A Meta-analysis Protocol Among Active Healthy Kids Report Cards’ Indicators In East Asian Regions

Abstract

Insufficient physical activity (PA) is one of the leading risk factors for mortality. Evidence related to PA in children and youth has been assessed comprehensively in the Active Healthy Kids Report Cards worldwide. However, the association between influence indicators and behavioral indicators among Report Cards are yet to be critically appraised and synthesized using the method of meta-analysis. PURPOSE: We aim to perform meta-analyses for indicators in overall PA, sedentary behaviors, school, family & peers, and community & environment among East Asian regions with very high Human Development Indices. METHODS: We conducted literature search in six international databases, including CENTRAL, MEDLINE, EMBASE, PscyINFO, Global Health, and BIOSIS. Observational studies with at least one influence indicator and one behavioral indicator will be considered eligible and data will be extracted for meta-analyses. The strength of association between influence indicators and behavioral indicators will be synthesized. The pooled effect sizes and their 95% confidence intervals for each association will be calculated. Newcastle-Ottawa Scale will be used for the risk of bias assessment among included observational studies. RESULTS: Twenty eligible observational studies including cohort studies and cross-sectional studies were included. From these 20 included studies, twelve, seven, and one were from Hong Kong, South Korea, and Japan respectively. Ten studies addressed behavioral indicators, e.g. the association between screen time and obesity. The other ten studies addressed influence indicators, e.g. the association between parents’ exercise frequency and the children’s intention to participate in PA. CONCLUSIONS: Results of meta-analyses may inform better decision-making in tackling complex public health crisis created by physical inactivity and sedentary behaviors among children and youth in East Asian regions, triggering the engagement with relevant stakeholders among sectors of the community, as well as their joint cooperation in the development of a more friendly environment for children and youth to perform PA.