Developing International Consensus on Key Indicators for a 24-Hour Movement Behaviour Report Card in Early Childhood: A Twin-Panel Delphi Study
Bibliographic record
Abstract
BACKGROUND: The World Health Organization has established recommendations for 24-h movement behaviours in children under 5 years. Building on the successful knowledge translation model of Active Healthy Kids Global Alliance Report Cards, this study aimed to develop a similar framework for the early years. METHODS: Using a three-round twin-panel Delphi survey (conducted via an online survey between 28 November 2024 and 11 March 2025), expert consensus was sought on indicators and benchmarks for the first dedicated report card on 24-h movement behaviours for the early years. The experts were identified through a three-step selection process, which included recognised international projects and networks as well as literature search. In Round 1, participants evaluated the applicability of 15 initial indicators. In Rounds 2 and 3, they rated the importance of each indicator, with results from their own panel (Round 2) and the other panel (Round 3) provided to inform their decisions. Qualitative feedback on definitions and benchmarks was systematically reviewed and incorporated. Consensus was predefined as ≥ 75% agreement, with stability across rounds considered. RESULTS: Of 175 invited experts, 72 (41.1% recruitment rate) from 15 regions participated in Round 1, with 61 (84.7% response rate) and 56 (77.8% response rate) completing Rounds 2 and 3, respectively. Consensus was achieved for 12 indicators, with definitions and benchmarks refined based on expert inputs. Notably, Weight Status and Motor Proficiency were excluded due to lower agreement. CONCLUSIONS: The finalised set of indicators, definitions, and benchmarks provides a robust foundation for creating a standardised report card for early childhood. The finalised results serve as a critical advocacy instrument to raise awareness, improve surveillance, facilitate cross-jurisdictional comparisons, and inform policy and public health initiatives, ultimately supporting the health and well-being of young children globally.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".