Collaborative Development of an Instrument to Monitor Physical Activity Promotion Based on Policy-Makers’ Needs – the TARGET:PA Tool

Articles in Press

Document Type : Original Article

Authors

1 Institute of Sport Sciences, Université de Lausanne, Lausanne, Switzerland

2 Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany

Abstract

Background 
To support policy development, a number of tools are available to inform policy-makers about the current status of physical activity (PA) promotion in a specific country. However, a recent exchange between policy-makers and researchers in Germany revealed two major gaps: First, examples of successful good practice projects are often not selected in an objective and systematic process. Second, there is usually no systematic assessment of “routine practice,” ie, PA promotion activities already taking place on large scale and regular basis. These issues are addressed by the newly developed TARGET:PA tool.
 
Methods 
The TARGET:PA tool was developed in a co-production process involving researchers from the World Health Organization Collaborating Centre for Physical Activity and Public Health (WHO CC) at FAU Erlangen-Nürnberg and the policy unit in charge of cardiovascular diseases, diabetes and non-communicable diseases at the German Ministry of Health. We documented the development process, details on the structure of the tool itself, and the outputs produced using the tool.
 
Results 
The development process involved a negotiation process between researchers and policy-makers and the need to adapt to extended decision-making timelines within the ministry. With regard to PA behavior at the individual level, the TARGET:PA tool includes an overview about (1) PA recommendations and (2) national PA prevalence rates. At the organizational/policy level, it contains information on (3) recommendations for PA promotion, (4) routine practice, (5) good practice projects, and (6) policies. Key outputs of the tool are policy briefs as well as scientific background documents.
 
Conclusion 
The TARGET:PA tool provides added value as it can support the integration of “good” and “routine” practices into the monitoring of PA promotion. While the tool has been developed and tested in Germany, it has the potential to be adapted to other countries, either by directly utilizing the tool or by emulating the collaborative development process to design new instruments adapted to specific contexts.

Keywords

References

  1. Martinez-Gomez D, Rodriguez-Artalejo F, Ding D, Ekelund U, Cabanas-Sanchez V. Trends in the association between meeting the physical activity guidelines and risk of mortality in US adults. Prog Cardiovasc Dis. 2024;83:116-123. doi:1016/j.pcad.2024.02.011
  2. Kaminsky LA, Arena R, Ellingsen Ø, et al. Cardiorespiratory fitness and cardiovascular disease - the past, present, and future. Prog Cardiovasc Dis. 2019;62(2):86-93. doi:1016/j.pcad.2019.01.002
  3. Warburton DE, Bredin SS. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. 2017;32(5):541-556. doi:1097/hco.0000000000000437
  4. World Health Organization (WHO). Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World. Geneva: WHO; 2018.
  5. Council of the European Union. Council Recommendation on Promoting Health-Enhancing Physical Activity Across Sectors. Brüssel: Council of the European Union; 2013.
  6. Klepac Pogrmilovic B, Ramirez Varela A, Pratt M, et al. National physical activity and sedentary behaviour policies in 76 countries: availability, comprehensiveness, implementation, and effectiveness. Int J Behav Nutr Phys Act. 2020;17(1):116. doi:1186/s12966-020-01022-6
  7. Gelius P, Messing S, Goodwin L, Schow D, Abu-Omar K. What are effective policies for promoting physical activity? A systematic review of reviews. Prev Med Rep. 2020;18:101095. doi:1016/j.pmedr.2020.101095
  8. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health. 2018;6(10):e1077-e1086. doi:1016/s2214-109x(18)30357-7
  9. Messing S, Tcymbal A, Abu-Omar K, Gelius P. Research- vs. government-driven physical activity policy monitoring: a systematic review across different levels of government. Health Res Policy Syst. 2023;21(1):124. doi:1186/s12961-023-01068-5
  10. Klepac Pogrmilovic B, O'Sullivan G, Milton K, Biddle SJ, Pedisic Z. A systematic review of instruments for the analysis of national-level physical activity and sedentary behaviour policies. Health Res Policy Syst. 2019;17(1):86. doi:1186/s12961-019-0492-4
  11. European Commission, WHO Europe. 2021 Physical Activity Factsheets for the European Union Member States in the WHO European Region. 2021. https://sport.ec.europa.eu/document/europe-physical-activity-factsheet-2021.
  12. Bull F, Milton K, Kahlmeier S. Health-Enhancing Physical Activity (HEPA) Policy Audit Tool (PAT): Version 2. Copenhagen: WHO Regional Office for Europe; 2015.
  13. Woods CB, Kelly L, Volf K, et al. The Physical Activity Environment Policy Index for monitoring government policies and actions to improve physical activity. Eur J Public Health. 2022;32(Suppl 4):iv50-iv58. doi:1093/eurpub/ckac062
  14. Global Observatory for Physical Activity GoPA! Country Cards. 2023. https://new.globalphysicalactivityobservatory.com/countrycards/. Accessed July 12, 2023.
  15. Aubert S, Barnes JD, Demchenko I, et al. Global matrix 4.0 physical activity report card grades for children and adolescents: results and analyses from 57 countries. J Phys Act Health. 2022;19(11):700-728. doi:1123/jpah.2022-0456
  16. Bull FC, Milton K, Kahlmeier S. National policy on physical activity: the development of a policy audit tool. J Phys Act Health. 2014;11(2):233-240. doi:1123/jpah.2012-0083
  17. Jansen MW, De Leeuw E, Hoeijmakers M, De Vries NK. Working at the nexus between public health policy, practice and research. Dynamics of knowledge sharing in The Netherlands. Health Res Policy Syst. 2012;10:33. doi:1186/1478-4505-10-33
  18. Boswell C, Smith K. Rethinking policy ‘impact’: four models of research-policy relations. Palgrave Commun. 2017;3(1):44. doi:1057/s41599-017-0042-z
  19. Bundesministerium für Ernährung und Landwirtschaft, Bundesministerium für Gesundheit. Aktionsplan ‘‘Weiterentwicklung IN FORM – Schwerpunkte des Nationalen Aktionsplans zur Prävention von Fehlernährung, Bewegungsmangel, Übergewicht und damit zusammenhängenden Krankheiten ab 2021.” 2021. https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/5_Publikationen/Praevention/Broschueren/in_form_aktionsplan_bf.pdf. Accessed July 12, 2023.
  20. The SURE Collaboration. SURE Guides for Preparing and Using Evidence-Based Policy Briefs: 1. Getting Started. The SURE Collaboration; 2011.
  21. Research to Action. How to Plan, Write and Communicate an Effective Policy Brief. Three Steps to Success. 2014. https://www.researchtoaction.org/wp-content/uploads/2014/10/PBWeekLauraFCfinal.pdf. Accessed July 12, 2022.
  22. Messing S, Gelius P, Abu-Omar K, et al. Developing a policy brief on physical activity promotion for children and adolescents. Front Public Health. 2023;11:1215746. doi:3389/fpubh.2023.1215746
  23. FAU. ZielBewegung. 2023. https://www.sport.fau.de/das-institut/forschung/bewegung-und-gesundheit/abgeschlossene-forschungsprojekte/zielbewegung/. Accessed April 17, 2025.
  24. Rütten A, Schow D, Breda J, et al. Three types of scientific evidence to inform physical activity policy: results from a comparative scoping review. Int J Public Health. 2016;61(5):553-563. doi:1007/s00038-016-0807-y
  25. Leone L, Pesce C. From delivery to adoption of physical activity guidelines: realist synthesis. Int J Environ Res Public Health. 2017;14(10):1193. doi:3390/ijerph14101193
  26. World Health Organization (WHO). Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children Under 5 Years of Age. Geneva: WHO; 2019.
  27. World Health Organization (WHO). WHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva: WHO; 2020.
  28. Rütten A, Pfeifer K. Nationale Empfehlungen für Bewegung und Bewegungsförderung. Cologne: Bundeszentrale für gesundheitliche Aufklärung; 2017.
  29. World Health Organization (WHO). Global Recommendations on Physical Activity for Health. Geneva: WHO; 2010.
  30. WHO Regional Office for Europe. Physical Activity Strategy for the WHO European Region 2016-2025. Vilnius, Lithuania: WHO; 2015.
  31. ISPAH. Eight Investments That Work for Physical Activity. 2020. https://www.ispah.org/resources/key-resources/8-investments/.
  32. Glasgow RE, Harden SM, Gaglio B, et al. RE-AIM planning and evaluation framework: adapting to new science and practice with a 20-year review. Front Public Health. 2019;7:64. doi:3389/fpubh.2019.00064
  33. Messing S, Rütten A. Quality criteria for the conception, implementation and evaluation of interventions for physical activity promotion: a state-of-the-art review. Gesundheitswesen. 2017;79(S 01):S60-S65. doi:1055/s-0042-123378
  34. Bundesinstitut für Sportwissenschaft. Sport Und Recherche im Fokus (SURF). Das Sportinformationsportal. 2023. https://www.bisp-surf.de. Accessed October 18, 2023.
  35. Kooperationsverbund Gesundheitliche Chancengleichheit. Praxisdatenbank. 2023. https://www.gesundheitliche-chancengleichheit.de/praxisdatenbank/recherche/. Accessed October 18, 2023.
  36. Active Healthy Kids Global Alliance. Global Matrix 4.0. 2022. https://www.activehealthykids.org/4-0/. Accessed July 12, 2023.
  37. Bundesministerium für Gesundheit. Bestandsaufnahme zur Bewegungsförderung bei Kindern und Jugendlichen in Deutschland (Kurzversion). 2022. https://www.bundesgesundheitsministerium.de/service/publikationen/details/bestandsaufnahme-zur-bewegungsfoerderung-bei-kindern-und-jugendlichen-in-deutschland-kurzversion.html. Accessed May 26, 2025.
  38. Bundesministerium für Gesundheit. Bestandsaufnahme zur Bewegungsförderung bei Kindern und Jugendlichen in Deutschland (Langversion). 2022. https://www.bundesgesundheitsministerium.de/service/publikationen/details/bestandsaufnahme-zur-bewegungsfoerderung-bei-kindern-und-jugendlichen-in-deutschland-langversion.html. Accessed May 26, 2025.
  39. Bundesministerium für Gesundheit. Zielgruppenspezifische Bestandsaufnahmen für Bewegungsförderung in Deutschland (ZielBewegung). Ressortforschung im Handlungsfeld “Gesundheitsförderung und Prävention’’. 2023. https://www.bundesgesundheitsministerium.de/ministerium/ressortforschung/handlungsfelder/gesundheitsfoerderung-und-praevention/zielbewegung. Accessed October 4, 2023.
  40. Bielak AT, Campbell A, Pope S, Schaefer K, Shaxson L. From science communication to knowledge brokering: the shift from ‘science push’ to ‘policy pull’. In: Cheng D, Claessens M, Gascoigne T, Metcalfe J, Schiele B, Shi S, eds. Communicating Science in Social Contexts: New Models, New Practices. Dordrecht: Springer; 2008:201-226. doi:1007/978-1-4020-8598-7_12
  41. Weiss CH. The many meanings of research utilization. Public Adm Rev. 1979;39(5):426-431. doi:2307/3109916
International Journal of Health Policy and Management

Articles in Press, Corrected Proof
Available Online from 23 September 2025

Files

History

  • Received Date: 24 July 2024
  • Revised Date: 17 April 2025
  • Accepted Date: 13 September 2025
  • First Published Date: 23 September 2025

Share

How to cite

Statistics