In 2012, the Global Observatory for Physical Activity (GoPA!) was established to provide information that would enable countries to initiate or improve research capacity, surveillance systems, program development, and policymaking to increase physical activity levels. Findings from the first GoPA! Country Cards showed an unequal distribution of physical activity surveillance, research productivity, and policy development and implementation around the world. Regular global monitoring of these factors, especially in countries with the largest data gaps, was recommended to combat the global pandemic of physical inactivity. After 6 years and using standardized methods, GoPA! is launching the second set of Country Cards based on data up to 2019 from 217 countries. Overall results showed that periodic national surveillance of physical activity was less common in low-income countries, compared with middle- and high-income countries. Large inequities were seen with more than a 50-fold difference in publications between high- and low-income countries and 32% of the countries worldwide had no physical activity policy. GoPA! has a critical role in facilitating evidence-based physical activity promotion building on international guidelines and the World Health Organization Global Action Plan. GoPA! will continue to monitor progress as we battle the global pandemic of physical inactivity.
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The GoPA! Second Set of Country Cards Informing Decision Making for a Silent Pandemic
Andrea Ramírez Varela and Michael Pratt
Moving Together to Advance Physical Activity Research in Low- and Middle-Income Countries: The Case of Latin America
Deborah Salvo, Andrea Ramírez Varela, and Alejandra Jáuregui
Introducing the Epidemiology Council of the International Society for Physical Activity and Health
Brigid M. Lynch, Andrea Ramirez Varela, and Terry Boyle
The Physical Activity Policy to Practice Disconnect
Michael Pratt, Andrea Ramirez Varela, and Adrian Bauman
Better Late Than Never?! Five Compelling Reasons for Putting Physical Activity in Low- and Middle-Income Countries High Up on the Public Health Research Agenda
Katja Siefken, Andrea Ramirez Varela, Temo Waqanivalu, and Nico Schulenkorf
Since 2020, the world has been navigating an epidemiologic transition with both infectious diseases (COVID-19) and noncommunicable diseases intertwined in complex and diverse ways. In fact, the pandemics of physical inactivity, noncommunicable diseases, and COVID-19 coincide in a tragically impactful ménage à trois with their detrimental long-term health consequences yet to be determined. We know that people in low- and middle-income countries not only have the highest risk of developing chronic diseases, they also develop the diseases at a younger age, they suffer longer, and they die earlier than people in high-income countries. This commentary features 5 compelling reasons for putting physical activity in low- and middle-income countries high up on the public health research agenda and calls for more commitment to inclusive and context-specific public health practices that are paired with locally relevant promotion and facilitation of PA practice, research, and policymaking.
Physical Inactivity and COVID-19: When Pandemics Collide
Andrea Ramirez Varela, Robert Sallis, Alex V. Rowlands, and James F. Sallis
Celebrating 10 Years of the Global Observatory for Physical Activity—GoPA!
Michael Pratt, Andrea Ramírez Varela, and Pedro C. Hallal
Physical Activity and Safety From Crime Among Adults: A Systematic Review
Inacio C. M. da Silva, Valerie L. C. Payne, Adriano Akira Hino, Andrea Ramirez Varela, Rodrigo S. Reis, Ulf Ekelund, and Pedro C. Hallal
Background:
The aim of this study was to review the evidence to date on the association between physical activity and safety from crime.
Methods:
Articles with adult populations of 500+ participants investigating the association between physical activity and safety from crime were included. A methodological quality assessment was conducted using an adapted version of the Downs and Black checklist.
Results:
The literature search identified 15,864 articles. After assessment of titles, abstracts and full-texts, 89 articles were included. Most articles (84.3%) were derived from high-income countries and only 3 prospective articles were identified. Articles presented high methodological quality. In 38 articles (42.7%), at least one statistically significant association in the expected direction was reported (ie, safety from crime was positively associated with physical activity). Nine articles (10.1%) found an association in the unexpected direction and 42 (47.2%) did not find statistically significant associations. The results did not change when we analyzed articles separately by sex, age, type of measurement, or domains of physical activity evaluated.
Conclusions:
The current evidence, mostly based on cross-sectional studies, suggests a lack of association between physical activity and safety from crime. Prospective studies and natural experiments are needed, particularly in areas with wide crime variability.
Worldwide Surveillance, Policy, and Research on Physical Activity and Health: The Global Observatory for Physical Activity
Andrea Ramirez Varela, Michael Pratt, Kenneth Powell, I-Min Lee, Adrian Bauman, Gregory Heath, Rafaela Costa Martins, Harold Kohl, and Pedro C. Hallal
Background:
The Global Observatory for Physical Activity (GoPA!) was launched in response to the physical inactivity pandemic. The aim of this article is to present current information about surveillance, policy, and research on physical activity (PA) and health worldwide.
Methods:
Information was collected for 217 countries. For 139 of these nations we identified a contact who confirmed information’s accuracy and completeness. Associations were calculated among surveillance, policy and research categories.
Results:
Of the 139 countries, 90.6% reported having completed 1 or more PA survey, but less than one-third had 3 or more. 106 included PA on a national plan, but only one-quarter of these were PA-specific. At least 1 peer reviewed publication was identified for 63.3% of the countries. Positive associations (P < .001) were found between research and policy (ρ = 0.35), research and surveillance (ρ = 0.41), and surveillance and policy (ρ = 0.31). Countries with a standalone plan were more likely to have surveillance. Countries with more research were more likely to have a standalone plan and surveillance.
Conclusions:
Surveillance, policy, and research indicators were positively correlated, suggesting that action at multiple levels tends to stimulate progress in other areas. Efforts to expand PA-related surveillance, policy, and research in lower income countries are needed.
Approaches to Improve Causal Inference in Physical Activity Epidemiology
Brigid M. Lynch, Suzanne C. Dixon-Suen, Andrea Ramirez Varela, Yi Yang, Dallas R. English, Ding Ding, Paul A. Gardiner, and Terry Boyle
Background: It is not always clear whether physical activity is causally related to health outcomes, or whether the associations are induced through confounding or other biases. Randomized controlled trials of physical activity are not feasible when outcomes of interest are rare or develop over many years. Thus, we need methods to improve causal inference in observational physical activity studies. Methods: We outline a range of approaches that can improve causal inference in observational physical activity research, and also discuss the impact of measurement error on results and methods to minimize this. Results: Key concepts and methods described include directed acyclic graphs, quantitative bias analysis, Mendelian randomization, and potential outcomes approaches which include propensity scores, g methods, and causal mediation. Conclusions: We provide a brief overview of some contemporary epidemiological methods that are beginning to be used in physical activity research. Adoption of these methods will help build a stronger body of evidence for the health benefits of physical activity.
