Report card grades on physical activity for children and adolescents from 18 Asian countries: Patterns, trends, gaps, and future recommendations.
Eun-Young Lee, An-Chi Shih, Maia Collins, Yeong-Bae Kim, Patrick Abi Nader, Jasmin Bhawra, Tarun Reddy Katapally, Chiaki Tanaka, Pairoj Saonuam, Piyawat Katewongsa, Dyah Anantalia Widyastari, Wendy Y Huang, Stephen H Wong, Asaduzzaman Khan, Narayan Subedi, Susan Paudel, Chen-Kang Chang, Ching-Lin Wu, Justin Y Jeon, Yeon Soo Kim, Tom Loney, Falk Müller-Riemenschneider, Bozhi Chen, Jonathan Y Cagas, Jyh Eiin Wong, Mohd Razif Shahril, Agus Mahendra, Mark S Tremblay
Author Information
Eun-Young Lee: School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
An-Chi Shih: School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Maia Collins: School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Yeong-Bae Kim: Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada.
Patrick Abi Nader: Universite du Quebec a Rimouski, QC, Canada.
Jasmin Bhawra: School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, Ontario, Canada.
Tarun Reddy Katapally: School of Health Studies, Faculty of Health Sciences, Western University, ON, Canada.
Chiaki Tanaka: Department of Human Nutrition, Tokyo Kasei Gakuin University, Tokyo, Japan.
Pairoj Saonuam: Healthy Lifestyle Section, Thai Health Promotion Foundation (ThaiHealth), Bangkok, Thailand.
Piyawat Katewongsa: Institute for Population and Social Research, Mahidol University, Thailand.
Dyah Anantalia Widyastari: Institute for Population and Social Research, Mahidol University, Thailand.
Wendy Y Huang: Department of Sport, Physical Education, and Health, Hong Kong Baptist University, Hong Kong, China.
Stephen H Wong: Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China.
Asaduzzaman Khan: School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Narayan Subedi: Central Department of Public Health, Institute of Medicine, Tribhuvan University, Nepal.
Susan Paudel: School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Australia.
Chen-Kang Chang: Department of Sport Performance, National Taiwan University of Sport, Taichung, Taiwan.
Ching-Lin Wu: Graduate Institute of Sports and Health Management, National Chung Hsing University, Taichung, Taiwan.
Justin Y Jeon: Department of Sport Industry, Yonsei University, Seoul, South Korea.
Yeon Soo Kim: Institute of Sport Science, Seoul National University, Seoul, South Korea.
Tom Loney: Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Falk Müller-Riemenschneider: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Bozhi Chen: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Jonathan Y Cagas: Department of Sports Science, College of Human Kinetics, University of the Philippines Diliman, Philippines.
Jyh Eiin Wong: Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Mohd Razif Shahril: Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Agus Mahendra: Faculty of Sport and Health Education, Universitas Pendidikan, Indonesia.
Mark S Tremblay: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Background: Physical inactivity is a persistent and worsening population health concern in Asia. Led by the Active Healthy Kids Global Alliance, Global Matrix (GM) initiative provides an opportunity to explore how regional and cultural differences across 18 Asian countries relate to physical activity (PA) participation among children and adolescents. Objectives: To synthesize evidence from the GM2.0 to GM4.0 (2016-2022) in Asian countries. Methods: Report Card grades on behavioral/individual and sources of influence indicators were reported from 18 Asian countries. Letter grades were converted into numerical values for quantitative analyses. Based on this, cross-sectional and longitudinal analyses were conducted to investigate patterns and trends. Qualitative evidence synthesis was performed based on Report Card grades and published papers to identify gaps and suggest future recommendations. Results: In total, 18 countries provided grades for at least one round of GM, 12 countries provided grades for at least two rounds, and seven countries provided grades for all three GMs. Of possible grades, 72.8%, 69.2%, and 76.9% of the grades were assigned from GM 2.0 to GM 4.0, respectively. In terms of the Report Card grades, there was a slight decrease in behavioral/individual indicators from "D+" in GM 2.0 to "D-" in GM 3.0 but this reverted to "D" in GM 4.0. For the sources of influence, a "C" grade was given in all three rounds of GM. Longitudinal observation of seven Asian countries that provided grades in all three rounds of GM revealed that grades are generally stable for all indicators with some country-specific fluctuations. In future GM initiatives and research, considerations should be made to provide more accurate and rich data and to better understand contextual challenges in evaluating certain indicators such as Active Transportation, Active Play, and Physical Fitness in particular. Further, macro level factors such as socioeconomic/cultural disparities and gender-specific barriers, ideology, or climate change should also be proactively considered in future research as these factors are becoming increasingly relevant to indicators of GM and United Nation's Sustainable Development Goals. Conclusions: Participation from Asian countries in GM has increased over the years, which demonstrates the region's enthusiasm, capacity, and support for global PA promotion efforts. The efforts to promote a physically active lifestyle among children and adolescents should be a collective interest and priority of the Asia region based on the gaps identified in this paper.
