Article

Process description and evaluation of Canadian Physical Activity Guidelines development

Healthy Active Living and Obesity Research Group (HALO), Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1 Canada. .
International Journal of Behavioral Nutrition and Physical Activity (Impact Factor: 3.68). 05/2010; 7(1):42. DOI: 10.1186/1479-5868-7-42
Source: PubMed

ABSTRACT 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).
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.
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.
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.

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    • "The consensus was that there already were limited resources for the release of the new CPAG let alone for constantly updating materials promoting the guidelines. The CPAG are slated for review and update every three to five years [10]. This would be optimal timing for updating the messaging recommendations as well; likely new clarification messages would be necessary at minimum. "
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    ABSTRACT: Background Few validated guidelines exist for developing messages in health promotion practice. In clinical practice, the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) Instrument is the international gold standard for guideline assessment, development, and reporting. In a case study format, this paper describes the application of the AGREE II principles to guide the development of health promotion guidelines for constructing messages to supplement the new Canadian Physical Activity Guidelines (CPAG) released in 2011. Methods The AGREE II items were modified to suit the objectives of developing messages that (1) clarify key components of the new CPAG and (2) motivate Canadians to meet the CPAG. The adapted AGREE II Instrument was used as a systematic guide for the recommendation development process. Over a two-day meeting, five workgroups (one for each CPAG – child, youth, adult, older adult – and one overarching group) of five to six experts (including behavior change, messaging, and exercise physiology researchers, key stakeholders, and end users) reviewed and discussed evidence for creating and targeting messages to supplement the new CPAG. Recommendations were summarized and reviewed by workgroup experts. The recommendations were pilot tested among end users and then finalized by the workgroup. Results The AGREE II was a useful tool in guiding the development of evidence-based specific recommendations for constructing and disseminating messages that supplement and increase awareness of the new CPAG (child, youth, adults, and older adults). The process also led to the development of sample messages and provision of a rationale alongside the recommendations. Conclusions To our knowledge, these are the first set of evidence-informed recommendations for constructing and disseminating messages supplementing physical activity guidelines. This project also represents the first application of international standards for guideline development (i.e., AGREE II) to the creation of practical recommendations specifically aimed to inform health promotion and public health practice. The messaging recommendations have the potential to increase the public health impact of evidence-based guidelines.
    BMC Public Health 05/2013; 13(1):419. DOI:10.1186/1471-2458-13-419 · 2.32 Impact Factor
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    • "Unpublished). As such, the following inclusion criteria were employed to screen all participants for eligibility: a) female aged between 25 and 55, b) mother with one child aged 18 or younger still living in the home, c) physically active (i.e., meeting the Canadian PA Guidelines of a minimum of 150 minutes of moderate to vigorous PA per week (Tremblay et al. 2010), d) working full-time outside of the home (minimum of 30 hours/week), e) currently free from any underlying medical or mental health condition that would influence physical activity levels or impair mood. "
    01/2013; 3(4). DOI:10.1186/2211-1522-3-4
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    • "outlines the process used to develop the new Canadian Physical Activity Guidelines. Details on the process to guide the foundation papers (Tremblay et al. 2007b), the systematic reviews (Tremblay et al. 2010a), and the AGREE II instrument (Brouwers et al. 2010a, 2010b, 2010c) can be found elsewhere. The target populations and guideline development questions were as follows: "
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    ABSTRACT: The Canadian Society for Exercise Physiology (CSEP), in cooperation with ParticipACTION and other stakeholders, and with support from the Public Health Agency of Canada (PHAC), has developed the new Canadian Physical Activity Guidelines for Children (aged 5-11 years), Youth (aged 12-17 years), Adults (aged 18-64 years), and Older Adults (aged >=65 years). The new guidelines include a preamble to provide context and specific guidelines for each age group. The entire guideline development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process; we based the recommendations herein on evidence from 3 systematic reviews, and the final guidelines benefitted from an extensive online and in-person consultation process with hundreds of stakeholders and key informants, both domestic and international. Since 2006, the products of our efforts resulted in the completion of 21 peer-reviewed journal articles (including 5 systematic reviews) that collectively guided this work. The process that Canadian researchers undertook to update the national physical activity guidelines represents the most current synthesis, interpretation, and application of the scientific evidence to date.
    Applied Physiology Nutrition and Metabolism 02/2011; 36(1):36-46; 47-58. DOI:10.1139/H11-009 · 2.23 Impact Factor
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