Background: The literature on whole of system approaches (WSAs) has been largely theoretical in focus. The Australian Systems Approaches to Physical Activity is a national project designed to contribute a practical implementation focus to such approaches at the population level. Methods: National meetings were convened with federal and state government sector stakeholders to identify physical activity (PA) related policies and programs. Policies and programs were audited to develop an understanding of the existing PA system. A WSA conceptual map for PA was developed using feedback from system stakeholders, existing WSAs, and related work in obesity. Results: Completion of the policy audit has revealed key areas of need regarding policy governance, coordination, financing, and evaluation. An initial WSA conceptual map for Australia has been developed incorporating governance, translation, and advocacy. Stakeholder co-production of an integrated framework for PA and design plans for a community of practice knowledge hub has commenced. Conclusions: In Australia, Australian Systems Approaches to Physical Activity project partners have developed a conceptual whole of systems map that is guiding progress beyond the theoretical to application in the real world: a national PA policy audit, co-production of an integrated PA policy framework, and planning for a PA community of practice knowledge hub.
Background Physical activity and sport have numerous health benefits and participation is thought to be lower in disadvantaged children and adolescents. However, evidence for the disparity in physical activity is inconsistent, has not been reviewed recently, and for sport has never been synthesised. Our aim was to systematically review, and combine via meta-analyses, evidence of the socioeconomic disparities in physical activity and sport participation in children and adolescents in high income countries. Methods We conducted searches of five electronic databases using physical activity, sport, and socioeconomic disparity related terms. Two independent reviewers assessed 21,342 articles for peer-reviewed original research, published in English that assessed socioeconomic disparities in physical activity and sport participation in children and adolescents. We combined evidence from eligible studies using a structural equation modelling approach to multilevel meta-analysis. Results From the 104 eligible studies, we meta-analysed 163 effect sizes. Overall, children and adolescents living in higher socioeconomic status households were more likely to participate in sport (OR: 1.87, 95% CIs 1.38, 2.36) and participated for a longer duration (d = 0.24, 95% CIs 0.12, 0.35). The socioeconomic disparity in the duration of sport participation was greater in children (d = 0.28, 95% CIs 0.15, 0.41) compared with adolescents (d = 0.13, 95% CIs − 0.03, 0.30). Overall, children and adolescents living in higher socioeconomic status households were more likely to meet physical activity guidelines (OR: 1.21, 95% CIs 1.09, 1.33) and participated for a longer duration (d = 0.08, 95% CIs 0.02, 0.14). The socioeconomic disparity in the duration of total physical activity between low and high socioeconomic status households was greater in children (d = 0.13, 95% CIs 0.04, 0.21) compared with adolescents (d = 0.05, 95% CIs − 0.05, 0.15). There was no significant disparity in leisure time physical activity (d = 0.13, 95% CIs − 0.06, 0.32). Conclusions There was evidence of socioeconomic disparities in sport participation and total physical activity participation among children and adolescents. Socioeconomic differences were greater in sport compared to total physical activity and greater in children compared with adolescents. These findings highlight the need importance of targeting sport programs according to socio-economic gradients, to reduce inequities in access and opportunity to organised sport.
Introduction The past decade has increasingly seen systems approaches as a featured theme in public health studies and policy documents. This trend is evident in the area of physical activity, which is a significant global health risk factor that is addressed in WHO’s Global Action Plan on Physical Activity. We undertook a comprehensive scoping review to characterize the application of systems approaches to physical activity, to develop a typology of the objectives, themes and methods of research papers that purported to apply systems thinking to this issue. Methods We searched electronic databases (PubMed, Web of Science, Scopus and PsycINFO) for studies published during the period 2010–2021 that explicitly applied systems approaches or methods to investigate and/or address population physical activity. A framework using systems-based methodological approaches was adapted to classify physical activity studies according to their predominant approach, covering basic descriptive, complex analytical and advanced forms of practice. We selected case studies from retained studies to depict the current “state of the art”. Results We included 155 articles in our narrative account. Literature reporting the application of systems approaches to physical activity is skewed towards basic methods and frameworks, with most attention devoted to conceptual framing and predictive modelling. There are few well-described examples of physical activity interventions which have been planned, implemented and evaluated using a systems perspective. There is some evidence of “retrofitted” complex system framing to describe programmes and interventions which were not designed as such. Discussion We propose a classification of systems-based approaches to physical activity promotion together with an explanation of the strategies encompassed. The classification is designed to stimulate debate amongst policy-makers, practitioners and researchers to inform the further implementation and evaluation of systems approaches to physical activity. Conclusion The use of systems approaches within the field of physical activity is at an early stage of development, with a preponderance of descriptive approaches and a dearth of more complex analyses. We need to see movement towards a more sophisticated research agenda spanning the development, implementation and evaluation of systems-level interventions.
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