# data[].attributes.headline
SR/MA for RCT school based interventions however showed no effect when looked at whole day PA e.g. they were more active at school but then did less outside of school (compensation - activity stat- wilkin)  ( Love et al) - high risk of bias in studies- efficacy not effectiveness

# data[].attributes.subject
SR/MA for RCT school based interventions however showed no effect when looked at whole day PA e.g. they were more active at school but then did less outside of school (compensation - activity stat- wilkin)  ( Love et al) - high risk of bias in studies- efficacy not effectiveness

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Great variation in estimates within and between countries - do we really have accurate information on current prevalence ? (think about issues with measurement of PA) - most are subjective assessment - global matrix uses objective data in sub sample. 

# data[].attributes.subject
Great variation in estimates within and between countries - do we really have accurate information on current prevalence ? (think about issues with measurement of PA) - most are subjective assessment - global matrix uses objective data in sub sample. 

# data[].attributes.body
selection bias? do all reply to surveys?

Data not presented for subgroups - who we know are less active e.g. low SES, ethnic, disability groups, population specific.

Key article for critique

Aubert 2021

(see slide 13 assync children)

What part of the GAPPA could this relate to? - Data systems Objective 4 and overall objective of 10% and 15% reduction in inactivity.

Gaps - no data for pre school, by specific ages, population groups - we know children generally less active as they get older, girls less active (slide 17 assync children)

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Comparing the two interventions used in the report critically but still focusing on them 

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Comparing the two interventions used in the report critically but still focusing on them 

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Range of interventions have been used to improve PA in children and reduce inactivity, these range from policy interventions and initiatives funded by national lottery (PE curriculum, PE funding, daily mile, sport england - play their way, YMCA etc) aswell as research designed and funded targeting broadly the school or parts of the school day, home and family interventions, community interventions or multi-component interventions (combination of the above, often use combination of strategies also e.g. education with activity (sometimes diet aswell).

Despite policy intervention- change to PE curriculum, large investment (PE funding) since 2013 - schools are still not compliant with 2 hours of quality PE a week, lack competency in the fundamental movement skills required for lifelong PA,only 72% can swim... obesity figures still stable and ofsted series review for PE shows a number of issues in it's implementation (See slides 27 -39).

The wealth of this evidence has focused on the school, less beyond the school (community, family) (Mannocci et al., 2020- SR). They are most effective (Add effect sizes) when they are theory informed (designed and implemented through the theoretical elements - remember the behaviour change theories here) and have multi components - PA is mainly the outcome measures assessed- BUT studies are reported as low quality generally and only show efficacy NOT effectiveness (not implemented in real world settings with the real world challenges - think back to the arguments in the HAGGER & WEED paper you read as a directed task).- see Slides 44, 45 assync children. Equally - we need to be able to effectively intervene we need to understand the factors influencing PA behaviours and target these - do the planned interventions target the wider issues (See qualitative studies on barriers such as presented in slide 22, what teachers say about daily mile - slide 26, qualitative data presented on slide 69 and you will find other arguments - have we captured this for all the people currently inactive? )

meta-analysis of RCT suggested from pooled effect of studies in school - that there was no effect on daily minutes in MVPA across the day (they were active at school but then seemed to do less outside of this - compensation effect, activity stat?) - Love et al., 2019 - slide 49.

Difficult to move the field forward when we lack data on what makes interventions work or not (the influencers and mediators of change - think about process evaluation and implementation science here - slide 43, 62.

Despite this, some theory informed and well designed studies (SCORES, Y-PATH) that have understood the needs of the group and used that to design interventions have shown some success (add values and variables). These students have used a combination of strategies and integration of multiple theories (you can extend your argument here - what theories are commonly used? integrated? common outcomes, gaps e.g. health outcomes?) (See slides 51, 52, 53, 54 of assync lecture children) -

Play their way also well designed/theory informed - but we dont have how they will evaluate their effectiveness....

Further critical arguments for this section see slide 55 and 59 for summaries (but make sure you support these arguments - these arguments were generated from the content in the slides that came before them.

Key papers:

Love et al., 2019

Mannacci et al., 2020

Hagger & Weed debate

& many more..... but draw from systematic reviews

What parts of the global action plan does it fit with:

Mainly promoting active people

if there is an education elements - it may also fit within creating active societies e.g. shifting in knowledge and appreciation of PA

cost of implementation?

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Global Matrix (uses subjective and objective data) 

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Global Matrix (uses subjective and objective data) 

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Global Overall PA suggested to be C- (Succeeding approx half of all children)

Sedentary behaviours - C+ - Succeeding 54- 59%

+ also presents data for other areas which may be helping in understanding areas to target and tracking changes by objectives e.g. active transport (active spaces and places objective),

see slide 15, 16, 17 of assync lecture

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Theory informed, multi-component interventions most successful (large number of SR/MA confirm this - see Dobbins, Jones, etc)

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Theory informed, multi-component interventions most successful (large number of SR/MA confirm this - see Dobbins, Jones, etc)

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New initiatives for early years coming out: IMPORTANT as little research in younger years

SUNRISE

SADEY

AHKGA

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Screen time limits to help reduce physical inactivity

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Looking at different populations and issues as money, transport and ethnicity can all effect people's participation in PA

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Looking at different populations and issues as money, transport and ethnicity can all effect people's participation in PA

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Our guidelines show an AVERAGE of 60mins per day however other countries show it to be a mix

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worldwide variation in PA guidelines for children and adolescents (Parrish et al., 2020), generally agree 60 minutes and moderate but vary in bone and muscle (frequency), sedentary, some include sleep and some discuss that bouts have to be achieved 

# data[].attributes.subject
worldwide variation in PA guidelines for children and adolescents (Parrish et al., 2020), generally agree 60 minutes and moderate but vary in bone and muscle (frequency), sedentary, some include sleep and some discuss that bouts have to be achieved 

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Chief Medical Officer UK guidelines (2019-2020)

World Health Organisation (2020) guidelines

Evidence since guidelines have been developed show benefits of PA on education outcomes (classroom concentration, behaviour, academic achievement), affective responses (emotional regulation, impulse control, intrinsic motivation, task behaviour, decreased discipline) social (social interaction, social engagement, peer support, feeling connected) and wellbeing (see slide 11 assync children for refs). Specifically, systematic reviews and Meta-analysis by Li et al., (2022) reports 30-60min PA in adolescents on positive emotions.

Areas less known about?

Key article for critique:

Parrish et al. 2020 (See slide 12- Assync children)

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Subjective population data is synthesised using questionnaires which only provides a limited view.

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Lower PA in ethnic and SES groups (Aubert)

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Lower PA in ethnic and SES groups (Aubert)

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Focus conclusion on interventions already conducted rather than new content

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Aubert et al (2021) ~~> show insufficient PA in kids across world (9-86%)

Girls are more like to be less active

No prevalence data on kids less then 5

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Large methodological inconsistencies across international/national ~~> leads to differing estimates

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Interventions/questionnaires/lots of valid paper are done or focused in high income western countries ~~> what about language barriers/cultural difference