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Open access

Pawel Zembura, Aleksandra Goldys and Hanna Nalecz

Background:

Poland’s 2016 Report Card on Physical Activity for Children and Youth is the first assessment of child and youth physical activity (PA) in Poland using the Active Healthy Kids Global Alliance grading system. The main goal was to summarize and describe the current state of child and youth PA to increase awareness and surveillance.

Methods:

The systematic methodology that underpins the Active Healthy Kids Canada Report Card was adapted and applied to the Polish report card. The best available data were consolidated, reviewed by a group of experts, and used to assign the letter grades to 9 core PA indicators on a scale ranging from A (highest) to F (lowest).

Results:

The 9 indicators were graded as such: 1) Overall Physical Activity (D), 2) Organized Sport Participation (C), 3) Active Play (INC), 4) Active Transportation (C), 5) Sedentary Behaviors (D), 6) Family and Peers (C), 7) School (B), 8) Community and the Built Environment (C), and 9) Government Strategies and Investments (C).

Conclusions:

The final grades show a strong role of school in providing PA for children and youth in Poland. However, promotion of school-based sport participation appears to be insufficient by itself to sustainably promote PA in this group.

Open access

Jorge Mota, Manuel João Coelho-e-Silva, Armando M. Raimundo and Luís B. Sardinha

Background:

This article describes the procedures and development of the first Portuguese Report Card on Physical Activity in Children and Adolescents.

Methods:

Comprehensive searches for data related to indicators of physical activity (PA) were completed by a committee of physical activity and sports specialists. Grades were assigned to 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. The following grades were assigned: Overall Physical Activity Levels, D; Organized Sport Participation, B; Active Play, D; Active Transportation, C; Sedentary Behaviors, D; Family and Peers, C; Schools, B; Community and the Built Environment, D; and Government, C.

Conclusions:

Portuguese children and adolescents do not reach sufficient physical activity levels and spend larger amounts of time spent in sedentary behaviors compared with recommendations. Effective policies of PA promotion and implementation are needed in different domains of young people’s daily lives.

Open access

Mohamed G. Al-Kuwari, Izzeldin A. Ibrahim, Eiman M. Al Hammadi and John J. Reilly

Background:

The first Qatar Active Healthy Kids (QAHK) Report Card was developed in 2015–2016. It is a synthesis of the available evidence on physical activity in children and youth in the state of Qatar—an assessment of the state of the nation. The report card is important for future physical activity advocacy, policy, and program development.

Methods:

The QAHK Report Card was inspired by the Active Healthy Kids Scotland 2013 Report Card. The methodology used in Scotland’s report card was adapted for Qatar. A Working Group identified indicators for physical activity and related health behaviors, and evaluated the available data on these indicators. The card grades were determined by the percentage of children meeting guidelines or recommendations.

Results:

The 2016 QAHK Report Card consisted of 9 indicators: 6 Physical Activity and Health Behaviors and Outcomes, and 3 Settings and Influences on these health behaviors and outcomes. The indicator National Policy, Strategy, and Investment was assigned the highest grade (B). Four indicators were assigned D grades: Sedentary Behavior, Dietary Habits, Organized Sports Participation, and Family and Peer Influence. Physical Activity and Obesity were both graded F. Two indicators could not be graded due to insufficient data and/or absence of a recommendation: Active and Outdoor Play, and Community and School Influence.

Conclusions:

The QAHK Report Card identified weaknesses and gaps in the evidence on physical activity and health in children and youth in Qatar. The quality of evidence was poor for some indicators, with some data collection methods of limited validity and reliability, or only available for a limited age range, so the grades are best estimates of the current situation in Qatar. Future surveys and research using objective physical activity measures will support the development of a second QAHK Report Card by 2018.

Open access

John J. Reilly, Avril Johnstone, Geraldine McNeill and Adrienne R. Hughes

Background:

The 2016 Active Healthy Kids Scotland Report Card aims to improve surveillance of physical activity (PA), facilitate international comparisons, and encourage evidence-informed PA and health policy.

Methods:

Active Healthy Kids Canada Report Card methodology was used: a search for data on child and adolescent PA and health published after the 2013 Scottish Report Card was carried out. Data sources were considered for grading if based on representative samples with prevalence estimates made using methods with low bias. Ten health behaviors/outcomes were graded on an A to F scale based on quintiles (prevalence meeting recommendations ≥80% graded A down to <20% graded F).

Results:

Three of the seven Health Behaviors and Outcomes received F or F- grades: Overall PA, Sedentary Behavior, and Obesity. Active and Outdoor Play and Organized Sport Participation could not be graded. Active Commuting to School was graded C, and Diet was graded D-. Family and Peer Influence was graded D-; Perceived Safety and Availability of Space for PA as well as the National Policy Environment were more favorable (both B).

Conclusions:

Grades were identical to those in 2013. Scotland has a generally favorable environment for PA, but children and adolescents have low PA and high sedentary behavior. Gaps in surveillance included lack of objectively measured PA, no surveillance of moderate-to-vigorous PA in children, summary surveillance data not expressed in ways which match recommendations (eg, for PA in young children; for screen-time), and no surveillance of Sport Participation, Active and Outdoor Play, or Sitting. Scottish policy does not include sedentary behavior at present.

Open access

Yang Liu, Yan Tang, Zhen-Bo Cao, Pei-Jie Chen, Jia-Lin Zhang, Zheng Zhu, Jie Zhuang, Yang Yang and Yue-Ying Hu

Background:

Internationally comparable evidence is important to advocate for young people’s physical activity. The aim of this article is to present the inaugural Shanghai (China) Report Card on Physical Activity for Children and Youth.

Methods:

Since no national data are available, the working group developed the survey questionnaire and carried out the school surveys for students (n = 71,404), parents (n = 70,346), and school administrators and teachers (n = 1398). The grades of 9 report card indicators were assigned in accordance with the survey results against a defined benchmark: A is 81% to 100%; B is 61% to 80%; C is 41% to 60%, D is 21% to 40%; F is 0% to 20%.

Results:

The 9 indicators were graded as follows: Overall Physical Activity Levels (F), Organized Sport Participation (F), Active Play (D-), Active Transportation (C-), Sedentary Behavior (F), Family and Peers (B), School (B+), Community and the Built Environment (D+), and Government (D).

Conclusions:

Levels of physical activity and sedentary behavior were low and below the respective recommended guidelines. Interventions and policies at the community level should be encouraged to promote physical activity and reduce sedentary behavior. Future national surveys should be encouraged to strengthen Shanghai’s Report Card on Physical Activity for Children and Youth.

Open access

Monika Uys, Susan Bassett, Catherine E. Draper, Lisa Micklesfield, Andries Monyeki, Anniza de Villiers, Estelle V. Lambert and the HAKSA 2016 Writing Group

Background:

We present results of the 2016 Healthy Active Kids South Africa (HAKSA) Report Card on the current status of physical activity (PA) and nutrition in South African youth. The context in which we interpret the findings is that participation in PA is a fundamental human right, along with the right to “attainment of the highest standard of health.”

Methods:

The HAKSA 2016 Writing Group was comprised of 33 authorities in physical education, exercise science, nutrition, public health, and journalism. The search strategy was based on peer-reviewed manuscripts, dissertations, and ‘gray’ literature. The core PA indicators are Overall Physical Activity Level; Organized Sport Participation; Active and Outdoor Play; Active Transportation; Sedentary Behaviors; Family and Peer Influences; School; Community and the Built Environment; and National Government Policy, Strategies, and Investment. In addition, we reported on Physical Fitness and Motor Proficiency separately. We also reported on nutrition indicators including Overweight and Under-nutrition along with certain key behaviors such as Fruit and Vegetable Intake, and policies and programs including School Nutrition Programs and Tuck Shops. Data were extracted and grades assigned after consensus was reached. Grades were assigned to each indicator ranging from an A, succeeding with a large majority of children and youth (81% to 100%); B, succeeding with well over half of children and youth (61% to 80%); C, succeeding with about half of children and youth (41% to 60%); D, succeeding with less than half but some children and youth (21% to 40%); and F, succeeding with very few children and youth (0% to 20%); INC is inconclusive.

Results:

Overall PA levels received a C grade, as we are succeeding with more than 50% of children meeting recommendations. Organized Sports Participation also received a C, and Government Policies remain promising, receiving a B. Screen time and sedentary behavior were a major concern. Under- and over-weight were highlighted and, as overweight is on the rise, received a D grade.

Conclusions:

In particular, issues of food security, obesogenic environments, and access to activity-supportive environments should guide social mobilization downstream and policy upstream. There is an urgent need for practice-based evidence based on evaluation of existing, scaled up interventions.

Open access

Yoonkyung Song, Hyuk In Yang, Eun-Young Lee, Mi-Seong Yu, Min Jae Kang, Hyun Joo Kang, Wook Song, YeonSoo Kim, Hyon Park, Han Joo Lee, Sang-hoon Suh, John C. Spence and Justin Y. Jeon

Background:

South Korea’s 2016 Report Card on Physical Activity for Children and Youth is the first assessment of physical activity according to the indicators set by Active Healthy Kids Global Alliance.

Methods:

National surveys were used as preferred sources of data. This was then supported by peer-reviewed papers and government reports identified by a systematic search of the literature written in English or Korean. A Research Working Group then graded indicators based on the collected evidence.

Results:

Each indicator was graded as follows: Overall Physical Activity, D-; Organized Sport and Physical Activity Participation, C-; Active Transport, C+; Sedentary Behavior, F; School, D; Government and Investment, C; Active Play, Physical Literacy, Family and Peers, and Community and Built Environment were graded INC (incomplete) due to lack of available evidence.

Conclusions:

Though the final grades of key indicators for South Korean children and youth are not satisfactory, increasing interests and investments have been demonstrated at a national level. More evidence is required for comprehensive assessment on all indicators to better inform policy and practice. This should be accompanied by the use of consistent criteria to contribute to global efforts for active healthy kids.

Open access

Blanca Roman-Viñas, Jorge Marin, Mairena Sánchez-López, Susana Aznar, Rosaura Leis, Raquel Aparicio-Ugarriza, Helmut Schroder, Rocío Ortiz-Moncada, German Vicente, Marcela González-Gross and Lluís Serra-Majem

Background:

The first Active Healthy Kids Spanish Report Card aims to gather the most robust information about physical activity (PA) and sedentary behavior of children and adolescents.

Methods:

A Research Working Group of experts on PA and sport sciences was convened. A comprehensive data search, based on a review of the literature, dissertations, gray literature, and experts’ nonpublished data, was conducted to identify the best sources to grade each indicator following the procedures and methodology outlined by the Active Healthy Kids Canada Report Card model.

Results:

Overall PA (based on objective and self-reported methods) was graded as D-, Organized Sports Participation as B, Active Play as C+, Active Transportation as C, Sedentary Behavior as D, School as C, and Family and Peers as Incomplete, Community and the Built Environment as Incomplete, and Government as Incomplete.

Conclusions:

Spanish children and adolescents showed low levels of adherence to PA and sedentary behavior guidelines, especially females and adolescents. There is a need to achieve consensus and harmonize methods to evaluate PA and sedentary behavior to monitor changes over time and to evaluate the effectiveness of policies to promote PA.

Open access

Christine Delisle Nyström, Christel Larsson, Bettina Ehrenblad, Hanna Eneroth, Ulf Eriksson, Marita Friberg, Maria Hagströmer, Anna Karin Lindroos, John J. Reilly and Marie Löf

Background:

The 2016 Swedish Report Card on Physical Activity (PA) for Children and Youth is a unique compilation of the existing physical and health related data in Sweden. The aim of this article is to summarize the procedure and results from the report card.

Methods:

Nationally representative surveys and individual studies published between 2005–2015 were included. Eleven PA and health indicators were graded using the Active Healthy Kids Canada grading system. Grades were assigned based on the percentage of children/youth meeting a defined benchmark (A: 81% to 100%, B: 61% to 80%, C: 41% to 60%, D: 21% to 40%, F: 0% to 20%, or incomplete (INC).

Results:

The assigned grades were Overall Physical Activity, D; Organized Sport Participation, B+; Active Play, INC; Active Transportation, C+; Sedentary Behaviors, C; Family and Peers, INC; School, C+; Community and the Built Environment, B; Government Strategies and Investments, B; Diet, C-; and Obesity, D.

Conclusions:

The included data provides some support that overall PA is too low and sedentary behavior is too high for almost all age groups in Sweden, even with the many national policies as well as an environment that is favorable to the promotion of PA.

Open access

Areekul Amornsriwatanakul, Kasem Nakornkhet, Piyawat Katewongsa, Chairat Choosakul, Tippawan Kaewmanee, Kurusart Konharn, Atchara Purakom, Anoma Santiworakul, Patraporn Sitilertpisan, Sonthaya Sriramatr, Araya Yankai, Michael Rosenberg and Fiona C. Bull

Background:

Physical activity (PA) is recognized as one of the core modifiable risk factors of noncommunicable diseases. However, little is known about PA in the Thai population, particularly in children. The report card (RC) project provided Thailand with an opportunity to assess PA behaviors in children. This paper summarizes the methodology, grading process, and the final grades of the Thai RC.

Methods:

A school-based survey was conducted to collect data from a nationally representative sample of children aged 6 to 17 years. Survey results provided the primary source for the RC. Nine indicators were graded using the Global Matrix 2.0 framework. Grading was undertaken by a national committee comprising experts from key stakeholders.

Results:

Grades ranged from F to B. Overall PA and Sedentary Behaviors both received the grade D-. Organized Sport Participation scored a C. Active Play scored the grade F. Active Transport and support from Family and Peers were both graded B. School, Community, and Government indicators were scored C.

Conclusions:

In Thai children, participation in PA and active play is very low; conversely, sedentary behaviors are high. These first data on patterns of activity for the Thailand RC will serve to guide national actions and advocacy aimed at increasing PA in children.