A systematic review of instruments for the analysis of national-level physical activity and sedentary behaviour policies

Background: This systematic review aimed to identify and critically assess available instruments for the analysis of national-level physical activity (PA) and sedentary behaviour (SB) policies and provide recommendations for their future use. Methods: We conducted a systematic search of academic and grey literature through six bibliographic databases, Google, and the websites of three international organisations for PA promotion, to identify instruments that are used or that may be used for national-level PA/SB policy analysis. In order to describe and categorise the identified instruments, we used the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework. The frameworkspecifies the elements of a comprehensive analysis of PA/SB policies, through the following categories: purpose; level; policy sector; type of policy; stages of policy cycle; and scope of analysis. Results: Out of 22,071 screened items, 26 publications describing 16 instruments met the selection criteria. All of the instruments can be used for analysing PA policy, whilst only two include questions about SB policy. None of the instruments allow for the analysis of all the relevant components of national PA/SB policy. Some important elements of PA policy analysis such as the tourism and research sectors, the agenda setting and endorsement/legitimisation stages, and the effects of policy are addressed by only a few instruments. Moreover, none of the instruments address unwritten formal statements, informal policies, and the termination and succession stages of the policy cycle. Conclusion: Designing new instruments or adapting existing ones is needed to allow for a more thorough analysis of national PA and SB policies. Given that policy analysis covering all important components of PA/SB policy may be extremely time-consuming, a way forward might be to develop a set of complementary instruments, with each tool collecting detailed information about a specific component.