. 2025 Jan;55(1):203-219.

doi: 10.1007/s40279-024-02104-2. Epub 2024 Oct 3.

Improving National and International Surveillance of Movement Behaviours in Childhood and Adolescence: An International Modified Delphi Study

John J Reilly^#¹, Rachel Andrew², Chalchisa Abdeta³, Liane B Azevedo⁴, Nicolas Aguilar Farias⁵, Sharon Barak⁶, Farid Bardid⁷, Bruno Bizzozero-Peroni^{8

9}, Javier Brazo-Sayavera^{10

11}, Jonathan Y Cagas¹², Mohamed-Souhaiel Chelly¹³, Lars B Christiansen¹⁴, Visnja D Djordjic¹⁵, Catherine E Draper¹⁶, Asmaa El-Hamdouchi¹⁷, Elie-Jacques Fares¹⁸, Aleš Gába¹⁹, Kylie D Hesketh²⁰, Mohammad Sorowar Hossain^{21

22}, Wendy Huang²³, Alejandra Jáuregui²⁴, Sanjay K Juvekar²⁵, Nicholas Kuzik²⁶, Richard Larouche²⁷, Eun-Young Lee²⁸, Sharon Levi^{29

30}, Yang Liu³¹, Marie Löf³², Tom Loney³³, José Francisco López-Gil³⁴, Evelin Mäestu³⁵, Taru Manyanga³⁶, Clarice Martins^{37

38}, Maria Mendoza-Muñoz³⁹, Shawnda A Morrison⁴⁰, Nyaradzai Munambah^{41

42}, Tawonga W Mwase-Vuma⁴³, Rowena Naidoo⁴⁴, Reginald Ocansey⁴⁵, Anthony D Okely⁴⁶, Aoko Oluwayomi⁴⁷, Susan Paudel⁴⁸, Bee Koon Poh⁴⁹, Evelyn H Ribeiro⁵⁰, Diego Augusto Santos Silva⁵¹, Mohd Razif Shahril⁵², Melody Smith⁵³, Amanda E Staiano⁵⁴, Martyn Standage⁵⁵, Narayan Subedi⁵⁶, Chiaki Tanaka⁵⁷, Hong K Tang⁵⁸, David Thivel⁵⁹, Mark S Tremblay⁶⁰, Edin Uzicanin⁶¹, Dimitris Vlachopoulos⁶², E Kipling Webster⁶³, Dyah Anantalia Widyastari⁶⁴, Pawel Zembura⁶⁵, Salome Aubert^#⁶⁶

Affiliations

¹ Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland. john.j.reilly@strath.ac.uk.
² Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland.
³ School of Education, University of Wollongong, Wollongong, Australia.
⁴ School of Sport and Physical Activity, Sheffield Hallam University, Sheffield, UK.
⁵ Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile.
⁶ Department of Nursing, Faculty of Health Science, Ariel University, Ariel, Israel.
⁷ Institute of Education, University of Strathclyde, Glasgow, Scotland.
⁸ Instituto Superior de Educación Física, Universidad de La República, Rivera, Uruguay.
⁹ Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
¹⁰ Department of Sports and Computer Science, Universidad Pablo de Olavide, Seville, Spain.
¹¹ PDU EFISAL, Centro Universitario Regional Noreste, Universidad de La República, Montevideo, Uruguay.
¹² Department of Sports Science, College of Human Kinetics, University of the Philippines Diliman, Quezon, Philippines.
¹³ Research Laboratory (LR23JS01) «Sport Performance, Health and Society», Higher Institute of Sport and Physical Education of Ksar Saîd, University of Manouba, Tunis, Tunisia.
¹⁴ Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
¹⁵ Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia.
¹⁶ Faculty of Health Sciences, SAMRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
¹⁷ National Centre for Energy Sciences and Nuclear Techniques, Kenitra, Morocco.
¹⁸ American University of Beirut, Beirut, Lebanon.
¹⁹ Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.
²⁰ Institute of Physical Activity and Nutrition, Deakin University, Burwood, Australia.
²¹ Biomedical Research Foundation, Dhaka, Bangladesh.
²² Independent University, Dhaka, Bangladesh.
²³ Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
²⁴ Department of Physical Activity and Healthy Lifestyles, National Institute of Public Health, Cuernavaca, México.
²⁵ Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
²⁶ Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 5B2, Canada.
²⁷ Faculty of Health Sciences, University of Lethbridge, Lethbridge, Canada.
²⁸ School of Kinesiology and Health Studies, Queen's University, Kingston, Canada.
²⁹ Efsharibari- National Program for Active and Healthy Living, Ministry of Health, Haifa, Israel.
³⁰ School of Public Health, University of Haifa, Haifa, Israel.
³¹ School of Physical Education, Shanghai University of Sport, Shanghai, China.
³² Department of Biosciences and Nutrition, Karolinska Institutet, Solna, Sweden.
³³ College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates.
³⁴ One Health Research Group, Universidad de Las Américas, Quito, Ecuador.
³⁵ Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia.
³⁶ Division of Medical Sciences, University of Northern British Columbia, Prince George, Canada.
³⁷ Faculty of Sports, Research Centre of Physical Activity, Health and Leisure, Porto, Portugal.
³⁸ Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal.
³⁹ Faculty of Sport Sciences, University of Extremadura, Badajoz, Spain.
⁴⁰ Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁴¹ Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
⁴² Department of Occulational and Physical Therapy, University of Namibia, Windhoek, Namibia.
⁴³ Centre for Social Research, University of Malawi, Zomba, Malawi.
⁴⁴ Discipline of Biokinetics, Exercise and Leisure Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
⁴⁵ School of Education and Leadership Studies, University of Ghana, Legon, Ghana.
⁴⁶ School of Health and Society, University of Wollongong, Wollongong, Australia.
⁴⁷ Human Kinetics and Health Education, University of Lagos, Lagos, Nigeria.
⁴⁸ Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.
⁴⁹ Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
⁵⁰ Evelyn H. Ribeiro, Physical Activity Epidemiology Group at the University of Sao Paulo (GEPAF/USP), Sao Paulo, Brazil.
⁵¹ Department of Physical Education, Sports Center, Federal University of Santa Catarina, Santa Catarina, Brazil.
⁵² Centre for Healthy Ageing and Wellness (HCARE), Universiti Kebangsaan Malaysia, Bandar Baru Bangi, Malaysia.
⁵³ School of Nursing, The University of Auckland, Auckland, New Zealand.
⁵⁴ Pennington Biomedical Research Center, Louisiana State University, Louisiana, USA.
⁵⁵ Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK.
⁵⁶ The Lown Scholar, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, USA.
⁵⁷ Department of Human Nutrition, Tokyo Kasei Gakuin University, Tokyo, Japan.
⁵⁸ Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
⁵⁹ Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Condition (AME2P UPR3533), International Research Chair "Health in Motion", Clermont Auvergne University, Clermont-Ferrand, France.
⁶⁰ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
⁶¹ Faculty of Physical Education and Sport, University of Tuzla, Tuzla, Bosnia-Herzegovina.
⁶² Department of Sport and Health Science, University of Exeter, Devon, UK.
⁶³ Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, USA.
⁶⁴ Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand.
⁶⁵ Jozef Pilsudski University of Physical Education, Warsaw, Poland.
⁶⁶ Active Healthy Kids Global Alliance, Healthy Active Living and Obesity Research, Ottawa, Canada.

^# Contributed equally.

PMID: 39361231
PMCID: PMC11787202
DOI: 10.1007/s40279-024-02104-2

Improving National and International Surveillance of Movement Behaviours in Childhood and Adolescence: An International Modified Delphi Study

John J Reilly et al. Sports Med. 2025 Jan.

. 2025 Jan;55(1):203-219.

doi: 10.1007/s40279-024-02104-2. Epub 2024 Oct 3.

Authors

Affiliations

¹ Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland. john.j.reilly@strath.ac.uk.
² Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland.
³ School of Education, University of Wollongong, Wollongong, Australia.
⁴ School of Sport and Physical Activity, Sheffield Hallam University, Sheffield, UK.
⁵ Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile.
⁶ Department of Nursing, Faculty of Health Science, Ariel University, Ariel, Israel.
⁷ Institute of Education, University of Strathclyde, Glasgow, Scotland.
⁸ Instituto Superior de Educación Física, Universidad de La República, Rivera, Uruguay.
⁹ Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
¹⁰ Department of Sports and Computer Science, Universidad Pablo de Olavide, Seville, Spain.
¹¹ PDU EFISAL, Centro Universitario Regional Noreste, Universidad de La República, Montevideo, Uruguay.
¹² Department of Sports Science, College of Human Kinetics, University of the Philippines Diliman, Quezon, Philippines.
¹³ Research Laboratory (LR23JS01) «Sport Performance, Health and Society», Higher Institute of Sport and Physical Education of Ksar Saîd, University of Manouba, Tunis, Tunisia.
¹⁴ Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
¹⁵ Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia.
¹⁶ Faculty of Health Sciences, SAMRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
¹⁷ National Centre for Energy Sciences and Nuclear Techniques, Kenitra, Morocco.
¹⁸ American University of Beirut, Beirut, Lebanon.
¹⁹ Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.
²⁰ Institute of Physical Activity and Nutrition, Deakin University, Burwood, Australia.
²¹ Biomedical Research Foundation, Dhaka, Bangladesh.
²² Independent University, Dhaka, Bangladesh.
²³ Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
²⁴ Department of Physical Activity and Healthy Lifestyles, National Institute of Public Health, Cuernavaca, México.
²⁵ Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
²⁶ Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 5B2, Canada.
²⁷ Faculty of Health Sciences, University of Lethbridge, Lethbridge, Canada.
²⁸ School of Kinesiology and Health Studies, Queen's University, Kingston, Canada.
²⁹ Efsharibari- National Program for Active and Healthy Living, Ministry of Health, Haifa, Israel.
³⁰ School of Public Health, University of Haifa, Haifa, Israel.
³¹ School of Physical Education, Shanghai University of Sport, Shanghai, China.
³² Department of Biosciences and Nutrition, Karolinska Institutet, Solna, Sweden.
³³ College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates.
³⁴ One Health Research Group, Universidad de Las Américas, Quito, Ecuador.
³⁵ Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia.
³⁶ Division of Medical Sciences, University of Northern British Columbia, Prince George, Canada.
³⁷ Faculty of Sports, Research Centre of Physical Activity, Health and Leisure, Porto, Portugal.
³⁸ Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal.
³⁹ Faculty of Sport Sciences, University of Extremadura, Badajoz, Spain.
⁴⁰ Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁴¹ Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
⁴² Department of Occulational and Physical Therapy, University of Namibia, Windhoek, Namibia.
⁴³ Centre for Social Research, University of Malawi, Zomba, Malawi.
⁴⁴ Discipline of Biokinetics, Exercise and Leisure Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
⁴⁵ School of Education and Leadership Studies, University of Ghana, Legon, Ghana.
⁴⁶ School of Health and Society, University of Wollongong, Wollongong, Australia.
⁴⁷ Human Kinetics and Health Education, University of Lagos, Lagos, Nigeria.
⁴⁸ Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.
⁴⁹ Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
⁵⁰ Evelyn H. Ribeiro, Physical Activity Epidemiology Group at the University of Sao Paulo (GEPAF/USP), Sao Paulo, Brazil.
⁵¹ Department of Physical Education, Sports Center, Federal University of Santa Catarina, Santa Catarina, Brazil.
⁵² Centre for Healthy Ageing and Wellness (HCARE), Universiti Kebangsaan Malaysia, Bandar Baru Bangi, Malaysia.
⁵³ School of Nursing, The University of Auckland, Auckland, New Zealand.
⁵⁴ Pennington Biomedical Research Center, Louisiana State University, Louisiana, USA.
⁵⁵ Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK.
⁵⁶ The Lown Scholar, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, USA.
⁵⁷ Department of Human Nutrition, Tokyo Kasei Gakuin University, Tokyo, Japan.
⁵⁸ Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
⁵⁹ Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Condition (AME2P UPR3533), International Research Chair "Health in Motion", Clermont Auvergne University, Clermont-Ferrand, France.
⁶⁰ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
⁶¹ Faculty of Physical Education and Sport, University of Tuzla, Tuzla, Bosnia-Herzegovina.
⁶² Department of Sport and Health Science, University of Exeter, Devon, UK.
⁶³ Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, USA.
⁶⁴ Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand.
⁶⁵ Jozef Pilsudski University of Physical Education, Warsaw, Poland.
⁶⁶ Active Healthy Kids Global Alliance, Healthy Active Living and Obesity Research, Ottawa, Canada.

^# Contributed equally.

PMID: 39361231
PMCID: PMC11787202
DOI: 10.1007/s40279-024-02104-2

Erratum in

Correction to: Improving National and International Surveillance of Movement Behaviours in Childhood and Adolescence: An International Modified Delphi Study.
Reilly JJ, Andrew R, Abdeta C, Azevedo LB, Farias NA, Barak S, Bardid F, Bizzozero-Peroni B, Brazo-Sayavera J, Cagas JY, Chelly MS, Christiansen LB, Djordjic VD, Draper CE, El-Hamdouchi A, Fares EJ, Gába A, Hesketh KD, Hossain MS, Huang W, Jáuregui A, Juvekar SK, Kuzik N, Larouche R, Lee EY, Levi S, Liu Y, Löf M, Loney T, López-Gil JF, Mäestu E, Manyanga T, Martins C, Mendoza-Muñoz M, Morrison SA, Munambah N, Mwase-Vuma TW, Naidoo R, Ocansey R, Okely AD, Oluwayomi A, Paudel S, Poh BK, Ribeiro EH, Silva DAS, Shahril MR, Smith M, Staiano AE, Standage M, Subedi N, Tanaka C, Tang HK, Thivel D, Tremblay MS, Uzicanin E, Vlachopoulos D, Webster EK, Widyastari DA, Zembura P, Aubert S. Reilly JJ, et al. Sports Med. 2025 Apr;55(4):1057-1060. doi: 10.1007/s40279-025-02185-7. Sports Med. 2025. PMID: 40172588 Free PMC article. No abstract available.

Abstract

Background: The actions required to achieve higher-quality and harmonised global surveillance of child and adolescent movement behaviours (physical activity, sedentary behaviour including screen time, sleep) are unclear.

Objective: To identify how to improve surveillance of movement behaviours, from the perspective of experts.

Methods: This Delphi Study involved 62 experts from the SUNRISE International Study of Movement Behaviours in the Early Years and Active Healthy Kids Global Alliance (AHKGA). Two survey rounds were used, with items categorised under: (1) funding, (2) capacity building, (3) methods, and (4) other issues (e.g., policymaker awareness of relevant WHO Guidelines and Strategies). Expert participants ranked 40 items on a five-point Likert scale from 'extremely' to 'not at all' important. Consensus was defined as > 70% rating of 'extremely' or 'very' important.

Results: We received 62 responses to round 1 of the survey and 59 to round 2. There was consensus for most items. The two highest rated round 2 items in each category were the following; for funding (1) it was greater funding for surveillance and public funding of surveillance; for capacity building (2) it was increased human capacity for surveillance (e.g. knowledge, skills) and regional or global partnerships to support national surveillance; for methods (3) it was standard protocols for surveillance measures and improved measurement method for screen time; and for other issues (4) it was greater awareness of physical activity guidelines and strategies from WHO and greater awareness of the importance of surveillance for NCD prevention. We generally found no significant differences in priorities between low-middle-income (n = 29) and high-income countries (n = 30) or between SUNRISE (n = 20), AHKGA (n = 26) or both (n = 13) initiatives. There was a lack of agreement on using private funding for surveillance or surveillance research.

Conclusions: This study provides a prioritised and international consensus list of actions required to improve surveillance of movement behaviours in children and adolescents globally.

PubMed Disclaimer

Conflict of interest statement

Declarations. Author Contributions: J.J.R. and S.A. were responsible for the original concept and study design. Original concept/ design/ methods were developed by the study leadership group (J.J.R., S.A., C.A., R.A., J.Y.C., R.L., S.K.L., N.M., A.D.O., C.T., M.T., D.A.W.). The replies from all the participants in the first round of the Delphi determined the content and format of the second round of the survey. J.J.R. and R.A. led the analysis and take responsibility for the integrity of the data. J.J.R. and S.A. drafted the manuscript. All authors: completed both rounds of the Delphi survey, reviewed and contributed significantly to the editing and critical reviewing of the manuscript, contributed significantly to interpretation of results, stated their formal approval of the manuscript, and stated their formal agreement to be accountable for all aspects of the work. All authors met al ICMJE authorship criteria. Funding: This study had no specific funding. Reilly and Andrew were funded by the Scottish Funding Council at the time the study was carried out. Conflicts of Interest: The authors have no conflicts of interest to declare. Availability of Data: The anonymised data from survey rounds 1 and 2 are available from the corresponding author upon reasonable request. Consent for Publication: Not applicable. Consent to Participate: All participants gave electronic informed written consent and were aware that participation was voluntary, and they could withdraw at any point during the survey without any consequences. Ethics Approval: The study was approved by the University of Strathclyde, Glasgow Scotland, School of Psychological Sciences and Health Research Ethics Committee (reference 03.05.10.2022).

Figures

**Fig. 1**
Flow chart describing recruitment of participants. AHKGA, Active Healthy Kids Global Alliance; SUNRISE, International Surveillance Study of Movement Behaviours in the Early Years

**Fig. 2**
Countries with participant(s) in the present Delphi study

**Fig. 3**
Top two priorities in round 2 for each of the four categories. Percentage agreement for each of the items is reported in blue. NCD, non-communicable diseases

**Fig. 4**
Conceptual model for improving national and international surveillance and achieving a society with more active children and adolescents

See this image and copyright information in PMC

References

1. Reilly J, Aubert S, Brazo-Sayavera J, Liu Y, Cagas J, Tremblay M. Surveillance to improve physical activity of children and adolescents. Bull World Health Organ. 2022;100(12):815–24. 10.2471/blt.22.288569. - PMC - PubMed
1. Sallis JF, Pate RR. Creating the future of physical activity surveillance in the USA: better data for better health. J Phys Act & Health. 2021;18:S1–5. 10.1123/jpah.2021-0182. - PubMed
1. Aubert S, Brazo-Sayavera J, Gonzalez SA, et al. Global prevalence of physical activity for children and adolescents; inconsistencies, research gaps, and recommendations: a narrative review. Int J Behav Nutr Phys Act. 2021;18:81. - PMC - PubMed
1. Global action plan on physical activity 2018–2030: More active people for a healthier world. Geneva, WHO, 2018.
1. Guidelines on physical activity, sedentary behaviour, and sleep for the under 5s. Geneva, WHO, 2019 https://apps.who.int/iris/handle/10665/311664

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Improving National and International Surveillance of Movement Behaviours in Childhood and Adolescence: An International Modified Delphi Study

Affiliations

Improving National and International Surveillance of Movement Behaviours in Childhood and Adolescence: An International Modified Delphi Study

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical