An international consensus statement on the methodological standards for physical activity and sedentary behaviour guidelines development

Background: The World Health Organization and many national health bodies have released physical activity and sedentary behaviour guidelines; however, there are inconsistencies across jurisdictions, which may partly be due to variation in guideline development processes. This study aimed to develop international consensus on the methodological standards for the development of future physical activity and sedentary behaviour guidelines. Methods: We conducted a modified Delphi study. Experts in physical activity and/or guideline development rated a series of statements on stakeholder involvement, the types of evidence and study designs considered, and the utilisation of formal approaches in guideline development. Consensus was defined as group agreement of ≥80%. Results: Twenty-three participants from eight countries reached consensus that 1) different stages of the guidelines development process require the involvement of different stakeholders; 2) previous study-level synthesised evidence must be included in evidence reviews and individual studies can be included if published after the most recent review or where review evidence is unavailable; 3) parallel randomised controlled studies must be included in review processes (83.3% agreement), with observational cohort studies marginally missing the agreement criterion (79.2% agreement), while predictive modelling, crossover trials, non-randomised trials and case control studies can be included; and 4) formal approaches must be utilised to assess the quality of individual primary studies, the reporting and quality of systematic reviews, and the overall process for grading evidence. Conclusions: The findings provide a set of methodological standards to improve consistency and rigour in the development of future physical activity and sedentary behaviour guidelines.