Non-communicable diseases (NCDs) are a major global public health crisis. Low- and middle-income countries (LMICs) are especially hard-hit. With few resources and weak health systems, these countries struggle under the double burden of infectious diseases and NCDs. The main NCDs, like cancer, diabetes, and heart disease, can be prevented by addressing the four common risk factors: physical inactivity, tobacco use, alcohol misuse, and unhealthy diets. This project will help inform policy options for increasing physical activity among children and youth in sub-Saharan Africa as a key strategy to reduce the NCD burden. Evidence suggests that a physical activity transition is currently occurring in LMICs. Increasing urbanization has reduced physical activity and active transportation (walking or cycling to work, school, etc.) levels. This may in turn increase the risk of becoming overweight or obese, and of developing NCDs. This study will assess physical activity and active transportation levels among 3,000 school children in Kenya, Nigeria, and Mozambique (1,000 from each participating country). The research team will collect existing active transportation policies for school children in each jurisdiction. They will compile a policy catalogue and collect data. The research will inform physical activity report cards in each country, based on Active Healthy Kids Canada's model. The study also aims to develop a surveillance model that can be used in other LMICs to assess physical activity and active transportation among children and youth. The researchers will prepare a report with policy-relevant recommendations for each country and targeted to policy-makers. The project's specific objectives include: - To develop or refine an instrument or protocol to collect physical activity and active transport data; - To collect physical activity and active transport data from African school children living in urban, suburban, and rural areas; -To create report cards for Kenya, Nigeria, and Mozambique, which will be presented during the Global Summit on Physical Activity of Children in 2014; - To modify the Neighbourhood Environment Walkability Scale instrument (NEWS) for use in African countries, assess its reliability, and examine the association between these characteristics and active transportation in African school children; - To compare provincial/county, municipal, and school policies related to active transportation; - To develop a physical activity and active transport surveillance model for other LMIC countries to use; and, - To provide recommendations for policy, programs, and future research.
