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With the promotion of physical activity in young people, an established global health priority [1], it is critically important for governments and public health agencies to have a clear understanding of the proportion of children and adolescents meeting guidelines for physical activity and sedentary behaviour. Historically, the assessment of physical activity in large scale population-level surveillance systems has been limited to self-report measures. However, among youth, self-report methods are subject to significant social desirability and recall bias [2, 3]. Younger children, in particular, have difficulty recalling their past behaviour accurately; and struggle to understand the concepts of physical activity frequency, intensity, duration, and type [4]. Proxy self-reports completed by parents or caregivers are one solution, but this method is also subject to recall bias since respondents can only report on the time they are in contact with the child [2, 3]. In light of the limitations of self-report methods, device based physical activity measures such as accelerometers have become the preferred method in studies involving children and young people [2, 5]. Despite the ubiquitous use of accelerometer-based motion sensors in physical activity studies involving children and adolescents, the application of accelerometers in population-level physical activity surveillance systems has been seriously questioned [6]. Citing methodological limitations related to questionable validity, betweenmonitor variability, multiple sets of conflicting intensitybased cut-points, and bias resulting from monitoring non-compliance, Pedisic and Bauman [6] concluded that without appropriate standardisation protocols, the adoption of accelerometers for large-scale physical activity surveillance was premature. They further concluded that accelerometer-based physical activity measures should not substitute, but only supplement self-report information systems; and that self-report methods should be the primary assessment tool in physical activity surveillance systems. The newly published paper by Steene-Johannessen et al. [7] goes a long way to dispel Pedisic and Bauman’s notion that accelerometer-based measures are not yet ready for “prime time” when it comes to populationlevel physical activity surveillance. Based on the reanalysis of accelerometer data from more than 47,000 young people from 30 different studies across 18 European countries, the authors present what could be argued as the most detailed and comprehensive descriptions of physical activity and sedentary behaviour levels in European children and adolescents to date. The results indicate that approximately two-thirds of European children and adolescents do not meet the daily 60min moderate-to-vigorous physical activity (MVPA) recommendation, with youth from southern European countries being at significantly greater risk for inactivity than those residing in central or northern Europe. The findings are concerning to say the least and underscore the need for effective policies and programs to promote physical activity and reduce sedentary behaviour in children and young people. Through the implementation of a carefully conceived accelerometer data processing protocol, Steene-Johannessen and colleagues [7] mitigate many of the concerns identified in the Pedisic and Bauman review [6]. The analysis was delimited to studies using an ActiGraph accelerometer on the hip, epoch length was standardised to 60 s, data from midnight to 6:00 am was excluded to minimise any bias associated with between-study variation in monitoring protocols and minimal wear time criteria, and point estimates of MVPA and sedentary behaviour were based on a single set of cut-point values, regardless of child age. Nevertheless,

Population-level physical activity surveillance in young people: are accelerometer-based measures ready for prime time?