Despite the many health benefits associated with physical activity (PA) throughout childhood, the majority of children and adolescents in Flanders, the northern Dutch-speaking part of Belgium, do not meet the current guideline of 60 minutes of moderate-to-vigorous PA (MVPA) per day.1 Moreover, this proportion of children and adolescents remained relatively stable from 2002 to 2014.2 The purpose of this paper is to summarize the results of the 2018 Flemish Report Card (Figure 1). Grades were based on the best available evidence. Sources included national surveys, peer-reviewed literature, and gray literature such as government and nongovernment reports and online content.
The 2018 Report Card included the 10 core indicators that are common to the Global Matrix 3.0 (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and Environment, Government, and Physical Fitness). The Report Card synthesized data from multiple sources to inform the 10 indicator grades. The Belgian Food Consumption Survey3 (FCS) 2014-2015 conducted by Sciensano (i.e., the former Belgian Institute of Public Health) was selected as primary data source given its assessment of a wide range of health behaviors in a representative sample of Flemish children and youth. The FCS collects objectively measured data on PA (i.e. by accelerometry using the Evenson cut points4). Alternative data sources were consulted in case information on selected indicators was not available in the FCS, including the 2013-2014 Health Behaviour in School-aged Children (HBSC) study (Organized Sport Participation and Physical Activity), the 2012 ToyBox study (Family and Peers), the 2010 ENERGY study (Family), the 2013 National Health Interview Survey (Family), the 2016 School Health Policy monitor of The Flemish Institute for Healthy Living (School), the 2014-2015 IPEN Adolescent study (Community and Environment) and the 2017 Flanders Community and City Monitor (Community and Environment).
Results and Discussion
The 2018 Flemish Report Card on Physical Activity for Children and Youth shows that levels of overall physical activity are very low and levels of sedentary behaviors (i.e. screen time) are high (Table 1). Nonetheless, moderately positive scores were observed for specific PA behaviors such as organized sport participation and active transportation. Despite the good availability of facilities, policies and programs at the municipal/community and school levels, over 90 percent of Flemish children and youth are not meeting the current guideline of 60 minutes of MVPA daily. Cooperation across policy domains (e.g., Education, Sport, Youth, Public Health, Mobility) and settings (e.g., Schools, Sport Clubs) is needed to make full use of the policies and programs currently in place and to translate healthy behaviors into sufficient levels of MVPA.
Grades and rationales for Flemish 2018 Report Card
|Overall Physical Activity||F||6.9%* of 6- to 9-year-olds and 2.6%* of 10- to 17-year-olds accumulate at least 60 minutes of moderate-to-vigorous physical activity (MVPA) per day.|
* accelerometer-derived physical activity using Evenson cut points4
|Organized Sport Participation and Physical Activity||B||69.3% of 6- to 9-year-olds and 67% of 11- to 15-year-olds report membership of an organized sports club.|
81.2% of 10- to 17-year-olds report participation in sports during leisure time or extracurricular physical activity at school.
|Active Play||INC||81% and 86% of 6- to 9-year-olds report playing outdoors on weekday and weekend days, respectively.|
No data was available on active play for 10- to 17-year-olds.
|Active Transportation||C+||55.5% of 6- to 9-year-olds and 58.9% of 10- to 17-year olds report using active transportation (walking, cycling) to school.|
|Sedentary Behaviours||C||88.1% of 6- to 9-year-olds and 46.9% 10- to 17-year-olds report no more than 2 hours of electronic media time on an average weekday.|
44.5% of 6- to 9-year-olds and 17.6% 10- to 17-year-olds report no more than 2 hours of electronic media time on an average weekend day.
|Family and Peers||C+||57.4% of parents of 4- to 6-year-olds and 36.4% of parents of 10- to 12-year-olds accumulate at least 150 minutes of MVPA per week.|
72.7% of parents report being regularly physically active with their 4- to 6-year-olds.
51.6% of parents report being physically active at least once a week with their 10- to 12-year-olds.
|School||B-||Primary and secondary schools in Flanders achieve a total school physical activity policy score* of 58 and 49.5 (range 0-100), respectively.|
87.5% of primary schools and 100% of secondary schools hire specialized teachers to teach physical education.
94% of 10- to 17-year olds report to participate in at least 2 school physical education classes per week.
* total school physical activity policy score is an aggregated score based on health education lessons provided in schools, school physical activity regulations and the availability of extracurricular physical activities.
|Community and Environment||B||71% of residents report that they are satisfied with the sports and recreation services/facilities/provisions in their town/city 85.8% of 12- to 14-year olds report to have easy access to playground or park from home.|
75.8% of 12- to 14-year olds report to live in an area with well-maintained playgrounds, parks and recreation areas.
69.7% of 12- to 14-year olds report to have sidewalks in most streets in their neighborhood.
37% of 12- to 14-year olds that report to have cycle paths in most streets in their neighborhood.
83.2% of 12- to 14-year olds report that walking in their neighborhood is not dangerous because of traffic.
73.4% of 12- to 14-year olds report that cycling in their neighborhood is not dangerous because of traffic.
37.4% of 12- to 14-year olds report that it is safe to play on the streets in their neighborhood.
89.8% of 12- to 14-year olds report there is not a lot of crime in their neighborhood.
81.2% of 12- to 14-year olds report that there is no need to be afraid when they are alone in a playground or park.
|Government||B||In 2016, the Flemish government proposed a new action plan called “The Flemish Belgian lives healthier in 2025”. Nonetheless, physical activity promotion efforts and actions are not well coordinated across policy domains.|
|Physical Fitness||INC||No recent data available.|
Despite the availability of recent nationally representative data sources for a wide range of health behaviours, we were unable to grade two out of the 10 indicators. More specific, active play seems to be a neglected PA behaviour in adolescents when developing questionnaires and the physical fitness indicator could not be graded because of a lack of recent data. To investigate secular trends in physical fitness and to analyse the association between physical fitness and current health behaviours in school-aged youth, there is an urgent need to collect new physical fitness data in a representative sample of Flemish children and adolescents.
The 2018 Flemish Report Card on Physical Activity for Children and Youth shows that levels of overall physical activity are very low and levels of sedentary behaviors (i.e., screen time) are high, despite moderately positive influences from the social, political, and built environment. This may signal the need for a ‘Health in All Policies’ approach and a more coherent approach to PA promotion efforts at all levels of policy-making.
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