Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.

Background: To better understand the childhood physical inactivity crisis, Report Cards on physical activity of children and youth were prepared concurrently in 30 very high Human Development Index countries. The aim of this article was to present, describe, and compare the findings from these Report Cards. Methods: The Report Cards were developed using a harmonized process for data gathering, assessing, and assigning grades to 10 common physical activity indicators. Descriptive statistics were calculated after converting letter grades to interval variables, and correlational analyses between the 10 common indicators were performed using Spearman’s rank correlation coefficients. Results: A matrix of 300 grades was obtained with substantial variations within and between countries. Low grades were observed for behavioral indicators, and higher grades were observed for sources of influence indicators, indicating a disconnect between supports and desired behaviors. Conclusion: This analysis summarizes the level and context of the physical activity of children and youth among very high Human Development Index countries, and provides additional evidence that the situation regarding physical activity in children and youth is very concerning. Unless a major shift to a more active lifestyle happens soon, a high rate of noncommunicable diseases can be anticipated when this generation of children reaches adulthood.

Summary Comprehensive and meaningful policy analysis in the field of physical activity is difficult, not least because of the variable influence of other policy domains. However, in 2011 a Policy Assessment Tool (PAT) was developed by members of the WHO European Network for the Promotion of Health-Enhancing Physical Activity (HEPA Europe) and tested in several different countries. In 2014, Wales joined a global initiative, active healthy kids (AHK) Global Alliance, that supported the development of country level ‘Report Cards’ scoring a range of indicators that influence physical activity amongst children and young people, one of which was labelled ‘Government Strategies and Investments’. For the first two Report Cards this indicator and its associated ‘score’ was informed subjectively by expert consensus. In 2018, it was decided to utilize the Policy Audit Tool Version 2 (PAT v2) developed by HEPA Europe to aid analysis and to develop and test a scoring rubric aligned to the tool. The subsequent process indicated that the tool could be applied and translated into a ‘grade’ that could be used in conjunction with the other indicators of the AHK Report Card to generate overall Report Card grades. The use of both the HEPA PAT v2 and the scoring rubric offers an opportunity to provide greater consistency and potential for developing both comparative and trend data when assessing policy impact on physical activity in children and young people. These tools should be utilized by the AHK Global Alliance in future Report Cards.

The DC is a valid and reliable tool to measure elements of physical competence in children age 10 to 14 yr.

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Background: This is the second Active Healthy Kids Wales Report Card. The 2016 version consolidates and translates research related to physical activity (PA) among children and youth in Wales, and aims to raise the awareness of children's engagement in PA and sedentary behaviors. Methods: Ten PA indicators were graded using the Active Healthy Kids-Canada Report Card methodology involving a synthesis and expert consensus of the best available evidence. Results: Grades were assigned as follows: Overall PA, D+; Organized Sport Participation, C; Active and Outdoor Play, C; Active Transportation, C; Sedentary Behaviors, D-; Physical Literacy, INC; Family and Peer Influences, D+; School, B; Community and the Built Environment, C; and National Government Policy, Strategies, and Investments, B-. Conclusions: Despite the existence of sound policies, programs, and infrastructure, PA levels of children and youth in Wales are one of the lowest and sedentary behavior one of the highest globally. From the 2014 Report Card, the Family and Peer Influences grade improved from D to D+, whereas Community and the Built Environment dropped from B to C. These results indicate that a concerted effort is required to increase PA and decrease sedentary time in children and young people in Wales.

An improved understanding of relationships between moderate-to-vigorous physical activity (MVPA), screen-time and lifestyle factors is imperative for developing interventions, yet few studies have explored such relationships simultaneously. Therefore, the study's aim was to examine the relationship between sufficient MVPA (≥60 min•day-1) and excessive screen-time (≥2 h•day-1) with lifestyle factors in children. In total, 756 children (10.4 ± 0.6 years) completed a questionnaire, which assessed sleep duration, MVPA, homework/reading, screen-time and diet, and a 20 metre multi-stage shuttle run test to assess cardiorespiratory fitness (CRF). Body mass and stature were measured and used to calculate BMI (body mass index) for age/sex z-scores. Fruit and vegetable consumption and CRF were positively associated with sufficient MVPA, irrespective of sex (p < 0.05). Excessive screen-time was positively associated with sugary snack consumption in boys and girls, and diet soft drink intake in boys (p < 0.05). In addition, excessive screen-time was negatively associated with MVPA before school for both boys and girls, as well as with sleep duration and fruit and vegetable consumption for girls (p < 0.05). Sufficient MVPA and excessive screen-time were associated with healthy and unhealthy factors, respectively, with relationships sometimes differing by sex. Future health promoting interventions should consider targeting change in multiple lifestyle factors.

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