A systematic review of instruments for the analysis of national-level physical activity and sedentary behaviour policies

Grant O’Sullivan,Zeljko Pedisic,Stuart J. H. Biddle,Karen Milton,Bojana Klepac Pogrmilovic

doi:10.1186/s12961-019-0492-4

Abstract

BackgroundThis systematic review aimed to identify and critically assess available instruments for the analysis of national-level physical activity (PA) and sedentary behaviour (SB) policies and provide recommendations for their future use.MethodsWe conducted a systematic search of academic and grey literature through six bibliographic databases, Google and the websites of three international organisations for PA promotion to identify instruments that are used or that may be used for national-level PA/SB policy analysis. In order to describe and categorise the identified instruments, we used the Comprehensive Analysis of Policy on Physical Activity framework. This framework specifies the elements of a comprehensive analysis of PA/SB policies through the following categories: purpose, level, policy sector, type of policy, stages of policy cycle and scope of analysis.ResultsOut of 22,071 screened items, 26 publications describing 16 instruments met the selection criteria. All the instruments can be used for analysing PA policy, whilst only two include questions about SB policy. None of the instruments allow for the analysis of all the relevant components of national PA/SB policy. Some important elements of PA policy analysis, such as the tourism and research sectors, the agenda-setting and endorsement/legitimisation stages, and the effects of policy, are addressed by only a few instruments. Moreover, none of the instruments address unwritten formal statements, informal policies, and the termination and succession stages of the policy cycle.ConclusionDesigning new instruments or adapting existing ones is needed to allow for a more thorough analysis of national PA and SB policies. Given that policy analysis covering all important components of PA/SB policy may be extremely time-consuming, a way forward might be to develop a set of complementary instruments, with each tool collecting detailed information about a specific component.

Highlights

This systematic review aimed to identify and critically assess available instruments for the analysis of national-level physical activity (PA) and sedentary behaviour (SB) policies and provide recommendations for their future use
To help readers understand how these sets of criteria may be used to collect data about PA/SB policy, we developed sample questions based on the items of 1 set of criteria [37] (Additional file 3)
Recommendations for the use of instruments for PA/SB policy analysis We suggest to future users of the instruments, such as policy analysts, policy-makers and other stakeholders, to first use the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework as a ‘road map’ to determine a more specific ‘route’ to answer their research question [35]

Summary

Introduction

This systematic review aimed to identify and critically assess available instruments for the analysis of national-level physical activity (PA) and sedentary behaviour (SB) policies and provide recommendations for their future use. In 2008, it was estimated that 1 in 10 deaths worldwide were attributable to insufficient physical activity (PA) [1]. From 2002 to 2011, sedentary behaviour (SB) was responsible for 3.8% of all deaths [2]. Both SB and insufficient PA are among the key risk factors for non-communicable diseases (NCDs) such as type 2 diabetes, cancer and cardiovascular disease. NCDs are responsible for the deaths of almost 40 million people per year, which is approximately 70% of the overall global mortality [4].

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