1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconn...1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconnected social,economic,and environmental targets.展开更多
Background:Physical fitness is a key indicator of current and future health in children and adolescents.Evidence suggests that fitness levels have declined then stagnated in recent decades,but it remains unclear how t...Background:Physical fitness is a key indicator of current and future health in children and adolescents.Evidence suggests that fitness levels have declined then stagnated in recent decades,but it remains unclear how the coronavirus disease 2019(COVID-19)pandemic has impacted this trend.Methods:We conducted a systematic review and meta-analyses to assess pandemic-related changes in physical fitness among children and adolescents(0-19 years)in the World Health Organization European Region.Seven databases were searched up to February 28,2025 for studies reporting validated pre-and during/post-pandemic fitness measurements.Two reviewers independently performed screening,data extraction,risk-of-bias assessment(Risk Of Bias In Non-randomized Studies-of Exposure)(ROBINS-E),and certainty grading(Grading of Recommendations,Assessment,Development and Evaluation)(GRADE).Random-effects meta-analyses yielded standardized mean differences(SMDs)with 95%confidence intervals(95%CIs).Subgroup analyses examined sex,age,year,and national restriction severity(Oxford Stringency Index).Results:Thirty-two studies comprising 270,179 participants and 1,519,386 fitness measurements from 17 European countries were included.Cardiorespiratory fitness declined significantly during the pandemic,especially in 2021,with reductions in endurance(SMD=-0.43;95%CI:-0.61 to-0.25)and speed(SMD=-0.29;95%CI:-0.61 to 0.03).While speed returned to baseline by 2023,endurance remained below pre-pandemic levels(SMD=-0.10;95%CI:-0.12 to-0.08).Girls and adolescents were disproportionately affected.In contrast to cardiorespiratory fitness,muscular fitness remained largely unchanged.Stricter national regulations were associated with greater declines in cardiorespiratory fitness.Conclusion:COVID-19 pandemic restrictions were associated with a marked decline in cardiorespiratory fitness in European children and adolescents,with levels not recovered by 2023.These findings call for urgent,targeted public health interventions to improve physical fitness and prevent long-term health consequences.展开更多
Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is ...Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is designed to assess physical activity(PA)across all key domains(i.e.,school,chores,work/volunteering,transport,free time,outdoor time).It aimed to address multiple gaps in global PA surveillance(e.g.,omission of important PA domains,insufficient cultural adaptation,underrepresentation of rural areas in questionnaire validation studies).The purpose of this study was to assess the content validity of the GAC-PAQ among PA experts,8-to 17-year-olds,and one of their parents/guardians,and to discuss changes made to the questionnaire based on participants'feedback.Methods:Sixty-two experts in PA measurement and/or surveillance from 24 countries completed an online survey that included both closed-and open-ended questions about the content validity of the GAC-PAQ.The proportion of experts who agreed or strongly agreed with the items was calculated.Child-parent/guardian dyads from 15 countries(n=250;10-40 per country)participated in a structured cognitive interview to assess the clarity of the questions and response options,and they were encouraged to provide suggestions to improve clarity and facilitate completion of the questionnaire.Participating countries are:Aotearoa New Zealand,Brazil,Canada,China,Colombia,Czech Republic,India,Malawi,Mexico,Nepal,Nigeria,Spain,Sweden,Thailand,and the United Arab Emirates.Interviews were conducted in 13 different languages and structured by PA domain.Generic images were included to help participants in answering questions about PA intensity.Results:Expert agreement with the items for each domain exceeded 75%,and their qualitative feedback was used to revise the questionnaire before cognitive interviews.In general,participants found the questionnaire to be comprehensive.Adolescents(12-17 years)found it easier than children(8-11 years)to answer the questions.Several children struggled to answer questions about the duration and intensity of activities and/or concepts related to travel modes,active trips,and organized activities.Many parents/guardians were unsure about the frequency,duration,and intensity of their children's or adolescents'PA at school and/or recommended using more culturally relevant and appropriate images.Some participants misunderstood the concept of activities that“make you stronger”(intended to assess resistance activities)and/or struggled to differentiate between work,volunteering,and chores.Conclusion:Participants'feedback was used to develop a revised,simplified,and culturally adapted GAC-PAQ,which will be pilot-tested in all15 countries in an App that will include country-specific images and narration in local languages.Further research is needed to assess the reliability and validity of the revised GAC-PAQ.展开更多
文摘1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconnected social,economic,and environmental targets.
文摘Background:Physical fitness is a key indicator of current and future health in children and adolescents.Evidence suggests that fitness levels have declined then stagnated in recent decades,but it remains unclear how the coronavirus disease 2019(COVID-19)pandemic has impacted this trend.Methods:We conducted a systematic review and meta-analyses to assess pandemic-related changes in physical fitness among children and adolescents(0-19 years)in the World Health Organization European Region.Seven databases were searched up to February 28,2025 for studies reporting validated pre-and during/post-pandemic fitness measurements.Two reviewers independently performed screening,data extraction,risk-of-bias assessment(Risk Of Bias In Non-randomized Studies-of Exposure)(ROBINS-E),and certainty grading(Grading of Recommendations,Assessment,Development and Evaluation)(GRADE).Random-effects meta-analyses yielded standardized mean differences(SMDs)with 95%confidence intervals(95%CIs).Subgroup analyses examined sex,age,year,and national restriction severity(Oxford Stringency Index).Results:Thirty-two studies comprising 270,179 participants and 1,519,386 fitness measurements from 17 European countries were included.Cardiorespiratory fitness declined significantly during the pandemic,especially in 2021,with reductions in endurance(SMD=-0.43;95%CI:-0.61 to-0.25)and speed(SMD=-0.29;95%CI:-0.61 to 0.03).While speed returned to baseline by 2023,endurance remained below pre-pandemic levels(SMD=-0.10;95%CI:-0.12 to-0.08).Girls and adolescents were disproportionately affected.In contrast to cardiorespiratory fitness,muscular fitness remained largely unchanged.Stricter national regulations were associated with greater declines in cardiorespiratory fitness.Conclusion:COVID-19 pandemic restrictions were associated with a marked decline in cardiorespiratory fitness in European children and adolescents,with levels not recovered by 2023.These findings call for urgent,targeted public health interventions to improve physical fitness and prevent long-term health consequences.
基金supported by a Project Grant(Grant No.PJT183705)an Early Career Investigator Prize(Grant No.ECP 184184)from the Canadian Institutes of Health Research+7 种基金a Prentice Institute Research Affiliate Fund Grant from the Prentice Institute for Global Population and Economy(Grant No.G00004116)a Te Herenga Waka Victoria University of Wellington Division of Science Health Engineering Architecture and Design Innovation Faculty Strategic Research Grant(Grant No.FSRG-SHEADI-10724)The Thailand Physical Activity Knowledge Development Centre(TPAK)/Thai Health Promotion Foundation provided funding for the cognitive interviews and pilot study in Thailand(Grant No.66-P1-0473)The University Pablo de Olavide provided a scholarship for 2 undergraduate students working on the project(codes PPI2207 and PPI2308)In the Czech Republicthe study was supported by Palacky University IGA(Grant No.IGA_FTK_2023_017)supported by the Division of Intramural Research at the National Institute on Minority Health and Health Disparities of the National Institutes of Healthsupported by the Key Project of the National Philosophy and Social Science Foundation of China(23&ZD197)。
文摘Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is designed to assess physical activity(PA)across all key domains(i.e.,school,chores,work/volunteering,transport,free time,outdoor time).It aimed to address multiple gaps in global PA surveillance(e.g.,omission of important PA domains,insufficient cultural adaptation,underrepresentation of rural areas in questionnaire validation studies).The purpose of this study was to assess the content validity of the GAC-PAQ among PA experts,8-to 17-year-olds,and one of their parents/guardians,and to discuss changes made to the questionnaire based on participants'feedback.Methods:Sixty-two experts in PA measurement and/or surveillance from 24 countries completed an online survey that included both closed-and open-ended questions about the content validity of the GAC-PAQ.The proportion of experts who agreed or strongly agreed with the items was calculated.Child-parent/guardian dyads from 15 countries(n=250;10-40 per country)participated in a structured cognitive interview to assess the clarity of the questions and response options,and they were encouraged to provide suggestions to improve clarity and facilitate completion of the questionnaire.Participating countries are:Aotearoa New Zealand,Brazil,Canada,China,Colombia,Czech Republic,India,Malawi,Mexico,Nepal,Nigeria,Spain,Sweden,Thailand,and the United Arab Emirates.Interviews were conducted in 13 different languages and structured by PA domain.Generic images were included to help participants in answering questions about PA intensity.Results:Expert agreement with the items for each domain exceeded 75%,and their qualitative feedback was used to revise the questionnaire before cognitive interviews.In general,participants found the questionnaire to be comprehensive.Adolescents(12-17 years)found it easier than children(8-11 years)to answer the questions.Several children struggled to answer questions about the duration and intensity of activities and/or concepts related to travel modes,active trips,and organized activities.Many parents/guardians were unsure about the frequency,duration,and intensity of their children's or adolescents'PA at school and/or recommended using more culturally relevant and appropriate images.Some participants misunderstood the concept of activities that“make you stronger”(intended to assess resistance activities)and/or struggled to differentiate between work,volunteering,and chores.Conclusion:Participants'feedback was used to develop a revised,simplified,and culturally adapted GAC-PAQ,which will be pilot-tested in all15 countries in an App that will include country-specific images and narration in local languages.Further research is needed to assess the reliability and validity of the revised GAC-PAQ.
