MOVING physical activity policy index

The index rates countries’ “policy status” of physical activity policy. It combines a large amount of information in a single assessment of each policy area of the MOVING policy framework. Results are displayed by country and policy area of each framework, allowing comparisons between countries.

The policy index:

• Gives a value for the strength of policy design in the 6 areas of the MOVING framework for each country.
• Looks at the interplay between policies in each policy area, rather than individual policies.
• Produces an at-a-glance assessment of how well national governments are doing to enable physical activity.
• Identifies gaps and opportunities for action in each country and across Europe.

The index was produced by benchmarking physical activity policy actions in 30 European against aspirational standards. The benchmarking tool was designed to hold governments accountable to a higher, aspirational standard, rather than simply compare governments with other countries and with current best practices.

The MOVING benchmarking tool was applied on complete datasets of physical activity policy actions taken by a national government. Such datasets were collected through a comprehensive scan methodology for 30 European countries and are available in our MOVING database.

The scores were calculated in 2 stages. First, each country was given a benchmark score of 0–100, depending on whether a policy existed and how well it was designed. Second, we calculated the policy area scores as an average of the benchmark scores within the respective policy area.

We benchmarked 30 European countries which have data available from the Health Behaviour in School-aged Children (HBSC) Study. The countries are: Austria, Belgium, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, UK (England, Northern Ireland, Scotland and Wales).

> Read more about our selection criteria

The focus on health-related behaviours data in adolescents is in line with the focus of the CO-CREATE project: an innovative EU-funded project that aims to reduce childhood obesity by working with young people to create policy actions promoting healthier environments. It aims to reduce childhood obesity and associated co-morbidities in Europe and the rest of the world by providing knowledge and infrastructure on policies to support making the healthiest choices the preferred ones.

The number varied as every country has implemented a different number of policies relating to physical activity. Only policies that fitted our inclusion criteria were benchmarked.
> Read more about our inclusion criteria

The index has been developed to support young people, policymakers, civil society and researchers in engaging with policies that affect them, specifically policies that promote physical activity. In line with the focus of the CO-CREATE project, the findings are presented in an easy-to-understand format to make it as accessible as possible, including to young people. A youth-friendly overview of the index and country snapshots was prepared for the Healthy Voices website.

Young people can:

• see how well or poorly their country is doing in physical activity at national level.
• learn what the policy status is in Europe and compare their country with other European countries.
• identify weaknesses in the policy status that can inform advocacy efforts to improve the policy environments, either in their country, or across Europe.

The results are reflective of the status of physical activity policy up to May 2023. The results for England, Scotland and Northern Ireland were updated in May 2024 as further policies came to our attention.

The index provides an overview of the status of policies at a certain time and would have to be repeated to assess if there are changes in policy and/or new policies available. It allows the exploration of relevant European and national policies (the benchmarking tool assesses the overall level of government action on physical activity). It cannot indicate causality between any observed trends in obesity rates and related behaviours across countries and policy action, but it can generate hypotheses to be explored with further robust studies.

These results present a quality assessment of action at national government level. As such, they cannot draw a causal link between the quality of policy design and any changes in the prevalence of overweight and obesity in the absence of repeat benchmarking. Further, they do not consider the extent of implementation, or any action taken by regional, provincial or local governments. When used in context, these findings need to be judged carefully against a situational assessment in each country. Some suggested questions to contextualise findings:

1. Are countries that have taken action across all areas of the MOVING framework doing so in response to a lack of enabling conditions for healthy behaviours?
2. Conversely, will countries with an existing enabling environment for healthy behaviours be likely to take less action?
3. Do findings that focus on national level actions miss action at provincial, regional or local levels?

We reviewed the literature, followed by rigorous expert consultation, to develop the benchmarking tool. Any benchmarking tool has an element of subjectivity. To balance this the process of putting together the tool drew heavily from existing evidence, not only expert opinion. World Cancer Research Fund International and CO-CREATE researchers carried out the policy scan and assessments independently from national governments.

> Read more about MOVING benchmarking tool

The validity of the index is discussed on our paper in Obesity Reviews.

We shared the results with in-country government experts who verified the policy actions identified during the scan. Experts were given an opportunity to feed back on the results before publication.

As no gold standards exist on benchmarking national physical activity policy, there is an opportunity in the future to cross-validate findings with other existing tools.