Framework and Core Content of World Health Organization Policy and Guidelines of Physical Activity / 中国康复理论与实践

Objective To study and analyze the theory, policy framework, and core content of physical activity policies and physical activity guidelines. Methods Using a policy research and content analysis approach and the theory of the six components of World Health Organization (WHO) health service system, we specifically analyze the theory, framework, and core content of WHO Global Action Plan on Physical Activity and WHO Physical Activity Guidelines. Results The Global Plan of Action for Physical Activity 2018-2030 (Action Plan) is an international policy document on physical activity issued by WHO that incorporates physical activity within the context of the seven principles of human rights, the life span, evidence-based practice, proportional universality, policy coherence and integration of health into all policies, participation and empowerment, and multisectoral partnerships into health services and social development. The Action Plan consists of four strategic objectives and 20 policy actions, covering six areas of WHO health service system, and the integration of physical activity policies into health services is of great importance in promoting the achievement of the United Nations Sustainable Development Goal 3 of universal health coverage. As a technical document for the implementation of the Action Plan, 2020 WHO Guidelines on Physical Activity and Sedentary Behavior (Guidelines) adopted the PI/ECO approach to analyze the physical activity needs of various groups of people, and provide guidelines to increase physical activity and reduce sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic diseases and people with disabilities. The guidelines cover duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations. The Guidelines implement the relevant guiding principles of the Action Plan and aim to improve overall population participation in physical activity at the micro level and improve critical and important health outcomes for the overall population. Conclusion As a health and development strategy, the Action Plan promotes the integration of physical activity into the health delivery system to facilitate the achievement of the United Nations 2030 Sustainable Development Goal 3 of universal health coverage.The four strategic objectives and 20 policy actions of the Action Plan can be integrated into these six areas based on the six components of WHO Health Service Delivery System: leadership and governance, financing, human resources, service delivery, medical technology, and health information. As a technical document to implement the Action Plan, the Guidelines are based on the PI/ECO approach framework and provide guidance on increasing physical activity and reducing sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, chronic patients, and persons with disabilities. The core content addresses the target populations, duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations.

Framework and Core Content of World Health Organization Policy and Guidelines of Physical Activity / 中国康复理论与实践

Objective To study and analyze the theory, policy framework, and core content of physical activity policies and physical activity guidelines. Methods Using a policy research and content analysis approach and the theory of the six components of World Health Organization (WHO) health service system, we specifically analyze the theory, framework, and core content of WHO Global Action Plan on Physical Activity and WHO Physical Activity Guidelines. Results The Global Plan of Action for Physical Activity 2018-2030 (Action Plan) is an international policy document on physical activity issued by WHO that incorporates physical activity within the context of the seven principles of human rights, the life span, evidence-based practice, proportional universality, policy coherence and integration of health into all policies, participation and empowerment, and multisectoral partnerships into health services and social development. The Action Plan consists of four strategic objectives and 20 policy actions, covering six areas of WHO health service system, and the integration of physical activity policies into health services is of great importance in promoting the achievement of the United Nations Sustainable Development Goal 3 of universal health coverage. As a technical document for the implementation of the Action Plan, 2020 WHO Guidelines on Physical Activity and Sedentary Behavior (Guidelines) adopted the PI/ECO approach to analyze the physical activity needs of various groups of people, and provide guidelines to increase physical activity and reduce sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic diseases and people with disabilities. The guidelines cover duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations. The Guidelines implement the relevant guiding principles of the Action Plan and aim to improve overall population participation in physical activity at the micro level and improve critical and important health outcomes for the overall population. Conclusion As a health and development strategy, the Action Plan promotes the integration of physical activity into the health delivery system to facilitate the achievement of the United Nations 2030 Sustainable Development Goal 3 of universal health coverage.The four strategic objectives and 20 policy actions of the Action Plan can be integrated into these six areas based on the six components of WHO Health Service Delivery System: leadership and governance, financing, human resources, service delivery, medical technology, and health information. As a technical document to implement the Action Plan, the Guidelines are based on the PI/ECO approach framework and provide guidance on increasing physical activity and reducing sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, chronic patients, and persons with disabilities. The core content addresses the target populations, duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations.

Energy Expenditure of Eight Walking Activities in Normal Weight and Obese High School Students: Using an Indirect Calorimeter and Accelerometers Worn on Ankle and Waist

The purposes of this study were to assess energy expenditure of eight walking activities in normal weight and overweight or obese high school students and to evaluate the accuracy of two accelerometers worn on the ankle and waist. Thirty-five (male 17, female 18) healthy high school students participated in this study. They were classified into normal weight (n=21) and overweight or obese (n=14) groups. The subjects completed five treadmill walking activities (TW2.4, TW3.2, TW4.0, TW4.8, TW5.6), followed by three self-selected hallway walking activities (walk as if walking and talking with a friend: HWL, walk as if hurrying across the street at a cross-walk: HWB, walk as fast as you can but do not run: HWF). Energy expenditure and metabolic equivalents (METs) were measured using a portable indirect calorimeter, and predicted energy expenditures and METs were derived from two accelerometers placed on the ankle and waist. Measured energy expenditures per body weight (kg) of eight walking activities were significantly higher in the normal weight group than in the obese group and significantly higher in female than male. The ankle accelerometer overestimated energy expenditures and METs (bias 49.4~105.5%), whereas the waist accelerometer underestimated energy expenditures and METs (bias −30.3~−85.8). Except for HWF (fast) activity, METs of seven activities were moderate intensity based on Compendium METs intensity categories. HWF (fast) activity was vigorous intensity. METs from the ankle accelerometer were vigorous intensity except TW2.4 activity (moderate intensity). METs from the waist accelerometer were low intensity (TW2.4, TW3.2, TW4.0, TW4.8, HWL) and moderate intensity (TW5.6, HWB, HWF). Physical activity guidelines were developed based on measured physical activity level of high school students. Further studies should investigate the effects of body composition in larger subjects.

Physical Activity Advice Tool (PAAT)

Family physicians can play an important role in providing lifestyle advice that aims to prevent or delay chronic disease. Given the vast amount of evidence that regular physical activity improves health and wellbeing, providing brief tailored advice in a clinic setting has the potential to make a positive impact on population health. Working side by side with physicians, the Health Promotion Board has developed the Physical Activity Advice Tool (PAAT) to enable physicians to quickly and accurately provide evidence-based tailored physical activity advice.