2022 French Report Card on Physical Activity and Sedentary Behaviors in Children and Youth: From Continuous Alarming Conclusions to Encouraging Initiatives.

BACKGROUND: Scientific evidence and public health reports keep highlighting the continuous and alarming worldwide progression of physical inactivity and sedentary behaviors in children and adolescents. The present paper summarizes findings from the 2022 French Report Card (RC) on physical activity for children and youth and compares them to the 2016, 2018, and 2020 RCs. METHODS: The 2022 edition of the French RC follows the standardized methodology established by the Active Healthy Kids Global Matrix. Ten physical activity indicators have been evaluated and graded based on the best available evidence coming from national surveys, peer-reviewed literature, government and nongovernment reports, and online information. The evaluation was also performed in children and adolescents with disabilities. Indicators were graded from A (high level of evidence) to F (very low level of evidence) or INC for incomplete. RESULTS: The evaluated indicators received the following grades: overall physical activity: D-; organized sport participation and physical activity: C; active play: F; active transportation: C; sedentary behaviors: D-; family and peers: D; physical fitness: C; school: C-; community and the built environment: F; government: B. CONCLUSIONS: While this 2022 French RC shows progression for 7 out of the 10 indicators considered, it also underlines the continuous need for actions at the local, regional, and national levels to develop better surveillance systems and favor a long-term improvement of youth movement behaviors.

Global Matrix of Para Report Cards on Physical Activity of Children and Adolescents With Disabilities.

This is an overview of the results from 14 countries or jurisdictions in a Global Matrix of Para Report Cards on physical activity (PA) of children and adolescents with disabilities. The methodology was based on the Active Healthy Kids Global Alliance's Global Matrix 4.0. Data were aligned with 10 indicators (Overall PA, Organized Sport, Active Play, Active Transport, Physical Fitness, Sedentary Behavior, Family & Peers, Schools, Community & Environment, and Government) to produce Para Report Cards. Subsequently, there were 139 grades; 45% were incomplete, particularly for Active Play, Physical Fitness, and Family & Peers. Collectively, Overall PA was graded the lowest (F), with Schools and Government the highest (C). Disability-specific surveillance and research gaps in PA were apparent in 14 countries or jurisdictions around the world. More coverage of PA data in Para Report Cards is needed to serve as an advocacy tool to promote PA among children and adolescents with disabilities.

Results From Spain's 2022 Para Report Cards on Physical Activity of Children and Adolescents With Disabilities.

This report aims to provide a better understanding of physical activity (PA) and related factors among Spanish children and adolescents living with disabilities. The 10 indicators used for the Global Matrix on Para Report Cards of children and adolescents living with disabilities were evaluated based on the best available data in Spain. An analysis of strengths, weaknesses, opportunities, and threats based on data provision was drafted by three experts and critically reviewed by the authorship team to provide a national perspective for each evaluated indicator. Government was the indicator with the highest grade (C+), followed by Sedentary Behaviors (C-), School (D), Overall PA (D-), and Community & Environment (F). The remaining indicators received an incomplete grade. There were low levels of PA in Spanish children and adolescents living with disabilities. Yet, opportunities to improve the current surveillance of PA among this population exist.

"WOT" Do We Know and Do About Physical Activity of Children and Adolescents With Disabilities? A SWOT-Oriented Synthesis of Para Report Cards.

The purpose was to synthesize information gathered from the interpretation and conclusion sections of the Global Matrix of Para Report Cards on the physical activity of children and adolescents with disabilities. The synthesis was based on the strengths, weaknesses, opportunities, and threats framework. The procedure consisted of three stages: (a) the application of the International Classification of Functioning, Disability and Health as the theoretical framework; (b) identifying and aligning Global Matrix indicators and benchmarks with the International Classification of Functioning, Disability and Health components through a Delphi approach; and (c) using content analysis to identify themes from specific report cards. Outcomes reveal that further attention toward including children and adolescents with disabilities in fitness assessments is needed as well as adapted assessment methods. Program availability, equipment and facilities, and professional training emerged as strengths but need further development to overcome weaknesses. Paralympic inspiration was an opportunity, whereas extreme weather conditions presented potential threats to physical activity participation among children and adolescents with disabilities.

Evaluation of Physical Activity Indicators for French Children and Adolescents With Disabilities: National Para Report Card and SWOT Analysis.

The objectives of this work were (a) to adopt the Active Healthy Kids Global Alliance Report Card methodology to evaluate the state of physical activity (PA) for French children and adolescents with disabilities (CAWD) and (b) to identify the strengths, weaknesses, opportunities, and threats (SWOT) perceived by French PA experts for promoting PA among CAWD. The harmonized Active Healthy Kids Global Alliance Report Card development process was used to assign a grade to the 10 common PA indicators. SWOT templates were completed by PA experts and then collapsed in a summary figure. Despite increasing efforts to provide active opportunities to CAWD, concerning low grades were assigned to behavioral indicators. SWOT analysis provided important insights for the promotion of PA in CAWD. This work highlighted the need for the inclusion of CAWD in a comprehensive national PA surveillance system and for more efficient strategies promoting PA specifically targeting CAWD in France.

Surveillance to improve physical activity of children and adolescents.

The global transition to current low levels of habitual physical activity among children and adolescents began in the second half of the last century. Low physical activity harms health in both the short term (during childhood and adolescence) and long term (during adulthood). In turn, low physical activity could limit progress towards several sustainable development goals, undermine noncommunicable disease prevention, delay physical and mental health recovery from the coronavirus disease 2019 pandemic, increase health-care costs and hinder responses to climate change. However, despite the importance of physical activity, public health surveillance among children and adolescents is very limited globally and low levels of physical activity in children is not on the public health agenda in many countries, irrespective of their level of economic development. This article details proposals for improvements in global public health surveillance of physical activity from birth to adolescence based on recent systematic reviews, international collaborations and World Health Organization guidelines and strategies. Empirical examples from several countries illustrate how improved surveillance of physical activity can lead to public health initiatives. Moreover, better surveillance raises awareness of the extent of physical inactivity, thereby making an invisible problem visible, and can lead to greater capacity in physical activity policy and practice. The time has arrived for a step change towards more systematic physical activity surveillance from infancy onwards that could help inform and inspire changes in public health policy and practice globally.

Durant la seconde moitié du siècle dernier, l'activité physique des enfants et adolescents a commencé à baisser à l'échelle mondiale pour atteindre le faible niveau actuel. La sédentarité a des effets néfastes sur la santé, tant à court terme (pendant l'enfance et l'adolescence) qu'à long terme (à l'âge adulte). Elle peut également entraver la progression vers de nombreux objectifs de développement durable, compromettre les efforts de prévention des maladies non transmissibles, retarder la guérison physique et mentale liée à la pandémie de maladie à coronavirus 2019, accroître les dépenses en soins de santé et freiner les réactions au changement climatique. Pourtant, malgré l'importance que revêt l'activité physique, rares sont les dispositifs de surveillance de la santé publique mis en place pour les enfants et adolescents dans le monde. En outre, la lutte contre la sédentarité chez les plus jeunes ne figure pas parmi les priorités de santé publique dans la plupart des pays, quel que soit le niveau de développement économique de ces derniers. Le présent article détaille une série de propositions visant à améliorer la surveillance de la santé publique en matière d'activité physique de la naissance à l'adolescence, fondées sur des revues systématiques récentes, des collaborations internationales ainsi que des stratégies et lignes directrices de l'Organisation mondiale de la Santé. Des exemples empiriques provenant de plusieurs pays illustrent comment cette amélioration peut déboucher sur des initiatives de santé publique. De plus, une meilleure surveillance permet de sensibiliser à l'ampleur de cette inactivité, donnant ainsi de la visibilité à un problème jusqu'alors invisible, et peut renforcer les capacités politiques et pratiques relatives à l'activité physique. Il est temps de procéder à un changement en profondeur afin de surveiller plus systématiquement l'activité physique dès le plus jeune âge, en vue d'orienter et d'encourager l'évolution des politiques et pratiques en la matière dans le monde.

La transición mundial hacia los niveles bajos actuales de actividad física regular entre niños y adolescentes comenzó en la segunda mitad del siglo pasado. La disminución de la actividad física perjudica la salud tanto a corto plazo (durante la infancia y la adolescencia) como a largo plazo (durante la edad adulta). A su vez, la falta de actividad física podría limitar el progreso hacia varios objetivos de desarrollo sostenible, socavar la prevención de enfermedades no transmisibles, retrasar la recuperación de la salud física y mental tras la pandemia de la enfermedad por coronavirus de 2019, aumentar los costes de la atención sanitaria y dificultar las respuestas al cambio climático. No obstante, a pesar de la importancia de la actividad física, la vigilancia de la salud pública entre los niños y los adolescentes es muy limitada a nivel mundial y los niveles bajos de actividad física en los niños no se incluyen en la agenda de salud pública de muchos países, sea cual sea su nivel de desarrollo económico. En este artículo, se detallan propuestas para mejorar la vigilancia de la actividad física en la salud pública a nivel mundial, desde el nacimiento hasta la adolescencia, a partir de recientes revisiones sistemáticas, colaboraciones internacionales y directrices y estrategias de la Organización Mundial de la Salud. Ejemplos empíricos de varios países ilustran cómo una mejor vigilancia de la actividad física puede conducir a iniciativas de salud pública. Asimismo, una mejor vigilancia aumenta la concienciación sobre el alcance de la inactividad física, haciendo evidente un problema poco visible, y puede conducir a una mayor capacidad en la política y la práctica de la actividad física. Ha llegado el momento de dar un paso adelante hacia una vigilancia más sistemática de la actividad física desde la infancia que podría ayudar a informar e inspirar cambios en la política y la práctica de la salud pública en todo el mundo.

Economic Freedom, Climate Culpability, and Physical Activity Indicators Among Children and Adolescents: Report Card Grades From the Global Matrix 4.0.

BACKGROUND: Macrolevel factors such as economic and climate factors can be associated with physical activity indicators. This study explored patterns and relationships between economic freedom, climate culpability, and Report Card grades on physical activity-related indicators among 57 countries/jurisdictions participating in the Global Matrix 4.0. METHODS: Participating countries/jurisdictions provided Report Card grades on 10 common indicators. Information on economic freedom and climatic factors were gathered from public data sources. Correlations between the key variables were provided by income groups (ie, low- and middle-income countries/jurisdictions and high-income countries/jurisdictions [HIC]). RESULTS: HIC were more economically neoliberal and more responsible for climate change than low- and middle-income countries. Annual temperature and precipitation were negatively correlated with behavioral/individual indicators in low- and middle-income countries but not in HIC. In HIC, correlations between climate culpability and behavioral/individual and economic indicators were more apparent. Overall, poorer grades were observed in highly culpable countries/jurisdictions in the highly free group, while in less/moderately free groups, less culpable countries/jurisdictions showed poorer grades than their counterparts in their respective group by economic freedom. CONCLUSIONS: Global-level physical activity promotion strategies should closely evaluate different areas that need interventions tailored by income groups, with careful considerations for inequities in the global political economy and climate change.

Association Between Physical Activity Indicators and Human Development Index at a National Level: Information From Global Matrix 4.0 Physical Activity Report Cards for Children and Adolescents.

BACKGROUND: The aim of this study was to explore the associations between the 10 key indicators of the Global Matrix 4.0 project and human development index (HDI) at a national level according to sex, age, area of residence, and ability levels. METHODS: Information from the 57 countries/localities included in the Global Matrix 4.0 project was compiled and presented according to the HDI of each country/locality for each of the 10 key indicators. Grades were assigned based on the benchmarks of the Global Matrix 4.0 project ranged between "A+" (best performance) and "F" (worst performance). RESULTS: The population subgroups of females, children, rural residents, with/without disabilities from countries/localities with higher HDI performed better in the organized sport and physical activity indicator than their peers from countries/localities with lower HDI. Children and adolescents living in rural areas of countries/localities with higher HDI showed better performance for active play, and children and adolescents living in urban areas of countries/localities with lower HDI showed better performance for the active transportation. Countries/localities with higher HDI showed better grades for sources of influence than the countries/localities with lower HDI. CONCLUSIONS: Physical activity patterns in some population subgroups of children and adolescents differed according to the development level of countries/localities.

Active Healthy Kids Global Alliance Global Matrix 4.0-A Resource for Physical Activity Researchers.

BACKGROUND: This brief report provides an overview of the Active Healthy Kids Global Alliance (AHKGA); an introduction to the Global Matrix 4.0; an explanation of the value and opportunities that the AHKGA efforts and assets provide to the physical activity research, policy, practice, and advocacy community; an outline of the series of papers related to the Global Matrix 4.0 in this issue of the Journal of Physical Activity and Health; and an invitation for future involvement. METHODS: The AHKGA was formed to help power the global movement to get kids moving. In 2019-2021, we recruited countries to participate in the Global Matrix 4.0, a worldwide initiative to assess, compare, and contrast the physical activity of children and adolescents. RESULTS: A total of 57 countries/jurisdictions (hereafter referred to as countries for simplicity) were recruited. The current activities of the AHKGA are summarized. The overall findings of the Global Matrix 4.0 are presented in a series of papers in this issue of the Journal of Physical Activity and Health. CONCLUSIONS: The Global Matrix 4.0 and other assets of the AHKGA are publicly available, and physical activity researchers, practitioners, policy makers, and advocates are encouraged to exploit these resources to further their efforts.

Promoting Physical Activity Among Children and Adolescents With Disabilities: The Translation of Policy to Practice Internationally.

BACKGROUND: Physical inactivity among children and adolescents with disabilities (CAWD) is a global public health issue. Policy efforts to promote physical activity (PA) among CAWD have increased. This study summarizes the international policy trend for promoting PA among CAWD, with behavioral and policy insights specific to CAWD from country/regional indicators from the Active Healthy Kids Global Alliance Matrix on Physical Activity for Children and Adolescents to determine policy translation into practice. METHODS: International and national PA policy documents on CAWD were assessed. Data from the Global Matrix Para Report Cards on the behavioral and government indicators from 14 countries or regions (grouped by human development index) were reviewed and compared. RESULTS: Policy instruments began promoting PA for CAWD in 1989 via the Convention on the Rights of the Child. International policy has been advocating PA specifically for CAWD recently. In 2020, the World Health Organization published specific PA guidelines for CAWD. Data from the 14 Para Report Car found 14 grades on the average behavioral indicator and 12 on the government indicator. A gap between the average behavioral indicator (D-) and the government indicator (C+) was found in the Para Report Card data. CONCLUSIONS: Although international policies are consistent in their attention to the needs of CAWD, national/regional policies vary. Coverage ranges from nonexistent to embedded in broader inclusion concepts. A gap in policies to promote PA of CAWD is prevalent and is more prominent in countries or regions with a lower human development index ranking.

Global Matrix 4.0 Physical Activity Report Card Grades for Children and Adolescents: Results and Analyses From 57 Countries.

BACKGROUND: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children's and adolescents' (5-17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. METHODS: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders' top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. RESULTS: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. CONCLUSIONS: The Global Matrix 4.0 represents the largest compilation of children's and adolescents' PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.

Global Matrix 4.0 physical activity report cards grades for children and adolescents: A comparison among 15 Asian countries and regions.

Background: /Objective: This paper aimed to compare the report card grades among 15 Asian jurisdictions participating in the Global Matrix 4.0, and to explore differences in regional cultural and policy factors related to physical activity behaviors. Methods: All participating jurisdictions followed a harmonized process to develop a country report card. Ten required common indicators were assessed, including five behavioral indicators (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behavior), four sources of influence indicators (Family and Peers, School, Community and Environment, and Government), and an outcome indicator (Physical Fitness). Letter grades, ranging from A+ to F or incomplete (INC), were assigned to the indicators based on the predefined benchmarks and grading rubric, and were converted to numerical scale for analyses. Results: The country average scores ranged from F (Indonesia) to B- (Japan), with C+/C/C- the most prevalent grades. The mean behavioral score (D+) was lower than sources of influence score (C+). Poor grades (D or F) were observed for Overall Physical Activity among 73.3% (11/15) of the jurisdictions. Government was the indicator with the highest proportion of A or B grades (66.7%), followed by School (53.3%). Physical Fitness (n = 10) and Active Play (n = 8) were two indicators with the largest number of INC grades. Conclusions: Poor grades for physical activity and sedentary behavior were generally found in Asian jurisdictions. The better, though modest, grades on the sources of influence have not been translated into favorable behaviors among children and adolescents. The findings also suggested surveillance gaps for physical fitness, active play, and organized sport participation. National-level investments and action plans are needed to ensure physical activity interventions are developed, effectively implemented, and regularly evaluated in multiple settings.

Active Commuting to University Is Positively Associated with Physical Activity and Perceived Fitness.

BACKGROUND: Fitness is a powerful marker of health associated with physical activity (PA) in university students. However, insufficient PA is a serious health concern among university students. Active commuting provides an opportunity for increased PA levels. Therefore, the aims of this study were (a) to describe the mode of commuting, PA and fitness in university students; (b) to analyze the associations of mode of commuting with PA and fitness; and c) to analyze the relationship between mode of commuting, PA recommendations and fitness. METHODS: This was a cross-sectional study. A total of 1257 university students (52.4% women) participated (22.4 ± 5.6 years old). RESULTS: Public commuting was the main mode to and from university. Active and public commuters were more likely to meet the PA recommendations and reported higher muscular strength than those using private commuting. Active and public commuters who met PA recommendations present the highest fitness in most of its components. CONCLUSIONS: Achieving the PA recommendations was more relevant than adopting an active mode of commuting in order to have better fitness. Further research targeting a broader understanding of the mode of commuting, PA levels and fitness in university students is needed.

Prevalence of Physical Activity and Sedentary Behaviors in the French Population: Results and Evolution between Two Cross-Sectional Population-Based Studies, 2006 and 2016.

Insufficient physical activity and sedentary behaviors (SB) are major risk factors for non-communicable diseases. Monitoring the prevalence of physical activity (PA) and SB is essential to meet the health needs of the population. This article presents the prevalence of PA and SB in the French population and their evolution during the last decade. Data come from two cross-sectional surveys, representative of the population in France, the "Etude Nationale Nutrition Santé" 2006-2007 and the Esteban study 2014-2016, and were collected through the International Physical Activity Questionnaire and the Recent Physical Activity Questionnaire for adults, the Youth Risk Behavior Survey and specific questionnaire for children. In 2014-2016, 71% of men and 53% of women met the PA recommendations (5 or more days per week with a moderate-intensity physical activity of at least 30 min per day). Since 2006-2007, PA has decreased for women, but increased for men; 80% of adults reported a daily leisure screen time of at least three hours in 2014-2016, in strong growth since 2006-2007. Among children, only 51% of boys and 33% of girls were meeting the PA recommendations (at least 60 min of moderate- to vigorous-intensity physical activity daily). PA decreased significantly after the age of 10. Three-quarters of children spent two hours or more in front of a screen every day. These results show a lack of PA, in particular among women and girls, a high prevalence of SB in the French population, and a deterioration of these behaviours between 2006 and 2016.

Gender differences in physical activity and sedentary behavior: Results from over 200,000 Latin-American children and adolescents.

More physical activity and less sedentary behavior is beneficial for children and adolescents. Worldwide, gender differences are >8% favorable for men and the Latin-American region presents an even higher level of insufficient physical activity among women, with a lack of information in young population. Thus, the aim of the current study was to describe the gender differences in physical activity and recreational sedentary behavior in children and adolescents from Latin-American countries. The targeted age range was 5 to 17 years and included 219,803 participants (106,698 boys and 113,105 girls) from 33 out of 47 Latin-American countries identified. Physical activity guidelines from the World Health Organization (≥60 minutes of moderate-to-vigorous physical activity seven days of the week) and <3 hours recreational sedentary behavior daily were the references. In general, boys showed a higher prevalence of meeting physical activity guidelines in comparison with girls. A higher proportion of girls met the <3 hours recreational sedentary behavior cut-point in only ten countries. Thirty percent of the identified countries had no available data. The majority had data from the Global School-based Student Health Survey with data principally on adolescents and only 11/33 countries reported data in the last 5-year period. In conclusion, gender differences in the compliance with physical activity guidelines and the <3 hours recreational sedentary behavior cut-point are evident among children and adolescents from Latin-American countries, with boys being more active than girls.

Global prevalence of physical activity for children and adolescents; inconsistencies, research gaps, and recommendations: a narrative review.

BACKGROUND: One of the strategic actions identified in the Global Action Plan on Physical Activity (PA) 2018-2030 is the enhancement of data systems and capabilities at national levels to support regular population surveillance of PA. Although national and international standardized surveillance of PA among children and adolescents has increased in recent years, challenges for the global surveillance of PA persist. The aims of this paper were to: (i) review, compare, and discuss the methodological inconsistencies in children and adolescents' physical activity prevalence estimates from intercontinental physical activity surveillance initiatives; (ii) identify methodological limitations, surveillance and research gaps. METHODS: Intercontinental physical activity surveillance initiatives for children and adolescents were identified by experts and through non-systematic literature searches. Prevalence of meeting PA guidelines by country, gender, and age were extracted when available. A tool was created to assess the quality of the included initiatives. Methods and PA prevalence were compared across data/studies and against the methodological/validity/translation differences. RESULTS: Eight intercontinental initiatives were identified as meeting the selection criteria. Methods and PA definition inconsistencies across and within included initiatives were observed, resulting in different estimated national prevalence of PA, and initiatives contradicting each other's cross-country comparisons. Three findings were consistent across all eight initiatives: insufficient level of PA of children and adolescents across the world; lower levels of PA among girls; and attenuation of PA levels with age. Resource-limited countries, younger children, children and adolescents not attending school, with disability or chronic conditions, and from rural areas were generally under/not represented. CONCLUSIONS: There are substantial inconsistencies across/within included initiatives, resulting in varying estimates of the PA situation of children and adolescents at the global, regional and national levels. The development of a new PA measurement instrument that would be globally accepted and harmonized is a global health priority to help improve the accuracy and reliability of global surveillance.

France's 2020 Report Card on Physical Activity and Sedentary Behaviors in Children and Youth: Results and Progression.

BACKGROUND: There is an alarming and constant worldwide progression of physical inactivity and sedentary behaviors in children and adolescents. The present paper summarizes findings from France's 2020 Report Card on physical activity for children and youth, comparing its results to its 2 previous editions (2016 and 2018). METHODS: France's 2020 Report Card follows the standardized methodology established by the Active Healthy Kids Global Matrix, grading 10 common physical activity indicators using the best available evidence. The grades were informed by national surveys, peer-reviewed literature, government and nongovernment reports, and online information. RESULTS: The expert panel awarded the following grades: Overall Physical Activity: D; Organized Sport Participation and Physical Activity: C-; Active Play: INC; Active Transportation: C-; Sedentary Behaviors: D-; Family and Peers: D-; Physical Fitness: D; School: B-; Community and the Built Environment: F; Government: C. CONCLUSIONS: This 2020 edition of France's Report Card again highlights the alarming levels of physical activity and sedentary behaviors among French children and adolescents, calling for the development of effective national action. It also draws attention to the particular deleterious effects of the COVID-19 confinement on youth's movement behaviors, which significantly worsened the situation.

Profiles of Active Transportation among Children and Adolescents in the Global Matrix 3.0 Initiative: A 49-Country Comparison.

This article aims to compare the prevalence of active transportation among children and adolescents from 49 countries at different levels of development. The data was extracted from the Report Cards on Physical Activity for Children and Youth from the 49 countries that participated in the Global Matrix 3.0 initiative. Descriptive statistics and a latent profile analysis with active transportation, Human Development Index and Gini index as latent variables were conducted. The global average grade was a "C", indicating that countries are succeeding with about half of children and youth (47-53%). There is wide variability in the prevalence and in the definition of active transportation globally. Three different profiles of countries were identified based on active transportation grades, Human Development Index (HDI) and income inequalities. The first profile grouped very high HDI countries with low prevalence of active transport and low inequalities. The second profile grouped low and middle HDI countries with high prevalence of active transportation and higher inequalities. And the third profile was characterized by the relatively high prevalence of active transportation and more variability in the socioeconomic variables. Promising policies from countries under each profile were identified. A unified definition of active transportation and contextualized methods for its assessment are needed to advance in surveillance and practice.

Correction to: Comparing and assessing physical activity guidelines for children and adolescents: a systematic literature review and analysis.

An amendment to this paper has been published and can be accessed via the original article.