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Casey E. Gray, Joel D. Barnes, Jennifer Cowie Bonne, Christine Cameron, Jean-Philippe Chaput, Guy Faulkner, Ian Janssen, Peter T. Katzmarzyk, Angela M. Kolen, Stephen R. Manske, Art Salmon, John C. Spence, Brian W. Timmons, and Mark S. Tremblay

Background:

The Active Healthy Kids Canada (AHKC) Report Card consolidates and translates research and assesses how Canada is being responsible in providing physical activity opportunities for children (3- to 11-years-old) and youth (12- to 17-years-old). The primary aim of this article is to summarize the results of the 2014 AHKC 10th Anniversary Report Card.

Methods:

Ten physical activity indicators were graded using the AHKC Report Card development process, which includes a synthesis of the best available research, surveillance, policy and practice findings, and expert consensus.

Results:

Grades assigned were for: ‘Behaviors that Contribute to Overall Physical Activity Levels’ (Overall Physical Activity Levels, D-; Organized Sport Participation, C+; Active Play, INCOMPLETE; Active Transportation, D; Sedentary Behaviors, F), ‘Settings and Sources of Influence’ (Family and Peers, C; School, C+; and Community and the Built Environment, B+), and ‘Strategies and Investments’ (Government Strategies and Investments, C; and Non-Government Strategies and Investments, A-).

Conclusions:

Despite good availability of policies, programs, and infrastructure, the overall physical activity levels of Canadian children and youth remain low while sedentary behavior levels remain high. As with many nations, there is room for improvement in most physical activity behaviors and some sources of influence.

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Claire E. Francis, Patricia E. Longmuir, Charles Boyer, Lars Bo Andersen, Joel D. Barnes, Elena Boiarskaia, John Cairney, Avery D. Faigenbaum, Guy Faulkner, Beth P. Hands, John A. Hay, Ian Janssen, Peter T. Katzmarzyk, Han C. G. Kemper, Duane Knudson, Meghann Lloyd, Thomas L. McKenzie, Tim S. Olds, Jennifer M. Sacheck, Roy J. Shephard, Weimo Zhu, and Mark S. Tremblay

Background:

The Canadian Assessment of Physical Literacy (CAPL) was conceptualized as a tool to monitor children’s physical literacy. The original model (fitness, activity behavior, knowledge, motor skill) required revision and relative weights for calculating/interpreting scores were required.

Methods:

Nineteen childhood physical activity/fitness experts completed a 3-round Delphi process. Round 1 was open-ended questions. Subsequent rounds rated statements using a 5-point Likert scale. Recommendations were sought regarding protocol inclusion, relative importance within composite scores and score interpretation.

Results:

Delphi participant consensus was achieved for 64% (47/73) of statement topics, including a revised conceptual model, specific assessment protocols, the importance of longitudinal tracking, and the relative importance of individual protocols and composite scores. Divergent opinions remained regarding the inclusion of sleep time, assessment/scoring of the obstacle course assessment of motor skill, and the need for an overall physical literacy classification.

Conclusions:

The revised CAPL model (overlapping domains of physical competence, motivation, and knowledge, encompassed by daily behavior) is appropriate for monitoring the physical literacy of children aged 8 to 12 years. Objectively measured domains (daily behavior, physical competence) have higher relative importance. The interpretation of CAPL results should be reevaluated as more data become available.

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Tiago V. Barreira, Stephanie T. Broyles, Catrine Tudor-Locke, Jean-Philippe Chaput, Mikael Fogelholm, Gang Hu, Rebecca Kuriyan, Estelle V. Lambert, Carol A. Maher, José A. Maia, Timothy Olds, Vincent Onywera, Olga L. Sarmiento, Martyn Standage, Mark S. Tremblay, Peter T. Katzmarzyk, and for the ISCOLE Research Group

Background: To determine if children’s moderate to vigorous physical activity (MVPA) and sedentary time varied across levels of household income in countries at different levels of Human Development Index (HDI), consistent with the theory of epidemiological transition. Methods: Data from 6548 children (55% girls) aged 9–11 years from 12 countries at different HDI levels are used in this analysis to assess MVPA and sedentary time (measured using ActiGraph accelerometers) across levels of household income. Least-square means are estimated separately for boys and girls at the estimated 10th, 50th, and 90th percentiles of HDI for the sample. Results: For boys, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (both P < .002). For girls, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (all P < .01) and positively related with income at the 90th percentile (P = .04). Sedentary time is positively associated with income at the 10th percentile of HDI for boys (P = .03), but not for girls. Conclusions: Results support the possibility of an epidemiological transition in physical activity, with lower levels of MVPA observed at opposite levels of income depending on the HDI percentile. This phenomenon was not observed for sedentary time.

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Richard Larouche, Emily F. Mire, Kevin Belanger, Tiago V. Barreira, Jean-Philippe Chaput, Mikael Fogelholm, Gang Hu, Estelle V. Lambert, Carol Maher, José Maia, Tim Olds, Vincent Onywera, Olga L. Sarmiento, Martyn Standage, Catrine Tudor-Locke, Peter T. Katzmarzyk, Mark S. Tremblay, and For the ISCOLE Research Group

Purpose: This study investigated the relationship between outdoor time and physical activity (PA), sedentary time (SED), and body mass index z scores among children from 12 lower-middle-income, upper-middle-income, and high-income countries. Methods: In total, 6478 children (54.4% girls) aged 9–11 years participated. Outdoor time was self-reported, PA and SED were assessed with ActiGraph GT3X+ accelerometers, and height and weight were measured. Data on parental education, neighborhood collective efficacy, and accessibility to neighborhood recreation facilities were collected from parent questionnaires. Country latitude and climate statistics were collected through national weather data sources. Gender-stratified multilevel models with parental education, climate, and neighborhood variables as covariates were used to examine the relationship between outdoor time, accelerometry measures, and body mass index z scores. Results: Each additional hour per day spent outdoors was associated with higher moderate- to vigorous-intensity PA (boys: +2.8 min/d; girls: +1.4 min/d), higher light-intensity PA (boys: +2.0 min/d; girls: +2.3 min/d), and lower SED (boys: −6.3 min/d; girls: −5.1 min/d). Effect sizes were generally weaker in lower-middle-income countries. Outdoor time was not associated with body mass index z scores. Conclusions: Outdoor time was associated with higher PA and lower SED independent of climate, parental education, and neighborhood variables, but effect sizes were small. However, more research is needed in low- and middle-income countries.

Open access

Silvia A. González, Joel D. Barnes, Patrick Abi Nader, Dolores Susana Andrade Tenesaca, Javier Brazo-Sayavera, Karla I. Galaviz, Marianella Herrera-Cuenca, Piyawat Katewongsa, Juan López-Taylor, Yang Liu, Bilyana Mileva, Angélica María Ochoa Avilés, Diego Augusto Santos Silva, Pairoj Saonuam, and Mark S. Tremblay

Background: The Global Matrix 3.0 brings together the Report Card grades for 10 physical activity indicators for children and youth from 49 countries. This study describes and compares the Global Matrix 3.0 findings among 10 countries with high Human Development Index. Methods: Report Cards on physical activity indicators were developed by each country following a harmonized process. Countries informed their Report Cards with the best and most recent evidence available. Indicators were graded using a common grading rubric and benchmarks established by the Active Healthy Kids Global Alliance. A database of grades from the countries was compiled, and letter grades were converted to numerical equivalents. Descriptive statistics and scores for groups of indicators were calculated, and correlation analyses were conducted. Results: Grades for the 10 countries clustered around “D” ranging from “F” to “B+.” Active Transportation had the highest average grade (“C”), whereas Overall Physical Activity had the lowest average grade (“D-”). Low grades were observed for both behavioral and sources of influence indicators. Conclusions: In the context of social and economical changes of high- Human Development Index countries, urgent actions to increase physical activity among children and youth are required. Surveillance and monitoring efforts are required to fill research gaps.

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Mark S. Tremblay, Casey E. Gray, Kingsley Akinroye, Dierdre M. Harrington, Peter T. Katzmarzyk, Estelle V. Lambert, Jarmo Liukkonen, Ralph Maddison, Reginald T. Ocansey, Vincent O. Onywera, Antonio Prista, John J. Reilly, María del Pilar Rodríguez Martínez, Olga L. Sarmiento Duenas, Martyn Standage, and Grant Tomkinson

The Active Healthy Kids Canada (AHKC) Report Card on Physical Activity for Children and Youth has been effective in powering the movement to get kids moving by influencing priorities, policies, and practice in Canada. The AHKC Report Card process was replicated in 14 additional countries from 5 continents using 9 common indicators (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and Built Environment, and Government Strategies and Investments), a harmonized process and a standardized grading framework. The 15 Report Cards were presented at the Global Summit on the Physical Activity of Children in Toronto on May 20, 2014. The consolidated findings are summarized here in the form of a global matrix of grades. There is a large spread in grades across countries for most indicators. Countries that lead in certain indicators lag in others. Overall, the grades for indicators of physical activity (PA) around the world are low/poor. Many countries have insufficient information to assign a grade, particularly for the Active Play and Family and Peers indicators. Grades for Sedentary Behaviors are, in general, better in low income countries. The Community and Built Environment indicator received high grades in high income countries and notably lower grades in low income countries. There was a pattern of higher PA and lower sedentary behavior in countries reporting poorer infrastructure, and lower PA and higher sedentary behavior in countries reporting better infrastructure, which presents an interesting paradox. Many surveillance and research gaps and weaknesses were apparent. International cooperation and cross-fertilization is encouraged to tackle existing challenges, understand underlying mechanisms, derive innovative solutions, and overcome the expanding childhood inactivity crisis.

Open access

Salomé Aubert, Joel D. Barnes, Nicolas Aguilar-Farias, Greet Cardon, Chen-Kang Chang, Christine Delisle Nyström, Yolanda Demetriou, Lowri Edwards, Arunas Emeljanovas, Aleš Gába, Wendy Y. Huang, Izzeldin A.E. Ibrahim, Jaak Jürimäe, Peter T. Katzmarzyk, Agata Korcz, Yeon Soo Kim, Eun-Young Lee, Marie Löf, Tom Loney, Shawnda A. Morrison, Jorge Mota, John J. Reilly, Blanca Roman-Viñas, Natasha Schranz, John Scriven, Jan Seghers, Thomas Skovgaard, Melody Smith, Martyn Standage, Gregor Starc, Gareth Stratton, Tim Takken, Tuija Tammelin, Chiaki Tanaka, David Thivel, Richard Tyler, Alun Williams, Stephen H.S. Wong, Paweł Zembura, and Mark S. Tremblay

Background: To better understand the childhood physical inactivity crisis, Report Cards on physical activity of children and youth were prepared concurrently in 30 very high Human Development Index countries. The aim of this article was to present, describe, and compare the findings from these Report Cards. Methods: The Report Cards were developed using a harmonized process for data gathering, assessing, and assigning grades to 10 common physical activity indicators. Descriptive statistics were calculated after converting letter grades to interval variables, and correlational analyses between the 10 common indicators were performed using Spearman’s rank correlation coefficients. Results: A matrix of 300 grades was obtained with substantial variations within and between countries. Low grades were observed for behavioral indicators, and higher grades were observed for sources of influence indicators, indicating a disconnect between supports and desired behaviors. Conclusion: This analysis summarizes the level and context of the physical activity of children and youth among very high Human Development Index countries, and provides additional evidence that the situation regarding physical activity in children and youth is very concerning. Unless a major shift to a more active lifestyle happens soon, a high rate of noncommunicable diseases can be anticipated when this generation of children reaches adulthood.

Open access

Salomé Aubert, Joel D. Barnes, Chalchisa Abdeta, Patrick Abi Nader, Ade F. Adeniyi, Nicolas Aguilar-Farias, Dolores S. Andrade Tenesaca, Jasmin Bhawra, Javier Brazo-Sayavera, Greet Cardon, Chen-Kang Chang, Christine Delisle Nyström, Yolanda Demetriou, Catherine E. Draper, Lowri Edwards, Arunas Emeljanovas, Aleš Gába, Karla I. Galaviz, Silvia A. González, Marianella Herrera-Cuenca, Wendy Y. Huang, Izzeldin A.E. Ibrahim, Jaak Jürimäe, Katariina Kämppi, Tarun R. Katapally, Piyawat Katewongsa, Peter T. Katzmarzyk, Asaduzzaman Khan, Agata Korcz, Yeon Soo Kim, Estelle Lambert, Eun-Young Lee, Marie Löf, Tom Loney, Juan López-Taylor, Yang Liu, Daga Makaza, Taru Manyanga, Bilyana Mileva, Shawnda A. Morrison, Jorge Mota, Vida K. Nyawornota, Reginald Ocansey, John J. Reilly, Blanca Roman-Viñas, Diego Augusto Santos Silva, Pairoj Saonuam, John Scriven, Jan Seghers, Natasha Schranz, Thomas Skovgaard, Melody Smith, Martyn Standage, Gregor Starc, Gareth Stratton, Narayan Subedi, Tim Takken, Tuija Tammelin, Chiaki Tanaka, David Thivel, Dawn Tladi, Richard Tyler, Riaz Uddin, Alun Williams, Stephen H.S. Wong, Ching-Lin Wu, Paweł Zembura, and Mark S. Tremblay

Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.