Resources to support the Guidelines
Journal Supplement
Volume 45 • Number 10 (Suppl. 2) • October 2020
CSEP Special Supplement: Canadian 24–Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older (online only) / Supplément spécial de la SCPE : Directives canadiennes en matière de mouvement sur 24 heures pour les adultes âgés de 18 à 64 ans et les adultes âgés de 65 ans et plus (électronique seulement)
Guest Editor
Scientific Director, Cancer Epidemiology and Prevention Research
Cancer Care Alberta, Alberta Health Services
Adjunct Professor and Division Head, Preventive Oncology
Departments of Oncology, Community Health Sciences
Interim Scientific Director, O’Brien Institute of Public Health
Cumming School of Medicine and Faculty of Kinesiology
University of Calgary
Introduction
Introduction to the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep
Articles
Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep
Robert Ross, Jean-Philippe Chaput, Lora M. Giangregorio, Ian Janssen, Travis J. Saunders, Michelle E. Kho, Veronica J. Poitras, Jennifer R. Tomasone, Rasha El-Kotob, Emily C. McLaughlin, Mary Duggan, Julie Carrier, Valerie Carson, Sebastien F. Chastin, Amy E. Latimer-Cheung, Tala Chulak-Bozzer, Guy Faulkner, Stephanie M. Flood, Mary Kate Gazendam, Genevieve N. Healy, Peter T. Katzmarzyk, William Kennedy, Kirstin N. Lane, Amanda Lorbergs, Kaleigh Maclaren, Sharon Marr, Kenneth E. Powell, Ryan E. Rhodes, Amanda Ross-White, Frank Welsh, Juana Willumsen, and Mark S. TremblayThe Canadian Society for Exercise Physiology assembled a Consensus Panel representing national organizations, content experts, methodologists, stakeholders, and end-users and followed an established guideline development procedure to create the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These guidelines underscore the importance of movement behaviours across the whole 24-h day. The development process followed the strategy outlined in the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A large body of evidence was used to inform the guidelines including 2 de novo systematic reviews and 4 overviews of reviews examining the relationships among movement behaviours (physical activity, sedentary behaviour, sleep, and all behaviours together) and several health outcomes. Draft guideline recommendations were discussed at a 4-day in-person Consensus Panel meeting. Feedback from stakeholders was obtained by survey (n = 877) and the draft guidelines were revised accordingly. The final guidelines provide evidence-based recommendations for a healthy day (24-h), comprising a combination of sleep, sedentary behaviours, and light-intensity and moderate-to-vigorous-intensity physical activity. Dissemination and implementation efforts with corresponding evaluation plans are in place to help ensure that guideline awareness and use are optimized. Novelty First ever 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older with consideration of a balanced approach to physical activity, sedentary behaviour, and sleep Finalizes the suite of 24-Hour Movement Guidelines for Canadians across the lifespan.
Knowledge translation of the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: a collaborative movement guideline knowledge translation process
Vol. 45 No. 10 (Suppl. 2) pp. S103–S124
Establishing a step-by-step process that provides practitioners with a blueprint for translating movement guidelines into action stands to optimize the investment in guideline development, improve guideline promotion and uptake, and ultimately enhance population health. The purpose of this paper is to describe how the Knowledge-to-Action framework and integrated knowledge translation were operationalized to systematically inform our knowledge translation (KT) efforts for the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older. In October 2018, the need for a KT Process, operating in tandem with the Guideline Development Process, led to the establishment of a KT team with a specific structure and terms of reference. The KT team collaboratively agreed on decision-making principles prior to selecting target audiences to focus their efforts. We undertook formative research to assess the local context and determinants of guideline dissemination and implementation efforts among target audiences. Plans for the subsequent steps and research are outlined. We highlight recommendations and lessons learned for applying the process in other settings. Novelty We outline a collaborative and systematic process and research program for the knowledge translation of movement guidelines. This paper provides an innovative and replicable blueprint to optimize future movement guideline knowledge translation efforts.
Optimal messaging of the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years and older
Vol. 45No. 10 (Suppl. 2)pp. S125–S150
Development and application of an outcome-centric approach for conducting overviews of reviews
Vol. 45 No. 10 (Suppl. 2) pp. S151–S164
There are gaps in current guidance concerning how to conduct overviews of systematic reviews in an outcome-centric manner. Herein we summarize the methods and lessons learned from conducting 4 outcome-centric overviews to help inform the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older on the topics of resistance training, balance and functional training, sedentary behaviour, sleep duration. We defined “critical” and “important” outcomes a priori. We used AMSTAR 2 to assess review quality and sought 1 systematic review per outcome. If multiple reviews were required to address subgroups for an outcome, we calculated the corrected covered area (CCA) to quantify overlap. We report our methodology in a PRISMA table. Across the 4 overviews, authors reviewed 1110 full texts; 45 were retained (low to high quality per AMSTAR 2), representing 950 primary studies, enrolling over 5 385 500 participants. Of 46 outcomes, we identified data for 35. Nineteen outcomes required >1 review (CCA range: 0% to 71.4%). Our outcome-centric overviews addressed unique aspects of overviews, including selection and quality assessment of included reviews, and overlap. Lessons learned included consistent application of methodological principles to minimize bias and optimize reporting transparency. Novelty Overviews of reviews synthesize systematic reviews in a rigorous and transparent manner. Outcome-centric systematic reviews assess the quality of evidence for primary studies contributing to an outcome. This manuscript describes the development and application of extending the concept of outcome-centric systematic reviews to the design and conduct of outcome-centric overviews.
Reviews
Resistance training and health in adults: an overview of systematic reviews
Vol. 45 No. 10 (Suppl. 2) pp. S165–S179
Balance and functional training and health in adults: an overview of systematic reviews
Vol. 45No. 10 (Suppl. 2)pp. S180–S196
Sedentary behaviour and health in adults: an overview of systematic reviews
Vol. 45 No. 10 (Suppl. 2) pp. S197–S217
Sleep duration and health in adults: an overview of systematic reviews
Vol. 45 No. 10 (Suppl. 2) pp. S218–S231
Systematic Reviews
Sleep timing, sleep consistency, and health in adults: a systematic review
Jean-Philippe Chaput, Caroline Dutil, Ryan Featherstone, Robert Ross, Lora Giangregorio, Travis J. Saunders, Ian Janssen, Veronica J. Poitras, Michelle E. Kho, Amanda Ross-White, Sarah Zankar, and Julie Carrier
Vol. 45 No. 10 (Suppl. 2) pp. S232–S247
The objective of this systematic review was to examine the associations between sleep timing (e.g., bedtime/wake-up time, midpoint of sleep), sleep consistency/regularity (e.g., intra-individual variability in sleep duration, social jetlag, catch-up sleep), and health outcomes in adults aged 18 years and older. Four electronic databases were searched in December 2018 for articles published in the previous 10 years. Fourteen health outcomes were examined. A total of 41 articles, including 92 340 unique participants from 14 countries, met inclusion criteria. Sleep was assessed objectively in 37% of studies and subjectively in 63% of studies. Findings suggest that later sleep timing and greater sleep variability were generally associated with adverse health outcomes. However, because most studies reported linear associations, it was not possible to identify thresholds for “late sleep timing” or “large sleep variability”. In addition, social jetlag was associated with adverse health outcomes, while weekend catch-up sleep was associated with better health outcomes. The quality of evidence ranged from “very low” to “moderate” across study designs and health outcomes using GRADE. In conclusion, the available evidence supports that earlier sleep timing and regularity in sleep patterns with consistent bedtimes and wake-up times are favourably associated with health. (PROSPERO registration no.: CRD42019119534.) Novelty This is the first systematic review to examine the influence of sleep timing and sleep consistency on health outcomes. Later sleep timing and greater variability in sleep are both associated with adverse health outcomes in adults. Regularity in sleep patterns with consistent bedtimes and wake-up times should be encouraged.
Dissemination and implementation of national physical activity, sedentary behaviour, and/or sleep guidelines among community-dwelling adults aged 18 years and older: a systematic scoping review and suggestions for future reporting and research
Vol. 45 No. 10 (Suppl. 2) pp. S258–S283