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Adapted Physical Activity Policies for Children and Adolescents in Brazil: Extension of the Para Report Card Brazil

Diego Augusto Santos Silva and Carolina Fernandes da Silva

Brazil is a country member of the Para Report Card, and Brazilian researchers have frequently published information on physical activity of children and adolescents. The current study aimed to analyze the policies for the promotion of adapted physical activity to Brazilian children and adolescents with disabilities. Official government information on adapted physical activity was analyzed from the official websites. Policies were analyzed based on the Para Report Card benchmarks, and after that we used the principles of SWOT (strengths, weaknesses, opportunities, and threats) to analyze the information. Adapted physical activity is not the main focus of any of the many policies to promote physical activity for children and adolescents. Based on the Para Report Card initiative, the score for this indicator in Brazil is D. Brazil needs to develop specific policies to promote physical activity adapted to the pediatric population with disabilities.

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Results From Brazil’s 2018 Report Card on Physical Activity for Children and Youth

Diego Augusto Santos Silva, Diego Giulliano Destro Christofaro, Gerson Luis de Moraes Ferrari, Kelly Samara da Silva, Nelson Nardo, Roberto Jerônimo dos Santos Silva, Rômulo Araújo Fernandes, and Valter Cordeiro Barbosa Filho

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“WOT” Do We Know and Do About Physical Activity of Children and Adolescents With Disabilities? A SWOT-Oriented Synthesis of Para Report Cards

Yeshayahu Hutzler, Sharon Barak, Salomé Aubert, Kelly Arbour-Nicitopoulos, Riki Tesler, Cindy Sit, Diego Augusto Santos Silva, Piritta Asunta, Jurate Pozeriene, José Francisco López-Gil, and Kwok Ng

The purpose was to synthesize information gathered from the interpretation and conclusion sections of the Global Matrix of Para Report Cards on the physical activity of children and adolescents with disabilities. The synthesis was based on the strengths, weaknesses, opportunities, and threats framework. The procedure consisted of three stages: (a) the application of the International Classification of Functioning, Disability and Health as the theoretical framework; (b) identifying and aligning Global Matrix indicators and benchmarks with the International Classification of Functioning, Disability and Health components through a Delphi approach; and (c) using content analysis to identify themes from specific report cards. Outcomes reveal that further attention toward including children and adolescents with disabilities in fitness assessments is needed as well as adapted assessment methods. Program availability, equipment and facilities, and professional training emerged as strengths but need further development to overcome weaknesses. Paralympic inspiration was an opportunity, whereas extreme weather conditions presented potential threats to physical activity participation among children and adolescents with disabilities.

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Economic Freedom, Climate Culpability, and Physical Activity Indicators Among Children and Adolescents: Report Card Grades From the Global Matrix 4.0

Eun-Young Lee, Patrick Abi Nader, Salomé Aubert, Silvia A. González, Peter T. Katzmarzyk, Asaduzzaman Khan, Wendy Y. Huang, Taru Manyanga, Shawnda Morrison, Diego Augusto Santos Silva, and Mark S. Tremblay

Background: Macrolevel factors such as economic and climate factors can be associated with physical activity indicators. This study explored patterns and relationships between economic freedom, climate culpability, and Report Card grades on physical activity-related indicators among 57 countries/jurisdictions participating in the Global Matrix 4.0. Methods: Participating countries/jurisdictions provided Report Card grades on 10 common indicators. Information on economic freedom and climatic factors were gathered from public data sources. Correlations between the key variables were provided by income groups (ie, low- and middle-income countries/jurisdictions and high-income countries/jurisdictions [HIC]). Results: HIC were more economically neoliberal and more responsible for climate change than low- and middle-income countries. Annual temperature and precipitation were negatively correlated with behavioral/individual indicators in low- and middle-income countries but not in HIC. In HIC, correlations between climate culpability and behavioral/individual and economic indicators were more apparent. Overall, poorer grades were observed in highly culpable countries/jurisdictions in the highly free group, while in less/moderately free groups, less culpable countries/jurisdictions showed poorer grades than their counterparts in their respective group by economic freedom. Conclusions: Global-level physical activity promotion strategies should closely evaluate different areas that need interventions tailored by income groups, with careful considerations for inequities in the global political economy and climate change.

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Association Between Physical Activity Indicators and Human Development Index at a National Level: Information From Global Matrix 4.0 Physical Activity Report Cards for Children and Adolescents

Diego Augusto Santos Silva, Salomé Aubert, Kwok Ng, Shawnda A. Morrison, Jonathan Y. Cagas, Riki Tesler, Dawn Tladi, Taru Manyanga, Silvia A. González, Eun-Young Lee, and Mark S. Tremblay

Background: The aim of this study was to explore the associations between the 10 key indicators of the Global Matrix 4.0 project and human development index (HDI) at a national level according to sex, age, area of residence, and ability levels. Methods: Information from the 57 countries/localities included in the Global Matrix 4.0 project was compiled and presented according to the HDI of each country/locality for each of the 10 key indicators. Grades were assigned based on the benchmarks of the Global Matrix 4.0 project ranged between “A+” (best performance) and “F” (worst performance). Results: The population subgroups of females, children, rural residents, with/without disabilities from countries/localities with higher HDI performed better in the organized sport and physical activity indicator than their peers from countries/localities with lower HDI. Children and adolescents living in rural areas of countries/localities with higher HDI showed better performance for active play, and children and adolescents living in urban areas of countries/localities with lower HDI showed better performance for the active transportation. Countries/localities with higher HDI showed better grades for sources of influence than the countries/localities with lower HDI. Conclusions: Physical activity patterns in some population subgroups of children and adolescents differed according to the development level of countries/localities.

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Results From Brazil’s 2016 Report Card on Physical Activity for Children and Youth

Nelson Nardo Jr., Diego Augusto Santos Silva, Gerson Luis de Moraes Ferrari, Edio Luiz Petroski, Ricardo Lucas Pacheco, Priscila Custódio Martins, Luis Carlos Oliveira, Timóteo Leandro Araújo, Anselmo Alexandre Mendes, Samara Pereira Brito Lazarin, Tamires Leal Cordeiro dos Santos, and Victor Matsudo

Background:

Very few studies have comprehensively analyzed the physical activity of children and adolescents in Brazil. The purpose of this article is to show the methodology and summarize findings from the first Brazilian Report Card on Physical Activity for Children and Youth.

Methods:

Three Brazilian research institutions coordinated the activities to develop the Brazilian 2016 Report Card. The data available were collected independently and then synthesized by the Research Work Group using the grade system developed for the First Global Matrix released in 2014, which included 9 indicators of physical activity. Where possible, grades were assigned based on the percentage of children and youth meeting each indicator: 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%; INC is incomplete data.

Results:

Among the 9 indicators, only 5 had sufficient data for grading. Overall Physical Activity received a C- grade, Active Transportation received a C+ grade, Sedentary Behavior received a D+ grade, and Government Strategies and Investments received a D grade.

Conclusions:

The low grades observed highlight the need for continued efforts aimed at improving physical activity in Brazilian children.

Open access

Report Card Grades on the Physical Activity of Children and Youth From 10 Countries With High Human Development Index: Global Matrix 3.0

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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Promoting Physical Activity Among Children and Adolescents With Disabilities: The Translation of Policy to Practice Internationally

Cindy Sit, Salomé Aubert, Catherine Carty, Diego Augusto Santos Silva, José Francisco López-Gil, Piritta Asunta, Yves Palad, Roselle Guisihan, Jeongmin Lee, Kelly P. Arbour Nicitopoulos, Leigh M. Vanderloo, Heidi Stanish, Justin Haegele, Piotr K. Urbański, Jurate Pozeriene, Yeshayahu Hutzler, and Kwok Ng

Background: Physical inactivity among children and adolescents with disabilities (CAWD) is a global public health issue. Policy efforts to promote physical activity (PA) among CAWD have increased. This study summarizes the international policy trend for promoting PA among CAWD, with behavioral and policy insights specific to CAWD from country/regional indicators from the Active Healthy Kids Global Alliance Matrix on Physical Activity for Children and Adolescents to determine policy translation into practice. Methods: International and national PA policy documents on CAWD were assessed. Data from the Global Matrix Para Report Cards on the behavioral and government indicators from 14 countries or regions (grouped by human development index) were reviewed and compared. Results: Policy instruments began promoting PA for CAWD in 1989 via the Convention on the Rights of the Child. International policy has been advocating PA specifically for CAWD recently. In 2020, the World Health Organization published specific PA guidelines for CAWD. Data from the 14 Para Report Car found 14 grades on the average behavioral indicator and 12 on the government indicator. A gap between the average behavioral indicator (D−) and the government indicator (C+) was found in the Para Report Card data. Conclusions: Although international policies are consistent in their attention to the needs of CAWD, national/regional policies vary. Coverage ranges from nonexistent to embedded in broader inclusion concepts. A gap in policies to promote PA of CAWD is prevalent and is more prominent in countries or regions with a lower human development index ranking.

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Global Matrix of Para Report Cards on Physical Activity of Children and Adolescents With Disabilities

Kwok Ng, Cindy Sit, Kelly Arbour-Nicitopoulos, Salomé Aubert, Heidi Stanish, Yeshayahu Hutzler, Diego Augusto Santos Silva, Mary-Grace Kang, José Francisco López-Gil, Eun-Young Lee, Piritta Asunta, Jurate Pozeriene, Piotr Kazimierz Urbański, Nicolas Aguilar-Farias, and John J. Reilly

This is an overview of the results from 14 countries or jurisdictions in a Global Matrix of Para Report Cards on physical activity (PA) of children and adolescents with disabilities. The methodology was based on the Active Healthy Kids Global Alliance’s Global Matrix 4.0. Data were aligned with 10 indicators (Overall PA, Organized Sport, Active Play, Active Transport, Physical Fitness, Sedentary Behavior, Family & Peers, Schools, Community & Environment, and Government) to produce Para Report Cards. Subsequently, there were 139 grades; 45% were incomplete, particularly for Active Play, Physical Fitness, and Family & Peers. Collectively, Overall PA was graded the lowest (F), with Schools and Government the highest (C). Disability-specific surveillance and research gaps in PA were apparent in 14 countries or jurisdictions around the world. More coverage of PA data in Para Report Cards is needed to serve as an advocacy tool to promote PA among children and adolescents with disabilities.

Open access

Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries

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.