A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep
Authors: Okely Anthony D. , Ghersi Davina , Loughran Sarah P. , Cliff Dylan P. , Shilton Trevor , Jones Rachel A. , Stanley Rebecca M. , Sherring Julie , Toms Natalie , Eckermann Simon , Olds Timothy S. , Zhang Zhiguang , Parrish Anne-Maree , Kervin Lisa , Downie Sandra , Salmon Jo , Bannerman Clair , Needham Tamie , Marshall Elaine , Kaufman Jordy , Brown Layne , Wille Janecke , Wood Greg , Lubans David R. , Biddle Stuart J. H. , Pill Shane , Hargreaves Anthea , Jonas Natalie , Schranz Natasha , Campbell Perry , Ingram Karen , Dean Hayley , Verrender Adam , Ellis Yvonne , Chong Kar Hau , Dumuid Dorothea , Katzmarzyk Peter T. , Draper Catherine E. , Lewthwaite Hayley , Tremblay Mark S. 
Published: January 2022

Background

In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updatedAustralian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleepwere developed and the outcomes from this process.

Methods

The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. TheCanadian 24-Hour Movement Guidelines for Children and Youthbest met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or createde novorecommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines.

Results

Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and young people (13-17 years).

Conclusions

To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used to develop movement behaviour guidelines. The judgments of the Australian Guideline Development Group did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian Guidelines were adopted with only very minor alterations. This allowed the Australian Guidelines to be developed in a shorter time frame and at a lower cost. We recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines that was developed using the GRADE approach is available with all supporting materials. Other countries may consider this approach when developing and/or revising national movement guidelines.