Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries

May combine two claims.

Low or medium HDI countries averaged C for behavioral indicators and D+ for sources of influence.

“For the low or medium HDI countries, an average of”

May combine two claims.

Overall average grades were C- for low and medium HDI countries, D+ for high HDI countries, and C- for very high HDI countries.

“Overall, an average grade of”

May combine two claims.

Sedentary Behaviors showed greater variability, but most very high HDI countries had poor grades (D-F).

“A greater variability in grades was observed for Sedentary Behaviors, but poor grades (”

May combine two claims.

Nepal ranked first and Estonia last on the behavioral score.

“Nepal ranked first, and Estonia ranked last for the behavioral score”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Fifty-two countries expressed interest, 51 registered on time, and 2 later withdrew, leaving 49 participants.

“A total of 52 countries responded to the AHKGA and showed interest in participation in the Global Matrix 3.0, but only 51 fully registered on time, and later on 2 countries withdrew.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Forty-nine countries from six continents registered for Global Matrix 3.0 between April 2017 and January 2018.

“Between April 2017 and January 2018, 49 countries from 6 different continents (Africa, Asia, Europe, North America, Oceania, and South America) registered and paid a registration fee based on their HDI classification to cover costs associated with the Global Matrix 3.0 initiative.”

May combine two claims.

Average letter grades spanned from D for Overall Physical Activity up to C for several other indicators, including Organized Sport and Physical Activity, Active Transportation, School, Community and Environment, and Government.

“The mean letter grades ranged from”

May combine two claims.

Slovenia ranked first and China ranked 49th on the overall score.

“Slovenia ranked first, whereas China ranked 49th for the overall score”

May combine two claims.

Slovenia ranked first and Venezuela last on the sources of influence score.

“Slovenia ranked first, whereas Venezuela ranked last for the source of influence score”

Probably not a substantial claim: may not pass S3 (load-bearing).

Qatar's work group assigned a not applicable grade to Active Transportation because of unsafe roads and a hot climate for most of the year.

“A”

• cites [45] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The overall averages were the same for low/medium and very high HDI countries, which does not corroborate the overall score ranking.

“but this is not corroborated with results presented in Table 6 where the overall averages were the same for the low and medium HDI countries and the very high HDI countries.”

May combine two claims.

Active Play had the most INC grades (29), followed by Physical Fitness (27) and Family and Peers (22).

“the indicator with the highest number of”

May combine two claims. The quote only partly states this claim.

Slovenia was the only country with a very high Overall Physical Activity grade (A-), while most other countries had D-F (n=38).

“Slovenia was the only country out of 49 with a very high grade for Overall Physical Activity (”

May combine two claims. The quote only partly states this claim.

Slovenia had the best average grade (B), followed by Japan and Denmark (both B-).

“Slovenia obtained the best grade on average (”

May combine two claims.

Global Matrix 3.0 presented physical activity indicators for children and youth across 49 countries with varying human development: 9 low or medium HDI, 10 high HDI, and 30 very high HDI.

“the Global Matrix 3.0 allowed us to present physical activity-related indicators for children and youth assembled across 49 countries with varying levels of human development (9 low or medium HDI, 10 high HDI, and 30 very high HDI countries).”

May combine two claims.

In Colombia, the new benchmark produced a D+ for Overall Physical Activity in Global Matrix 3.0, while the national Report Card reported D- under the old benchmark.

“For example, in Colombia, with the new benchmark, a”

• cites [28] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

No statistically significant relationships were found between Overall Physical Activity and other core indicators, except a positive moderate correlation with Sedentary Behaviors (r = .39, P < .05).

“Overall Physical Activity grade and the other core indicator grades with the exception of Sedentary Behaviors for which a statistically significant positive moderate correlation was observed (r = .39,P < .05).”

May combine two claims.

The 49 work groups assigned 490 grades: 369 letter grades and 121 INC grades.

“A total of 490 grades, including 369 letter grades and 121”

May combine two claims.

Very high HDI countries averaged D+ for behavioral indicators and C+ for sources of influence.

“whereas for the very high HDI countries, an average of”

May combine two claims. The quote only partly states this claim.

The behavioral indicators averaged C-, sources of influence averaged C, and the overall average for the 369 letter grades was C-.

“An average grade of”

May combine two claims. The quote only partly states this claim.

Nepal shared the best Active Transportation grade with Japan and Zimbabwe (A-), had a high Sedentary Behaviors grade (B+), and the highest Family and Peers grade (A).

“Nevertheless, Nepal shared the best grade for Active Transportation with Japan and Zimbabwe (”

May combine two claims.

In three of four very high HDI countries in Eastern Asia, Active Transportation grades were very high: Japan A-, Hong Kong B+, and South Korea B+.

“In 3 of the 4 very high HDI countries from Eastern Asia, very high grades were assigned to this indicator: Japan (”

• Also stated in: § Active Transportation · plain

  “), Hong Kong (”

• Also stated in: § Active Transportation · plain

  “), and South Korea (”

Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). May combine two claims.

China averaged D-, while Ethiopia and Venezuela averaged D.

“An average grade of”

May combine two claims.

Active Play grades ranged from F in Estonia and Thailand to B in Ethiopia and The Netherlands, averaging D+.

“The grades ranged from”

• Also stated in: § Active Play · plain

  “(Estonia and Thailand) to”

• Also stated in: § Active Play · plain

  “(Ethiopia and The Netherlands) with an average of”

May combine two claims.

Active Play had the most INC grades, with 29 of 49 countries unable to find data to grade it.

“Active Play was the indicator with the most”

• Also stated in: § Active Play · plain

  “grades where 29 of 49 countries were unable to find available data to grade this indicator.”

May combine two claims.

Organized Sport grades ranged from F in Lebanon and Uruguay to A- in Denmark, averaging C.

“The Organized Sport and Physical Activity grades ranged from”

• Also stated in: § Organized Sport and Physical Activity · plain

  “(Lebanon and Uruguay) to”

• Also stated in: § Organized Sport and Physical Activity · plain

  “(Denmark), with an average of”

May combine two claims.

Average Organized Sport grades were C for low and medium HDI countries, D+ for high HDI countries, and C+ for very high HDI countries.

“Organized Sport and Physical Activity was graded”

• Also stated in: § Organized Sport and Physical Activity · plain

  “on average for the low and medium HDI countries, the high HDI countries, and the very high HDI countries, respectively.”

• AssumptionRests on an assumption: The country-specific grades are sufficiently comparable across countries to support cross-country and HDI-group comparisons.
• AssumptionRests on an assumption: HDI groupings are a meaningful basis for comparing physical activity grades across countries.

May combine two claims.

Japan, Hong Kong, and South Korea had a high urban population percentage (83.3%-100%).

“and have shown a high percentage of urban population (83.3%-100%,Table 3).”

May combine two claims.

Zimbabwe had the second-best Overall Physical Activity grade (C+) after Slovenia, with high behavioral grades (B for Organized Sport and Physical Activity, A- for Active Transportation, B for Sedentary Behaviors), but sources of influence grades between D and C.

“Zimbabwe had the second-best grade for Overall Physical Activity (”

May combine two claims.

The average Overall Physical Activity grade was C- in low and medium HDI countries and D- in both high and very high HDI countries.

“The average grade for the low and medium HDI countries was”

• Also stated in: § Overall Physical Activity · plain

  “whereas both the high and very high HDI countries obtained an average of”

• AssumptionRests on an assumption: The country-specific grades are sufficiently comparable across countries to support cross-country and HDI-group comparisons.
• AssumptionRests on an assumption: HDI groupings are a meaningful basis for comparing physical activity grades across countries.

May combine two claims.

Zimbabwe's grades for School, Community and Environment, and Government improved from the previous Report Card due to recent policy implementations and government commitments.

“In comparison with the previous Report Card in Zimbabwe, the grades for School, Community and Environment, and Government, have improved due to recent policy implementations and commitments made by the government to promote physical activity and nutritional status among Zimbabwean children and youth.50”

• cites [50] sourceNot checked yet

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May combine two claims.

Ethiopia received F for Sedentary Behaviors, Family and Peers, and Community and Environment; other indicators ranged D to C, except Active Play at B.

“In Ethiopia, an”

May combine two claims.

Slovenia was the only country with a high Overall Physical Activity grade (A-); more than 80% of its 6- to 19-year-olds (self-report), 88% of 11-year-olds, and 66% of 14-year-olds (objective data) met guidelines.

“Slovenia, where more than 80% of children and youth aged between 6 and 19 years (according to subjective self-reported data), 88% of the 11-year-olds, and 66% of the 14-year-olds (according to objective data) were meeting the physical activity guidelines, was the only country reporting a high grade for this indicator (”

• cites [57] sourceNot checked yet

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May combine two claims.

China received F for four indicators (Overall Physical Activity, Sedentary Behaviors, Community and Environment, and Government), with remaining indicators between D- and C+.

“An”

May combine two claims.

Active Transportation had the highest average grade for low and medium HDI countries (C+) and for high HDI countries (C).

“Active Transportation was the indicator with the highest average grade for the low and medium HDI countries (”

• Also stated in: § Active Transportation · plain

  “) and for the high HDI countries (”

• Also stated in: § Overall Physical Activity · plain

  “).”

• AssumptionRests on an assumption: The country-specific grades are sufficiently comparable across countries to support cross-country and HDI-group comparisons.
• AssumptionRests on an assumption: HDI groupings are a meaningful basis for comparing physical activity grades across countries.

May combine two claims.

In high HDI countries, Organized Sport grades ranged from F to C+ and averaged D+.

“Among the high HDI countries, the grades ranged from”

• Also stated in: § Overall Physical Activity · plain

  “to”

• Also stated in: § Organized Sport and Physical Activity · plain

  “with an average of”

May combine two claims.

Average Active Play grades were C- for low and medium HDI countries, D for high HDI countries, and D+ for very high HDI countries.

“The average grades for the low and medium HDI countries, high HDI countries, and very high HDI countries were”

• Also stated in: § Overall Physical Activity · plain

  “,”

• Also stated in: § Organized Sport and Physical Activity · plain

  “, and”

• AssumptionRests on an assumption: The country-specific grades are sufficiently comparable across countries to support cross-country and HDI-group comparisons.
• AssumptionRests on an assumption: HDI groupings are a meaningful basis for comparing physical activity grades across countries.

May combine two claims.

In very high HDI countries, Organized Sport averaged C+ and was the highest graded behavioral indicator.

“In the very high HDI countries, with an average grade of”

Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). May combine two claims.

Venezuela received F for Government, D or D- for remaining indicators, and B- for Active Transportation.

“An”

May combine two claims.

Active Transportation averaged D+ and ranged from F in Chile to A- in Japan, Nepal, and Zimbabwe.

“The average grade for this indicator was D+ and ranged from”

• Also stated in: § Active Transportation · plain

  “(Chile) to”

• Also stated in: § Active Transportation · plain

  “(Japan, Nepal, and Zimbabwe).”

May combine two claims.

Although no physical activity data were available for Venezuelans under 15, the work group found most adolescents over 15 did not engage in regular physical activity.

“Although there were no physical activity data available for those under 15 years of age, the work group found that the majority of adolescents older than 15 years do not engage in physical activity regularly.”

May combine two claims.

Among the nine low and medium HDI countries, five assigned an Organized Sport letter grade, ranging from D to B with an average of C.

“Among the 9 low and medium HDI countries, 5 assigned a letter grade to this indicator, which ranged from”

• Also stated in: § Overall Physical Activity · plain

  “to”

• Also stated in: § Organized Sport and Physical Activity · plain

  “, with an average of”

May combine two claims.

Overall Physical Activity received the lowest average grade among the indicators, a D.

“Overall Physical Activity was the indicator with the lowest average grade”

May combine two claims.

In China, 13.1% of 9- to 17-year-olds met physical activity guidelines and 7.1% met sedentary behavior guidelines.

“The small proportions of 9-to 17-year-old children in China meeting the physical activity guidelines (13.1%) or the sedentary behavior guidelines (7.1%) are alarming.51”

• cites [51] sourceNot checked yet

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The quote only partly states this claim.

High to very high Active Transportation grades were reported in several developing countries: Colombia B, Nepal A-, Nigeria B, Venezuela B-, and Zimbabwe A-.

“High to very high grades for this indicator were also reported in several developing countries: Colombia (”

• Also stated in: § Active Transportation · plain

  “), Nepal (”

• Also stated in: § Active Transportation · plain

  “), Nigeria (”

May combine two claims.

Among the remaining countries, Physical Fitness grades ranged from F in India to A in Japan, with an average of C-.

“In the remaining countries, the grade for Physical Fitness ranged from”

May combine two claims.

Of the 10 high HDI countries, only Brazil (D), China (D), Colombia (D-), and Uruguay (C-) had a Physical Fitness letter grade, averaging D.

“Among the 10 high HDI countries, only 4 had a letter grade reported for this indicator: Brazil (”

Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). May combine two claims.

School grades ranged from D- in South Africa, the United Arab Emirates, and the United States to A in Finland, Portugal, and Slovenia.

“This indicator ranged from”

Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

Very high HDI countries had an average School grade of B-.

“The very high HDI countries obtained an average grade of”

Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). May combine two claims.

Twenty-two countries received an INC grade for Family and Peers: 4 low/medium HDI, 6 high HDI, and 12 very high HDI.

“An”

May combine two claims.

For Sedentary Behaviors, grades spanned from F in China, Estonia, Ethiopia, Scotland, and Wales to A- in Bangladesh, with a mean of D+.

“The grades for this indicator ranged from”

The quote only partly states this claim.

Among the eight low and medium HDI countries, only Ethiopia (F) and India (C-) received low Sedentary Behaviors grades.

“only 2 of the 8 countries had a low grade: Ethiopia”

May combine two claims.

Seventeen of the 30 very high HDI countries received a Physical Fitness letter grade, ranging from D in Canada, Chile, Hong Kong, and Jersey to A in Japan.

“A letter grade was assigned to 17 of the 30 very high HDI countries, ranging from”

May combine two claims.

Sedentary Behaviors grades showed no significant relationship with HDI or other sociodemographic indicators, except for mean years of schooling (r = .31, P < .05) and summer Olympic medal count (r = -.57, P < .05).

“Regardless, the Sedentary Behaviors grades were not significantly related to HDI or to the other sociodemographic indicators except the mean years of schooling (r = .31,P < .05)and the summer Olympic medal count (r = -.57,P < .05) in the correlational analysis presented in the Supplementary Material 1 (available online).”

May combine two claims.

The number of INC grades and the letter grades for Family and Peers match those in previous Global Matrices.

“This amount of”

• cites [16] sourceNot checked yet

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• cites [19] sourceNot checked yet

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May combine two claims.

Poor Active Transportation grades were reported for 16 of the 30 very high HDI countries, with grades between F and C-.

“whereas poor grades were reported for 16 of the 30 very high HDI countries (with grades between”

• Also stated in: § Overall Physical Activity · plain

  “and”

• Also stated in: § Overall Physical Activity · plain

  “).”

May combine two claims.

The mean grade for Active Play was 6.5 (SD 2.7), corresponding to D+.

“| Active Play | 20 | 29 | 6.5 | 2.7 | D+ |”

May combine two claims.

Correlation analyses showed that the Overall Physical Activity grade had a moderate positive association with Sedentary Behaviors and was not statistically related to the other eight indicators.

“The correlation analyses showed that the Overall Physical Activity grade had a moderate positive association with Sedentary Behaviors and was not statistically related with the 8 remaining indicators (Supplementary Material 1 [available online]).”

May combine two claims.

Developing a national physical activity Report Card and participating in the Global Matrix initiative were found to build capacity within participating countries.

“building capacity within participating countries”

• cites [23] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Developing a national physical activity Report Card and participating in the Global Matrix initiative were found to raise awareness of the childhood physical inactivity issue nationally and internationally.

“the development of a national Report Card of physical activity for children and youth and the participation in the Global Matrix initiative were found to contribute to raising awareness on the childhood physical inactivity issue nationally and internationally”

• cites [23] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

In countries with very high Human Development Index, behavioral indicator grades tended to be lower and source-of-influence indicator grades tended to be higher.

“whereas lower behavioral grades and higher source of influence grades were observed for the very high HDI countries”

May combine two claims. The quote only partly states this claim.

In low and medium HDI countries, Government averaged C- and was the source-of-influence indicator with the highest average.

“With an average of”

• AssumptionRests on an assumption: Government can influence children's and youth's physical activity in multiple ways.

May combine two claims.

The mean grade for Government was 8.6 (SD 3.1), corresponding to C.

“| Government | 41 | 8 | 8.6 | 3.1 | C |”

May combine two claims.

Low and medium HDI countries generally had higher behavioral grades and lower source-of-influence grades, very high HDI countries showed the opposite pattern, and high HDI countries generally had low average grades for every indicator.

“Higher behavioral grades and lower source of influence grades were generally observed in the low and medium HDI countries, whereas the opposite was observed for the very high HDI countries, and generally low average grades were reported for each indicator in the high HDI countries.”

May combine two claims.

The mean grade for Behavioral indicators was 7.0 (SD 1.6), corresponding to C-.

“| Behavioral indicators | 49 | 0 | 7.0 | 1.6 | C- |”

May combine two claims.

The mean grade for School was 8.8 (SD 3.0), corresponding to C.

“| School | 41 | 8 | 8.8 | 3.0 | C |”

May combine two claims.

In countries with low or medium Human Development Index, behavioral indicator grades tended to be higher and source-of-influence indicator grades tended to be lower.

“Higher behavioral grades and lower source of influence grades were generally observed in the low and medium HDI countries”

May combine two claims.

The mean grade for Community and Environment was 8.9 (SD 3.0), corresponding to C.

“| Community and Environment | 36 | 13 | 8.9 | 3.0 | C |”

May combine two claims.

More diversity was seen between the three HDI groupings, between countries, and within each country.

“More diversity was observed between the 3 HDI groupings, between the countries, and within each country.”

May combine two claims.

Across the 10 indicators, average grades were low and varied only slightly, from D to C.

“Overall, the average grades obtained for each indicator were low, and a small variation was observed within the 10 indicators (”

May combine two claims.

The mean grade for All indicators was 7.5 (SD 1.6), corresponding to C-.

“| All indicators | 49 | 0 | 7.5 | 1.6 | C- |”

May combine two claims.

The mean grade for Sedentary Behaviors was 6.4 (SD 2.8), corresponding to D+.

“| Sedentary Behaviors | 46 | 3 | 6.4 | 2.8 | D+ |”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Each country faces unique challenges and can learn from others' successes or difficulties.

“showing that every country is facing unique challenges and can learn from the successes or difficulties experienced by others.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Global Matrix 1.0 in 2014 involved 15 countries and Global Matrix 2.0 in 2016 involved 38 countries, each producing Report Cards for 9 physical activity indicators.

“Fifteen countries in 2014 (Global Matrix 1.0) and 38 countries in 2016 (Global Matrix 2.0) developed and launched Report Cards presenting grades for 9 physical activity indicators, allowing for international comparisons and offering insights from global data.16,19”

• cites [16] sourceNot checked yet

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• cites [19] sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Draft country grades and rationales were audited by AHKGA Executive Committee members to check consistency with harmonized benchmarks and grading scheme.

“A draft of each country Report Card grades were submitted along with their rationale by Report Card leaders and were audited by members of the AHKGA Executive Committee to ensure that the grades were consistent with the harmonized benchmarks and grading scheme.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The audit led to minor changes in grades or rationale for most countries.

“This audit process led to minor changes of the grades or rationale for most of the countries.”

May combine two claims.

The Global Matrix of Report Card grades was first launched in 2014 to better understand international differences in child and youth physical activity and its correlates.

“To achieve a better understanding of the global variation in child and youth physical activity and its correlates, the Global Matrix of Report Card grades on physical activity was launched for the first time in 2014.16”

• cites [16] sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

The AHKGA Executive Committee reached consensus that Global Matrix 3.0 indicator grades should use only data from school-aged children and youth about 5-17 years old to ensure consistency across countries.

“consensus was reached among the AHKGA Executive Committee that the 10 indicator grades should only be informed by data from school-aged children and youth (∼5-17 y old) for the Global Matrix 3.0 to ensure consistency across countries.”

May combine two claims.

Inactivity in school-aged children and youth is linked to poorer physical, mental, social, and cognitive health, lower fitness, and lower activity later in life.

“This is alarming given that physical inactivity among school-aged children and youth has been found to be associated with adverse physical, mental, social, and cognitive health outcomes, 5,8,12,13 lower physical fitness, 14 and lower physical activity levels in later life.15”

• cites [5] sourceNot checked yet

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• cites [8] sourceNot checked yet

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• cites [12] sourceNot checked yet

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• cites [13] sourceNot checked yet

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• cites [14]Not checked yet

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• cites [15] sourceNot checked yet

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May combine two claims.

The first two Global Matrices highlighted a paradox: poorer-infrastructure countries had higher physical activity and lower sedentary behavior, while better-infrastructure countries had lower physical activity and higher sedentary behavior.

“Also, a paradox of higher physical activity and lower sedentary behavior in countries reporting poorer infrastructure, and lower physical activity and higher sedentary behavior in countries reporting better infrastructure was highlighted.16,19”

• cites [16] sourceNot checked yet

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• cites [19] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Canadian Report Card has for over ten years successfully raised awareness and influenced policies for childhood physical activity promotion.

“For over a decade, the Canadian Report Card has been successful in raising awareness and influencing policies for childhood physical activity promotion.”

• cites [17] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A mentoring system paired new Report Card leaders with experienced leaders from Global Matrix 2.0.

“New Report Card leaders and teams were paired with an experienced Report Card leader from a country who participated in the Global Matrix 2.0.”

Probably not a substantial claim: may not pass S3 (load-bearing).

China's work group developed a national surveillance protocol to collect nationally representative data for its 2018 Report Card.

“China's Report Card work group developed a national surveillance protocol to collect nationally representative data for China's 2018 Report Card.51”

• cites [51] sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

For these reasons, cross-country comparability of the results should be interpreted with caution.

“For such reasons, the comparability of these results among the countries should be interpreted with caution.”

Probably not a substantial claim: may not pass S3 (load-bearing).

This finding agrees with earlier Global Matrices and recent global estimates.

“This finding is consistent with the results from the previous Global Matrices 16,19 and recent global estimates.11”

• cites [16] sourceNot checked yet

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• cites [19] sourceNot checked yet

  Not checked in the free run.

• cites [11] sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim. May combine two claims.

The Organized Sport grade depends on the availability of organized sport opportunities and on data about the prevalence of children and youth using them.

“The grade for this indicator depends on the availability of organized sport opportunities and the availability of data reporting the prevalence of children and youth who have taken advantage of these opportunities.”

May combine two claims.

High air pollution in China is a major threat to physical activity promotion and a potential barrier to exercise for Chinese children and youth.

“the high level of air pollution in China represents a major threat to the promotion of physical activity 53 and is a potential barrier stopping the Chinese children and youth from exercising.”

• cites [53]Not checked yet

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May combine two claims.

A Japanese policy limiting distance between homes and public elementary and junior high schools, plus high density in Hong Kong, Japanese, and South Korean cities, allows children and youth to live close to school, which can reduce motorized vehicle use and promote active travel.

“A specific policy in Japan (limiting the distance between the children and youth homes and the public elementary and junior high schools) 77 and the high density of Hong Kong, Japanese, and South Korean cities, allow children and youth to live a short trip away from their school, which can minimize the use of cars or other forms of motorized vehicles, and promote active travel.25,78,79”

• cites [77] sourceNot checked yet

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• cites [25] sourceNot checked yet

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• cites [78] sourceNot checked yet

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• cites [79] sourceNot checked yet

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May combine two claims.

Economic development in Nepal is rapidly increasing motorized vehicles and may increase access to screen devices.

“Due to the concurrent economic development in recent years in Nepal, the number of motorized vehicles is increasing rapidly with the expansion of road networks in rural areas, 49 and potentially more people have access to screen devices.”

• cites [49] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The Organized Sport benchmark measured participation in organized sport or physical activity programs and did not capture dose (duration, frequency, intensity) because few countries had such data.

“The benchmark recommended for this indicator was the”

• Also stated in: § Organized Sport and Physical Activity · plain

  “(Table 1), meaning that this indicator did not provide any information on the dose (ie, duration, frequency, intensity) of physical activity while participating in sport and organized physical activities, because few countries have such data.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Quality school physical activity policies and programs in Finland, Portugal, and Slovenia have been highlighted in other work.

“Quality school policies and programs related to physical activity for the 3 European countries leading this indicator (Finland, Portugal, and Slovenia) have already been highlighted elsewhere.19,25”

• cites [19] sourceNot checked yet

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• cites [25] sourceNot checked yet

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May combine two claims.

The number of INC grades and measurement variation for Family and Peers restrict comparison and interpretation of the letter grades.

“The number of”

Probably not a substantial claim: may not pass S3 (load-bearing).

Parental and peer support is acknowledged as a factor linked to physical activity among children and youth.

“Support from parents and peers is recognized as a correlate of physical activity in children and youth 90 ; however, the nature of this relationship is complex and no valid and internationally recognized instrument exists to measure the influence of family and friends on children and youth's physical activity at present.”

• cites [90]Not checked yet

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May combine two claims.

Taking time from physical education to add academic instruction did not improve academic achievement and may harm health.

“Evidence showed that adding more time to academic or curricular subjects by taking time away from physical education programs was found not to enhance academic achievement in the corresponding academic subjects and to be potentially detrimental to health.98”

• cites [98]Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

International estimates indicate that at least two-thirds of children exceed two hours of recreational screen time daily.

“These findings are consistent with international estimates reporting that at least two-thirds of the children exceed 2 hours of recreational screen time per day, 83 although comparison may be limited by the heterogeneity in Sedentary Behaviors across countries.”

• cites [83]Not checked yet

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May combine two claims.

Reallocating time from other subjects to physical activity can increase children's MVPA without risking poorer academic achievement.

“Conversely, allocating more time to physical activity from other subjects can improve the time children spend engaging in MVPA without the risk of”

• cites [98]Not checked yet

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May combine two claims.

Several Sedentary Behaviors grades used data on sitting or non-screen sedentary activities, and some countries used screen time cutoffs different from the benchmark (≤1 h/d, <2 used hours/day, ≤3 h/d) because of available data.

“Several Sedentary Behaviors grades were partially or totally informed by data reporting time spent sitting or doing other sedentary activities that did not involve screens, and screen time cutoff points differing from the one in the benchmark (ie, ≤1 h/d, <2 used hours/day, ≤3 h/d) were also used by some countries because of available data.”

May combine two claims.

Cardiorespiratory fitness is an important marker of current and future health in school-aged children and youth and can serve as a holistic population health indicator for this group.

“Therefore, cardiorespiratory fitness is an important indicator of current and future health among school-aged children and youth and can be used as a holistic indicator of population health in this age group.88”

• cites [88]Not checked yet

  Not checked in the free run.

May combine two claims.

Although the 2018 Korean national curriculum mandates physical education, it is treated as a minor subject and becomes devalued in later grades.

“Although the new 2018 Korean national curriculum requires schools to provide mandatory physical education, it is regarded as a minor subject and, with progressing school grades, it is devalued and neglected.97”

• cites [97]Not checked yet

  Not checked in the free run.

May combine two claims.

South Pacific island nations, Central Asia, and North Africa were missing from the analysis.

“In particular, the South Pacific islands nations, where the average body mass indices for child and youth were estimated to be the highest of the world, 103 are missing, as well as countries from Central Asia and North Africa.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The AHKGA Executive Committee modified and standardized the benchmarks and grading rubric for the Global Matrix 3.0.

“the AHKGA Executive Committee for modifying and standardizing the benchmarks and grading rubric and leading this international initiative.”

Classified as probably not a substantial claim.

Adjustments were made to the behavioral score to account for missing and incomplete grades.

“The behavioral score was adjusted for missing and incomplete grades.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

The situation may worsen as low, medium, and high HDI countries grow economically, and very high noncommunicable disease rates can be expected when the current generation of children and youth reaches adulthood unless a major shift to a more active lifestyle occurs soon.

“Moreover, this phenomenon may get worse with the economic growth and development of low, medium, and high HDI countries, and very high rates of noncommunicable diseases can be anticipated when the current generation of children and youth reaches adulthood unless a major shift to a more active lifestyle happens soon.”

May combine two claims.

Government grades were based on very different data types across countries, and work groups often lacked relevant quantitative data, so they graded mostly from expert opinion when necessary.

“As a result, the grades were informed by very different types of data across countries, and the Report Card work groups did not always have access to relevant quantitative data and, therefore, graded this indicator mostly based on expert opinion when required.”

• AssumptionRests on an assumption: Government can influence children's and youth's physical activity in multiple ways.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Absence of choice, child labor, and cultural values attributed to physical activity and sports were not evaluated in this study.

“In addition, the absence of choice (ie, children who have no other options than using active transportation regardless of safety and any other characteristics of the source of influence), child labor, and the cultural values attributed to physical activity and sports were not evaluated in this study.”

Probably not a substantial claim: may not pass S2 (checkable).

With 49 participating countries and 10 common indicators graded by each, Global Matrix 3.0 is the most comprehensive and meaningful comparison of the contexts of children's and youth's physical activity.

“With the 49 countries participating and the 10 common indicators being graded by each participating country, the Global Matrix 3.0 represents the most comprehensive and meaningful comparison of the contexts of the physical activity of children and youth.”

May combine two claims.

Data used for grades varied greatly across countries for each indicator in benchmark, measurement instrument, age range, sample size, quality, and quantity, and in many cases the available data did not allow strict alignment with recommended benchmarks.

“In addition, the great variability of the data (eg, in terms of benchmark, measurement instrument, age range, sample size, quality, quantity) that were used to inform the grades was observed between the countries for each indicator, and in many cases, the available data did not permit the Report Card work groups to align strictly with the recommended benchmarks.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The involvement of governmental and nongovernmental organizations in developing some national Report Cards may indicate growing interest in the childhood physical inactivity crisis.

“The involvement of governmental and nongovernmental organizations in the development of some of the national Report Cards is a potential sign of a growing interest in the childhood physical inactivity crisis”

May combine two claims.

Another limitation was the lack of representativeness of some world areas and specific child and youth populations; with 49 countries participating, most countries worldwide were still missing.

“Another limitation of the Global Matrix 3.0 was the lack of representativeness of some areas of the world and some specific child and youth populations.Indeed, the participation of a total of 49 countries or nations meant that most of the countries around the world were still missing.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Disparities and inequities by gender, socioeconomic status, or urban versus rural dwelling were mentioned in only a few Report Card articles and were not analyzed or discussed in this study.

“Furthermore, the disparities and inequities across gender, socioeconomic status, or urban versus rural dwelling were mentioned in only a handful of Report Card articles; thus, they were not analyzed or discussed in this study.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The lack of statistically significant correlations between Overall Physical Activity and Organized Sport and Physical Activity, Active Play, and Active Transportation may be because the physical activity dose related to those indicators was not measured.

“The absence of statistically significant correlations between Overall Physical Activity and Organized Sport and Physical Activity, Active Play, and Active Transportation may have resulted from the fact that the physical activity dose related to these indicators was not measured.”

Classified as probably not a substantial claim. May combine two claims.

Developing a national physical activity Report Card and participating in the Global Matrix initiative may affect future opportunities for physical activity.

“and potentially influencing the creation of physical activity opportunities in the future.23”

• cites [23] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The Community and Environment findings were consistent with earlier Global Matrices and support the importance of income and gender equity for physical activity and population health.

“These findings aligned with the results of the previous Global Matrices 16,19 and reinforce the importance of income and gender equity for the physical activity and overall population health.”

• cites [16] sourceNot checked yet

  Not checked in the free run.

• cites [19] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Adjustments were made to the overall score to account for missing and incomplete grades.

“The overall score was adjusted for missing and incomplete grades.”

May combine two claims.

All comparisons, correlations, and interpretations involving the grades are limited and should be interpreted cautiously, because two identical grades for the same indicator can represent very different national contexts.

“Consequently, all the comparisons, correlations, and interpretations involving the grades are limited and should be interpreted with caution, as 2 identical grades for the same indicator can capture 2 very different contexts from one country to another.”

May combine two claims.

Among children and youth globally, insufficient physical activity and excessive sedentary behavior are continuing patterns.

“Internationally collaborative and collective efforts are needed to redirect the persisting trend of low physical activity and high sedentary behavior among children and youth worldwide.”

• AssumptionRests on an assumption: The 49 countries included in the Global Matrix 3.0 are representative of children and youth worldwide.

Probably not a substantial claim: may not pass S2 (checkable).

The overall concerning levels of physical activity and sedentary behavior among children and youth may indicate a global crisis.

“It is important to highlight that the overall concerning levels of physical activity and sedentary behavior among children and youth may be indicative of a global crisis.”

Classified as probably not a substantial claim.

The Global Matrix 3.0 and Report Card initiatives identified gaps in international research and surveillance.

“International research and surveillance gaps were also identified by the Global Matrix 3.0 and the Report Card initiatives.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Adjustments were made to the source-of-influence score to account for missing and incomplete grades.

“The source of influence score was adjusted for missing and incomplete grades.”

May combine two claims.

Estimates of the sources-of-influence score are likely imprecise because of missing data used to calculate the score, so they should be interpreted with caution.

“These estimates of sources of influence score are interpreted with a high degree of caution as they are likely imprecise estimates of sources of influence due to the level of missing data used to determine this score.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The absence of a relation between source-of-influence indicators and Overall Physical Activity may suggest that a favorable physical and social environment is not sufficient to make individuals engage in enough MVPA.

“The absence of a relation between the source of influence indicators and Overall Physical Activity may suggest that a favorable physical and social environment is not enough to induce individual engagement in sufficient amounts of MVPA.”

May combine two claims.

The generally low behavioral grades in Global Matrix 3.0 suggest that government efforts and physical activity policies have not increased MVPA prevalence among children and youth, and/or that an implementation gap exists between strategy-level source-of-influence indicators and individual-level behavioral indicators.

“The low behavioral grades that were reported broadly in the Global Matrix 3.0 suggest that the government's efforts and physical activity policies are not reflected in an increase in the prevalence of MVPA among children and youth, and/or that there is an implementation gap between the strategy level (source of influence indicators) and individual level (behavioral indicators).”

• AssumptionRests on an assumption: Government can influence children's and youth's physical activity in multiple ways.

May combine two claims.

Available evidence suggests that built-environment characteristics that may influence children's and youth's physical activity are already favorable in very high HDI countries, and that Community and Environment grades should rise as low, medium, and high HDI countries develop further.

“The available evidence from this indicator suggests that the characteristics of the built environment potentially influencing the physical activity of children and youth are already favorable in the very high HDI countries, and that an increase of the grades for this indicator is expected with the further development of low, medium, and high HDI countries.”

Classified as probably not a substantial claim. May combine two claims.

Major strengths include the large number of countries that adopted the harmonized Report Card development process and the quantity of data used to inform an international, comprehensive, and meaningful comparison of children's and youth's physical activity behaviors.

“Major strengths of this work include the large number of countries who adopted the harmonized Report Card development process and the quantity of data used to inform an international, comprehensive, and meaningful comparison of physical activity behaviors of children and youth.”