Unlike the other indicators there are no purely objective measures that can be used to inform the report card. However, we did utilise the WHO Europe Health-enhancing physical activity (HEPA) policy audit tool (PAT). This tool provided an internationally recognised framework that offers both credibility and potential continuity if used in future. It could also offer potential comparability if adopted across other countries.
In interpreting this indicator we included national policies, strategies, action plans, legislation and a few other advisory and technical documents that have a direct bearing on children’s physical activity, that were still ‘active’. Twenty-one national instruments were identified.
Guided by the HEPA PAT tool we considered the evidence relating to key policy domains that influence physical activity in children including: Health, Education, Sport, Transport, Environment, Design & Planning, Play, Sustainable Development, and Cross- cutting (i.e. cut across all policy portfolios). Within each of these domains a range of key ‘elements’ were identified from the HEPA PAT tool refined by the research working group (RWG), that could individually or collectively impact on the effectiveness of the policy instrument. These elements included:
The following policy documents were used in assigning a grade to this indicator: Climbing Higher, Creating an Active Wales, the Active Travel Act, Sport Wales, Every Child Hooked on Sport, Play Wales, The Right to Play, Healthy Schools, Future Generations, the National Health Service Together for Health, and the Welsh Government’s Our Healthy Future.
Local policies were not considered in the grading process due to time and resource constraints.
Whilst the HEPA PAT tool was very helpful in analysing this indicator it was still a largely subjective process, and so a simple scoring system was developed using the ‘elements’ described in the tool. Each element was ascribed a percentage score ‘weighted’ to reflect the element’s perceived importance in translating the policy instruments effectively. So, for example, the number of policies was deemed less important than the identifiable supporting actions. After initial ‘weighting’ by the indicator lead experts, the final weighting was considered, refined and agreed by the whole RWG.
The final scoring matrix was as follows:
Applying this led to an overall grade of 54% that translates to a C+. Since the 2016 AHK- Wales report card, the Government grade has decreased slightly from B- to C+. One possible explanation for this change may be the use of the HEPA PAT tool in 2018 which made the process less subjective.