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Introduction

The French Government officially recognises the health benefits of physical activity for children and youth and has supported the development and promotion of national physical activity guidelines since 2002, and their recent renewal in 2016.1 France’s first Report Card of grades on Physical Activity for Children and Adolescents was developed in 2016 with an incomplete grade for the Overall Physical Activity indicator given a lack of recent nationally representative data.2 The purpose of this paper is to summarize the results of the 2018 France Report Card that includes new data from two national surveys.

Methods

The 2018 France Report Card synthesized available evidence for 10 indicators of physical activity: Overall Physical Activity Levels, Organized Sport Participation, Active Transportation, Active Play, Sedentary Behaviours, Physical Fitness, Family and Peers, School, Community and Environment and Government. Two French national surveys were used to inform the Overall Physical Activity, the Active transportation and the Sedentary Behavior indicators: the National Study of Individual Nutritional Consuption 3 (INCA 3 2014-2015) and the Health Study of the Environment, Biosurveillance, Physical Activity, and Nutrition (ESTEBAN 2014-2016). To measure child and youth physical activity and its characteristics, both of these surveys used a modified version of the French Surveillance and Nutritional Epidemiology Unit (USEN) questionnaire for the 6-10 year-olds (reported by a parent); and a modified version of the Youth Risk Behaviour Surveillance System questionaire for the 11-17 year-olds (self-reported). The other indicators were informed by national statistics, reports and scientific studies. The French Report Card Group, composed of national experts discussed and assigned the grades to each indicator, using standardized benchmarks and the same grading scheme (from A+ =excellent, to F = failing), taking into account the nature and origin of the data sources, the sample size, the age range of participants, the year of publication, and the quality of the available data.

Results and Discussion

The cover of the 2018 France Report Card is presented in Figure 1, and the grades and rationales for each indicator are presented in Table 1. There is still a lack of large, good quality, national surveys assessing physical activity and sedentary behavior characteristics in France. The two national surveys presented here have a relatively small sample size (ie, 3,117 6-17 years children in total), and they are not using commonly used, validated questionnaires. In addition, the way the data were treated potentially led to an underestimation of the physical activity in the 6-10 years age category, and to a potential overestimation of the screen time. Moreover, there is a lack of data to inform grades for the Active Play, Family and Peers, and the Community and Environment indicators.

Figure 1
Figure 1

—France’s 2018 Report Card cover.

Citation: Journal of Physical Activity and Health 15, s2; 10.1123/jpah.2018-0511

Table 1

Grades and rationales for France’s 2018 Report Card

IndicatorGradeRationale
Overall Physical ActivityDIn the two national surveys, a “high level of physical activity” corresponded to five or more days a week of physical activity and the regular use of active transportation (reported by the parents) for the 6-10 years old; and to practicing a moderate to vigorous physical activity at least 5 days a week (self-reported for the 11-17 years old).

Only 24% of the 7-10 years old were reported to have a high level of physical activity; 38% of the 11-14 years old reported a high level of physical activity; 24% of the 15-17 years old reported a high level of physical activity.3 And only 23% of the 6-17 years old were estimated to have a high level of physical activity in ESTEBAN 2015.4
Organized Sport ParticipationC-The proportion of children and youth enrolled in sport federations in 2016 (not including the school sport federations) was 33% for the 0-9 year-olds, 60% for the 10-14 year-olds, and 34% for the 15-19 year-olds.5
Active PlayINCAmong the 6-10 year-olds, 38% of the boys and 39% of the girls reported playing outside every school day of the week; and 32% of the boys and 33% of the girls reported playing outside every day on day with reduced or no school time.4
Active TransportationC-It was estimated in INCA3 2014-2015 that 44% of the 3-10 year-olds and 43% of the 11-14 year-olds use active transportation to go to school.3 And 41% of the 6-10 year-olds report using active transportation to go to school in ESTEBAN 2015.4
Sedentary BehavioursD-On average, children and youth spend 3 to 4 hours daily in front of a screen. This estimate varies depending on the data source, the age, and the sex.3,4

Only 35% of 6-10 year-olds, 17% of 11-14 year-olds, and 8% of 15-17 year-olds spend less than 2 hours in front of a screen daily.4

Screen time may be overestimated because parents or children were asked to report the time for each type of screen (ie,TV, phone, etc.) and then these times were added. It is a possible that some of these screen times occurred simultaneously.
Physical FitnessB-On average, 10-14.9 year-old French adolescents (n=10,631) are at the 68th percentile for cardiorespiratory fitness (V02max estimated from the 20m-shuttle-run test)6 based on age- and sex-specific international normative data from 24 countries.7 On average, 10-14.9 year-old French adolescents (n=10,776) are at the 58th percentile for flexibility (measured with the test sit-and-reach)6 based on age- and sex-specific international normative data from 27 countries.7
Family and PeersINCA cross sectional study that surveyed 1713 boys and 1724 girls (all 12 years old) in Bas-Rhin found that 46% of fathers and 42% of the mothers “engaged regularly in physical activities”.8 46% of 2385 adolescents (11-18 years old) reported that at least one of their parents “is regularly active” in a cross-sectional survey realised in Aquitaine in 2005.9
SchoolBIn primary school (6-10 years old), 3 hours are dedicated to physical education (PE) but only 2 hours and 15 minutes on average were reported,10 and these classes do not have to be taught by a physical education specialist.

In middle school (11-14 years old) and high school (15-17 years old), PE is mandatory for all the students (except proved medical condition), and PE time is fixed and mandatory for 100% of the public educational institutions. Middle school must provide 4 hours of PE weekly the first year, and then 3 hours weekly for the next 3 years. As for high school, 2 hours of physical education weekly is mandatory. Those classes must be taught by a PE teacher (an expert trained for 5 years). Any institution caught not respecting these rules could face disciplinary procedures.

In 2016, 22% of all students in middle school or high school were enrolled with the scholar sport federations (National Statistics),11 which means that they were potentially practicing 1 to 3 additional hours of sport per week but we do not have data to confirm the actual attendance of those enrolled.
Community and EnvironmentINCIn 2016, 60 territorial communities were enrolled in the “Cycling Cities and Territories Club” (9 with <50,000 inhabitants, 11 between 50,000 and 100,000 inhabitants, 26 between 100,000 and 250,000 inhabitants, and 14 with > 250,000 inhabitants). Among these communities, 26% of the roadway is equipped with cycling path.12 In addition, 63% of the territorial communities have a budget dedicated to cycling promotion, and the average annual budget is 7.7 euros/year/ inhabitant (vs 5.8 euros/year/ inhabitant in 2013).12
GovernmentCWe decided to assign a grade of C to this indicator because the importance of physical activity is officially acknowledged by the government in official texts, but this acknowledgement is more translated into promotional campaigns (i.e. physical activity and sedentary behaviours guidelines) and local action such as the intervention based on the ICAPS randomized control trial13 in small population. However, several forms of financial help exist to support the registration of children and adolescent from medium- and low-income families to sport federations. In addition, financial support is also provided to sport clubs annually. This help increases if the clubs are hosting activities after school time, if there are many children or youths or girls or women enrolled, if they are welcoming people with disabilities, and/ or if they are situated in poor, rural or critical areas. This help does not exceed 1,500 euros in 65% of the cases, but 100% of the clubs receive it annually.

Conclusion

While findings from two national surveys show that French children and youth are spending too much time in front of a screen, and that only a small part of the pediatric population is meeting the physical activity guidelines, these negative outcomes might be exaggerated because of the method used in these surveys. In contrast, French pre-adolescents (10-14 years old) show a good level of physical fitness that can potentially be explained by the good level of organized sport participation in this age group and the mandatory time devoted to PE.

References

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    Santé Publique France. Synthèse pour les professionnels des recommandations de l’Anses de février 2016 sur l’activité physique et la sédentarité. Actualisation des repères du PNNS. 2016:34. http://www.santepubliquefrance.fr.

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    Aucouturier J, Ganière C, Aubert S, et al. Results from the first French Report Card on physical activity for children and adolescents. J Phys Act Heal. 2017;14(8):660–663. doi:10.1123/jpah.2017-0046

    • Crossref
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    Anses. étude individuelle nationale des consommations alimentaires 3. 2017. https://www.anses.fr/fr/system/files/NUT2014SA0234Ra.pdf. Accessed June 8, 2018.

    • Export Citation
  • 4.

    équipe de surveillance et d’épidémiologie nutritionnelle (Esen). étude de santé sur l’environnement, la biosurveillance, l’activité physique et la nutrition (Esteban) 2014–2016. Volet nutrition. Chapitre Activité physique et sédentarité. Saint Maurice, Switzerland: Santé Publique France, 2017:58. www.santepubliquefrance.fr.

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    Mission des études de l’Observation et des Statistiques (MccEOS - INJEP). Recensement Annuel Des Licences et Clubs Auprès Des Fédérations Sportives Agréées Par Le Ministère Des Sports (2016); 2017.

    • Export Citation
  • 6.

    Vanhelst J, Labreuche J, Béghin L, et al. Physical Fitness Reference Standards in French Youth. J Strength Cond Res. 2017;31(6):1709–1718. doi:10.1519/JSC.0000000000001640

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    Tomkinson GR, Carver KD, Atkinson F, et al. European normative values for physical fitness in children and adolescents aged 9-17 years: results from 2 779 165 Eurofit performances representing 30 countries [published online ahead of print November30, 2017]. Br J Sports Med. doi:10.1136/bjsports-2017-098253

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    Wagner A, Klein-Platat C, Arveiler D, Haan MC, Schlienger JL, Simon C. Parent-child physical activity relationships in 12-year old French students do not depend on family socioeconomic status. Diabetes Metab. 2004;30(4):359–366. doi:10.1016/S1262-3636(07)70129-5

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    Thibault H, Contrand B, Saubusse E, Baine M, Maurice-Tison S. Risk factors for overweight and obesity in French adolescents: Physical activity, sedentary behavior and parental characteristics. Nutrition. 2010;26(2):192–200. doi:10.1016/J.NUT.2009.03.015

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    Ministère Jeunesse Education et Recherche. L’éducation Physique et Sportive Dans Le Premier Degré En 2002-2003. 2004. http://www.snepfsu.net/ftp2/peda/enquete_men_prim.pdf. Accessed June 13, 2018.

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  • 11.

    Union Nationale du Sport Scolaire. Rapport Général 2015/2016. 2017. http://unss.org/blog/consulter-le-rapport-general/. Accessed June 13, 2018.

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  • 12.

    Observatoire des Mobilités Actives. Les Politiques En Faveur Des Piétons et Des Cyclistes Dans Les Villes Françaises - Résultats Synthétiques de l’enquête Nationale 2015/2016. Paris. 2016. https://www.gart.org/wp-content/uploads/2017/02/cvtc_enquete_nationale_2016_resultats_synthetiques.pdf. Accessed May 2, 2018.

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  • 13.

    Lanckriet S, Brissieux E, Borys J-M, et al. Assessment of the Impact of a Sports Kit on Physical Activity in Children 8 to 11 Years of Age. J Phys Act Res. 2017;2(1):50–60. doi:10.12691/jpar-2-1-9

    • Search Google Scholar
    • Export Citation

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Aubert is with the Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. Aucouturier is with A7369, Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS), Equipe “Activité Physique, Muscle, Santé”, Université de Lille, France. Ganière is with the Laboratoire du Centre d’Etude des Transformations des Activités Physiques et Sportives (CETAPS), Rouen, France. Fillon is with the Laboratory of metabolic adaptations to exercise under physiological and pathological conditions (AME2P), the Research Center for Human Nutrition (CRNH Auvergne); and the Clermont Auvergne University, UGECAM, Clermont-Ferrand, Auvergne, France. Genin is with the Laboratory of metabolic adaptations to exercise under physiological and pathological conditions (AME2P) and Research Center for Human Nutrition (CRNH Auvergne), Clermont-Ferrand, France. Schipman is with IRMES (Institute for biomedical and epidemiological research in sport), INSEP, Paris, France. Larras and Praznoczy are with the French National Observatory for Physical Activity and Sedentary Behaviours (ONAPS), Clermont-Ferrand, France. Duclos is with the Department of Sport Medicine and Functional Exploration, University Hospital CHU G.Montpied, INRA, UMR 1019, UNH, the Research Center for Human Nutrition (CRNH Auvergne), University of Auvergne; and the French National Observatory for Physical Activity and Sedentary Behaviours (ONAPS), F-63000 Clermont-Ferrand, France. Thivel is with the Laboratory of metabolic adaptations to exercise under physiological and pathological conditions (AME2P), the Research Center for Human Nutrition (CRNH Auvergne), Clermont Auvergne University; and the French National Observatory for Physical Activity and Sedentary Behaviours (ONAPS), Clermont-Ferrand, France.

Aubert (saubert@cheo.on.fr) is corresponding author.
  • 1.

    Santé Publique France. Synthèse pour les professionnels des recommandations de l’Anses de février 2016 sur l’activité physique et la sédentarité. Actualisation des repères du PNNS. 2016:34. http://www.santepubliquefrance.fr.

    • Search Google Scholar
    • Export Citation
  • 2.

    Aucouturier J, Ganière C, Aubert S, et al. Results from the first French Report Card on physical activity for children and adolescents. J Phys Act Heal. 2017;14(8):660–663. doi:10.1123/jpah.2017-0046

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Anses. étude individuelle nationale des consommations alimentaires 3. 2017. https://www.anses.fr/fr/system/files/NUT2014SA0234Ra.pdf. Accessed June 8, 2018.

    • Export Citation
  • 4.

    équipe de surveillance et d’épidémiologie nutritionnelle (Esen). étude de santé sur l’environnement, la biosurveillance, l’activité physique et la nutrition (Esteban) 2014–2016. Volet nutrition. Chapitre Activité physique et sédentarité. Saint Maurice, Switzerland: Santé Publique France, 2017:58. www.santepubliquefrance.fr.

    • Search Google Scholar
    • Export Citation
  • 5.

    Mission des études de l’Observation et des Statistiques (MccEOS - INJEP). Recensement Annuel Des Licences et Clubs Auprès Des Fédérations Sportives Agréées Par Le Ministère Des Sports (2016); 2017.

    • Export Citation
  • 6.

    Vanhelst J, Labreuche J, Béghin L, et al. Physical Fitness Reference Standards in French Youth. J Strength Cond Res. 2017;31(6):1709–1718. doi:10.1519/JSC.0000000000001640

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Tomkinson GR, Carver KD, Atkinson F, et al. European normative values for physical fitness in children and adolescents aged 9-17 years: results from 2 779 165 Eurofit performances representing 30 countries [published online ahead of print November30, 2017]. Br J Sports Med. doi:10.1136/bjsports-2017-098253

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Wagner A, Klein-Platat C, Arveiler D, Haan MC, Schlienger JL, Simon C. Parent-child physical activity relationships in 12-year old French students do not depend on family socioeconomic status. Diabetes Metab. 2004;30(4):359–366. doi:10.1016/S1262-3636(07)70129-5

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Thibault H, Contrand B, Saubusse E, Baine M, Maurice-Tison S. Risk factors for overweight and obesity in French adolescents: Physical activity, sedentary behavior and parental characteristics. Nutrition. 2010;26(2):192–200. doi:10.1016/J.NUT.2009.03.015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Ministère Jeunesse Education et Recherche. L’éducation Physique et Sportive Dans Le Premier Degré En 2002-2003. 2004. http://www.snepfsu.net/ftp2/peda/enquete_men_prim.pdf. Accessed June 13, 2018.

    • Export Citation
  • 11.

    Union Nationale du Sport Scolaire. Rapport Général 2015/2016. 2017. http://unss.org/blog/consulter-le-rapport-general/. Accessed June 13, 2018.

    • Export Citation
  • 12.

    Observatoire des Mobilités Actives. Les Politiques En Faveur Des Piétons et Des Cyclistes Dans Les Villes Françaises - Résultats Synthétiques de l’enquête Nationale 2015/2016. Paris. 2016. https://www.gart.org/wp-content/uploads/2017/02/cvtc_enquete_nationale_2016_resultats_synthetiques.pdf. Accessed May 2, 2018.

    • Export Citation
  • 13.

    Lanckriet S, Brissieux E, Borys J-M, et al. Assessment of the Impact of a Sports Kit on Physical Activity in Children 8 to 11 Years of Age. J Phys Act Res. 2017;2(1):50–60. doi:10.12691/jpar-2-1-9

    • Search Google Scholar
    • Export Citation
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