Process description and evaluation of Canadian Physical Activity Guidelines development

Tremblay et al. International Journal of Behavioral Nutrition and Physical Activity 2010, 7:42 Open Access METHODOLOGY Process description and evaluation of Canadian Physical Activity Guidelines development Methodology Mark S Tremblay*1, Michelle E Kho2, Andrea C Tricco3 and Mary Duggan4 Abstract Background: This paper describes the process used to arrive at recommended physical activity guidelines for Canadian school-aged children and youth (5-17 years), adults (18-64 years) and older adults (≥65 years). Methods: The Canadian Society for Exercise Physiology (CSEP) Physical Activity Measurement and Guidelines (PAMG) Steering Committee used the Appraisal of Guidelines for Research Evaluation (AGREE II) Instrument to inform the guideline development process. Fourteen background papers and five systematic reviews were completed. Systematic review authors appraised and synthesized the data, and proposed specific recommendations at an international consensus conference of invited experts and key stakeholders. Independently, an international panel of experts interpreted the evidence from the systematic reviews and developed recommendations following attendance at the Consensus Conference. Results: Using the AGREE II instrument as a guide, specific foci for each of the guidelines were defined and systematic review methodology was used to synthesize the evidence base. The expert panel, CSEP PAMG Steering Committee and methodological consultants reviewed the systematic reviews and Consensus Statement. The expert panel achieved consensus on the level of evidence informing the physical activity guidelines and developed a separate document outlining key recommendations, interpretation of the evidence and justification of each recommendation. Conclusion: The CSEP and Public Health Agency of Canada followed a rigorous process to examine the evidence informing potential revisions to existing physical activity guidelines for Canadians. It is believed that this is the first physical activity guideline development process in the world to be guided and assessed by AGREE II and AMSTAR instruments. Background Over the past several decades habitual physical activity among Canadians has decreased, while corresponding increases in obesity and prevalence of chronic disease have been observed [1]. Engaging in regular physical activity reduces the risk of developing chronic disease and contributes to overall health [1-4]. Since 1995, the Canadian Society for Exercise Physiology (CSEP) and Public Health Agency of Canada - Centre for Health Promotion have collaborated on the development of physical activity guidelines to preserve and promote the health of Canadians, to help Canadians become more aware of the * Correspondence: 1 Healthy Active Living and Obesity Research Group (HALO), Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1 Canada Full list of author information is available at the end of the article benefits of physical activity, and to encourage Canadians of all ages to become more physically active. The mandate of CSEP is "to promote the generation, synthesis, transfer and application of knowledge and research related to exercise physiology (encompassing physical activity, fitness, health, nutrition, epidemiology, and human performance)." [5] With a membership of approximately 4000 individuals across Canada, the CSEP actively encourages scientific investigators to pursue new knowledge in all areas of human movement physiology, and to publish and interpret their results. The CSEP's Health and Fitness Program is involved in the application of this knowledge to develop and improve physical activity and health strategies to enhance human health, reduce the prevalence of overweight and obesity, and reduce the prevalence and alleviate the symptoms of acute and chronic diseases or conditions. The CSEP is unique in that it provides access to relevant, high-quality cutting- © 2010 Tremblay et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Tremblay et al. International Journal of Behavioral Nutrition and Physical Activity 2010, 7:42 http://www.ijbnpa.org/content/7/1/42 edge science through their member's research and organizational liaisons, and facilitates translation of this knowledge to health and fitness professionals from many physical activity-related fields for use in their professional practice. The CSEP also ensures that the new knowledge is incorporated into informative, practical educational materials for investigators, health and fitness professionals, and the general public. The Public Health Agency of Canada is an agency of the Government of Canada that is responsible for public health - the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals. Its mission is to promote and protect the health of Canadians through leadership, partnership, innovation and action in public health. Among its responsibilities for public health, the Public Health Agency of Canada has the lead on the Government of Canada's policy regarding physical activity, the objectives of which are to: (a) promote physical activity as a fundamental element of health and well-being; (b) encourage all Canadians to improve their health by integrating physical activity into their daily lives; and (c) assist in reducing barriers faced by Canadians that prevent them from being active. The Healthy Living Program, part of the federal Healthy Living and Chronic Disease Initiative, is a cornerstone of the Public Health Agency of Canada's health promotion efforts and a proactive response to the rapid increase in chronic disease across population groups. It aims to lead, foster and support action to address the conditions that support physical activity, healthy eating, and healthy weights for all Canadians and with particular emphasis on sub-populations experiencing health disparities. The Program encompasses a range of initiatives, tools and strategies that seek to directly impact key determinants of health; for example by fostering the creation of health-supporting social and physical environments, seeking to optimize personal health practices, and laying the groundwork for healthy child development. The CSEP, in partnership with the Public Health Agency of Canada, led the process to develop each of Canada's Physical Activity Guidelines and Guides [6-15] and convened the Steering Committee guiding the process to review current evidence underlying physical activity measurement and guidelines in Canada. Overview of the Project In 1995 the CSEP and the Public Health Agency (...truncated)