Results from Germany’s 2018 Report Card on Physical Activity for Children and Youth (original) (raw)

Introduction

Even though positive health effects of regular physical activity (PA) are well known,1,2 national and international surveillance data show that PA is the “pill not taken”. This leads to widespread negative health and economic consequences. The 2018 German Report Card on Physical Activity for Children and Youth provides a comprehensive evaluation of PA levels in different domains and correlated indicators using the Active Healthy Kids Canada (AHKC) grading framework. The Report Card aims to evaluate and benchmark the national PA promotion efforts in children and youth in Germany with the ultimate aim to raise awareness for the promotion of PA. The purpose of this contribution is to summarize the results of the 2018 German Report Card (Figure 1).

Methods

The 2018 German Report Card evaluates population-based levels of PA in different domains and the presence and implementation of strategies for promoting PA identified by an expert panel. The 10 core PA indicators that are common to the Global Matrix 3.0 and belong to one of three categories were included: Daily Behaviors (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behaviors, Physical Fitness), Settings and Sources of Influence (Family and Peers, School, Community and Environment), and Strategies and Investments (Government).

Sources included national surveys, peer-reviewed literature, and government and non-government reports. The Report Card 2018 was developed by the Research Work Group (RWG), based on the Canadian model and consisted of 12 researchers from 7 universities and two research institutes, who are authors of this manuscript. The RWG had a wide presentation of researchers and experts in PA, health behaviours, and represented different scientific perspectives and methodological background. The RWG assigned grades (ie, A, B, C, D, F, or INC (incomplete)) to the 10 Report Card indicators using the benchmarks provided by the AHKC.

Results and Discussion

For Germany, the expert panel assigned good grades (eg, B+, B-) for most indicators relating to Setting and Sources of Influence with the exception of the Government indicator, which was assigned an incomplete grade (Table 1). Nevertheless, most children and youth in Germany failed to meet the World Health Organization (WHO) recommendation for PA and engaged in high levels of sedentary behaviours (SB) despite the favourable condition within the relevant settings.1–3 Therefore, we assigned poor grades for most behavioural indicators (Overall PA, SB, Active Play and Active Transportation) with the exception of Organized Sport Participation.

Table 1

Grades and Rationales for Germany’s 2018 Report Card

Indicator Grade Rationale
Overall Physical Activity D- National data show that only about 20% of girls and boys accumulate at least 60 minutes of moderate-to-vigorous PA per day. The percentages of girls and boys fulfilling the World Health Organization recommendations vary slightly between studies and type of measurement (subjective/objective). The recommendation compliance is lower in older compared to younger age groups and among girls compared to boys.1,2,4,5
Organized Sport Participation B National data show that a high percentage of children and adolescents are members in sport clubs (about 70%). The membership numbers decrease slightly with rising age and girls are less often members in a sports club in comparison to boys.3,6,7
Active Play D- Less than 25% of the children and the adolescents play actively for several hours per day. More children than adolescents actively play and slightly more girls than boys engage in active play.3
Active Transportation C- Approximately 40% of the children and adolescents commute actively to school. Girls walk to school more often and boys cycle to school slightly more often.8
Sedentary Behaviours D- About 80% of children and adolescents spend more than two hours per day sedentary, watching TV or using other screen devises. The results range across studies depending on the measurement instrument and the type of behaviour in focus (screen based/ total sedentary behaviour).2,5
Physical Fitness INC Summary analyses for endurance performance are planned for the next report card. The focus for the current report card was placed on the PA behavior.
Family and Peers B- 66% of the parents are regularly physically active and 60% of the children feel that they receive positive support from their parents and friends to be physically active.9
School B+ In primary schools, only about half of the physical education (PE) teachers have university qualifications to teach PE whereas in secondary schools nearly all teachers are professionally educated PE teachers. All schools provide some kind of sports facilities to carry out PE classes whereas access to swimming pools for PE was lower (ca. 70%). As part of the curriculum, PE is mandatory in all school types independent of students’ class level.10
Community and Environment B+ Most cities and communities provide good infrastructures facilitating daily PA, such as bicycle lanes, inner-city roads with 30 km/h speed limit, public playgrounds, parks and soccer pitches.The majority (75%) of parents state that their children can play outside without supervision.8
Government INC Many interventions exist and have been implemented to promote PA in children and adolescents. However, very few standardised government policies exist and their implementation and effectiveness have not been evaluated yet.

We were not able to assign grades for two indicators – Physical Fitness, Government – due to insufficient evidence. Even though many studies exist that assessed child and youth physical fitness in Germany, no overall data aggregation and analysis has been carried out according to the AHKC benchmarks. Additionally, evaluations regarding the reach and effectiveness of government policies to promote PA do not exist.

Conclusion

The proportion of German children and youth meeting the WHO recommended levels of PA and with screen time below two hours daily is low even though the Settings and Sources of Influence are favourable in promoting PA levels. Despite high membership rates in sport clubs, this alone does not appear to lead to sufficiently high PA levels. The fact that no overall government policy exists to promote PA in children and adolescents signals a need for further actions from government that facilitates PA and creates environments that support healthy active living among German children and youth. Furthermore, the differences existing in girls’ and boys’ PA levels call for intervention programmes that lower this gap and that further explore the similarities and differences in sex/gender groups.

References