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Mark S. Tremblay, Joel D. Barnes and Jennifer Cowie Bonne

For 20 years Active Healthy Kids Canada (AHKC) has worked to inspire the country to engage all children and youth in physical activity (PA). The primary vehicle to achieve this is the AHKC Report Card on Physical Activity for Children and Youth, which has been released annually since 2005. Using 10 years of experience with this knowledge translation and synthesis mechanism, this paper aggregates and consolidates diverse evidence demonstrating the impact of the Report Card and related knowledge translation activities. Over the years many evaluations, consultations, assessments, and surveys have helped inform changes in the Report Card to improve its impact. Guided by a logic model, the various assessments have traversed areas related to distribution and reach, meeting stakeholder needs, use of the Report Card, its influence on policy, and advancing the mission of AHKC. In the past 10 years, the Report Card has achieved > 1 billion media impressions, distributed > 120,000 printed copies and > 200,000 electronic copies, and benefited from a collective ad value > $10 million. The Report Card has been replicated in 14 countries, 2 provinces, 1 state and 1 city. AHKC has received consistent positive feedback from stakeholders and endusers, who reported that the Report Card has been used for public awareness/education campaigns and advocacy strategies, to strengthen partnerships, to inform research and program design, and to advance and adjust policies and strategies. Collectively, the evidence suggests that the Report Card has been successful at powering the movement to get kids moving, and in achieving demonstrable success on immediate and intermediate outcomes, although the long-term goal of improving the PA of Canadian children and youth remains to be realized.

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John J. Reilly, Smita Dick, Geraldine McNeill and Mark S. Tremblay

Background:

The Active Healthy Kids Scotland Report Card aims to consolidate existing evidence, facilitate international comparisons, encourage more evidence-informed physical activity and health policy, and improve surveillance of physical activity.

Methods:

Application of the Active Healthy Kids Canada Report Card process and methodology to Scotland, adapted to Scottish circumstances and availability of data.

Results:

The Active Healthy Kids Scotland Report Card 2013 consists of indicators of 7 Health Behaviors and Outcomes and 3 Influences on Health Behaviors and Outcomes. Grades of F were assigned to Overall Physical Activity, Sedentary Behavior (recreational screen time), and Obesity Prevalence. A C was assigned to Active Transportation and a D- was assigned to Diet. Two indicators, Active and Outdoor Play and Organized Sport Participation, could not be graded. Among the Influences, Family Influence received a D, while Perceived Safety, Access, and Availability of Spaces for Physical Activity and the National Policy Environment graded more favorably with a B.

Conclusions:

The Active Healthy Kids Canada process and methodology was readily generalizable to Scotland. The report card illustrated low habitual physical activity and extremely high levels of screen-based sedentary behavior, and highlighted several opportunities for improved physical activity surveillance and promotion strategies.

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Lucy-Joy M. Wachira, Stella K. Muthuri, Mark S. Tremblay and Vincent O. Onywera

Background:

The report card presents available evidence on the physical activity (PA) and body weight status of Kenyan children and youth. It highlights areas where Kenya is succeeding and those in which more action is needed.

Methods:

Comprehensive review and analysis of available data on core indicators for Kenyan children and youth 5−17 years were conducted. The grading system used was based on a set of specific criteria and existing grading schemes from similar report cards in other countries.

Results:

Of the 10 core indicators discussed, body composition was favorable (grade B) while overall PA levels, organized sport participation, and active play were assigned grades of C. Active transportation and sedentary behaviors were also favorable (grade B). Family/peers, school, governmental and nongovernmental strategies were graded C.

Conclusions:

The majority of Kenyan children and youth have healthy body composition levels and acceptable sedentary time, but are not doing as well in attaining the World Health Organization (WHO) recommendation on PA. Although Kenya seems to be doing well in most indicators compared with some developed countries, there is a need for action to address existing trends toward unhealthy lifestyles. More robust and representative data for all indicators are required.

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Marcella Burghard, Karlijn Knitel, Iris van Oost, Mark S. Tremblay, Tim Takken and the Dutch Physical Activity Report Card Study Group

Background:

The Active Healthy Kids the Netherlands (AHKN) Report Card consolidates and translates research and assesses how the Netherlands is being responsible in providing physical activity (PA) opportunities for children and youth (<18 years). The primary aim of this article is to summarize the results of the 2016 AHKN Report Card.

Methods:

Nine indicators were graded using the Active Healthy Kids Global Alliance 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: Overall Physical Activity Levels, D; Organized Sport Participation, B; Active Play, B; Active Transportation, A; Sedentary Behaviors, C; Family and Peers, B; School, C; Community and the Built Environment, A; Government Strategies and Investments, INC.

Conclusions:

Sedentary behavior and overall PA levels are not meeting current guidelines. However, the Dutch youth behaviors in sports, active transportation, and active play are satisfactory. Several modifiable factors of influence might be enhanced to improve these indicators or at least prevent regression. Although Dutch children accumulate a lot of daily PA through cycling, it is not enough to meet the current national PA guidelines of 60 minutes of moderate-to-vigorous PA per day.

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Mark S. Tremblay, Silvia A. Gonzalez, Peter T. Katzmarzyk, Vincent O. Onywera, John J. Reilly and Grant Tomkinson

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Taru Manyanga, Daga Makaza, Carol Mahachi, Tholumusa F. Mlalazi, Vincent Masocha, Paul Makoni, Eberhard Tapera, Bhekuzulu Khumalo, Sipho H. Rutsate and Mark S. Tremblay

Background:

The report card was a synthesis of the best available evidence on the performance of Zimbabwean children and youth on key physical activity (PA) indicators. The aim of this article was to summarize the results from the 2016 Zimbabwe Report Card.

Methods:

The Report Card Working Group gathered and synthesized the best available evidence, met, discussed and assigned grades to 10 indicators based on the Active Healthy Kids Global Alliance global matrix grading system.

Results:

The indicators were graded as follows: overall PA (C+), organized sport participation (B), active play (D+), active transportation (A-), sedentary behaviors (B), school (D), family and peers (Incomplete), community and the built environment (F), government (D) and nongovernmental organizations (Incomplete).

Conclusions:

Although the majority of children used active transport, played organized sports and engaged in acceptable levels of PA, most of them did not meet the recommended hours of unstructured/unorganized play per day. At present, there are limited data to accurately inform the Zimbabwe Report Card therefore studies employing robust research designs with representative samples are needed. Zimbabwe also needs to prioritize policies and investments that promote greater and safe participation in PA among children and youth.

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Mark S. Tremblay, Joel D. Barnes, Silvia A. González, Peter T. Katzmarzyk, Vincent O. Onywera, John J. Reilly, Grant R. Tomkinson and the Global Matrix 2.0 Research Team

The Active Healthy Kids Global Alliance organized the concurrent preparation of Report Cards on the physical activity of children and youth in 38 countries from 6 continents (representing 60% of the world’s population). Nine common indicators were used (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and the Built Environment, and Government Strategies and Investments), and all Report Cards were generated through a harmonized development process and a standardized grading framework (from A = excellent, to F = failing). The 38 Report Cards were presented at the International Congress on Physical Activity and Public Health in Bangkok, Thailand on November 16, 2016. The consolidated findings are summarized in the form of a Global Matrix demonstrating substantial variation in grades both within and across countries. Countries that lead in certain indicators often lag in others. Average grades for both Overall Physical Activity and Sedentary Behavior around the world are D (low/poor). In contrast, the average grade for indicators related to supports for physical activity was C. Lower-income countries generally had better grades on Overall Physical Activity, Active Transportation, and Sedentary Behaviors compared with higher-income countries, yet worse grades for supports from Family and Peers, Community and the Built Environment, and Government Strategies and Investments. Average grades for all indicators combined were highest (best) in Denmark, Slovenia, and the Netherlands. Many surveillance and research gaps were apparent, especially for the Active Play and Family and Peers indicators. International cooperation and cross-fertilization is encouraged to address existing challenges, understand underlying determinants, conceive innovative solutions, and mitigate the global childhood inactivity crisis. The paradox of higher physical activity and lower sedentary behavior in countries reporting poorer infrastructure, and lower physical activity and higher sedentary behavior in countries reporting better infrastructure, suggests that autonomy to play, travel, or chore requirements and/or fewer attractive sedentary pursuits, rather than infrastructure and structured activities, may facilitate higher levels of physical activity.

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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.

Open access

Joel D. Barnes, Christine Cameron, Valerie Carson, Jean-Philippe Chaput, Rachel C. Colley, Guy E.J. Faulkner, Ian Janssen, Roger Kramers, Travis J. Saunders, John C. Spence, Patricia Tucker, Leigh M. Vanderloo and Mark S. Tremblay