{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T17:23:03Z","timestamp":1765732983824,"version":"3.48.0"},"reference-count":62,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003107","name":"Bundesministerium f\u00fcr Gesundheit","doi-asserted-by":"publisher","award":["ZMVI1-2520WHO001"],"award-info":[{"award-number":["ZMVI1-2520WHO001"]}],"id":[{"id":"10.13039\/501100003107","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,3,28]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of the study is to compare how member states of the European Union (EU) develop their national physical activity (PA) recommendations and to provide an overview of the methodologies they apply in doing so. Information was collected directly from the physical activity focal points of EU member states in 2018. Five countries were chosen for detailed case study analysis of development processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The representatives of the 28 EU member state governments to the EU physical activity Focal Point Network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>From national documents we extracted data on (1) the participants of the development process, (2) the different methods used during development, and (3) on which sources national PA recommendations were based. An additional survey for case study countries provided details on (1) anonymised information on the participants of development process, (2) methods employed and rationale for choosing them, (3) development process and timeline, and (4) main source documents used for recommendation development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen national documents on PA recommendations contained information about development process. The results showed that countries used different approaches to develop national recommendations. The main strategies were (1) adoption of WHO 2010 recommendations or (2) a combination of analysis and adoption of other national and international recommendations and literature review. All of the five case study countries relied on review processes rather than directly adopting WHO recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While there are arguments for the use of particular strategies for PA recommendation development, there is currently no evidence for the general superiority of a specific approach. Instead, our findings highlight the broad spectrum of potential development methods, resources utilisation and final recommendations design currently available to national governments. These results may be a source of inspiration for other countries currently planning the development or update of national PA recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-041710","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T14:08:15Z","timestamp":1618495695000},"page":"e041710","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Development of national physical activity recommendations in 18 EU member states: a comparison of methodologies and the use of evidence"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3164-1084","authenticated-orcid":false,"given":"Antonina","family":"Tcymbal","sequence":"first","affiliation":[{"name":"Department of Sport Science and Sport, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4120-4996","authenticated-orcid":false,"given":"Peter","family":"Gelius","sequence":"additional","affiliation":[{"name":"Department of Sport Science and Sport, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}]},{"given":"Karim","family":"Abu-Omar","sequence":"additional","affiliation":[{"name":"Department of Sport Science and Sport, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}]},{"given":"Charlie","family":"Foster","sequence":"additional","affiliation":[{"name":"Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol Faculty of Health Sciences, Bristol, UK"}]},{"given":"Stephen","family":"Whiting","sequence":"additional","affiliation":[{"name":"European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation"},{"name":"EPIUnit \u2013 Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3806-438X","authenticated-orcid":false,"given":"Romeu","family":"Mendes","sequence":"additional","affiliation":[{"name":"European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation"},{"name":"EPIUnit \u2013 Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Porto, Portugal"}]},{"given":"Sylvia","family":"Titze","sequence":"additional","affiliation":[{"name":"Institute of Sports Science, University of Graz, Graz, Austria"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5218-1160","authenticated-orcid":false,"given":"Thomas Ernst","family":"Dorner","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Institute of Social Medicine, Medical University of Vienna, Vienna, Austria"}]},{"given":"Christian","family":"Halbwachs","sequence":"additional","affiliation":[{"name":"Abteilung Breitensport, Bundes-Sport GmbH, Vienna, Austria"}]},{"given":"Martine","family":"Duclos","sequence":"additional","affiliation":[{"name":"Department of Sport Medicine and Functional Exploration, University Hospital CHU G. Montpied, INRA, UNH, CRNH Auvergne, University of Auvergne, Clermont-Ferrand, France"}]},{"given":"Jean-Francois","family":"Toussaint","sequence":"additional","affiliation":[{"name":"IRMES (Institut de Recherche bioM\u00e9dicale et d'Epid\u00e9miologie du Sport\/INSEP), Universit\u00e9 de Paris, Paris, France"}]},{"given":"Wanda","family":"Wendel-Vos","sequence":"additional","affiliation":[{"name":"Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands"}]},{"given":"Beelin","family":"Baxter","sequence":"additional","affiliation":[{"name":"Population Health, United Kingdom Department of Health and Social Care, London, UK"}]},{"given":"Susanne","family":"Ferschl","sequence":"additional","affiliation":[{"name":"Department of Sport Science and Sport, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}]},{"given":"Joao Joaquim","family":"Breda","sequence":"additional","affiliation":[{"name":"European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation"}]}],"member":"239","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"2025121409191229000_11.4.e041710.1","unstructured":"World Health Organisation . Physical activity factsheets for the 28 European Union member states of the who European region. Copenhagen: WHO Regional Office for Europe, 2018."},{"key":"2025121409191229000_11.4.e041710.2","unstructured":"World Health Organisation . Global recommendations on physical activity for health. Geneva, 2010."},{"key":"2025121409191229000_11.4.e041710.3","unstructured":"Council recommendation of 26 November 2013 on promoting health-enhancing physical activity across sectors. Official Journal of the European Union 2013;56."},{"key":"2025121409191229000_11.4.e041710.4","unstructured":"World Health Organisation . Who global strategy on diet, physical activity and health: a framework to monitor and evaluate implementation, 2008."},{"key":"2025121409191229000_11.4.e041710.5","unstructured":"World Health Organisation . Physical activity strategy for the who European region 2016-2025, 2015."},{"key":"2025121409191229000_11.4.e041710.6","unstructured":"World Health Organisation . 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