. 2022 Jan 6;19(1):2.

doi: 10.1186/s12966-021-01236-2.

A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep

Anthony D Okely^{1

2}, Davina Ghersi^{3

4}, Sarah P Loughran^{5

6}, Dylan P Cliff^{5

6}, Trevor Shilton⁷, Rachel A Jones^{5

6}, Rebecca M Stanley^{5

6}, Julie Sherring⁵, Natalie Toms⁸, Simon Eckermann⁹, Timothy S Olds¹⁰, Zhiguang Zhang⁵, Anne-Maree Parrish⁵, Lisa Kervin⁵, Sandra Downie⁸, Jo Salmon¹¹, Clair Bannerman¹², Tamie Needham¹³, Elaine Marshall¹⁴, Jordy Kaufman¹⁵, Layne Brown⁵, Janecke Wille¹⁶, Greg Wood¹⁷, David R Lubans¹⁸, Stuart J H Biddle¹⁹, Shane Pill²⁰, Anthea Hargreaves²¹, Natalie Jonas²², Natasha Schranz^{10

23}, Perry Campbell²⁴, Karen Ingram²⁵, Hayley Dean²⁵, Adam Verrender⁵, Yvonne Ellis⁵, Kar Hau Chong⁵, Dorothea Dumuid¹⁰, Peter T Katzmarzyk²⁶, Catherine E Draper²⁷, Hayley Lewthwaite⁹, Mark S Tremblay²⁸

Affiliations

¹ Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia. tokely@uow.edu.au.
² Illawarra Health and Medical Research Institute, Wollongong, Australia. tokely@uow.edu.au.
³ Research Policy and Translation, National Health and Medical Research Council, Canberra, Australia.
⁴ National Health & Medical Research Council Clinical Trials Centre, Sydney Medical School, University of Sydney, Sydney, Australia.
⁵ Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.
⁶ Illawarra Health and Medical Research Institute, Wollongong, Australia.
⁷ National Heart Foundation (WA), 334 Rokeby Road, Subiaco, Australia.
⁸ Preventive Programs, Commonwealth Department of Health, Canberra, Australia.
⁹ Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia.
¹⁰ Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
¹¹ Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia.
¹² Department of Education, Canberra, Australia.
¹³ Department of Health, Darwin, NT, Australia.
¹⁴ Department of Health, Tasmania, Australia.
¹⁵ Swinburne University of Technology, Melbourne, Australia.
¹⁶ Federation of Ethnic Communities Council of Australia (FECCA), Canberra, Australia.
¹⁷ Australian Sports Commission, Leederville, Western Australia.
¹⁸ Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, Australia.
¹⁹ Centre for Health Research, University of Southern Queensland, Springfield Central, Toowoomba, Australia.
²⁰ The Australian Council for Health, Physical Education and Recreation (ACHPER), Wayville, Australia and Flinders University, Adelaide, South Australia.
²¹ Cycling and Walking Australia New Zealand, Whanganui, New Zealand.
²² Australian Curriculum, Assessment and Reporting Authority (ACARA), SA, Sydney, Australia.
²³ Active Healthy Kids Australia, Adelaide, Australia and National Heart Foundation, Adelaide, South Australia.
²⁴ Australian Children's Education & Care Quality Authority (ACECQA), Sydney, Australia.
²⁵ NSW Education Standards Authority (NESA), Sydney, Australia.
²⁶ Pennington Biomedical Research Center, Louisiana, USA.
²⁷ SAMRC/Wits Developmental Pathways for Health, University of the Witwatersrand, Johannesburg, South Africa.
²⁸ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.

PMID: 34991606
PMCID: PMC8734238
DOI: 10.1186/s12966-021-01236-2

A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep

Anthony D Okely et al. Int J Behav Nutr Phys Act. 2022.

. 2022 Jan 6;19(1):2.

doi: 10.1186/s12966-021-01236-2.

Authors

Affiliations

¹ Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia. tokely@uow.edu.au.
² Illawarra Health and Medical Research Institute, Wollongong, Australia. tokely@uow.edu.au.
³ Research Policy and Translation, National Health and Medical Research Council, Canberra, Australia.
⁴ National Health & Medical Research Council Clinical Trials Centre, Sydney Medical School, University of Sydney, Sydney, Australia.
⁵ Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.
⁶ Illawarra Health and Medical Research Institute, Wollongong, Australia.
⁷ National Heart Foundation (WA), 334 Rokeby Road, Subiaco, Australia.
⁸ Preventive Programs, Commonwealth Department of Health, Canberra, Australia.
⁹ Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia.
¹⁰ Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
¹¹ Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia.
¹² Department of Education, Canberra, Australia.
¹³ Department of Health, Darwin, NT, Australia.
¹⁴ Department of Health, Tasmania, Australia.
¹⁵ Swinburne University of Technology, Melbourne, Australia.
¹⁶ Federation of Ethnic Communities Council of Australia (FECCA), Canberra, Australia.
¹⁷ Australian Sports Commission, Leederville, Western Australia.
¹⁸ Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, Australia.
¹⁹ Centre for Health Research, University of Southern Queensland, Springfield Central, Toowoomba, Australia.
²⁰ The Australian Council for Health, Physical Education and Recreation (ACHPER), Wayville, Australia and Flinders University, Adelaide, South Australia.
²¹ Cycling and Walking Australia New Zealand, Whanganui, New Zealand.
²² Australian Curriculum, Assessment and Reporting Authority (ACARA), SA, Sydney, Australia.
²³ Active Healthy Kids Australia, Adelaide, Australia and National Heart Foundation, Adelaide, South Australia.
²⁴ Australian Children's Education & Care Quality Authority (ACECQA), Sydney, Australia.
²⁵ NSW Education Standards Authority (NESA), Sydney, Australia.
²⁶ Pennington Biomedical Research Center, Louisiana, USA.
²⁷ SAMRC/Wits Developmental Pathways for Health, University of the Witwatersrand, Johannesburg, South Africa.
²⁸ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.

PMID: 34991606
PMCID: PMC8734238
DOI: 10.1186/s12966-021-01236-2

Abstract

Background: In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updated Australian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleep were developed and the outcomes from this process.

Methods: The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. The Canadian 24-Hour Movement Guidelines for Children and Youth best met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines.

Results: Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and young people (13-17 years).

Conclusions: To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used to develop movement behaviour guidelines. The judgments of the Australian Guideline Development Group did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian Guidelines were adopted with only very minor alterations. This allowed the Australian Guidelines to be developed in a shorter time frame and at a lower cost. We recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines that was developed using the GRADE approach is available with all supporting materials. Other countries may consider this approach when developing and/or revising national movement guidelines.

Keywords: GRADE-ADOLOPMENT; Guideline development; Methodology; Public health recommendations.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
Timeline and sequence of events involved in the development of the Australian 24-hr movement guidelines for children and young people: an integration of physical activity, sedentary behaviour, and sleep

See this image and copyright information in PMC

References

1. Trost S: Discussion paper for the development of recommendations for children's and youth's participation in health promoting physical activity. In. Canberra: Department of Health and Ageing; 2003.
1. Okely A, Salmon J, Vella SA, Cliff D, Timperio A, Tremblay M, Trost SG, Shilton T, Hinkley T, Ridgers N et al: A Systematic Review to inform the Australian Sedentary Behaviour Guidelines for Children and Young People. Report prepared for the Australian Government Department of Health. In. (Print ISBN: 978-1-74186-067-2; Online ISBN: 978-1-74186-068-9); 2012.
1. Okely A, Salmon J, Vella SA, Cliff D, Timperio A, Tremblay M, Trost SG, Shilton T, Hinkley T, Ridgers N et al: A Systematic Review to update the Australian Physical Activity Guidelines for Children and Young People. Report prepared for the Australian Government Department of Health. In. (Print ISBN: 978-1-74186-067-2; Online ISBN: 978-1-74186-068-9); 2012.
1. Rosenberger ME, Fulton JE, Buman MP, Troiano RP, Grandner MA, Buchner DM, Haskell WL. The 24-Hour Activity Cycle: A New Paradigm for Physical Activity. Medicine and science in sports and exercise. 2019;51(3):454–464. - PMC - PubMed
1. Tremblay MS, Carson V, Chaput J-P, Connor Gorber S, Dinh T, Duggan M, Faulkner G, Gray CE, Gruber R, Janson K, et al. Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Applied Physiology, Nutrition, and Metabolism. 2016;41(6):S311–S327. - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Consumer Health Information
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep

Affiliations

A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous