At-a-glance – Conceptualizing a framework for the surveillance of physical activity, sedentary behaviour and sleep in Canada

Gregory P. Butler,Author reference * MScAuthor reference 1; Karen C. Roberts,Author reference * MScAuthor reference 1; Erin Kropac, RDAuthor reference 1; Deepa P. Rao, PhDAuthor reference 1; Brenda BranchardAuthor reference 1; Stephanie A. Prince, PhDAuthor reference 1,Author reference 2; Wendy Thompson, MScAuthor reference 1; Gayatri Jayaraman, PhDAuthor reference 3,Author reference 4

https://doi.org/10.24095/hpcdp.39.5.04

Author references:

Author reference 1

Public Health Agency of Canada, Ottawa, Ontario, Canada

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Author reference 2

Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

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Author reference 3

Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada

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Author reference 4

Marketed Health Products Safety and Effectiveness Information Bureau, Health Canada, Ottawa, Ontario, Canada

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Author reference 5

Joint first authors.

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Correspondence: Gregory Butler, 785 Carling Avenue West, Ottawa, ON  K1A 0K9; Tel: 613-240-9642; Fax: 613-941-2057; Email: Gregory.Butler@canada.ca

Abstract

The Public Health Agency of Canada (PHAC) has modernized its approach to physical activity surveillance by broadening its scope to include sedentary behaviour and sleep. The first step was to develop a conceptual framework which covers the full spectrum of physical movement from moderate-to-vigorous intensity physical activity (MVPA) and light intensity physical activity (LPA) to sedentary behaviour and sleep. The framework accounts for the environments in which these behaviours take place (home, work/school, transportation, and community), and applies a socioecological approach to incorporate individual factors and broader built, social, and societal environmental indicators. A visual model of the conceptual framework was created to aid dissemination.

Keywords: motor activity, sedentary behaviour, sleep, framework

Highlights

  • The Public Health Agency of Canada (PHAC) has modernized its approach to physical activity surveillance to include all aspects of daily movement from moderate-to-vigorous intensity physical activity (MVPA) and light intensity physical activity (LPA) to sedentary behaviour and sleep.
  • The new approach accounts for the environments where these behaviours take place (home, work/school, transportation, and community) and the socioecological model.
  • To guide this process, the PHAC has developed a conceptual framework and visual model.

Canada has a long series of physical activity surveillance dataFootnote 1 which have received international recognition.Footnote 2 Canada’s physical activity surveillance system has traditionally focused on measures of leisure-time physical activity. In recent years, there has been a growth in research identifying the independent effects of prolonged sedentary behaviour (e.g., time spent sitting, lying or reclining while awake at a low energy expenditure)Footnote 3 and inadequate sleepFootnote 4,Footnote 5 on chronic disease.Footnote 6,Footnote 7 Further, at the international level, there has been a move away from measuring physical activity through the single lens of leisure-time physical activity and instead examining physical activity behaviours/indicators from across domains of physical activity, such as home, work/school, transportation, and community.Footnote 8 Finally, a number of scientific systematic reviews and key research papers have been published outlining a broad range of individual, social and environmental correlates or dimensions for physical activity, sedentary behaviour and sleep that were important for consideration with an evidence based surveillance system.Footnote 9,Footnote 10,Footnote 11,Footnote 12,Footnote 13,Footnote 14,Footnote 15,Footnote 16,Footnote 17 Drawing on these developments, the Public Health Agency of Canada (PHAC) modernized its physical activity surveillance system.

To support the identification and selection of a set of surveillance indicators that would form the foundation of the PHAC’s Physical Activity, Sedentary behaviour and Sleep (PASS) surveillance system, a conceptual framework was developed.Footnote 18 The conceptual framework included three core components (i.e., behaviours, settings, socioecological approach) and the 24-hour movement spectrum (i.e., physical activity [light, moderate and vigorous], sedentary behaviour and sleep). The first component identified the behaviours of interest: moderate-to-vigorous intensity physical activity (MVPA), light intensity physical activity (LPA), sedentary behaviour, and sleep. The second component looked to incorporate a domain approach to the conceptual frameworkFootnote 8 by recognizing the settings in which these behaviours take place including: home; work/school; transportation; and, community. The final component is the use of a socioecological approach recognizing the importance of indicators across multiple levels of influence including: the individual (e.g., age, sex, ethnicity, socioeconomic status); the family/social environment (e.g., intrapersonal relationships, social norms, crime, neighbourhood demographics); and, the built environment (e.g., roadways, buildings, parks, playgrounds, public transit). 

To quickly and easily describe the components of the conceptual framework, a visual model was created (Figure 1). This initial visual model, which displayed the components of the conceptual framework using a pyramid format, was presented to experts in the fields of physical activity, sedentary behaviour and sleep, who broadly agreed that it was consistent with current knowledge, and it was used during the selection of the PASS surveillance indicators at a meeting in Ottawa on June 24, 2014.Footnote 18 This initial framework lacked descriptions of the types of activities which the indicators were intended to illustrate.  Further, the sense of hierarchy in the outcomes implied by the use of a pyramid was not its intended purpose. As a result, a second, visual model (Figure 2) was developed and has been adopted for use alongside the PASS Indicators.Footnote 18 The revised visual model includes illustrative examples of the components of the PASS Indicators.

Figure 1. Initial visual model of the conceptual framework

Figure 1

Abbreviation: MVPA, moderate-to-vigorous intensity physical activity.

Text Description

This figure depicts the first visual model that was developed to quickly and easily describe the components of the conceptual framework. This initial visual model displayed the components of the conceptual framework using a pyramid format (from center to bottom: moderate-to-vigorous physical activity, light physical activity, sedentary behaviour and sleep; home, community and work/school are represented by the 3 sides of the pyramid, with transportation connecting all three vertexes and meeting in the middle) placed over a circle representing the various levels (individual; built and social environments; society, structural).

This initial framework lacked descriptions of the types of activities which the indicators were intended to illustrate. Further, the sense of hierarchy in the outcomes implied by the use of a pyramid was not its intended purpose.

Figure 2. Current physical activity, sedentary behaviour and sleep (PASS) visual model of the conceptual framework for surveillance in Canada 

Figure 2

Text Description

This figure presents the revised visual model, which includes illustrative examples of the components of the physical activity, sedentary behaviour and sleep (PASS) Indicators. Three buildings represent work, school and home. These are connected by a common driveway, on which people are walking, cycling and jogging, representing transportation. Further below, running across the grass, is a path being built (built environment), children playing together in a playground (social environment), a few people absorbed in solitary activities like reading on a park bench (individual), and a few land-surveyors working (society). A sign at the top of the representation, beside the buildings, says “Community.” Finally, the components of the framework are represented by a frame going around the depiction, with its four components clearly identified: moderate to vigorous physical activity, light physical activity, sedentary behaviour, and sleep.

The visual model illustrates the proposed depth and breadth of the PHAC’s modernized PASS surveillance system. Work to ensure data development and reporting are undertaken in such a way that all areas of the conceptual framework are meaningfully represented is part of the PHAC’s ongoing surveillance activities.

The visual model illustrates the proposed depth and breadth of the PHAC’s modernized PASS surveillance system. Work to ensure data development and reporting are undertaken in such a way that all areas of the conceptual framework are meaningfully represented is part of the PHAC’s ongoing surveillance activities. In addition, both the visual model and the conceptual framework communicate the PHAC’s approach to PASS surveillance to other international and domestic governmental partners working in surveillance and policy, and to researchers for their contribution and critical appraisal.

Conflicts of interest

The authors declare no conflicts of interest.

Authors’ contributions and statement

GB, KR, EK, DR and GJ developed the concepts in the paper and GB and KR wrote the paper. BB, SP and WT reviewed the paper and offered advice, comments or refinements. The study was carried out under the management of WT and GJ.

The content and views expressed in this article are those of the authors and do not necessarily reflect those of the Government of Canada.

References

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Footnote 18

Roberts KC, Butler G, Branchard B, et al. The physical activity, sedentary behaviour and sleep (PASS) indicator framework. Health Promot Chronic Dis Prev Can. 2017;37(8):252-6.

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