Step it up:Promoting physical activity in school-aged children and adolescents in China Barbara E.Ainsworth

School of Nutrition and Health Promotion,Arizona State University,Phoenix,AZ 85004,USA

In this special issue of the Journal of Sport and Health Science,a series of articles describe the results of the 2016 Physical Activity and Fitness in China—The Youth Study.The results show a relatively high prevalence of sedentary behaviors,unhealthy weight,lower fitnes levels,and lower levels of engagement in physical exercise and fitnes activities than anticipated.Of additional concern are differences by sex,residence locale,and grade levels.While disappointing,there is room for optimism that these metrics can be improved in coming years.

Multiple health promotion efforts are underway in China designed to improve health systems and expand opportunities for all persons to be come more physically active and physically fit The activities reflec an ecological approach that involves multiple influence to improve physical exercise and physical fitness As described by Sallis et al.,1the social environment,physical environment,and policies influenc whether a person decides to engage in physical activity behaviors.These influences have the potential to bridge one’s intrapersonal characteristics(e.g.,age,sex,and self-motivation)with their perceptions of physical activity environments(e.g.,accessibility,safety),characteristics of the places where people can be active(e.g.,schools,neighborhoods,homes),and policies that govern access to exercise areas(e.g.,zoning codes,pubic recreation investment).

Recent initiatives in China reflec a multilevel ecological approach to create active living communities that can improve physical exercise and physical fitnes levels in children and adolescents.Guided by Healthy China 2030,2,3an outcome of the 9th Global Conference on Health Promotion,4strategic goals and key indicators have been developed to guide health promoting actions for Chinese populations.Central to the vision of promoting health through action,strategies call for environmental,community,educational,medical,and policy initiatives that invite all persons to be physically active and more physically fit

Four activities within the strategic goal,“to increase the proportion of Chinese children and adolescents who engage in targeted levels of physical exercise and who meet the fitnes standards(as define in the National Physical Fitness Standards)”4are identified The firs activity is to improve physical fitnes services.The plan proposes having a network of public sports facilities in villages,townships,and county levels where people can be active within a 15 m in walk from their homes.Combined with the networks,it is proposed that define sports grounds of no less than 2.3m2per capita be built for exercise and sports participation.

The second activity proposes a nation wide fitnes campaign.Within the facilities and space developed,cultural,geographic,age-and gender-appropriate exercise opportunities and sports events should be offered to all persons.These opportunities could be provided through adoption of existing favored exercises and the development of new activities that offer all persons,especially children and adolescents,an intentional space to engage in health-enhancing and fitness-promotin physical exercise and sports.

The third activity is to promote physical exercise among priority groups.Teenage years show the greatest decline in exercise and sports participation,especially among girls.5Various individual,social,and environmental factors can modify this decline.Opportunities to learn fundamental motor skills in pre-adolescence and sports skills in middle schools also can help to maintain lifelong physical activity habits.6Assuring that students have access to daily physical education in schools and opportunities to develop sport skills in community settings are two ways students can learn new skills.This education,combined with easy access to networks of sports grounds with organized physical exercise and sports opportunities,achieving 60min of daily physical exercise is possible.

The fourth activity is to integrate sports exercises with medical care decision-makers and to strengthen non-medical health interventions.As people seek medical care for various reasons,health care providers can be aware of physical exercise and fitnes guidelines to help each patient engage in health-enhancing physical exercise.7This is especially important for youth who are over weight and obese.

While necessary,national goals are not sufficien to assure that children and adolescents will engage in physical exercise at levels to improve their physical fitness Parents and extended families,schools,parks and recreation departments,and other community organizations need to act intentionally to assure that youth have the opportunities to be physically active.In short,we need to “step it up”to get youth away from the screens and onto the playing fields

Numerous examples of approaches to increase physical exercise and physical fitnes in youth are available on the website.One example is the Youth Physical Activity Toolkit User Guide8developed by the U.S.Centers for Disease Control and Prevention(CDC).The toolkit provides a set of handouts,videos,power point slides,and instructions for active games that engage students intellectually and physically.The CDC also provides ways that families,schools,and community organizations can intentionally encourage children and adolescents to increase their physical exercise.For example,schools can provide quality physical education by creating activities that are enjoyable and have students moving for at least50%of the class time.Schools also can provide recess and physical activity breaks for children in lower grades.After school intramural sports activities can be effective in increasing exercise after school hours.9Parents can incorporate physical activities into birthday parties,family gatherings,and family outings.They also can chose activity-oriented gifts such as jump ropes,bicycles,or fitnes club memberships instead of gifts that promote sedentary behaviors.10,11As outlined in Healthy China 2030,communities can make changes that make it easier to be physically active and help children and adolescents fin safe and accessible places where they can exercise.12Communities also can work with schools to increase out of school exercise opportunities and partner with other community groups to provide popular activities that promote physical fitnes that are fun(e.g.,youth sports,Youth Fitness Warriors13).

The relatively high prevalence of sedentary behaviors,unhealthy weight,lower fitnes levels,and low engagement in physical exercise and fitnes activities among Chinese children and adolescents meets the definitio of a public health problem.It affects the health,function,and well-being of a large number of people and it has as its major impact,the reduction of the health of children and adolescents.Of concern are the differences in the study results observed by gender,residence locale,and grade levels as this reflect health disparities among some high-risk populations disproportion ally to the rest of society.If not addressed as a community responsibility,participation in physical exercise,physical fitnes levels,and rates of overweight and obesity will get worse in larger proportions of children.The best approach to reverse these concerns is for government agencies,community groups,families,and youth themselves to “step it up”by making prompt and coordinated efforts to help children and adolescents move away from their screens and onto the play grounds.

Competing interests

The author declares that she has no competing interests.

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