Review of global and national physical activity and sedentary behaviour guideline development processes

Background: The World Health Organization and national health bodies of many countries have released physical activity guidelines (with many also covering sedentary behaviour). Despite significant overlap in the body of evidence reviewed, the resultant sets of guidelines are not always consistent.

Purpose: This study involved a review of the processes used to develop global and national physical activity and sedentary behaviour guidelines and examined the extent to which they conform with minimum methodological standards.

Methods: The most recent national and global physical activity guidelines for children and youth and/or adults (any language) were eligible for inclusion if they were developed through a formal review process. We rated each set of guidelines as high, medium, or low quality in relation to each item in domain 3 (rigour of development) of the Appraisal of Guidelines for Research and Evaluation 2 (AGREE 2) tool. We extracted data on nine sets of guidelines from seven jurisdictions (WHO, Australia, Canada, Japan, the Netherlands, UK, and US).

Results: We observed variation in the quality of guideline development processes across jurisdictions and across different elements of AGREE 2. The strongest ratings related to the criteria for selecting the evidence being clearly described and stating an explicit link between the recommendations and the supporting evidence. The weakest ratings related to the methods for formulating the recommendations being clearly described, and the guidelines being externally reviewed by experts prior to publication.

Conclusion: Against different elements of AGREE 2, the quality of guideline development processes was highly variable across jurisdictions. Reaching agreement on acceptable guideline development processes, as well as the inclusion and appraisal procedures of different types of evidence, would strengthen and align future physical activity and sedentary behaviour guidelines.

Practical implications: This study highlights the need to establish consensus on the minimum standards for guideline development.

Funding:
None