An international Delphi-based consensus statement on physical activity and sedentary behaviour guideline development processes

Background: The World Health Organization and many national health bodies have released physical activity and sedentary behaviour guidelines. However, there is variation in the quality of guideline development processes, the types of evidence considered, and how evidence is appraised, which may partly explain inconsistencies in existing guidelines.

Purpose: To develop international consensus on the methodological standards applied to the development of future physical activity and sedentary behaviour guidelines.

Methods: We used a three round modified Delphi study. Participants with expertise in physical activity and/or guideline development rated a series of statements on expert involvement; the types of evidence and study designs considered; and the utilisation of formal approaches in guideline development processes. Consensus was defined as group agreement of ≥80%.

Results: 23 participants from eight countries reached consensus that 1) a range of stakeholders should be involved in different stages of the guideline development process (evidence review, production of recommendations, messaging, and guideline dissemination); 2) previous study-level synthesised evidence must be included in evidence reviews and individual studies can be included if published after the most recent review or where review evidence is unavailable; 3) parallel randomised controlled studies must be included, prospective cohort studies should be included, and predictive modelling, cross-over trials, non-randomised trials and case control studies can be included in review processes; and 4) formal approaches should be utilised to assess the quality of individual primary studies, the reporting and quality of systematic reviews, and the overall process for grading evidence.

Conclusions: Consensus on who should be involved, the types of evidence and study designs that should be considered, and the need for formal quality assessments was achieved.

Practical implications: The findings provide a set of methodological standards to improve consistency and rigour in the development of future physical activity and sedentary behaviour guidelines.  

Funding: None