in 2014, Ireland’s second Report Card on Physical Activity for Children and Youth allows for continued surveillance of indicators related to PA in children and youth.

Methods:

Data and information were extracted and collated for 10 indicators and graded using an international standardized grading system.

Results:

Overall, 7 grades stayed the same, 2 increased, and 1 decreased. Grades were assigned as follows: Overall PA, D (an increase); Sedentary Behavior (TV), C-; Physical Education, D-; Active Play, Incomplete/Inconclusive (INC); Active Transportation, D; School, D (a decrease); Home (Family), INC; Community and the Built Environment, B+ (an increase); and Government, INC. Unlike 2014’s report card, different grades for the Republic (C-) and Northern Ireland (C+) were assigned for Organized Sport Participation.

Conclusions:

Although the grade for Overall PA levels increased to a D, this may reflect the increased quality and quantity of data available. The double burden of low PA and high sedentary levels are concerning and underscore the need for advocacy toward, and surveillance of, progress in achieving targets set by the new National Physical Activity Plan in the Republic and obesity and sport plans in the North.

Open access

Chiaki Tanaka, Shigeho Tanaka, Shigeru Inoue, Motohiko Miyachi, Koya Suzuki and John J. Reilly

Background:

The Report Card on Physical Activity for Children and Youth aims to consolidate existing evidence, encourage greater evidence-informed physical activity, and improve surveillance of physical activity.

Methods:

The Japan report card followed the methodology of the Canadian and Scottish report cards, but was adapted to reflect the Japanese context. Nationally representative data were used to score each of the respective indicators.

Results:

The 2016 Japan Report Card on Physical Activity for Children and Youth consists of Health Behaviors and Outcomes (7 indicators), and Influences on Health Behaviors (4 indicators). Three Health Behaviors and Outcomes received C grades (Participation in Sport; Sedentary Behavior; Recreational Screen Time; Physical Fitness), while 2 indicators could not be graded (Overall Physical Activity, and Active Play). The indicators Active Transportation (B) and Weight Status were favorable (A). In the Influences domain, Family Influence and Community and the Built Environment were graded as D, while School and Government Strategies and Investments were favorable (B).

Conclusions:

The Japan report card illustrated some favorable health behaviors, health outcomes, and influences. There is a need for more evidence especially on overall physical activity levels, active play, and community and the built environment.

Open access

Vincent O. Onywera, Stella K. Muthuri, Sylvester Hayker, Lucy-Joy M. Wachira, Florence Kyallo, Robert O. Mang’eni, Peter Bukhala and Caleb Mireri

Background:

Kenya’s 2016 report card aimed to highlight the health and well-being of Kenyan children and youth using the best available evidence on the physical activity of Kenyan children and youth. The report pointed at areas where Kenya was succeeding and areas where more action is required.

Methods:

Inclusive analyses of available data sources on the core indicators related to physical activity and body weights of Kenyan children and youth (5 to 17 years) were conducted. These were assigned grades based on a set of specific criteria.

Results:

Results show that Active Play, Active Transportation, Overweight and Obesity, and Sedentary Behavior were favorable with a grade of B. Overall Physical Activity, Organized Sport Participation, and School (infrastructure, policies, and programs) each received a grade of C, while Family and Peers, Government and Nongovernment organizations, as well as the Community and the Built Environment were assigned grade D.

Conclusions:

Over 72% of Kenyan children and youth use active transportation to and from school and in their daily lives. Although majority of the children and youth have normal body weight, there is need to ensure that they meet and maintain the physical activity levels recommended by the World Health Organization. More needs to be done especially in relation to the governmental and nongovernmental organizations, organized sports participation, as well as involvement of family and peers in promoting healthy active lifestyles among Kenyan children and youth. More representative data for all indicators are required in Kenya.

Open access

Razinah Sharif, Kar Hau Chong, Nur Hadiyani Zakaria, Min Li Ong, John J. Reilly, Jyh Eiin Wong, Hazizi Abu Saad and Bee Koon Poh

Background:

The 2016 Malaysia Active Healthy Kids Report Card aims to collect, assess, and grade current and comprehensive data on physical activity (PA) and associated factors in Malaysian children and adolescents aged 5 to 17 years.

Methods:

This report card was developed following the Active Healthy Kids Canada Report Card protocol. The Research Working Group identified the core matrices, assessed the key data sources, and evaluated the evidence gathered for grade assignments. A grade was assigned to each indicator by comparing the best available evidence against relevant benchmark using a standardized grading scheme.

Results:

Overall Physical Activity, Active Transportation, and Sedentary Behavior were assigned the D grade. The lowest grade of F was assigned to Diet, while School and Government Strategies and Investments were graded higher with a B. Five indicators were assigned INC (incomplete) due to a lack of representative data.

Conclusions:

The report card demonstrates that Malaysian children and adolescents are engaging in low levels of PA and active commuting, high levels of screen time, and have extremely low compliance with dietary recommendations. More efforts are needed to address the root causes of physical inactivity while increasing the opportunities for children and adolescents to be more physically active.