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Previous physical activity interventions for children (5-12yrs) have aimed to change determinants associated with self-report physical activity behaviour (PAB) and/or sedentary behaviour (SB), however, the associations between these determinants and PAB/SB in different settings are uncertain. The present study aimed to identify modifiable determinants targeted in previous PAB/SB interventions for children. Intervention effects on the determinants and their associations with self-report PAB/SB were assessed across settings. Search of relevant interventions from pre-defined databases was conducted up to July 2023. Randomized and non-randomized controlled trials with modifiable determinants were included. Data extraction and risk of bias assessments were conducted by two independent researchers. Where data could be pooled, we performed Robust Bayesian meta-analyses. Heterogeneity, publication bias and certainty of evidence were assessed. Fifteen studies were deemed eligible to be included. Thirty-seven unique determinants within four settings were identified–school, family, school with family/home, and community with(out) other settings. Ninety-eight percent of determinants belonged to individual/interpersonal determinant categories. Narratively, intervention effects on student perception of teachers’ behaviour (school), self-management, perceived barriers, external motivation, exercise intention, parental modeling on SB (school with family/home) and MVPA expectations (community) were weak to strong, however, corresponding PAB/SB change was not evident. There were negligible effects for all other determinants and the corresponding PAB/SB. Meta-analyses on self-efficacy, attitude, subjective norm and parental practice and PAB/SB in two settings showed weak to strong evidence against intervention effect, while the effect on knowledge could not be determined. Similarly, publication bias and heterogeneity for most analyses could not be ascertained. We found no concrete evidence of association between the modifiable determinants and self-report PAB/SB in any settings. This is presumably due to intervention ineffectiveness. Design of future interventions should consider to follow the systems-based approach and identify determinants unique to the context of a setting, including policy and environmental determinants.

Background Increasing population-level physical activity (PA) requires system-level policy action. However, public policies targeting the general population, without addressing socially disadvantaged populations, might unintentionally increase socioeconomic inequities in PA. This is particularly concerning since disadvantaged groups are less likely to meet PA recommendations to begin with. This systematic review assesses evidence on the effects of public policies on equity in PA. Methods A literature search was performed in seven bibliographic databases on May 7, 2024, in collaboration with a librarian. Studies were included if they a) focused on changes in PA behaviour, PA proxies, or the PA environment as outcomes, b) examined public policy as the independent variable, and c) included a low socioeconomic status (SES) (sub)population. Screening was done in duplicate. Key data extracted included: public policy information, target population and/or SES subgroup measures, PA outcomes, and equity-related findings. Policies were grouped into domains aligned with the eight investments of the International Society for Physical Activity and Health and categorized based on their impact on inequities: reduction, increase, no effect, or mixed effects. Results Out of 10,350 records screened, 81 studies were included. Results showed that 27% of the public policies reduced inequities, 38% had no effect, 10% increased them, and 25% had mixed effects. The fewest PA policies were identified in the healthcare ( n  = 2) and workplace ( n  = 0) domains, the most in the community-wide domain ( n  = 22). Based on the available evidence, the school, transport, community-wide, and mass media policy domains most frequently demonstrated potential to reduce inequities in PA and/or to benefit high and low SES populations equally. Policies that most consistently reduced inequities or had a neutral equity effect included a) infrastructure policies, b) financial incentives supporting active transport, c) multi-component school-based PA and health policy programmes, d) school physical education policies, and e) policies supporting mass media campaigns. Conversely, urban design and sport for all policies varied in their effects on inequities. Conclusions Most policies do not appear to exacerbate inequities. Policies in the school, transport, community-wide, and mass media domains show particular promise for promoting PA in an equitable way. These findings offer valuable insights for future policymaking.

Background Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings. Methods A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874. Results Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d  = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d  = 0.90, 95%CI (0.09, 1.70), choice provided, d  = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. Conclusions Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables.

Abstract Increasing population levels of physical activity is an important global health priority. The World Health Organization and many countries have developed evidence-based public health recommendations and action plans to do so. However, implementing these recommendations and plans remains limited in almost all countries, even Europe, where priorities and resources seem well aligned. Several research groups have developed policy assessment tools to understand better these challenges to evaluate policy development and implementation. The process has proved to be complex for several reasons. Increasing physical activity among populations depends upon actions in many sectors. Thus, policies must engage and include sectors beyond health. While policy is typically developed nationally, implementation often occurs at sub-national levels such as states and cities. Balancing the need for collecting complex data across multiple sectors and government levels while keeping instruments short enough to be useful for public health practitioners and appealing to policymakers takes work. In this session, we will hear from six research groups that have developed and applied policy assessment tools in Europe, Latin America, and Japan at national and sub-national levels. Each presenter will share their experiences, strengths, and weaknesses of the instruments, challenges, and planned next steps. The brief presentations will be followed by a panel discussion guided by a discussant to synthesize the research to date, summarize progress and remaining challenges, and suggest the way forward for both policy research and public health practice.

Background: As public policies have the potential to change the entire system of physical activity (PA) promotion and to create conducive environments, they are particularly relevant to address the persistently low levels of PA across the world. Furthermore, WHO’s Global Action Plan on Physical Activity highlights the relevance of local governments as important partners for policy action. However, our knowledge on how local PA promotion policy compares across countries remains limited. Methods: We conducted an exploratory study as part of the LoGoPAS project to compare the status quo of local PA policies across five municipalities in five different countries. Using purposive sampling, Jyväskylä (Finland), Nice (France), Erlangen (Germany), Fujisawa (Japan) and Cluj-Napoca (Romania) were selected. Data were collected and analysed via desk research and expert consultation using the CAPLA-Santé, a validated tool designed to assess relevant aspects of local PA promotion policies. Results: The analysis showed that the main responsibility for PA promotion varied between municipalities, resting either with the sport or the health sector. A total of 50 relevant PA policy documents were identified, focusing on multiple settings and target groups. Budgets for PA promotion differed across municipalities. Research on PA was reported to have informed policy development in some but not all cases. Across countries, political support was identified as a key driver of local PA promotion. Conclusion: LoGoPAS is the first study to apply the CAPLA-Santé outside of France and the first to use it for an international comparative analysis. Results highlight the ability of the tool to provide insights into local PA policy development, contents, and implementation worldwide. While this study provided a cross-sectional in-depth analysis of the status quo in select municipalities, future research could also aim to assess policies at a large scale, i.e. for multiple municipalities and/or on a regular basis.

The importance of local governments' engagement in physical activity promotion at local level has been acknowledged and advocated by the World Health organization in documents such as: “Promoting physical activity and active living in urban environments: the role of local governments” or “Global action plan on physical activity 2018–2030: more active people for a healthier world”. However, given the relative “youngness” of the physical activity policy research domain, the local level initiatives have been underrepresented in the scientific literature. The current symposium aims to present a number of diverse initiatives to promote health enhancing physical activity at sub-national level, each having a very unique context and approach. The paper from Eastern Michigan University presents the actions taken to implement Active People, Healthy Nation (APHN) program in geographic areas in Michigan where the priority population (Asian Americans) lives and the outcomes of this initiative. The contribution from Japan describes the process of developing and applying the L-PAT (local policy audit tool), an instrument comprising 11 items based on WHO’s HEPA Policy Audit Tool (HEPA PAT) and the results of this survey within 47 Japanese prefectures and the C-PAT (city policy audit tool), a 6 items tool, in a selection of 272 Japanese municipalities. The EU study presented in this symposium comprises the results of evaluation, using the CAPLA- Santé, a validated instrument, of local HEPA policies in 4 selected municipalities, one from each of the following countries: Finland, France, Germany, Romania and from one municipality in Japan. The responsibilities of local authorities in health promotion and protection are undeniable. The way the authorities manage to fulfil these responsibilities is gaining more and more interest from various stakeholders from local level activists to researchers and policymakers at national and international level. Local communities are increasingly stimulated to contribute to their own wellbeing, so data on the status quo and progress is needed more than ever. The initial discussion points of the symposium will focus on strengths and weaknesses of the initiatives presented, as well as the potential for knowledge exchange and replication & scaling-up.

Background Ensuring health policies are informed by evidence still remains a challenge despite efforts devoted to this aim. Several tools and approaches aimed at fostering evidence-informed policy-making (EIPM) have been developed, yet there is a lack of availability of indicators specifically devoted to assess and support EIPM. The present study aims to overcome this by building a set of measurable indicators for EIPM intended to infer if and to what extent health-related policies are, or are expected to be, evidence-informed for the purposes of policy planning as well as formative and summative evaluations. Methods The indicators for EIPM were developed and validated at international level by means of a two-round internet-based Delphi study conducted within the European project ‘REsearch into POlicy to enhance Physical Activity’ (REPOPA). A total of 82 researchers and policy-makers from the six European countries (Denmark, Finland, Italy, the Netherlands, Romania, the United Kingdom) involved in the project and international organisations were asked to evaluate the relevance and feasibility of an initial set of 23 indicators developed by REPOPA researchers on the basis of literature and knowledge gathered from the previous phases of the project, and to propose new indicators. Results The first Delphi round led to the validation of 14 initial indicators and to the development of 8 additional indicators based on panellists’ suggestions; the second round led to the validation of a further 11 indicators, including 6 proposed by panellists, and to the rejection of 6 indicators. A total of 25 indicators were validated, covering EIPM issues related to human resources, documentation, participation and monitoring, and stressing different levels of knowledge exchange and involvement of researchers and other stakeholders in policy development and evaluation. Conclusion The study overcame the lack of availability of indicators to assess if and to what extent policies are realised in an evidence-informed manner thanks to the active contribution of researchers and policy-makers. These indicators are intended to become a shared resource usable by policy-makers, researchers and other stakeholders, with a crucial impact on fostering the development of policies informed by evidence.

Background Physical activity on prescription (PAP) - like schemes, have been documented to encourage sustained increases in the levels of physical activity of populations. Although proven effective, these PA promotion schemes have only been implemented high-income countries (eg. Northern/Western Europe). The aim of this study was to explore the opportunity to test PAP (related) schemes in Romania, a developing country. Methods In the timeframe May-June 2018 we conducted a transversal study, using an online questionnaire adressed at general practitioners (GPs) in the county of Cluj. The instrument had 4 sections: 1. attitudes/opinions regarding role of GP in PA promotion; 2. GPs (current) behavior related to PA promotion in their practice; 3. Knowledge regarding the recommended PA levels for children, youth and adults; and 4. Socio-professional information. Results A number of 84 GPs (out of 350) have completed the questionnaire, for a response rate of aproximatelly 25%, the sample being representative of the population - considering gender distribution and workplace location, urban/rural. The majority of the GPs (78%) stated that their role in PA promotion is limited to broadly disscussing this topic with their patients. The more consultations they have (less time available), the more they are prone to promote PA in their practice (contrary to current literature). Only 1 in 5 GPs have reported the correct number of minutes of PA for both adults and children & youth. The lower measured knowledge, the higher were the self-assessed levels of knowledge regarding PA benefits they report. Conclusion Romanian GPs knowledge, attitudes and behavior related to PA prescription/recommendation are strongly influenced by lack of proper information, incentives and/or enforcement. Before attempting to introduce PAP in Romania, more education, awareness and financial/structural resources should be allocated to improve acceptability and feasibility of such PA promotion scheme.

Although cross-sectoral cooperation is important at all levels, in practice it often remains at a declarative level. Different sectoral policies and the resulting measures to promote HEPA are usually disconnected, uncoordinated and without the necessary synergies. This pertains especially to local environments with less financial and expert support, such as small rural communities, where people have few HEPA options that are suitable and attractive for vulnerable groups: children and adolescents, elderly and people with disabilities. “Development of indicators for the assessment of the provision of settlements with green spaces for outdoor physical activity” is a research project co-funded by the Slovenian Research and Innovation Agency, the Ministry of Health and the Ministry of Natural Resources and Spatial Planning and implemented at the Urban Planning Institute of the Republic of Slovenia. The aim of the project is to define indicator(s) for the provision of green spaces for PA and active lifestyles in settlements, which could be used at local level to assess, improve, and monitor the situation. We took a medium-sized city and a small rural community as pilot projects, the latter often being a disadvantaged environment in terms of HEPA in spatial planning compared to larger cities. On the pilots, our objectives have been to establish cooperation at the local level between at least three different sectors and to test methodology and indicators developed in the project to assess the provision of green spaces to promote PA in selected environments, thus enabling more equitable and inclusive spatial conditions for HEPA at the local level. The presentation will present the approach, results and overall experiences with the work implemented in the pilot project of a rural community. It will highlight the benefits of cross-sectoral cooperation for more effective local level HEPA policies to ensure the inclusive and equitable access to green spaces in settlements.