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Developing International Consensus on Key Indicators for a 24-Hour Movement Behaviour Report Card in Early Childhood: A Twin-Panel Delphi Study
Background
The World Health Organization has established recommendations for 24-h movement behaviours in children under 5 years. Building on the successful knowledge translation model of
Active Healthy Kids Global Alliance Report Cards
, this study aimed to develop a similar framework for the early years.
Methods
Using a three-round twin-panel Delphi survey (conducted via an online survey between 28 November 2024 and 11 March 2025), expert consensus was sought on indicators and benchmarks for the first dedicated report card on 24-h movement behaviours for the early years. The experts were identified through a three-step selection process, which included recognised international projects and networks as well as literature search. In Round 1, participants evaluated the applicability of 15 initial indicators. In Rounds 2 and 3, they rated the importance of each indicator, with results from their own panel (Round 2) and the other panel (Round 3) provided to inform their decisions. Qualitative feedback on definitions and benchmarks was systematically reviewed and incorporated. Consensus was predefined as ≥ 75% agreement, with stability across rounds considered.
Results
Of 175 invited experts, 72 (41.1% recruitment rate) from 15 regions participated in Round 1, with 61 (84.7% response rate) and 56 (77.8% response rate) completing Rounds 2 and 3, respectively. Consensus was achieved for 12 indicators, with definitions and benchmarks refined based on expert inputs. Notably,
Weight Status
and
Motor Proficiency
were excluded due to lower agreement.
Conclusions
The finalised set of indicators, definitions, and benchmarks provides a robust foundation for creating a standardised report card for early childhood. The finalised results serve as a critical advocacy instrument to raise awareness, improve surveillance, facilitate cross-jurisdictional comparisons, and inform policy and public health initiatives, ultimately supporting the health and well-being of young children globally.
Key points
Global experts from 15 world regions collaborated to create the first standardised indicators and their benchmarks for inclusion in dedicated report cards on 24-hour movement behaviours for young children through a structured consensus process.
Experts reached strong consensus on 12 indicators, with benchmarks refined to practical implementation.
This new assessment framework enables consistent international comparisons while providing stakeholders with measurable improvements in early childhood health and development.
Journal Article
Ace in the hole
\"Since a strange alien virus created the superhuman beings known as aces and jokers four decades ago, they have struggled for respect and recognition. Now they are key players in a presidential convention torn by hatred and dissent. Assassins stalk the halls of the convention, and one of the candidates plans to use his secret Wild Card power for evil.\"--Page 4 of cover.
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Earth and Mars
Nearly five billion years ago, Earth and Mars were born together as planetary siblings orbiting a young, emerging Sun. Yet today, one planet is water rich and life bearing, while the other is seemingly cold, dry, and forbidding.Earth and Marsis a fusion of art and science, a blend of images and essays celebrating the successful creation of our life-sustaining planet and the beauty and mystery of Mars. Through images of terrestrial landscapes and photographs selected from recent NASA and European Space Agency missions to Mars, Earth and Mars reveals the profound beauty resulting from the action of volcanism, wind, and water. The accompanying text provides a context for appreciating the role of these elemental forces in shaping the surfaces of each planet, as well as the divergent evolutionary paths that led to an Earth that is teeming with life, and Mars that is seemingly lifeless.Earth and Marsinspires reflection on the extraordinarily delicate balance of forces that has resulted in our good fortune: to be alive and sentient on a bountiful blue world.
eBook
High stakes : a wild cards mosaic novel
Officer Francis, vigilante joker \"The Infamous Black Tongue,\" and ace thief Tesseract are forced by a cold-blooded Baba Yaga into an illegal fight ring as part of her effort to placate a vicious monster from another dimension.
Book