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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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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

activity and its correlates, the Global Matrix of Report Card grades on physical activity was launched for the first time in 2014. 16 Physical activity Report Cards were developed based on the Canadian Report Card model, 17 using a harmonized process for data gathering, assessing, and assigning grades to

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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

– 23 This international effort has been consolidated in the creation of a “Global Matrix” of grades, which has compiled and compared grades across physical activity–related indicators for 15, 38, and 49 countries in its first, second, and third versions, respectively. 21 – 23 As the Global Matrix

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Taru Manyanga, Joel D. Barnes, Chalchisa Abdeta, Ade F. Adeniyi, Jasmin Bhawra, Catherine E. Draper, Tarun R. Katapally, Asaduzzaman Khan, Estelle Lambert, Daga Makaza, Vida K. Nyawornota, Reginald Ocansey, Narayan Subedi, Riaz Uddin, Dawn Tladi and Mark S. Tremblay

. 23 – 25 This initiative facilitates the development of report cards 26 on indicators of child and youth physical activity in countries that participate in the global matrix initiatives. 23 , 24 However, documented variation in physical activity and other lifestyle behaviors across regions and

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Mark S. Tremblay, Casey E. Gray, Kingsley Akinroye, Dierdre M. Harrington, Peter T. Katzmarzyk, Estelle V. Lambert, Jarmo Liukkonen, Ralph Maddison, Reginald T. Ocansey, Vincent O. Onywera, Antonio Prista, John J. Reilly, María del Pilar Rodríguez Martínez, Olga L. Sarmiento Duenas, Martyn Standage and Grant Tomkinson

The Active Healthy Kids Canada (AHKC) Report Card on Physical Activity for Children and Youth has been effective in powering the movement to get kids moving by influencing priorities, policies, and practice in Canada. The AHKC Report Card process was replicated in 14 additional countries from 5 continents using 9 common indicators (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and Built Environment, and Government Strategies and Investments), a harmonized process and a standardized grading framework. The 15 Report Cards were presented at the Global Summit on the Physical Activity of Children in Toronto on May 20, 2014. The consolidated findings are summarized here in the form of a global matrix of grades. There is a large spread in grades across countries for most indicators. Countries that lead in certain indicators lag in others. Overall, the grades for indicators of physical activity (PA) around the world are low/poor. Many countries have insufficient information to assign a grade, particularly for the Active Play and Family and Peers indicators. Grades for Sedentary Behaviors are, in general, better in low income countries. The Community and Built Environment indicator received high grades in high income countries and notably lower grades in low income countries. There was a pattern of higher PA and lower sedentary behavior in countries reporting poorer infrastructure, and lower PA and higher sedentary behavior in countries reporting better infrastructure, which presents an interesting paradox. Many surveillance and research gaps and weaknesses were apparent. International cooperation and cross-fertilization is encouraged to tackle existing challenges, understand underlying mechanisms, derive innovative solutions, and overcome the expanding childhood inactivity crisis.

Open access

Salomé Aubert, Joel D. Barnes, Nicolas Aguilar-Farias, Greet Cardon, Chen-Kang Chang, Christine Delisle Nyström, Yolanda Demetriou, Lowri Edwards, Arunas Emeljanovas, Aleš Gába, Wendy Y. Huang, Izzeldin A.E. Ibrahim, Jaak Jürimäe, Peter T. Katzmarzyk, Agata Korcz, Yeon Soo Kim, Eun-Young Lee, Marie Löf, Tom Loney, Shawnda A. Morrison, Jorge Mota, John J. Reilly, Blanca Roman-Viñas, Natasha Schranz, John Scriven, Jan Seghers, Thomas Skovgaard, Melody Smith, Martyn Standage, Gregor Starc, Gareth Stratton, Tim Takken, Tuija Tammelin, Chiaki Tanaka, David Thivel, Richard Tyler, Alun Williams, Stephen H.S. Wong, Paweł Zembura and Mark S. Tremblay

is needed to explore environmental and sociocultural explanations for these differences. To develop a better understanding of childhood physical activity and inactivity across countries, the first Global Matrix (Global Matrix 1.0) of Report Card grades on physical activity was launched in 2014. 36

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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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Patrick Abi Nader, Lina Majed, Susan Sayegh, Lama Mattar, Ruba Hadla, Marie Claire Chamieh, Carla Habib Mourad, Elie-Jacques Fares, Zeina Hawa and Mathieu Bélanger

were combined into “Global Matrix 1.0” 4 and “Global Matrix 2.0.” 5 Results from global matrices were to foster collaborations between international stakeholders and open up a platform where different countries learn from the successes and failures of other countries. 3 Results from the first 2

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Tim Takken

The one million dollar question in our discipline might be how to get kids with chronic disease moving. Most of the current strategies are focused on children in our general population; However, children with disability are in desperate need of our attention since inactivity might be a bigger issue compared with their “healthy” peers. What we can learn (among others) from this year’s released Global Matrix on Physical Activity for Children and Youth (1), that many countries struggle to get their children moving. To get children with chronic disease or disability moving is even more challenging. In the current year, The Year That Was, I want to focus on two studies that might help us further on this topic.

Open access

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

Cards on physical activity for children and youth. 11 , 15 Internationalization of the Report Card: The Global Matrix of Physical Activity Grades In 2014, the Canadian Report Card process was replicated in 15 countries from 5 continents (Australia, Canada, Colombia, England, Finland, Ghana, Ireland