Cited by 799Physical Activity and HealthObesity, Physical Activity, DietRecreational Sport and Physical Activity

The DOI matches its Crossref record; 83 of the 86 references it cites were found in a registry or an index; none of the 81 sources its claims cite is checked for support yet.

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

Open access

Abstract

Background : Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods : Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results : A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions : The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

Global Matrix 3.0 compiled harmonized physical activity Report Card grades for children and youth from 49 countries, assigning 490 grades across 10 common indicators. Overall grades were low (overall average C-), with concerning physical activity and sedentary behavior levels worldwide and variation by HDI grouping.

Key findings

  • A total of 490 grades were assigned: 369 letter grades and 121 incomplete (“INC”) grades. Overall average grade was “C-”; by HDI category, averages were “C-” for low/medium HDI countries, “D+” for high HDI countries, and “C-” for very high HDI countries. Behavioral indicators averaged “C-” and sources of influence indicators averaged “C.”
  • Indicator averages ranged from “D” for Overall Physical Activity to “C” for Organized Sport and Physical Activity, Active Transportation, School, Community and Environment, and Government; Active Play, Sedentary Behaviors, and Family and Peers averaged “D+,” and Physical Fitness averaged “C-.” Overall Physical Activity was the lowest-graded indicator; Slovenia was the only country with an “A-” for Overall Physical Activity, while most other countries had “D-F” grades (n = 38).
  • Rankings showed Slovenia first and China 49th for overall score; Nepal first and Estonia last for behavioral score; Slovenia first and Venezuela last for sources of influence score.
  • Correlational analyses found Overall Physical Activity negatively associated with HDI (r = -.30, P < .05) and gross national income per capita (r = -.33, P < .05); Community and Environment was positively associated with HDI (r = .73, P < .001) and GNI per capita (r = .80, P < .001); School was positively associated with HDI (r = .53, P < .001) and negatively with the Gini index (r = -.66, P < .001).

Methods

  • Work groups from 49 countries/regions followed harmonized procedures to grade 10 common indicators using the best available data; countries were divided by United Nations HDI classification into low/medium (9), high (10), and very high (30) HDI groups.
  • Each country work group gathered published and unpublished evidence, national surveys, official reports, and expert opinion for school-aged children and youth (∼5-17 y); draft grades and rationales were audited by AHKGA Executive Committee members.
  • Letter grades were converted to interval values, “INC” grades were treated as missing, and descriptive statistics, overall/behavioral/sources-of-influence scores, and Spearman rank correlations were calculated in R version 3.4.1.

Limitations

  • The paper states a major limitation was missing data: 121 “INC” grades of 490 total, plus great variability across countries in benchmarks, measurement instruments, age range, sample size, quality, and quantity of data; translating prevalence data into letter grades also lost information, so comparisons and correlations should be interpreted with caution.
  • The paper states the sample was not globally representative: most countries worldwide were missing, including South Pacific island nations, Central Asia, and North Africa; children and youth with disabilities were not explicitly included, and disparities by gender, socioeconomic status, or urban versus rural dwelling were not analyzed.
  • The paper states Overall Physical Activity was not statistically related to 8 other indicators except a positive moderate correlation with Sedentary Behaviors, possibly due to limitations, unmeasured physical activity dose, absence of choice, child labor, and cultural values not evaluated; evident from the text, the grades rely on available surveillance data and expert opinion rather than standardized primary measurement, and the analyses are cross-sectional and correlational.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1123/jpah.2018-0472

Cites

83 of 83 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 81 cited sources checked · 0 supported · 0 flagged

Show all 127 claims

  • It may state two separate claims as one. 99
  • Probably not a substantial claim. 37
  • The quote only partly states this claim. 7
124 of 124
  • The paper relies on this without support.

    The 49 participating countries are sufficiently representative of countries worldwide for the conclusion that child and youth physical activity is a global concern.

    “The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide.”
  • The paper relies on this without support.

    The country-specific grades are sufficiently comparable across countries to support cross-country and HDI-group comparisons.

    “The average grade for the low and medium HDI countries was”
    “whereas both the high and very high HDI countries obtained an average of”
  • The paper relies on this without support.

    HDI groupings are a meaningful basis for comparing physical activity grades across countries.

    “A distinction was observed between the low and medium HDI countries and the 2 other HDI groupings.”
  • The paper relies on this without support.

    No valid, internationally recognized instrument currently exists to measure how family and friends influence children's and youth's physical activity.

    “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.”
  • The paper relies on this without support.

    Government can influence children's and youth's physical activity in multiple ways.

    “Similar to the Community and Environment indicator, a government can potentially influence the physical activity level of children and youth in multiple ways.”
  • The paper relies on this without support.

    A large number of built-environment characteristics could potentially influence children's and youth's physical activity.

    “Given that a great number of characteristics could potentially influence the physical activity of children and youth, numerous benchmarks were proposed to evaluate this indicator.”
  • The paper relies on this without support.

    There is no official standardized method for evaluating government influence on physical activity.

    “As there is no official standardized method to evaluate this influence, the recommended benchmark for this indicator focused on evidence of leadership and commitment, allocated funds and resources, and demonstrated progress for the promotion of physical activity opportunities for all children and youth (Table 1).”
  • The paper relies on this without support.

    The 49 countries included in the Global Matrix 3.0 are representative of children and youth worldwide.

    “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.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Four fee tiers are described as three

    Minor

    The sentence says there were three registration-fee tiers but lists four distinct fees, one for each HDI classification.

  • Community and Environment range excludes reported F grades

    Minor

    The section states that D- was the lowest Community and Environment grade, but the paper also says China received F for that indicator.

  • Botswana is not the highest on the reported Gini index

    Minor

    The text names Botswana's 60.5 as the highest Gini index, but Table 3 reports 63 for South Africa.

  • Active Transportation average is reported as both D+ and C

    Minor

    The discussion calls the average D+, whereas Table 5 reports C, with a mean number grade of 8.3 that maps to C under the grading rubric.

  • The nonletter grades cannot all be INC

    Minor

    The reported 369 letter grades and 121 INC grades account for all 490 grades, but Qatar's Active Transportation grade is separately identified as "not applicable," not INC.

  • Qatar is not the highest on the reported gender inequality index

    Minor

    The text names Qatar's 0.542 as the highest gender inequality index, but the sociodemographic data give Ghana a higher value of 0.547.

6 of 6

Citations

Cites

Flagged first, then by citations

3 of the 86 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Mukaka, 2012, A guide to appropriate use of correlation coefficient in medical research, Malawi Med J, 24, 69

Cited by

Sorted by citations

See all 799

Metadata

Authors
Aubert, S., Barnes, J. D., Abdeta, C., Abi Nader, P., Adeniyi, A. F., Aguilar-Farias, N., Andrade Tenesaca, D. S., Bhawra, J., Brazo-Sayavera, J., Cardon, G., Chang, C.-K., Delisle Nyström, C., Demetriou, Y., Draper, C. E., Edwards, L., Emeljanovas, A., Gába, A., Galaviz, K. I., González, S. A., Herrera-Cuenca, M., Huang, W. Y., Ibrahim, I. A. E., Jürimäe, J., Kämppi, K., Katapally, T. R., Katewongsa, P., Katzmarzyk, P. T., Khan, A., Korcz, A., Kim, Y. S., Lambert, E., Lee, E.-Y., Löf, M., Loney, T., López-Taylor, J., Liu, Y., Makaza, D., Manyanga, T., Mileva, B., Morrison, S. A., Mota, J., Nyawornota, V. K., Ocansey, R., Reilly, J. J., Roman-Viñas, B., Silva, D. A. S., Saonuam, P., Scriven, J., Seghers, J., Schranz, N., Skovgaard, T., Smith, M., Standage, M., Starc, G., Stratton, G., Subedi, N., Takken, T., Tammelin, T., Tanaka, C., Thivel, D., Tladi, D., Tyler, R., Uddin, R., Williams, A., Wong, S. H. S., Wu, C.-L., Zembura, P., & Tremblay, M. S.
Affiliations
  • University of Ibadan (NG)
  • Universidad de Guadalajara (MX)
  • Children's Hospital of Eastern Ontario (CA)
  • Centre Hospitalier de l’Université de Montréal (CA)
  • Lithuanian Sports University (LT)
  • University of Southern Denmark (DK)
  • Haramaya University (ET)
Corresponding author
Tremblay, Mark S.
Venue
Journal of Physical Activity and Health
Published
2018-01-02
Volume
15
Issue
s2
Pages
S251-S273
ISSN
  • 1543-3080 (ISSN-L)
  • 1543-5474
OpenAlex
W2902173239
Cited by
799
References
86
Citations by year
2026: 24 · 2025: 55 · 2024: 105 · 2023: 72 · 2022: 153 · 2021: 160 · 2020: 157 · 2019: 66 · 2018: 7
FWCI
66.85
Type
journal article
Language
en
Open access
Locations
  • Journal of Physical Activity and Health (publishedVersion)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
  • Lirias (KU Leuven) (submittedVersion, other-oa)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by)
  • Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (submittedVersion)
  • Repositorio Institucional (Universidad de Cuenca) (submittedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Figshare (submittedVersion, cc-by)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
  • Edge Hill University Research Information Repository (Edge Hill University) (submittedVersion, cc-by-nc-nd)
  • Pure (University of Bath) (submittedVersion, other-oa)
  • Cardiff Metropolitan Research Repository (Cardiff Metropolitan University) (submittedVersion)
  • ResearchSpace (University of Auckland) (submittedVersion, cc-by)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Social Sciences › Life-span and Life-course Studies › Recreational Sport and Physical Activity
Keywords
children's physical activity, moderate-to-vigorous physical activity, Human Development Index, cross-national comparison, physical activity opportunities, public health interventions
MeSH terms
Adolescent, Child, Child, Preschool, Female, Health Promotion, Humans, Exercise, Research Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-08, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-08 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review