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.
—France’s 2018 Report Card cover.
Citation: Journal of Physical Activity and Health 15, s2; 10.1123/jpah.2018-0511
Grades and rationales for France’s 2018 Report Card
| Indicator | Grade | Rationale |
|---|---|---|
| Overall Physical Activity | D | In 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 Participation | C- | 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 Play | INC | Among 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 Transportation | C- | 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 Behaviours | D- | 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 Fitness | B- | 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 Peers | INC | A 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 |
| School | B | In 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 Environment | INC | In 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 |
| Government | C | We 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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