Developing International Consensus on Key Indicators for a 24-Hour Movement Behaviour Report Card in Early Childhood: A Twin-Panel Delphi Study

  • Wendy Y. Huang*
  • , Danqing Zhang
  • , Mark S. Tremblay
  • , Martin C.S. Wong
  • , Cindy H.P. Sit
  • , Sam W.S. Wong
  • , Derwin K.C. Chan
  • , Stephen H.S. Wong
  • , Long Yin
  • , Sunyue Ye
  • , Guanghai Wang
  • , Leigh M. Vanderloo
  • , Patricia Tucker
  • , Grant R. Tomkinson
  • , Simone Tomaz
  • , Brian W. Timmons
  • , Chiaki Tanaka
  • , Tim Takken
  • , Gareth Stratton
  • , Martyn Standage
  • Ann Christin Sollerhed, Mohd Razif Shahril, John Scriven, Olga Lucia Sarmiento, Diego Augusto Santos Silva, Rute Santos, Blanca Roman-Viñas, John J. Reilly, Alessandra Prioreschi, Bee Koon Poh, Sabine Plancoulaine, Vincent O. Onywera, Line Grønholt Olesen, Timothy Olds, Christine Delisle Nyström, Paulina Nowicka, Nelson Nardo Junior, Rowena Naidoo, Jorge Mota, Shawnda A. Morrison, Clarice Martins, Taru Manyanga, Daga Makaza, Marlene Rosager Lund Pedersen, Himangi Lubree, Marie Löf, Yang Liu, Cong Liu, Eun Young Lee, Nicholas Kuzik,
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The World Health Organization has established recommendations for 24-h movement behaviours in children under 5 years. Building on the successful knowledge translation model of Active Healthy Kids Global Alliance Report Cards, this study aimed to develop a similar framework for the early years. Methods: Using a three-round twin-panel Delphi survey (conducted via an online survey between 28 November 2024 and 11 March 2025), expert consensus was sought on indicators and benchmarks for the first dedicated report card on 24-h movement behaviours for the early years. The experts were identified through a three-step selection process, which included recognised international projects and networks as well as literature search. In Round 1, participants evaluated the applicability of 15 initial indicators. In Rounds 2 and 3, they rated the importance of each indicator, with results from their own panel (Round 2) and the other panel (Round 3) provided to inform their decisions. Qualitative feedback on definitions and benchmarks was systematically reviewed and incorporated. Consensus was predefined as ≥ 75% agreement, with stability across rounds considered. Results: Of 175 invited experts, 72 (41.1% recruitment rate) from 15 regions participated in Round 1, with 61 (84.7% response rate) and 56 (77.8% response rate) completing Rounds 2 and 3, respectively. Consensus was achieved for 12 indicators, with definitions and benchmarks refined based on expert inputs. Notably, Weight Status and Motor Proficiency were excluded due to lower agreement. Conclusions: The finalised set of indicators, definitions, and benchmarks provides a robust foundation for creating a standardised report card for early childhood. The finalised results serve as a critical advocacy instrument to raise awareness, improve surveillance, facilitate cross-jurisdictional comparisons, and inform policy and public health initiatives, ultimately supporting the health and well-being of young children globally.

Original languageEnglish
Article number92
JournalSports medicine - open
Volume11
Issue number1
DOIs
Publication statusPublished - Dec 2025

Keywords

  • Children
  • Consensus
  • Physical activity
  • Sedentary behaviour
  • Sleep

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