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Chen-Kang Chang and Ching-Lin Wu

Introduction Recent national surveys in Taiwan revealed that a large proportion of children and youth did not engage in sufficient physical activity. The lack of physical activity in children and youth could lead to serious health and economic burden in the adulthood. The Chinese Taipei (Taiwan

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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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Martyn Standage, Hannah J. Wilkie, Russell Jago, Charlie Foster, Mary A. Goad and Sean P. Cumming

Background:

The Active Healthy Kids 2014 England Report Card aims to provide a systematic assessment of how England is performing in relation to engaging and facilitating physical activity (PA) in children and young people.

Methods:

The systematic methods and processes that underpin the Active Healthy Kids Canada Report Card were used and adapted. Data and evidence were consolidated, reviewed by a panel of content experts, and used to inform the assignment of letter grades (A, B, C, D, F) to 9 core indicators related to PA.

Results:

Children’s Overall Physical Activity received a grade of C/D. Active Transportation and Organized Sport Participation received grades of C and C-, respectively. The indicators of School and Community and the Built Environment were graded favorable with grades of A- and B, respectively. Active Play, Sedentary Behaviors, Family and Peers, and Government Strategies and Investments were graded as INC (incomplete) due to a lack of nationally representative data and/or as a result of data not mapping onto the benchmarks used to assign the grades.

Conclusions:

Substantial provision for PA opportunities in England exists. Yet more effort is required to maximize use of these resources to increase PA participation.

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Lisbeth Runge Larsen, Jens Troelsen, Kasper Lund Kirkegaard, Søren Riiskjær, Rikke Krølner, Lars Østergaard, Peter Lund Kristensen, Niels Christian Møller, Bjørn Friis Neerfeldt Christensen, Jens-Ole Jensen, Charlotte Østergård and Thomas Skovgaard

Background:

The first Danish Report Card on Physical Activity (PA) for Children and Youth describes Denmark’s efforts in promoting and facilitating PA and PA opportunities for children and youth.

Methods:

The report card relies primarily on a synthesis of the best available research and policy strategies identified by the Report Card Research Committee consisting of a wide presentation of researchers and experts within PA health behaviors and policy development. The work was coordinated by Research and Innovation Centre for Human Movement and Learning situated at the University of Southern Denmark and the University College Lillebaelt. Nine PA indicators were graded using the Active Healthy Kids Canada Report Card development process.

Results:

Grades from A (highest) to F (lowest) varied in Denmark as follows: 1) Overall Physical Activity (D+), 2) Organized Sport Participation (A), 3) Active Play (INC; incomplete), 4) Active Transportation (B), 5) Sedentary Behaviors (INC), 6) Family and Peers (INC), 7) School (B), 8) Community and the Built Environment (B+), and 9) Government strategies and investments (A-).

Conclusions:

A large proportion of children in Denmark do not meet the recommendations for PA despite the favorable investments and intensions from the government to create good facilities and promote PA.

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Helena Kruusamäe, Merike Kull, Kerli Mooses, Eva-Maria Riso and Jaak Jürimäe

Background:

The 2016 Report Card on Physical Activity for Children and Youth, the first of its kind, aims to set baseline physical activity (PA) indicators using the Active Healthy Kids Global Alliance grading system.

Methods:

A research work group analyzed and selected data for the grade assignment meeting (GAM). During the GAM, 17 leading researchers and policy experts from Estonia assessed the data and assigned grades for each of the 9 PA indicators. In addition, recommendations were provided for further actions to improve the grades.

Results:

Grades from A (highest) to F (lowest) were assigned as follows: 1) Overall PA (F); 2) Organized Sport (C); 3) Active Play [incomplete data (INC)]; 4) Active Transportation (INC); 5) Sedentary Behaviors (F); 6) Family and Peers (C); 7) School (C); 8) Community and the Built Environment (B); and 9) Government (C). An indicator was marked as incomplete (INC) when there was a lack of representative quality data.

Conclusions:

Evidence suggests that PA levels of Estonian children remain very low, despite moderately supportive social, environmental, and regulatory factors. There are many challenges to overcome in supporting and promoting PA of children and youth (eg, cross-sectional cooperation, implementing interventions, changing social norms, empowerment of parents and educational institutions).

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Reginald Ocansey, Richmond Aryeetey, Seidu Sofo, Margaret Badasu Delali, Prince Pambo and Vida Korleki Nyawornota

Background:

Limited evidence exists on indicators of physical activity (PA) and guidelines for children and youth in Ghana, despite the growing burden of physical inactivity, obesity, and related morbidity. A baseline description of PA indicators of Ghanaian children and youth is hereby presented in the 2014 Ghanaian Physical Activity Report Card.

Methods:

Data for the report card were obtained from a very limited available literature on PA among children and youth in Ghana. PA experts independently assigned grades to indicators based on available evidence, which were then harmonized and agreed to by group consensus.

Results:

The report card is based on limited evidence. Thus, 2 indicators were not graded (Active Play, and Family and Peer Support). For sedentary behavior, a B grade was assigned based on evidence from the 2012 Ghana School Health Survey which indicated that 21% of children and youth were sedentary. Organized Sports was graded a C, while the remainder of indicators (Overall PA levels, Active Transportation, School, Community, and Government) were graded a D.

Conclusions:

About one-third of Ghanaian children and youth engage in inadequate PA. More research on PA behavior and enabling environments is needed to better grade the indicators of PA in the future and to inform policy and interventions in Ghana. Appropriate school physical education and after-school sports policies and programs are warranted.

Open access

Mouza Al Zaabi, Syed Mahboob Shah, Mohamud Sheek-Hussein, Abdishakur Abdulle, Abdulla Al Junaibi and Tom Loney

Background:

The Active Healthy Kids 2016 United Arab Emirates (UAE) Report Card provides a systematic evaluation of how the UAE is performing in supporting and engaging physical activity (PA) in children and adolescents.

Methods:

The Active Healthy Kids Global Alliance framework and standardized set of procedures were used to perform the systematic assessment of PA in UAE youth and children. Indicator grades were based on the proportion of children and youth achieving a defined benchmark: A = 81% to 100%; B = 61% to 80%; C = 41% to 60%; D = 21% to 40%; F = 0% to 20%; INC = incomplete data.

Results:

Overall Physical Activity Level and Active Transportation both received a grade of D-/F-. Sedentary Behavior and Family and Peers both received a C- minus grade and School was graded D. Minus grades indicate PA disparities related to age, gender, nationality, socioeconomic status, and geographic location. Government Strategies and Investments received a B+ grade. Sport Participation, Active Play, and Community and the Built Environment were graded INC due to a lack of nationally representative data for all 7 emirates.

Conclusions:

The majority of UAE children are not achieving the daily recommended level of PA. The UAE leadership has invested significant resources into improving PA through school- and community-based PA interventions; however, inter- and intraemirate population-based strategies remain fragmented.

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Ralph Maddison, Samantha Marsh, Erica Hinckson, Scott Duncan, Sandra Mandic, Rachael Taylor and Melody Smith

Background:

In this article, we report the grades for the second New Zealand Report Card on Physical Activity for Children and Youth, which represents a synthesis of available New Zealand evidence across 9 core indicators.

Methods:

An expert panel of physical activity (PA) researchers collated and reviewed available nationally representative survey data between March and May 2016. In the absence of new data, (2014–2016) regional level data were used to inform the direction of existing grades. 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:

Overall PA, Active Play, and Government Initiatives were graded B-; Community Environments was graded B; Sport Participation and School Environment received a C+; Sedentary Behaviors and Family/Peer Support were graded C; and Active Travel was graded C-.

Conclusions:

Overall PA participation was satisfactory for young children but not for youth. The grade for PA decreased slightly from the 2014 report card; however, there was an improvement in grades for built and school environments, which may support regional and national-level initiatives for promoting PA.

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Susan A. Carlson, Roxanna Guide, Thomas L. Schmid, Latetia V. Moore, Danielle T. Barradas and Janet E. Fulton

Background:

Street-scale urban design policies are recommended to increase physical activity in communities. Our purpose was to examine U.S. public support for local street-scale urban design features and policies.

Methods:

Analysis is based on a cross-sectional national sample of adults (n = 4682) participating in the 2006 HealthStyles mail survey.

Results:

About 57% of adults rated local street-scale urban design as highly important in determining the amount of physical activity they obtain. Adjusted odds of rating neighborhood features as having high importance were higher in people aged ≥65 years versus those <65 and minority racial/ethnic groups versus non-Hispanic whites. Two-thirds of adults were willing to take civic action to support local street-scale urban design policy. Adjusted odds of being willing to take any action versus none was higher in non-Hispanic blacks and Hispanics versus non-Hispanic whites, was higher in those with household incomes ≥$60,000 versus ≤$15,000 per year, and increased as education and perceived importance of neighborhood features increased.

Conclusions:

There are high levels of public support for local street-scale urban design policies; however, demographic differences exist in the level of support. These differences are important considerations for policymakers and for those designing community programs targeting street-scale urban design features and policies.

Open access

Razinah Sharif, Kar Hau Chong, Nur Hadiyani Zakaria, Min Li Ong, John J. Reilly, Jyh Eiin Wong, Hazizi Abu Saad and Bee Koon Poh

Background:

The 2016 Malaysia Active Healthy Kids Report Card aims to collect, assess, and grade current and comprehensive data on physical activity (PA) and associated factors in Malaysian children and adolescents aged 5 to 17 years.

Methods:

This report card was developed following the Active Healthy Kids Canada Report Card protocol. The Research Working Group identified the core matrices, assessed the key data sources, and evaluated the evidence gathered for grade assignments. A grade was assigned to each indicator by comparing the best available evidence against relevant benchmark using a standardized grading scheme.

Results:

Overall Physical Activity, Active Transportation, and Sedentary Behavior were assigned the D grade. The lowest grade of F was assigned to Diet, while School and Government Strategies and Investments were graded higher with a B. Five indicators were assigned INC (incomplete) due to a lack of representative data.

Conclusions:

The report card demonstrates that Malaysian children and adolescents are engaging in low levels of PA and active commuting, high levels of screen time, and have extremely low compliance with dietary recommendations. More efforts are needed to address the root causes of physical inactivity while increasing the opportunities for children and adolescents to be more physically active.