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How o design and es ablish a na ional school‐based physical i ness moni o ing and
su eillance sys em o child en and adolescen s : A 10‐s ep app oach ecommended by
he Fi Back ne wo k
© 2024 The Au ho s. Scandina ian Jou nal o Medicine & Science In Spo s published by John Wiley & Sons L d.
Published e sion
Joensuu, Lau a; Csányi, Tamás; Huh iniemi, Mikko; Kälbi, Ka alin; Magalhães,
João; Milano ić, I ana; Mo ison, Shawnda A.; O ega, F ancisco B.; Sa dinha, Luis
B.; S a c, G ego ; Tammelin, Tuija H.; Ju ak, G ego
Joensuu, L., Csányi, T., Huh iniemi, M., Kälbi, K., Magalhães, J., Milano ić, I., Mo ison, S. A.,
O ega, F. B., Sa dinha, L. B., S a c, G., Tammelin, T. H., & Ju ak, G. (2024). How o design and
es ablish a na ional school‐based physical i ness moni o ing and su eillance sys em o
child en and adolescen s : A 10‐s ep app oach ecommended by he Fi Back ne wo k.
Scandina ian Jou nal o Medicine and Science in Spo s, 34(3), A icle e14593.
h ps://doi.o g/10.1111/sms.14593
2024
Scand J Med Sci Spo s. 2024;34:e14593.
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1 o 14
h ps://doi.o g/10.1111/sms.14593
wileyonlinelib a y.com/jou nal/sms
Recei ed: 1 Oc obe 2023
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Re ised: 23 Feb ua y 2024
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Accep ed: 26 Feb ua y 2024
DOI: 10.1111/sms.14593
REVIEW
How o design and es ablish a na ional school- based
physical i ness moni o ing and su eillance sys em o
child en and adolescen s: A 10- s ep app oach ecommended
by he Fi Back ne wo k
Lau aJoensuu1,2
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TamásCsányi3,4
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MikkoHuh iniemi2
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Ka alinKälbi4,5
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JoãoMagalhães6
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I anaMilano ić7
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Shawnda A.Mo ison8,9
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F ancisco B.O ega2,10
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Luis B.Sa dinha6
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G ego S a c8
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Tuija H.Tammelin1
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G ego Ju ak8
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on behal o he Fi Back Ne wo k
1LIKES, Jamk Uni e si y o Applied Sciences, Jy äskylä, Finland
2Facul y o Spo and Heal h Sciences, Uni e si y o Jy äskylä, Jy äskylä, Finland
3Depa men o Physical Educa ion Theo y and Me hodology, Hunga ian Uni e si y o Spo s Science, Budapes , Hunga y
4Hunga ian School Spo Fede a ion, Budapes , Hunga y
5Eö ös Lo ánd Uni e si y (ELTE) Bá czi Gusz á Facul y o Special Needs Educa ion, Ins i u e o he Me hodology o Special Needs Educa ion and
Rehabili a ion, Budapes , Hunga y
6Exe cise and Heal h Labo a o y, CIPER, Faculdade de Mo icidade Humana, Uni e sidade de Lisboa, C uz Queb ada, Po ugal
7Facul y o Spo s and Physical Educa ion, Uni e si y o Belg ade, Belg ade, Se bia
8Facul y o Spo , Uni e si y o Ljubljana, Ljubljana, Slo enia
9Human Po en ial T ansla ional Resea ch P og amme, Yong Loo Lin School o Medicine, Na ional Uni e si y o Singapo e, Singapo e, Singapo e
10Depa men o Physical Educa ion and Spo s, Facul y o Spo Sciences, Spo and Heal h Uni e si y Resea ch Ins i u e (iMUDS), Uni e si y o
G anada and CIBEROBN Physiopa hology o Obesi y and Nu i ion, G anada, Spain
Co espondence
Lau a Joensuu, Facul y o Spo
and Heal h Sciences, Uni e si y o
Jy äskylä, Rau pohjanka u 8, Jy äskylä
40700, Finland.
Email: lau a.p[email p o ec ed]
Funding in o ma ion
Slo enian Resea ch Agency wi hin he
Resea ch p og amme Bio- psycho- social
con ex o kinesiology, G an /Awa d
Numbe : P5- 0142; E asmus+ Spo
P og amme o he Eu opean Union,
G an /Awa d Numbe : 613010- EPP- 1-
2019- 1- SI- SPO- SCP
Abs ac
Backg ound: P o iding indi idual- and popula ion- le el da a on child en's
physical i ness (PF) is a c ucial public heal h and educa ion p io i y. Howe e ,
ew na ional i ness moni o ing o su eillance sys ems a e cu en ly in p ac ice
in e na ionally. We aim o summa ize he cu en Eu opean PF moni o ing and
su eillance sys ems o school- aged child en and o p o ide expe ience- based
guidelines on how o design such sys ems.
Me hods: The Fi Back ne wo k consis s o expe s om di e se backg ounds
wi h he common in e es o imp o e he accessibili y o PF moni o ing o young
people globally. Th ough Fi Back ne wo k, we iden i ied and compa ed he na-
ional o egional PF moni o ing and su eillance sys ems cu en ly in ope a ion
ac oss Eu ope. We o mula ed a 10- s ep app oach o designing and es ablishing
This is an open access a icle unde he e ms o he C ea i e Commons A ibu ion License, which pe mi s use, dis ibu ion and ep oduc ion in any medium, p o ided
he o iginal wo k is p ope ly ci ed.
© 2024 The Au ho s. Scandina ian Jou nal o Medicine & Science In Spo s published by John Wiley & Sons L d.
Tuija H. Tammelin and G ego Ju ak con ibu ed equally o his wo k.
2 o 14
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JOENSUU e al.
1
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INTRODUCTION
Physical i ness (PF) e e s o a se o a ibu es ha
an indi idual has o achie es,1 which p o ide an abil-
i y o ca y ou daily asks wi h igo , ale ness, and
ample ene gy o enjoy leisu e- ime pu sui s o o mee
an un o eseen eme gency.2 These a ibu es include:
body composi ion (p opo ion o di e en issues in he
human body), ca dio espi a o y i ness (abili y o he
whole- body o sus ain p olonged pe o mance), muscu-
loskele al i ness wi h muscula s eng h and endu ance
(muscle p ope ies enabling wo k) and lexibili y ( ange
o mo ion a ailable a a join o g oup o join s), and
mo o i ness (speed o mo emen , agili y, and coo di-
na ion).3–5 The e is subs an ial accumula ed e idence
suppo ing he impo ance o main aining adequa e
PF a a young age, no only limi ed o one's unc ional
capaci y and pe o mance, bu also in e ms o encou -
aging li elong heal h and educa ional aspec s. Physical
i ness in you h is consis en ly associa ed wi h a o able
educa ional a ainmen , b ain p ope ies and cogni i e
unc ion,6–11 soma ic and men al heal h,12–14 as well as
lowe mo bidi y and mo ali y la e in li e.15–18 Physical
i ness also associa es closely wi h physical li e acy— he
“mo i a ion, con idence, physical compe ence, knowl-
edge and unde s anding o alue and ake esponsibili y
o engagemen in physical ac i i ies o li e,”19 a con-
s uc ha is well- posi ioned in educa ional policies as
a key componen o main aining a heal hy and ac i e
li es yle.20,21
The secula ends o child en- and adolescen - speci ic
i ness componen s a ies based on he socie al and en i-
onmen al ac o s child en ace o e ime.22 Fi ness mon-
i o ing and su eillance is an una oidable con empo a y
opic since many global p essu es (e.g., con lic , clima e
change, pandemics, and cul u al e olu ion h ough ech-
nological de elopmen ) can di ec ly (o indi ec ly) nega-
i ely a ec child PF.23 Su eying childhood i ness a scale
can cap u e a wide a ie y o physical a ibu es, which a e
highly ele an o cha ac e izing child en and adolescen s'
cu en and u u e heal h ou comes, and complemen s al-
eady exis ing amewo ks, which egula ly moni o 24- h
mo emen beha io s such as physical ac i i y, seden a y
beha io , and sleep.24 Physical i ness moni o ing and
su eillance was one o he op 10 p io i ies ou lined by
in e na ional expe s in he i ness domain,25 and he de-
elopmen o such sys ems is a high p io i y o enhance
he desc ip ion o child en and adolescen s heal h s a us
globally. Accu a e ongoing assessmen s o he s a e o a
popula ion's i ness can also be used o c ea e mo e e ec-
i e policy in e en ions when u u e ex e nal challenges
o socie y ine i ably a ise.
He ein, we e e o “moni o ing” as obse ing and/o
assessing he changes o one's i ness o e ime, usually
o a special pu pose (e.g., educa ional o heal h- ela ed),
whe eas “su eillance” emphasizes he impo ance o
dissemina ing he da a and ela ed indings o pa ies e-
sponsible o p e en ing and con olling public heal h con-
ce ns.26 Globally, he e a e limi ed examples o a - scale PF
moni o ing and su eillance sys ems in ope a ion.24,25,27,28
one's own sys em, based on analysis o expe ienced s eng hs, weaknesses, op-
po uni ies, and h ea s o moni o ing childhood i ness.
Resul s: We iden i ied a o al o eigh PF moni o ing sys ems in Finland, F ance,
Galicia o Spain, Hunga y, Li huania, Po ugal, Se bia, and Slo enia. The Fi Back
ne wo k ecommends he ollowing s eps o designing and es ablishing one's
own sys em: (1) se up mission s a emen s and aims, (2) in ol e s akeholde s, (3)
u ilize scien i ic backg ound, (4) go e nance s uc u e, (5) ensu e su icien und-
ing, (6) da a managemen planning, (7) p o ide meaning ul eedback, (8) conduc
pilo es ing, (9) plan implemen a ion p ocess, and (10) in es in communica ion
wi h s akeholde s.
Conclusions: This s udy p o ides an upda ed o e iew o he bes p ac-
ices o school- aged child en's i ness moni o ing and su eillance in Eu ope.
Addi ionally, i o e s a 10- s ep app oach o assis in he c ea ion o simila sys-
ems in Eu ope o globally.
KEYWORDS
assessmen , disease p e en ion, educa ion, epidemiology, NCDs, physical li e acy, policy,
popula ion heal h
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3 o 14
JOENSUU e al.
Fo he ones ha do exis , hei de elopmen is bes op-
e a ionalized h ough he in e na ional coope a ion o di-
e se pa ne s in science, ci il socie ies, and educa ional
o ganiza ions.29 P e iously, mos o his wo k ega ding
sys ema ic i ness moni o ing has been a he compa -
men alized and localized. To add ess his dispa i y, he
Eu opean Union E asmus+ Spo unded a la ge- scale
p ojec named “The Eu opean Ne wo k o he Suppo o
De elopmen o Sys ems o Moni o ing Physical Fi ness
o Child en and Adolescen s' (abb e ia ed as ‘Fi Back’).”30
Fi Back is a nonp o i coali ion o 10 Eu opean ounde -
membe s who ha e had expe ise conduc ing child i ness
assessmen , moni o ing, o su eillance a he popula ion
le el. The Fi Back p ojec builds on a p e ious Eu opean
Union- unded wo k called he “ALPHA p ojec ,” which
es ablished and e alua ed an e idence- based heal h-
ela ed ield- es ba e y o school- aged child en.3,31
This s udy communica es he wo k conduc ed wi hin
he Fi Back p ojec 2020- 2022. Mo e speci ically, he wo
main aims o his s udy we e as ollows: (1) o iden i y,
compa e, and con as examples o cu en bes - p ac ice
PF moni o ing and su eillance sys ems among school-
aged child en in Eu ope, and (2) o p o ide an expe ience-
based easy- o- ollow se o guidelines o policymake s,
which can be used o design hei own PF moni o ing and
su eillance sys em. De ailed ou comes o he Fi Back
p ojec can be ound by accessing i s online, ee- o - use,
web po al he e: h ps:// www. i ba ckeu ope. eu/ en- us/ .
2
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METHODS
2.1
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Iden i ying cu en PF moni o ing
bes - p ac ices in Eu ope
The Fi Back p ojec was launched on Feb ua y 12, 2020,
jus be o e he COVID- 19 global pandemic was decla ed
by he Wo ld Heal h O ganiza ion. Despi e hese chal-
lenges, he p ocess began in ea nes by iden i ying and
desc ibing exis ing na ional o egional PF moni o ing
and su eillance sys ems ac oss Eu ope, he ein unca ed
o “sys ems.” In o ma ion ela ed o na ional and/o e-
gional sys ems was disco e ed la gely om nonacademic
publica ions, and in local languages. Hence, a na a i e
e iew app oach was selec ed. Eligible sys ems we e iden-
i ied by he expe s in ol ed in he Fi Back conso ium,
and hei espec i e p o essional ne wo ks.
The Fi Back wo king g oup hen o med a s uc u ed
ques ionnai e ha was sen o ep esen a i es o he iden-
i ied sys ems. Rep esen a i es we e eques ed o p o ide
desc ip ions o hei i ness sys em, including de ails
such as he aims, design, ela ionship o physical educa-
ion p og ams in schools, ope a ional ime lines, leading
ins i u ions, subjec s, es i ems, ins uc ional ma e ials,
da a collec ion, eedback, e e ence alues, c i e ia o
possible in e en ions and sou ces o u he in o ma-
ion. All ep esen a i es o he iden i ied sys ems we e
success ul in p o iding de ailed desc ip ions o hei e-
gional wo ks.
2.2
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Compiling guidelines o
designing no el school- based PF
moni o ing and su eillance sys ems
In he second phase o he p ocess, a key guideline docu-
men en i led “How o design a physical i ness moni o -
ing sys em” was c ea ed. These guidelines we e p epa ed
in collabo a ion wi h i e ounde - membe s o he Fi Back
conso ium—Finland, Hunga y, Po ugal, Se bia, and
Slo enia—coun ies ha also possess unique expe iences
in es ablishing and ope a ing hei own na ional- le el child
i ness sys ems. The o ma ion o he guidelines ollowed an
i e a i e design, which included an ini ial planning s age,
conside a ion o equi emen s, analysis, design, es ing,
and e alua ion. The wo king g oup analyzed he S eng hs,
Weaknesses, Oppo uni ies, and Th ea s (SWOT) ela ed
o each sys em by illing ou a SWOT o m, whe ea e ,
answe s we e hema ically clus e ed. The mos common
SWOT hemes we e i s discussed wi hin he wo king
g oup, and po en ial solu ions o add ess hese opics, (e.g.,
key guidelines), we e ca e ully conside ed. A e se e al
i e a ion ounds, he wo king g oup decided upon 10 p i-
o i y guidelines. Discussions also included how o lis /com-
munica e hei o de o p esen a ion. The inal ma e ials
we e hen p epa ed in se e al o ma s wi hin he wo king
g oup be o e being sha ed wi h he Fi Back conso ium a
la ge, and p io o inal publica ion on he Fi Back online
web po al (www. i ba ckeu ope. eu/ en- us/ moni o ing - i ne
ss/ 10- s ep- o- design). These key guidelines, con en s, docu-
men s, and he online po al i sel ha e since been success-
ully pilo ed among ac ual policy make s.32
3
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RESULTS
3.1
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Eu opean na ional and egional
school- based PF moni o ing and
su eillance sys ems o child en and
adolescen s
3.1.1
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Exis ing PF moni o ing and
su eillance sys ems
The Fi Back ne wo k iden i ied eigh na ional- o egional-
le el sys ems in ope a ion wi hin Eu ope. They a e: Mo e!
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4 o 14
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JOENSUU e al.
(Finland), Diagno o m (F ance), DAFIS (Galicia, Spain),
NETFIT (Hunga y), The assessmen o s uden 's i ness
in p ima y and seconda y schools (Li huania), FITescola
(Po ugal), he Na ional Physical Fi ness Su eillance
Sys em (Se bia), and SLO i (Slo enia). Long- o m de-
sc ip ions o each sys em a e a ailable on he Fi Back web
po al (Fi Ba ck- Iden i ica ion- and- desc ip io ns- o - good-
p ac ices- in- diagn osing - he- physi cal- i ne ss. pd ( i ba
ckeu ope. eu) ). In his a icle, we p o ide an upda ed sum-
ma y o hese sys ems' cha ac e is ics (Table1).
The i s su eillance sys em was launched o e
40 yea s ago in Slo enia, back in 1982. O he sys ems we e
launched mo e ecen ly: in F ance and Galicia 2010–2012,
and in Finland, Hunga y, Li huania, Po ugal, and Se bia
2015–2020. These sys ems a e loca ed in di e se o al
popula ions anging om app oxima ely 2.1 million in-
habi an s (Slo enia) o 68 million (F ance). The sys ems
span Eu ope, ep esen ing geog aphical a eas o he no h
(Finland), sou h (Po ugal), eas (Li huania), and wes
(F ance) (Figu e1). Fi ness sys ems a e ope a ing p i-
ma ily wi hin high- income coun ies (Finland, F ance,
Galicia, Hunga y, Li huania, Po ugal, and Slo enia), and
one uppe middle- income (Se bia) coun y whose G oss
Domes ic P oduc pe capi a anges om 9230 $ (Se bia)
o 53 655 $ (Finland).33
All sys ems aim o assess PF among school- aged chil-
d en, wi h a speci ic emphasis on suppo ing physical ed-
uca ion, s uden s' physical and heal h li e acy, and heal h
( o u he de ails, see he long- o m desc ip ions om he
Fi Back pla o m). All sys ems ope a e in a school con ex
wi hin he physical educa ion subjec . In F ance, Galicia,
Li huania, Po ugal, and Slo enia schools a e ecom-
mended o u ilize hei egional/na ional sys em o assess
s uden 's PF, whe eas in Finland, Hunga y, and Se bia, he
use o he sys em is manda o y pa o he cu iculum.
The sys ems encompass a b oad ange o school- aged
child en, anging om 5 yea s o he younges (F ance)
o ≥19 yea in he oldes (Hunga y, Se bia, Slo enia). The
majo i y o sys ems assess i ness annually as pa o he
child en's educa ional pa hway, wi h up o 13- yea ajec-
o ies (Slo enia). As an excep ion, in Finland, child en and
adolescen s pa icipa e in na ional da a collec ion wice a
speci ic ages (in G ades 5 and 8, a ages 11 and 14).
Based on da a om sys ems wi h cen alized egis e s
(i.e., Finland, F ance, Galicia, Hunga y, Po ugal, and
Slo enia), app oxima ely one million child en and adoles-
cen s pa icipa e o i ness moni o ing pe yea . The la ges
absolu e numbe o school- aged child en a e in ol ed in
he Hunga y's sys em, which es s app oxima ely 650 000
s uden s annually, co esponding o app oxima ely 93% o
hei age- speci ic popula ion. The second la ges sys em
iden i ied based on pu e pa icipa ion a e is Slo enia, wi h
app oxima ely 200 000 annual pa icipan s (i.e., ~96% o
he age- speci ic popula ion), ollowed by Po ugal 120 000
(~12%), and Finland 100 000 (~96%). F ance and Galicia
ha e lowe pa icipa ion a es, wi h app oxima ely 32 000
and 26 000 pa icipan s since hei launch, espec i ely. In
Li huania and Se bia, ele an da a we e no a ailable a
he ime o analysis.
3.1.2
|
Compa ing PF moni o ing and
su eillance sys ems
A compa ison be ween sys ems e ealed ha , whe eas
each sys em assesses simila PF componen s, hey u ilize
di e en es i ems o his pu pose (Table1). The e -
minology used o compa e PF i ems ac oss sys ems was
adop ed om he ALPHA p ojec , which ca ego izes i -
ness in o body composi ion, ca dio espi a o y, musculo-
skele al (including muscula s eng h and endu ance, and
lexibili y) and mo o i ness. In his con ex , we u ilized
he e ms “musculoskele al i ness” and “mo o i ness,”
al hough in many physical educa ion cu icula hese es
i ems a e used o assess a s uden 's “mo o compe ence.”
Impo an ly, bo h Finland and Hunga y p o ide adap ed
i ness es s o s uden s wi h special needs.
An h opome ics and body composi ion
All sys ems, excep Finland and Li huania, assess an h o-
pome ics and/o body composi ion. Mos sys ems as-
sess an h opome ics; body mass index (F ance, Galicia,
Hunga y, Po ugal, Se bia, and Slo enia), wais ci cum e -
ence (Galicia and Po ugal), o wais - o- hip a io (Galicia).
Addi ionally, Hunga y, Po ugal, and Slo enia assess body
composi ion by body a pe cen age ( ia bioelec ical im-
pedance [Hunga y, Po ugal], o skin olds [Po ugal,
Slo enia]).
Ca dio espi a o y i ness is assessed using a a ie y o
echniques. I is mos equen ly de e mined using he 20- m
shu le un (Finland, Galicia, Hunga y, Li huania, Po ugal,
and Se bia). In Li huania, seconda y school s uden s a e
assessed using he 20- m shu le un bu p ima y s uden s
comple e a 6- min un. In Po ugal, a 1- mile un is p o ided
as an al e na i e o he 20- m shu le un es . In F ance and
Slo enia, ca dio espi a o y i ness is assessed using a 6- min
“ un and walk es ” and a 600- m un, espec i ely.
Musculoskele al i ness/muscula s eng h and
endu ance
Va ious es s a e used o assess muscula s eng h and
endu ance. Uppe - body s eng h is assessed by hand-
g ip s eng h (Galicia, Hunga y), ben - a m hang (Galicia,
Li huania [seconda y s uden s only], Se bia, and Slo enia),
and push- up (Finland, Hunga y, and Po ugal). Cen al
body assessmen s include si - ups (Se bia, Slo enia), cu l- up
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5 o 14
JOENSUU e al.
TABLE 1 O e iew o he cu en school- based physical i ness moni o ing and su eillance sys ems in Eu ope acco ding o he yea o es ablishmen .
Coun y
Slo enia F ance Galicia, Spain Hunga y Po ugal Finland Se bia Li huania
Desc ip i es
Name SLO i Diagno o m DAFIS (Da os Ac i idad
ísica Saludable)
NETFIT FITescola Mo e!—moni o ing
sys em o physical
unc ional capaci y
Na ional Physical
Fi ness
Su eillance
Sys em
The assessmen o
s uden 's i ness
in p ima y and
seconda y schools
Launched (yea ) 1982 2010 2012 2015 2016 2016 2017 2020
Popula ion (2021)33 2 108 079 67 749 632 2 696 88052 9 709 891 10 325 147 5 541 017 6 834 326 2 800 839
GDP/capi a (2021)33 29 291 $ 43 659 $ 31 272 $52 18 728 $ 24 567 $ 53 655 $ 9230 $ 23 723 $
Measu emen s
Timeline Annually du ing
Ap il
No manda o y
imeline
No manda o y imeline Annually be ween
Janua y and
May
No manda o y imeline Annually du ing
Augus /Sep embe
Annually du ing
Sep embe /
Oc obe and in
May
Annually be ween
Feb ua y and May
Age g oups 6–19- yea s 5–11- yea s 6–17- yea s 10–19- yea s 10–18- yea s 11 and 14- yea sa9–19- yea s 7–18- yea s
Annual pa icipan s
(% o age- speci ic
popula ion)
200 000 (~96%) ~3500 ~2600 650 000 (~93%) 120 000 (~12%) 100 000 (~96%) NA NA
An h opome ics and
body composi ion
BMI, body a
pe cen age
(skin old)
BMI BMI, wais
ci cum e ence,
wais - o- hip a io
BMI, body a
pe cen age
(BIA)
BMI, wais
ci cum e ence,
body a pe cen age
(BIA, skin old)
NAbBMI NA
Ca dio espi a o y i ness 600- m un 6- min un and
walk es
20- m shu le un 20- o 15- m
shu le un
20- m shu le un o
1- mile un
20- m shu le un 20- m shu le un 6- min unP, 20- m shu le
unS
Musculoskele al i ness/
Muscula s eng h and
endu ance
Ben - a m hang,
si - ups, s anding
long jump
S anding long
jump
Handg ip s eng h,
ben - a m hang,
s anding long jump
Handg ip
s eng h,
push- up,
cu l- up, unk
li , s anding
long jump
Push- up, cu l- up, squad
jump o e ical
jump, s anding
long jump
Push- up, cu l- up Ben - a m hang, si -
ups, s anding long
jump
S anding long jump,
ben - a m hangS
Musculoskele al i ness/
Flexibili y
S and and each Lowe - back
ex ension
in s anding
posi ion
Back- sa e si and each Back- sa e si and
each
Si and each, shoulde
s e ch
Squa , lowe - back
ex ension in si ing
pos u e, shoulde
s e ch
Si and each Si and eachS
Mo o i ness 20- s a m pla e
apping,
Obs acle cou se
backwa ds, 60- m
dash
5- s un es ,
Hopsco ch
es
4 × 10- m shu le un NA 4 × 10- m shu le un
Speed in 20- o
40- m
5- leaps es ,
Th owing- ca ching
combina ion es
4 × 10- m shu le un Tennis ball h ow,
10 × 5- m shu le un,
Flamingo balanceS
Adap ed i ness es s No No No Yes No Yes No No
(Con inues)
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6 o 14
|
JOENSUU e al.
Coun y
Slo enia F ance Galicia, Spain Hunga y Po ugal Finland Se bia Li huania
Feedback
No ma i e- ela ed eedback
(main age- and sex-
speci ic cen iles)
≥40 h i zone
(G een),
10 h–40 h need o
imp o e (yellow),
<10 h s ongly
ecommended o
imp o e (Red)34
≥90 h e y high,
70 h–90 h
high, 30–70 h
medium,
10 h–30 h
low, <10 h
e y low
o all
≥80 h g een, 60 h–80 h
blue, 40 h–60 h
yellow, 20 h–40 h
o ange, <20 h
ed, o ben - a m
hang,35,36 s anding
long jump,35,36 and
4 × 10- m shu le un35
Heal hy Zone ≥50 h
o 4 × 10- m
shu le un, ≥20 h
o e ical and
s anding long
jump,39 and ≥50 h
o 20- o 40- m
sp in es 46
>66 h good, 33 d–66 h
su icien ,
<33 d needs
imp o emen ,
o o he s han
lexibili y
25 h–75 h heal hy
zone
<25 h needs
imp o emen zone
o all49
≥ 40 h heal hy, 40 h–5 h
needs imp o emen ,
<5 h heal h isk, o
o he s han speci ied
(Va ying age- and sex
speci ic cen iles o
o he h esholds)
Cen iles o all34 NA Wais ci cum e ence,
and wais - o- hip
a io,37 20- m shu le
un,35 handg ip
s eng h,35,38
back- sa e si and
each39,40
Fo o he s han
speci ied44
Fo o he s han
speci ied39
Flexibili y: 0/1 p pe
measu emen . 4
p Good lexibili y,
1- 3p Needs some
imp o emen ,
0p Needs
imp o emen
<60 h Heal hy, 60 h–95 h
Needs imp o emen ,
>95 h Heal h isk, o
10 × 5- m shu le un
Heal h- ela ed eedback
(Th esholds de i ed
om ROC cu e o
o he analysis in
ela ion o a heal h
ou come)c
BMI41 NA BMI41 BMI,41 Body a
pe cen age,42
20- m shu le
un,43
Handg ip
s eng h45
BMI,47 20- m shu le
un es and 1- mile
un48
NA NA NA
A hle ic capaci y
(Age- and sex- speci ic
cen iles)
NA NA NA NA ≥90 h he a hle ic
p o ile
NA >75 h po en ial spo
alen zone
NA
Resou ces
Websi e h ps:// en. slo i . o g/ h ps:// i o. / h ps:// da is. xun a.
es/ es/
h ps:// www.
ne i . eu/
public/ pb_
ne i . php
h ps:// i es cola. dge.
mec. p / home. aspx
h ps:// www. oph. i/ en/
mo e
NA NA
No e: The e minology o i ness componen s ollows de ini ions o he ALPHA p ojec . In his con ex , we u ilize he e ms musculoskele al i ness and mo o i ness al hough in many physical educa ion cu icula
hese es i ems a e used o assess s uden 's mo o compe ence.
Abb e ia ions: BIA, bioimpedance analysis; BMI, body mass index; GDP, g oss domes ic p oduc ; NA, no applicable; p, poin s; P, p ima y school s uden s (7–10- yea s); ROC, ecei e ope a ing cha ac e is ic; S,
seconda y school s uden s (11–18- yea s).
aNa ional esul s a e ga he ed om 11- and 14- yea s s uden s. Howe e , no ma i e e e ence alues a e a ailable o 9–16 yea - olds and he schools a e encou aged o use he measu emen s annually.
bMeasu emen s a e add essed in school heal hca e whe e heigh , weigh and wais ci cum e ence a e measu ed sepa a ely.
cThe age- and sex- speci ic BMI cu - poin s p oposed by he In e na ional Obesi y Task Fo ce (Cole e al. 2000), Wo ld Heal h O ganiza ion o simila , o example, he U.S Cen e s o Disease Con ol and P e en ion,
ha e been linked o u u e heal h widely and consis en ly, including la ge coho s udies and e idence ha childhood obesi y (de ined wi h hose cu - poin s) associa es wi h u u e mo ali y and mo bidi y he e o e
p o iding s ong le el o e idence. So e en i he cu o poin s in pedia ic ages a e gene a ed based on cen iles o g ow h cu es, he Fi Back ne wo k conside s hem alida ed agains heal h ou comes and classi y hem
as heal h- ela ed eedback; The long o m o sys em desc ip ions is a ailable a he Fi Back webpages (Fi Ba ck- Iden i ica ion- and- desc ip io ns- o - good- p ac ices- in- diagn osing - he- physi cal- i ne ss. pd ( i ba ckeu ope. eu) ).
TABLE 1 (Con inued)
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7 o 14
JOENSUU e al.
(Finland, Hunga y, Po ugal), and unk li (Hunga y),
and lowe body assessmen s s anding long jump (Galicia,
Li huania [p ima y s uden s only], F ance, Hunga y, Se bia,
and Slo enia), and squa jump o e ical jump (Po ugal).
Musculoskele al i ness/ lexibili y
All sys ems include a leas one assessmen o lexibili y.
Si - and- each (Li huania [only o seconda y s uden s],
Po ugal, and Se bia) o back- sa e si - and- each es s
(Galicia, Hunga y) a e mos u ilized. Slo enia u ilizes a
s and- and- each es , while Finland and F ance use di -
e en e sions o lowe back ex ension. Shoulde s e ch
is u ilized in Finland and Po ugal, and in Finland also
squa .
Mo o i ness
Excep o Hunga y, all sys ems assess a leas one meas-
u e o mo o i ness. A 4 × 10- m shu le un es is u ilized
in Galicia, Po ugal, and Se bia. An addi ional 12 i ems a e
sys em- speci ic: 5- leap es and h owing- ca ching combi-
na ion es in Finland; 5- s un es and Hopsco ch es in
F ance; ennis ball h ow, 10 × 5- m shu le un, and la-
mingo balance (only in seconda y s uden s) in Li huania;
20- o 40- m sp in es in Po ugal; and 20- s a m pla e
apping, obs acle cou se backwa ds, and a 60- m dash in
Slo enia.
All sys ems p o ide eedback di ec ly o s uden s,
and o he s akeholde s as well, (e.g., pa en s, eache s,
school adminis a o s, and medical p o essionals) on
heal h- ela ed i ness. Addi ionally, Po ugal and Se bia
p o ide eedback on a hle ic po en ial. Sys ems u ilize
no ma i e- ela ed eedback (Finland, F ance, Galicia,
Hunga y, Li huania, Po ugal, Se bia, and Slo enia) and
heal h- ela ed eedback (Hunga y, Galicia, Po ugal, and
Slo enia) om unpublished na ional esea ch s udies o
published scien i ic li e a u e.34–49 Heal h- ela ed eed-
back e e s o h esholds de i ed om ecei e ope a ing
cha ac e is ic (ROC) cu e o o he analysis in ela ion
o a heal h ou come, and no ma i e- ela ed eedback o
o he s.
The child's indi idual esul s a e add essed wi hin
he physical educa ion cu iculum in all sys ems.
Fu he mo e, indi idual ollow- up da a a e also a ail-
able o la e pe sonal use in Finland, Galicia, Hunga y,
Po ugal, and Slo enia. Da a a e linked o heal h ca e
in Finland, Galicia, and Slo enia. In Finland, Galicia,
Hunga y, Po ugal, and Slo enia, egional/na ional da a
a e made a ailable o policymaking ( o u he de ails,
FIGURE 1 Iden i ied eigh na ional- o egional- le el physical i ness moni o ing and su eillance sys ems in Eu ope: Mo e! (Finland),
Diagno o m (F ance), DAFIS (Galicia, Spain), NETFIT (Hunga y), The assessmen o s uden 's i ness in p ima y and seconda y schools
(Li huania), FITescola (Po ugal), Na ional Physical Fi ness Su eillance Sys em (Se bia), and SLO i (Slo enia).
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8 o 14
|
JOENSUU e al.
see he long o m o desc ip ions om Fi Ba ck- Iden i ica
ion- and- desc ip io ns - o - good- p ac ices - in- diagn osing -
he- physi cal- i ne ss. pd ( i ba ckeu ope. eu) ).
3.1.3
|
Commonly expe ienced s eng hs,
weaknesses, oppo uni ies, and h ea s
Figu e2 p esen s he mos commonly expe ienced
s eng hs, weaknesses, oppo uni ies, and h ea s ela ed
o moni o ing and su eilling PF in school- aged child en.
S eng hs include p o iding a solid scien i ic and heo e i-
cal ounda ion o de e mining he bene i s o PF, easi-
bili y in school se ings, he use ulness o he sys em o
a ious p o essionals, and he p o ision o aluable da a
o educa ion, heal h policy, and spo s. The ele ance o
public heal h is e iden as moni o ing he PF s a us and
ends o child en and adolescen s can p o ide comp e-
hensi e assessmen o hei heal h, esponsi eness o
acu e c ises such as pandemics, collabo a ion wi h heal h-
ca e p o ide s, and high- quali y e alua ion o communi y
in e en ions.
The iden i ied weaknesses o es ablishing i ness su -
eillance sys ems include a po en ially long implemen a-
ion p ocess. The sys em migh no be well- adop ed by he
end use s and/o he sys em e alua o s may lack ele an
expe ise i no p ope ly ained. The exis ing sys em migh
be di icul o e ol e due lack o unding o in o ma ion,
o he complexi y o cu en go e nmen al s uc u es.
Oppo uni ies include he u he de elopmen o
PF, physical and heal h li e acy, and physical educa-
ion cu icula, and he po en ial o iden i y child en and
amilies o i ness and heal h in e en ions. The knowl-
edge gained om he sys em has he po en ial o in o m
decision- making a local, egional, and na ional le el.
Insu icien unding and changes in legisla ion, such
as Da a P o ec ion laws, may pose h ea s o es ablish-
ing o al eady es ablished i ness su eillance sys ems.
Addi ionally, he sys em may no be able o ope a e i i s
philosophy is no adop ed ac oss p o essional disciplines,
epu a ional c ises eme ge, o poli ical suppo luc ua es.
3.2
|
Ten- s eps o designing a PF
moni o ing o su eillance sys em
These guidelines a e designed o o e p ac ical s eps,
examples, and solu ions o o e come commonly-
obse ed challenges when one is wo king owa d es-
ablishing a no el sys em. The in og aphic is p esen ed
in Figu e3. The in e ac i e e sion o his in og aphic
is displayed on he Fi Back web po al and cu en ly
a ailable in six language e sions (English, Es onian,
Ge man, Spanish, I alian, and F ench) (10 s eps o desig
n a physi cal i ne ss moni o ing sys e m | Fi Ba ck ( i ba
ckeu ope. eu) ). In addi ion, a classical PDF in og aphic
is cu en ly a ailable in 15 language e sions (B azilian
Po uguese, C oa ian, English, Es onian, F ench,
FIGURE 2 Commonly expe ienced s eng hs, weaknesses, oppo uni ies, and h ea s in popula ion le el physical i ness moni o ing
among school- aged child en.
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