Physical activity of children: a global matrix of grades comparing 15 countries

The Active Healthy Kids Canada (AHKC) Report Card on Physical Activity for Children and Youth has been effective in powering
the movement to get kids moving by influencing priorities, policies, and practice in Canada. The AHKC Report Card process was
replicated in 14 additional countries from 5 continents using 9 common indicators (Overall Physical Activity, Organized Sport
Participation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and Built Environment,
and Government Strategies and Investments), a harmonized process and a standardized grading framework. The 15 Report
Cards were presented at the Global Summit on the Physical Activity of Children in Toronto on May 20, 2014. The consolidated
findings are summarized here in the form of a global matrix of grades. There is a large spread in grades across countries for most
indicators. Countries that lead in certain indicators lag in others. Overall, the grades for indicators of physical activity (PA) around
the world are low/poor. Many countries have insufficient information to assign a grade, particularly for the Active Play and Family
and Peers indicators. Grades for Sedentary Behaviors are, in general, better in low income countries. The Community and Built
Environment indicator received high grades in high income countries and notably lower grades in low income countries. There was
a pattern of higher PA and lower sedentary behavior in countries reporting poorer infrastructure, and lower PA and higher sedentary
behavior in countries reporting better infrastructure, which presents an interesting paradox. Many surveillance and research
gaps and weaknesses were apparent. International cooperation and cross-fertilization is encouraged to tackle existing challenges,
understand underlying mechanisms, derive innovative solutions, and overcome the expanding childhood inactivity crisis.