National physical activity policies

Background: Physical activity policies are key in creating enabling environments that prioritise population health. Unfortunately, less than one in five adolescents in Europe meet the daily physical activity recommendations of 60 minutes a day. Governments urgently need to enact policies to improve current physical activity levels. Purpose: The MOVING policy index assessed national government policy in physical activity across 30 European countries. The aim of the index was to compare government action and support stakeholders holding governments accountable on implementing well designed policies. Methods: Physical activity policies were identified through a comprehensive scan with a set methodology, including verification by national experts. These policy actions were benchmarked using evidence-informed policy design attributes. Results: Across all European countries analysed, action was concentrated on policy areas that require less systemic intervention. All countries developed public communications on physical activity, and policies to promote physical activity in schools and the community. Attention was also seen for action on offering physical activity counselling in healthcare settings but of comparatively worse policy design. Minimal action was taken at national level on policies targeting environments that support physical activity, including active design guidelines and infrastructure for active and public transport. Further, countries that did implement policies in these areas received poor assessments. For example, out of 25 countries that implemented policies on structures that enable physical activity, including design guidelines for open and green spaces, more than half were assessed as poor. Conclusions: Across Europe, key gaps in national government action in physical activity were seen in policies targeting the built environment and infrastructure for public and active transport. Practical implications: These findings are an important tool to keep track of national policy progress and to assess impact on population health outcomes in the future. Funding: This work received funding from EU Horizon 2020 programme (grant774210).

Background: The Gulf states have some of the lowest activity and some of the highest obesity levels in the world. Government policies are crucial for promoting physical activity but are under researched in this region. Purpose: To analyse physical activity policies in terms of structures, formulation, implementation, and evaluation in the six GCC member countries (Saudi Arabia, United Arab Emirates (UAE), Qatar, Oman, Kuwait, and Bahrain). Methods: We systematically searched the websites of the Ministries of Health, Education, Sport, Transport, Tourism, and Municipal Affairs of the GCC countries until February 2024. Experts from Saudi Arabia, Oman, and Bahrain were consulted to identify unpublished documents. Desk research questions from the HEPA Policy Audit Tool were used. Analytical themes were based on Howlett’s policy cycle framework, categorising policy-making into six stages. Results: Comparative analysis revealed centralised governance across GCC nations, except for the UAE’s federal monarchy system. Policy formulation typically involves collaboration among health, sports, and education ministries, though responsibilities vary. Sedentary behaviour reduction policies are lacking. Policy implementation lacks clear funding, especially for marginalised groups like individuals with disabilities. Evaluation lacks economic assessment. Conclusions: Our study revealed a dearth of policies targeting physical inactivity within the GCC. Enhancing transparency, inclusivity, and evaluation mechanisms are essential for fostering policy effectiveness. Practical implications: Our study provides insights for policymakers in the Gulf region, particularly in developing policies aimed at addressing sedentary behaviour and improving the evaluation framework for physical activity policies. Additionally, it serves as a foundation for researchers to identify and address gaps in future policy analysis, contributing to the advancement of effective strategies for promoting physical activity. Funding: This study was funded by the Ministry of Health of Saudi Arabia, and the University of Technology Sydney, Australia.

Growing of sedentary and physical inactivity behaviors added to the failure to respect primary schools curriculum in physical education in France, make the promotion of school physical activity a major stake. Hosting Olympics and Paralympics games in Paris in 2024 would be an opportunity. The 30 minutes of daily physical activity (“30APQ”) scheme, is seen as an important piece of the legacy project. This thesis project in public policy analysis and sociology focus on changes in educational politics through the example of physical activity promotion. We study the development of the program, emergence and implementation. In order to grasp talks that lead to form the scheme we realized observations during emerging phase (e.g. steering group meeting in games committee office, 2021). Thirty-five semi-structured interviews were conducted with individuals: 1) in a political setting (the Ministry of Sport, the Ministry of Education, the Olympic and Paralympic Games Committee); 2) in an intermediary capacity (in the decentralised departments of the ministries); 3) those working in the field (teachers). This first part of collection and data analysis is based on a qualitative methodology, a second part is a survey addressed to teachers. The objective is to measured extent of the scheme in two French departments. The first one is in the area of the games, the other around Rennes (Brittany). Data should complete first collection on the disparity of implementation, in number, forms and objectives, of the scheme. Our results from the qualitative analysis show that non-educational actors but medical staff and games organizer made choices about the form of the scheme. An outcome of it is the opposition, in the first place, of schools actors, explaining tardive implementation. We will defend that efficiency of physical activity promotion school programs cannot be understand without the study of his origin and actors involvement.

Background: Despite the opportunity that schools offer to access many students, the potential impacts of school-based interventions on the practice of moderate to high intensity physical activities (PA) remain uncertain (Love et al., 2019). Purpose: The objective of the research project was to document the effects, facilitating factors and barriers linked to the implementation of a government measure aimed at integrating a minimum of 60 minutes of opportunities to practice physical activities in a school context. Methods: A mixed longitudinal study over five years in five elementary schools in Quebec, Canada was carried out. Accelerometry data were collected to characterize the evolution of students’ PA practice. Semi-directed interviews and focus groups were conducted with students and members of school teams to identify the impact of the measure as well as the facilitating factors and barriers related to its implementation. Results: The measure allows schools to offer more than 60 minutes of opportunity per day to all students. A reduction in sedentary behavior and an increase in mild PA, in both girls and boys, was noted (p < .05). Facilitating factors and barriers are linked to different environments (political, municipal, community and school), as well as to student characteristics. Physical and health education (PE) teachers are identified as essential resources in the sustainability and quality of PA opportunities as well as motivating the school team to continue their actions. Conclusions: School-based interventions can have a positive effect on students' PA practice, but several factors can influence their implementation, including the central role that the PE teacher can play. References Love, R., et al. (2019). Are school‐based physical activity interventions effective and equitable? A meta‐analysis of cluster randomized controlled trials with accelerometer‐assessed activity. Obesity Reviews, 20(6), 859-870.

Background: To support policy development, a number of tools are available to inform policymakers about the current status of PA promotion in a country. However, an exchange between policymakers and researchers revealed a gap on the systematic assessment of “routine practice”, i.e. PA promotion activities already taking place on a large scale and on a regular basis (e.g., programs run by governmental or civil society organizations such as municipalities or sports federations). Purpose: This study aims to provide an overview of routine practice for PA promotion in Germany as part of the newly developed TARGET:PA tool. Methods: A systematic search for routine practice was conducted for adults, older adults and adults with noncommunicable diseases. Based on a search on Google and websites of relevant stakeholders, the results were categorized by sectors (e.g., sport, health, transport). In addition, the efficacy, reach, and maintenance of the identified routine practice were examined. Scientists and stakeholders were involved to verify the results. Results: The systematic approach yielded more than 100 routine practices of PA promotion. They focused both on behavior change (e.g., “bike to work” campaign, exercise referral schemes) and on structural interventions (e.g., public funding of sports for all). Most were identified for the sport sector. The results informed the development of policy briefs on PA promotion published by the German Federal Ministry of Health. Conclusions: Routine practice is relevant for policymakers as it already has a high reach, and substantial public health impact might be generated by further optimizing it rather than introducing new measures. Practical implications: Integrating routine practice into the monitoring of PA promotion could be an added value, and the approach has the potential to be adapted to other countries. Funding: This research was conducted as part of a project funded by the German Federal Ministry of Health (ZMI5-2523DIA001).

Background: Thailand has been working on health promotion policies since the signing of the 2010 Toronto Charter, and through the leadership of the Thai Health Promotion Foundation (ThaiHealth). The country has committed to support and promote physical activity (PA) for Thais in order to achieve and maintain good health. PA has also been entered as a national agenda under the country’s Promotion Plan for 2018–30. This presentation aims to assess Thailand’s policy readiness in supporting physical activity promotion for all populations. Policy Components: We collected 384 policy and strategy documents, rules, regulations, legislation, and guidelines on PA from online public databases and divided them into 8 domains following ISPAH’s recommendation on investments that works for PA. We evaluated and scored the policy documents using the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework, focusing on three indicators: Type of policy, Stage of policy cycle, and Policy resources. Evaluation: The highest policy readiness was found in the field of public education and mass media, shown by adequate amounts of policies/programs, available either at the national or community level, in various policy stages, and in any format. The least readiness was found in the workplace and healthcare settings, indicating a lack of investment in both sectors. Conclusions: Policies to support physical activity promotion have been readily available in Thailand, for all 8 domains of investment. Varying levels of readiness indicating government priorities and agenda have been primarily focused on the best-buys targeting general populations, and have not yet adequately addressed specific groups of population (workers, patients). Practical implications: Understanding policy readiness in PA promotion in 8 domains is important to evaluate the current policy practices. From this point, how far the policies have been implemented and the likelihood of public participation can be estimated. Funding: Thai Health Promotion Foundation

Background: Public policies are an important upstream component of physical activity (PA) as they can influence whole populations. The systematic evaluation, benchmarking and monitoring of public policies that promote healthy environments is needed for accountability and assessment of impact. Purpose: The Physical Activity Environment Policy Index (PA-EPI) is a tool developed to facilitate comparative PA policy research. This study presents the learnings of PA-EPI implementation in Ireland (IE) and the Netherlands (NL). Methods: Implementation of PA-EPI comprised 8-steps. Steps 1-4 involved collecting evidence of policy implementation and its validation by government officials. Cross-sectoral coalitions of non-government experts rated the extent of implementation against best practice (steps 5-6). Based on expert ratings, a scorecard categorized indicators into high, medium, low or none/very little implementation. Step 7-8 identified future implementation actions. Results: Government officials in IE (N=4) and NL (N=15) validated their respective PA-EPIs, yielding minor changes (steps 1-4). Experts in IE (N=16) and NL (n=14) rated the extent of policy implementation (step 5-6). IE obtained one none/very little, 25 low, 19 medium, and zero high implementation scores, whereas NL received zero none/very little, 10 low, 28 medium and 7 high implementation scores. Implementation gaps were identified in transport, urban design and healthcare policy domains for IE, and one indicator in the education, mass media, sport for all and workplace domains received a low score in NL. In infrastructure support, gaps for IE emerged in the Health in All Policies domain, leadership scored the lowest in NL. Conclusions: Results show policy implementation as uneven, with important gaps in several domains. Prioritized recommendations provided a pathway for governments to take action and demonstrate progress over time. Practical implications: Future cross-country comparisons of PA-EPI results will help establish benchmarks for governments at the forefront of creating and implementing policies to promote PA. Funding: JPI