International Journal of Public Health

, Volume 64, Issue 4, pp 615–623 | Cite as

Road map towards a harmonized pan-European surveillance of obesity-related lifestyle behaviours and their determinants in children and adolescents

  • Antje HebestreitEmail author
  • Barbara Thumann
  • Maike Wolters
  • Jens Bucksch
  • Inge Huybrechts
  • Joanna Inchley
  • Cornelia Lange
  • Nanna Lien
  • Kristin Manz
  • Nadia Slimani
  • Hidde P. van der Ploeg
  • Wolfgang Ahrens
  • DEDIPAC Consortium
Original article



To develop a road map towards a harmonized pan-European surveillance system for children and adolescents.


Representatives of five European surveillance systems and the German Health Interview and Examination Survey for Children and Adolescents contributed to the road map through a structured workshop in 2016.


A conceptual framework for this road map was developed with seven action points (APs) guiding the successive cross-country harmonization. First, key indicators of health behaviour and their determinants in children and adolescents will be identified (AP1, 2); short screening instruments will be developed and implemented to assess and monitor key indicators (AP3, 4). In parallel, optional supplementary modules could be implemented to provide objective data (AP5). This would allow mutual calibration and improvement of existing instruments before their progressive replacement by more comparable measurement tools (AP6). The establishment of a competence platform is envisaged for guiding the harmonization process (AP7).


This approach builds on existing systems, provides comparable key health indicators across European regions, helps to assess temporal trends and—once in place—will facilitate health reporting and monitoring of national and international health targets.


Surveillance Policy evaluation Health Diet Physical activity Sedentary behaviour 



Action points


Automated Self-Administered 24-h Recall


Determinants of Diet and Physical Activity


European Core Health Indicators


Expert Group on Health Information


European Food Safety Authority


European Health Interview Survey


Food Frequency Questionnaire


Health Behaviour in School-aged Children


Health-Enhancing Physical Activity Policy Audit Tool


International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support


German Health Interview and Examination Survey for Children and Adolescents


National Health and Nutrition Examination Survey


Organisation for Economic Co-operation and Development


Sedentary behaviour


World Health Organization


WHO European Childhood Obesity Surveillance Initiative


24-h dietary recall


Physical activity


Authors’ contributions

All authors were closely involved in the development of the conceptual framework and provided the discussion section related to their field of expertise. All authors provided feedback and contributed to further versions. All authors read and approved the final manuscript.


This work is supported by the Joint Programming Initiative ‘A Healthy Diet for a Healthy Life’. The funding agencies supporting this work are (in alphabetical order of participating country): Germany: Federal Ministry of Education and Research (BMBF); The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw); Norway: The Research Council of Norway, Division for Society and Health.

Compliance with Ethical Standards

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of Interest

The authors declare that they have no competing interests.


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Copyright information

© Swiss School of Public Health (SSPH+) 2019

Authors and Affiliations

  • Antje Hebestreit
    • 1
    Email author
  • Barbara Thumann
    • 1
  • Maike Wolters
    • 1
  • Jens Bucksch
    • 2
  • Inge Huybrechts
    • 3
  • Joanna Inchley
    • 4
  • Cornelia Lange
    • 5
  • Nanna Lien
    • 6
  • Kristin Manz
    • 5
  • Nadia Slimani
    • 3
  • Hidde P. van der Ploeg
    • 7
  • Wolfgang Ahrens
    • 1
    • 8
  • DEDIPAC Consortium
  1. 1.Leibniz Institute for Prevention Research and Epidemiology – BIPSBremenGermany
  2. 2.University of Education HeidelbergHeidelbergGermany
  3. 3.International Agency for Research On CancerLyonFrance
  4. 4.University of St AndrewsSt AndrewsUK
  5. 5.Robert Koch InstituteBerlinGermany
  6. 6.University of OsloOsloNorway
  7. 7.VU University Medical CenterAmsterdamThe Netherlands
  8. 8.University of BremenBremenGermany

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