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Physical Activity Report Cards: Active Healthy Kids Global Alliance and the Lancet Physical Activity Observatory

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

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Global Matrix 2.0: Report Card Grades on the Physical Activity of Children and Youth Comparing 38 Countries

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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Introduction to the Global Matrix 2.0: Report Card Grades on the Physical Activity of Children and Youth Comparing 38 Countries

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

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Results from Colombia’s 2014 Report Card on Physical Activity for Children and Youth

Silvia A. González, Olga L. Sarmiento, Daniel D. Cohen, Diana M. Camargo, Jorge E. Correa, Diana C. Páez, and Robinson Ramírez-Vélez

Background:

Physical activity (PA) is central to the global agenda for the prevention on noncommunicable diseases (NCDs). Although 80% of NCDs occur in low-to-middle-income countries, the evidence on PA comes mainly from high-income countries. In this context, the report card for Colombia is an advocacy tool to help in the translation of evidence into concrete actions. The aims of this paper were two-fold: to present the methodology used to develop the first Report Card on Physical Activity in Colombian Children and Youth and to summarize the results.

Methods:

Twelve indicators of PA were graded using numerical grades (5, highest, to 1, lowest) based on data from national surveys and policy documents.

Results:

National policy and obesity indicators were graded “4,” while departmental policy and overweight indicators were graded “3.” Overall PA levels, sports participation, sedentary behaviors and nongovernment initiatives were graded “2,” and school influence was graded “1.” Active transportation, active play, low cardiorespiratory fitness, and family and community influence received an incomplete.

Conclusion:

PA levels are low and sedentary behaviors are high in Colombian children and youth. Although the prevalence of obesity in Colombia is lower compared with other Latin American countries, it is increasing. A rich legal framework and availability of institutional arrangements provide unique opportunities to bridge the gap between knowledge and practice that need to be evaluated.

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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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Active Healthy Kids Global Alliance Global Matrix 4.0—A Resource for Physical Activity Researchers

Mark S. Tremblay, Joel D. Barnes, Iryna Demchenko, Silvia A. Gonzalez, Javier Brazo-Sayavera, Jakub Kalinowski, Peter T. Katzmarzyk, Taru Manyanga, John J. Reilly, Stephen Heung Sang Wong, and Salomé Aubert

Background: This brief report provides an overview of the Active Healthy Kids Global Alliance (AHKGA); an introduction to the Global Matrix 4.0; an explanation of the value and opportunities that the AHKGA efforts and assets provide to the physical activity research, policy, practice, and advocacy community; an outline of the series of papers related to the Global Matrix 4.0 in this issue of the Journal of Physical Activity and Health; and an invitation for future involvement. Methods: The AHKGA was formed to help power the global movement to get kids moving. In 2019–2021, we recruited countries to participate in the Global Matrix 4.0, a worldwide initiative to assess, compare, and contrast the physical activity of children and adolescents. Results: A total of 57 countries/jurisdictions (hereafter referred to as countries for simplicity) were recruited. The current activities of the AHKGA are summarized. The overall findings of the Global Matrix 4.0 are presented in a series of papers in this issue of the Journal of Physical Activity and Health. Conclusions: The Global Matrix 4.0 and other assets of the AHKGA are publicly available, and physical activity researchers, practitioners, policy makers, and advocates are encouraged to exploit these resources to further their efforts.

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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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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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The International Impact of the Active Healthy Kids Global Alliance Physical Activity Report Cards for Children and Youth

Salomé Aubert, Joel D. Barnes, Megan L. Forse, Evan Turner, Silvia A. González, Jakub Kalinowski, Peter T. Katzmarzyk, Eun-Young Lee, Reginald Ocansey, John J. Reilly, Natasha Schranz, Leigh M. Vanderloo, and Mark S. Tremblay

Background: In response to growing concerns over high levels of physical inactivity among young people, the Active Healthy Kids Global Alliance developed a series of national Report Cards on physical activity for children and youth to advocate for the promotion of physical activity. This article provides updated evidence of the impact of the Report Cards on powering the movement to get children and youth moving globally. Methods: This assessment was performed using quantitative and qualitative sources of information, including surveys, peer-reviewed publications, e-mails, gray literature, and other sources. Results: Although it is still too early to observe a positive change in physical activity levels among children and youth, an impact on raising awareness and capacity building in the national and international scientific community, disseminating information to the general population and stakeholders, and on powering the movement to get kids moving has been observed. Conclusions: It is hoped that the Report Card activities will initiate a measurable shift in the physical activity levels of children and contribute to achieving the 4 strategic objectives of the World Health Organization Global Action Plan as follows: creating an active society, creating active environments, creating active lives, and creating active systems.

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

Silvia A. González, Maria A Castiblanco, Luis F. Arias-Gómez, Andrea Martinez-Ospina, Daniel D. Cohen, Gustavo A. Holguin, Adriana Almanza, Diana Marina Camargo Lemos, Jorge Enrique Correa-Bautista, Iván D. Escobar, Johnattan García, Rocio Gámez, Mauricio Garzon, Yaneth Herazo Beltrán, Hernan Hurtado, Oscar Lozano, Diana C. Páez, Robinson Ramírez-Vélez, Nubia Ruiz, Gustavo Tovar, and Olga L. Sarmiento

Background:

Physical activity (PA) is vital to the holistic development of young people. Regular participation in PA is associated with substantial benefits for health, cognitive function, and social inclusion. Recognizing the potential of PA in the context of the current peace process in Colombia, the purpose of this article is to present the methodology and results of Colombia’s second Report Card on PA for children and youth.

Methods:

A group of experts on PA graded 14 PA indicators based on data from national surveys and policy documents.

Results:

National and departmental policy indicators received a grade of B, while organized sport participation, overweight, obesity, community influence, and nongovernment initiatives indicators received a grade of C. Overall PA levels, active transportation, sedentary behaviors, and school influence received a grade of D. Active play, low physical fitness, and family influence received an Incomplete grade.

Conclusions:

PA levels are low and sedentary behaviors are high in Colombian children and youth, with notable geographic differences. A broad policy framework translated into specific actions could provide unique opportunities to bridge the gap between knowledge and practice, and contribute to social integration goals in a postconflict setting.