A collaborative approach to adopting/adapting guidelines - The Australian 24-Hour Movement Guidelines for the early years (Birth to 5 years): an integration of physical activity, sedentary behavior, and sleep

BMC Public Health. 2017;17(S5):167-190 DOI 10.1186/s12889-017-4867-6

 

Journal Homepage

Journal Title: BMC Public Health

ISSN: 1471-2458 (Online)

Publisher: BMC

LCC Subject Category: Medicine: Public aspects of medicine

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML

 

AUTHORS

Anthony D. Okely (Early Start, Faculty of Social Sciences, University of Wollongong)
Davina Ghersi (Research Policy and Translation, National Health and Medical Research Council)
Kylie D. Hesketh (Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University)
Rute Santos (Early Start, Faculty of Social Sciences, University of Wollongong)
Sarah P. Loughran (Illawarra Health and Medical Research Institute)
Dylan P. Cliff (Early Start, Faculty of Social Sciences, University of Wollongong)
Trevor Shilton (National Heart Foundation (WA))
David Grant (Population Health and Sport Division, Australian Government Department of Health)
Rachel A. Jones (Early Start, Faculty of Social Sciences, University of Wollongong)
Rebecca M. Stanley (Early Start, Faculty of Social Sciences, University of Wollongong)
Julie Sherring (Early Start, Faculty of Social Sciences, University of Wollongong)
Trina Hinkley (Research Policy and Translation, National Health and Medical Research Council)
Stewart G. Trost (Institute of Health and Biomedical Innovation at Queensland Centre for Children’s Health Research, Queensland University of Technology)
Clare McHugh (Early Childhood Australia)
Simon Eckermann (Australian Health Services Research Institute, University of Wollongong)
Karen Thorpe (Institute for Social Science Research, The University of Queensland)
Karen Waters (Children’s Hospital Westmead and University of Sydney)
Timothy S. Olds (Alliance for Research in Exercise Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia)
Tracy Mackey (NSW Department of Education)
Rhonda Livingstone (Australian Children’s Education & Care Quality Authority (ACECQA))
Hayley Christian (School of Population and Global Health and Telethon Kids Institute, The University of Western Australia)
Harriette Carr (New Zealand Ministry of Health)
Adam Verrender (Illawarra Health and Medical Research Institute)
João R. Pereira (Early Start, Faculty of Social Sciences, University of Wollongong)
Zhiguang Zhang (Early Start, Faculty of Social Sciences, University of Wollongong)
Katherine L. Downing (Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University)
Mark S. Tremblay (Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute)

EDITORIAL INFORMATION

Open peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 18 weeks

 

Abstract | Full Text

Abstract Background In 2017, the Australian Government funded the update of the National Physical Activity Recommendations for Children 0–5 years, with the intention that they be an integration of movement behaviours across the 24-h period. The benefit for Australia was that it could leverage research in Canada in the development of their 24-h guidelines for the early years. Concurrently, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group published a model to produce guidelines based on adoption, adaption and/or de novo development using the GRADE evidence-to-decision framework. Referred to as the GRADE-ADOLOPMENT approach, it allows guideline developers to follow a structured and transparent process in a more efficient manner, potentially avoiding the need to unnecessarily repeat costly tasks such as conducting systematic reviews. The purpose of this paper is to outline the process and outcomes for adapting the Canadian 24-Hour Movement Guidelines for the Early Years to develop the Australian 24-Hour Movement Guidelines for the Early Years guided by the GRADE-ADOLOPMENT framework. Methods The development process was guided by the GRADE-ADOLOPMENT approach. A Leadership Group and Consensus Panel were formed and existing credible guidelines identified. The draft Canadian 24-h integrated movement guidelines for the early years best met the criteria established by the Panel. These were evaluated based on the evidence in the GRADE tables, summaries of findings tables and draft recommendations from the Canadian Draft Guidelines. Updates to each of the Canadian systematic reviews were conducted and the Consensus Panel reviewed the evidence for each behaviour separately and made a decision to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. An online survey was then conducted (n = 302) along with five focus groups (n = 30) and five key informant interviews (n = 5) to obtain feedback from stakeholders on the draft guidelines. Results Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Consensus Panel agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, keep the wording of the guidelines, preamble and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-h), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for infants (<1 year), toddlers (1–2 years) and preschoolers (3–5 years). Conclusions To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used. Following this approach, the judgments of the Australian Consensus Panel did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian recommendations were adopted with very minor alterations. This allowed the Guidelines to be developed much faster and at lower cost. As such, we would recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines, with all supporting materials and developed using a transparent process, is available. Other countries may consider using this approach when developing and/or revising national movement guidelines.