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Salomé Aubert, Julien Aucouturier, Jeremy Vanhelst, Alicia Fillon, Pauline Genin, Caroline Ganière, Corinne Praznoczy, Benjamin Larras, Julien Schipman, Martine Duclos and David Thivel

the 2016 Report Card cannot be interpreted accurately because 4 indicators that were not previously graded obtained a letter grade in 2018, and because the standardized grading scheme and benchmarks provided by the AHKGA were modified between 2016 and 2018. International Comparisons France

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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

conducting international comparisons within an HDI category. Finally, a loss of information potentially occurs when translating original data to a letter grade, as letter grades provide less information than continuous variables. The main strength of this study is the large number of participating countries

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Eva D’Hondt, Fotini Venetsanou, Antonis Kambas and Matthieu Lenoir

between various subsamples of children, such as when performing international comparisons. In several cross-cultural studies, well-known motor test batteries have been used. However, it should be noted that they often do not provide a complete picture of children’s motor competence level. For example

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Katelyn Barnes, Lauren Ball and Ben Desbrow

Personal trainers are well placed to provide nutrition care in line with their recommended scope of practice. However, providing nutrition care beyond their recommended scope of practice has been identified as an industry risk. The International Confederation of Registers for Exercise Professionals (ICREPs) have international standards for nutrition knowledge and skills that are recommended for all fitness professionals, including personal trainers. This study investigates whether the ICREPs standards align with i) national nutrition education standards and ii) national nutrition occupational standards and scopes of practice for personal trainers within ICREPs affiliated countries. Content analysis of each standard and/or scope of practice was undertaken to extract nutrition statements. Extracted statements were matched with nutrition components of the ICREPs standards to result in a score based on the number of aligned ICREPs knowledge and skills criteria. Ten countries, with 16 organizations, were identified as being involved in the development of national education standards, occupational standards, or scopes of practice for personal trainers. The educational and occupational standards varied widely among countries and had minimal alignment with the ICREPs standards. As such, the expected role of personal trainers in providing nutrition care appeared to differ between countries. Further work is required to support personal trainers to develop a level of knowledge and skills that enables the provision of safe, consistent, and effective nutrition care.

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Nicolas Aguilar-Farias, Sebastian Miranda-Marquez, Pia Martino-Fuentealba, Kabir P. Sadarangani, Damian Chandia-Poblete, Camila Mella-Garcia, Jaime Carcamo-Oyarzun, Carlos Cristi-Montero, Fernando Rodriguez-Rodriguez, Pedro Delgado-Floody, Astrid Von Oetinger, Teresa Balboa-Castillo, Sebastian Peña, Cristobal Cuadrado, Paula Bedregal, Carlos Celis-Morales, Antonio Garcia-Hermoso and Andrea Cortínez-O’Ryan

Background: The study summarizes the findings of the 2018 Chilean Report Card (RC) on Physical Activity (PA) for Children and Adolescents and compares the results with the first Chilean RC and with other countries from the Global Matrix 3.0. Methods: A Research Work Group using a standardized methodology from the Global Matrix 3.0 awarded grades for 13 PA-related indicators based on the percentage of compliance for defined benchmarks. Different public data sets, government reports, and papers informed the indicators. Results: The grades assigned were for (1) “behaviors that contribute to overall PA levels”: overall PA, D−; organized sport participation, D−; active play, INC; and active transportation, F; (2) “factors associated with cardiometabolic risk”: sedentary behavior, C−; overweight and obesity, F; fitness, D; sleep, INC; and (3) “factors that influence PA”: family and peers, F; school, D; inclusion, INC; community and built environment, B; government strategies and investments, B−. Conclusions: Chile’s grades remained low compared with the first RC. On the positive side, Chile is advancing in environmental and policy aspects. Our findings indicate that the implementation of new strategies should be developed through collaboration between different sectors to maximize effective investments for increasing PA and decreasing sedentary time among children and adolescents in Chile.

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Hsin-Yen Yen and Hsuan Hsu

Engaging in healthy eating and active living is an effective strategy for preventing noncommunicable diseases in older populations. The purposes were to compare the prevalence rates across countries and explore health factors associated with healthy eating and active living. The data were retrieved from a cross-sectional study conducted by the International Social Survey Program (2011 Health and Healthcare), with structured questionnaire surveys in 32 countries. The results showed that 38.42% reported active living and 39.11% reported healthy eating among 11,250 total respondents. Older adults with a long-standing illness or obesity who felt that they were not overcoming problems and had lost confidence were less likely to engage in healthy behavior. Perceived general health had a positive association with the odds of engaging in healthy eating and active living. The international comparisons provide a reference for local governments to decrease health disparities. Inspiring self-awareness about health might encourage older adults to pursue healthy lifestyles.

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John Cooper, Barbara Stetson, Jason Bonner, Sean Spille, Sathya Krishnasamy and Sri Prakash Mokshagundam

Background:

This study assessed physical activity (PA) in community dwelling adults with Type 2 diabetes, using multiple instruments reflecting internationally normed PA and diabetes-specific self-care behaviors.

Methods:

Two hundred and fifty-three Black (44.8%) and White (55.2%) Americans [mean age = 57.93; 39.5% male] recruited at low-income clinic and community health settings. Participants completed validated PA self-report measures developed for international comparisons (International Physical Activity Questionnaire Short Form), characterization of diabetes self-care (Summary of Diabetes Self-Care Activities Measure; SDSCA) and exercise-related domains including provider recommendations and PA behaviors and barriers (Personal Diabetes Questionnaire; PDQ).

Results:

Self-reported PA and PA correlates differed by instrument. BMI was negatively correlated with PA level assessed by the PDQ in both genders, and assessed with SDSCA activity items in females. PA levels were low, comparable to previous research with community and diabetes samples. Pain was the most frequently reported barrier; females reported more frequent PA barriers overall.

Conclusions:

When using self-report PA measures for PA evaluation of adults with diabetes in clinical settings, it is critical to consider population and setting in selecting appropriate tools. PA barriers may be an important consideration when interpreting PA levels and developing interventions. Recommendations for incorporating these measures in clinical and research settings are discussed.

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Anders Raustorp and Yvonne Ekroth

Background:

To explore the secular trends (time change) of pedometer-determined physical activity (steps per day) in Swedish young adolescents 13 to 14 years of age from 2000 to 2008.

Methods:

The study was analyzed between 2 cross-sectional cohorts carried out in October 2000 (235, 111 girls) and October 2008 (186, 107 girls) in the same school, using identical procedures. Data of mean steps per day were collected during 4 consecutive weekdays (sealed pedometer Yamax SW-200 Tokyo, Japan) and in addition height and weight were measured.

Results:

When comparing cohort 2000 with cohort 2008 no significant difference in physical activity were found neither among girls (12,989 vs 13,338 [t = −0.98, P < .325]) nor boys (15,623 vs 15,174 [t= 0.78, P = .436]). The share of girls and boys meeting weight control recommendations was none significantly higher in 2008 both among girls (68% versus 62%) and among boys (69% versus 65%).

Conclusion:

There was no significant difference of young adolescents’ physical activity during school weekdays in 2008 compared with 2000. This stabilized physical activity level, in an internationally comparison regarded as high, is promising. Enhanced focus on physical activity in society and at school might have influenced the result.

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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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John J. Reilly, Avril Johnstone, Geraldine McNeill and Adrienne R. Hughes

Background:

The 2016 Active Healthy Kids Scotland Report Card aims to improve surveillance of physical activity (PA), facilitate international comparisons, and encourage evidence-informed PA and health policy.

Methods:

Active Healthy Kids Canada Report Card methodology was used: a search for data on child and adolescent PA and health published after the 2013 Scottish Report Card was carried out. Data sources were considered for grading if based on representative samples with prevalence estimates made using methods with low bias. Ten health behaviors/outcomes were graded on an A to F scale based on quintiles (prevalence meeting recommendations ≥80% graded A down to <20% graded F).

Results:

Three of the seven Health Behaviors and Outcomes received F or F- grades: Overall PA, Sedentary Behavior, and Obesity. Active and Outdoor Play and Organized Sport Participation could not be graded. Active Commuting to School was graded C, and Diet was graded D-. Family and Peer Influence was graded D-; Perceived Safety and Availability of Space for PA as well as the National Policy Environment were more favorable (both B).

Conclusions:

Grades were identical to those in 2013. Scotland has a generally favorable environment for PA, but children and adolescents have low PA and high sedentary behavior. Gaps in surveillance included lack of objectively measured PA, no surveillance of moderate-to-vigorous PA in children, summary surveillance data not expressed in ways which match recommendations (eg, for PA in young children; for screen-time), and no surveillance of Sport Participation, Active and Outdoor Play, or Sitting. Scottish policy does not include sedentary behavior at present.