Policy Evaluation Network (PEN): Protocol for systematic literature review examining the evidence for impact of school policies on physical activity

Kevin Volf,Anna Gobis,Sarah Forberger,Joanna Zukowska,Catherine Woods,Jeroen Lakerveld,Enrique García Bengoechea,Liam Kelly,Sven Messing,Blathin Casey,Peter Gelius

doi:10.12688/hrbopenres.13089.1

Abstract

Introduction: Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity attributes an estimated 9% to this figure. Global responses have included the sustainable development goals and the global action plan on physical activity. Both point to policy action in physical activity (PA) to address change, yet the impact of policy is unknown. The protocol described outlines a systematic literature review that will be undertaken by the Policy Evaluation Network to address this knowledge gap. Protocol: This review of school PA policies is the first of seven planned reviews. The seven best investments for promotion of population PA identified in the Toronto Charter (whole-of-school programmes, transport policy, urban design policy, primary health care policy, public education policy, community programmes and sport programmes) will form the basis of these reviews. Seven individual scientific literature searches across six electronic databases, using key concepts of policy, PA, evaluation and a distinct concept for each area will be conducted. This will be supplemented with a search of the reference list of included articles. Methodological quality will be assessed and overall effectiveness for each included study will be described according to pre-determined categories. Conclusions: The review will provide policy makers with a list of policy statements and corresponding actions which the evidence has determined impact on PA directly or indirectly. By collating the evidence, and demonstrating the depth of the science base which informs these policy recommendations, this review will provide guidance to policymakers to use evidence-based or evidence-informed policies to achieve the 15% relative reduction in physical inactivity as defined by the ‘Global Action Plan on Physical Activity’. Registration: PROSPERO CRD42020156630 (10/07/2020).

Highlights

Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity attributes an estimated 9% to this figure
Insufficient physical activity (PA) has been identified by the World Health Organisation (WHO) as the fourth leading risk factor for mortality worldwide (WHO, 2009) and in 2012 it was estimated that 9% of global premature mortality can be attributed to physical inactivity (Lee et al, 2012)
In order to reflect the complexity of the policies that may affect the PA policy environment, a distinction is made between “direct” policies, which refers to policies where improving the PA environment and increasing participation is the primary aim, and “indirect” policies, where the primary aim of the policy is not to increase PA but this may occur as a co-benefit of successful implementation

Summary

Introduction

It would be helpful to include specific aims of the systematic review. P 4- Eligibility criteria The authors need to clearly define what they mean by a ‘whole of school approach’ what are the critical components or does a policy just need to be labelled as such? For examples, does a ‘whole of school’ approach need to address the elements identified in ISPAH 2012: i.e. “prioritizing: regular, highly-active, physical education classes; providing suitable physical environments and resources to support structured and unstructured physical activity throughout the day (e.g., play and recreation before, during and after school); supporting walk/cycle-to-school programs and enabling all of these actions through supportive school policy and engaging staff, students, parents and the wider community”. Each review is designed to determine the impact of policy, either directly or indirectly, on physical activity outcomes across the different policy domains identified in the “Seven Best Investments” ( ISPAH, 2011) These policy domains are whole-of-school programmes, transport policies and systems, urban design regulations and infrastructure, primary health care, public education, communitywide programmes involving multiple settings and sport systems and programmes that promote ‘sport for all’. -This may be challenging, but until we examine the main results and conclusions of any systematic reviews that have reference to policy impact in the targeted domains, we cannot be sure of whether their evidence is strong enough and clearly defined in order to assess impact While we agree it may be difficult, in the search strategy we will include these documents in the initial search and depending on what we find include or exclude in the final data synthesis.

Conclusion

Findings