Open Access Research article

Evidence-informed recommendations for constructing and disseminating messages supplementing the new Canadian Physical Activity Guidelines

Amy E Latimer-Cheung1*, Ryan E Rhodes2, Michelle E Kho34, Jennifer R Tomasone5, Heather L Gainforth1, Kristina Kowalski2, Gabriella Nasuti2, Marie-Josée Perrier1, Mary Duggan6 and The Canadian Physical Activity Guidelines Messaging Recommendation Workgroup

Author Affiliations

1 School of Kinesiology and Health Studies, Queen’s University, 28 Division St, Kingston, ON, K7L 3N6, Canada

2 Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, STN CSC, PO Box 3010, Victoria, BC, V8W 3N4, Canada

3 School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 4K1, Canada

4 Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Phipps 197, Baltimore, MD, 21287, USA

5 Department of Kinesiology, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4K1, Canada

6 Canadian Society for Exercise Physiology, 18 Louisa St., Suite 370, Ottawa, ON, K1R 6Y6, Canada

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BMC Public Health 2013, 13:419  doi:10.1186/1471-2458-13-419

Published: 1 May 2013



Few validated guidelines exist for developing messages in health promotion practice. In clinical practice, the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) Instrument is the international gold standard for guideline assessment, development, and reporting. In a case study format, this paper describes the application of the AGREE II principles to guide the development of health promotion guidelines for constructing messages to supplement the new Canadian Physical Activity Guidelines (CPAG) released in 2011.


The AGREE II items were modified to suit the objectives of developing messages that (1) clarify key components of the new CPAG and (2) motivate Canadians to meet the CPAG. The adapted AGREE II Instrument was used as a systematic guide for the recommendation development process. Over a two-day meeting, five workgroups (one for each CPAG – child, youth, adult, older adult – and one overarching group) of five to six experts (including behavior change, messaging, and exercise physiology researchers, key stakeholders, and end users) reviewed and discussed evidence for creating and targeting messages to supplement the new CPAG. Recommendations were summarized and reviewed by workgroup experts. The recommendations were pilot tested among end users and then finalized by the workgroup.


The AGREE II was a useful tool in guiding the development of evidence-based specific recommendations for constructing and disseminating messages that supplement and increase awareness of the new CPAG (child, youth, adults, and older adults). The process also led to the development of sample messages and provision of a rationale alongside the recommendations.


To our knowledge, these are the first set of evidence-informed recommendations for constructing and disseminating messages supplementing physical activity guidelines. This project also represents the first application of international standards for guideline development (i.e., AGREE II) to the creation of practical recommendations specifically aimed to inform health promotion and public health practice. The messaging recommendations have the potential to increase the public health impact of evidence-based guidelines.

Physical activity guidelines; AGREE II; Messaging; Knowledge translation