Physical activity interventions among children and adolescents in China: a scoping review through an equity lens

Equity in health promotion is essential to ensuring fair opportunities for children to engage in physical activity (PA). While China has implemented numerous PA interventions, little is known about how these programs address or overlook equity considerations. This scoping review synthesizes evidence on equity measures in PA interventions among Chinese children. A scoping review was conducted following the guidance of PROGRESS-Plus framework to assess equity measures across PA interventions for children in China. Published studies were analysed to identify equity-related indicators including place of residence, ethnicity, occupation, sex, education, and household income. This review was registered on OSF registries (https://osf.io/zbfpd). Sixty-five individual interventions were identified. Equity considerations were rarely explicit. Most interventions were concentrated in well-developed cities, with only two conducted in rural regions. Male participants slightly outnumbered females. Children from families with lower parental education or occupational status, as well as those from ethnic minoritised groups and children who are left-behind or displaced, were consistently underrepresented. While a number of interventions focused on children with health issues, these efforts were not intentionally designed to address PA inequities. Equity considerations are largely absent from PA interventions for Chinese children. The disproportionate region and sex focus, combined with neglect of rural, minority, and disadvantaged groups, suggests these interventions may unintentionally widen health disparities. Future efforts should apply an equity lens in PA interventions by prioritizing underserved children and considering upstream, policy-level strategies to promote fair and inclusive PA opportunities.