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.

Tremblay and Barnes are with the Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. González is with the School of Medicine, Universidad de los Andes, Bogotá, Colombia. Katzmarzyk is with the Pennington Biomedical Research Center, Baton Rouge, LA, USA. Onywera is with the Dept of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya. Reilly is with the Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland. Tomkinson is with the Dept of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND, USA; and the Alliance for Research in Exercise, Nutrition, and Activity, School of Health Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, Australia. The Global Matrix 2.0 Research Team consists of Nicolas Aguilar-Farias (Universidad de La Frontera, Chile), Kingsley K. Akinroye (Nigerian Heart Foundation), Mohamed Ghaith Al-Kuwari (Aspetar Hospital, Qatar), Areekul Amornsriwatanakul (University of Western Australia), Salomé Aubert (Children’s Hospital of Eastern Ontario Research Institute, Canada), Sarahjane Belton (Dublin City University, Ireland), Aleksandra Gołdys (University of Warsaw, Poland), Marianella Herrera-Cuenca (Central University of Venezuela), Justin Y. Jeon (Yonsei University, South Korea), Jaak Jürimäe (University of Tartu, Estonia), Tarun R. Katapally (University of Regina, Canada), Estelle V. Lambert (University of Cape Town, South Africa), Lisbeth R. Larsen (University College Lillebælt, Denmark), Yang Liu (Shanghai University of Sport, China), Marie Löf (Karolinska Institutet, Sweden), Tom Loney (United Arab Emirates University), Juan R. López y Taylor (Universidad de Guadalajara, México), Ralph Maddison (University of Auckland, New Zealand), Taru Manyanga (Children’s Hospital of Eastern Ontario Research Institute, Canada), Shawnda A. Morrison (University of Primorska, Slovenia), Jorge Mota (Universidade do Porto, Portugal), Marie H. Murphy (Ulster University, Northern Ireland), Nelson Nardo Jr. (Universidade Estadual de Maringa, Brazil), Reginald T-A. Ocansey (Active Healthy Kids Ghana Group, Ghana), António Prista (Universidade Pedagógica, Mozambique), Blanca Roman-Viñas (Nutrition Research Foundation, Spain), Natasha K. Schranz (University of South Australia), Jan Seghers (KU Leuven, Belgium), Razinah Sharif (University Kebangsaan Malaysia), Martyn Standage (University of Bath, United Kingdom), Gareth Stratton (Swansea University, Wales), Tim Takken (Wilhelmina Children’s Hospital, the Netherlands), Tuija H. Tammelin (LIKES Research Centre for Physical Activity and Health, Finland), Chiaki Tanaka (J.F. Oberlin University, Japan), Yan Tang (Shanghai University of Sport, China), and Stephen H. Wong (The Chinese University of Hong Kong, China). Tremblay ( is corresponding author.