The Associations between 24-Hour Movement Behaviours and Quality of Life in Preschoolers: A Compositional Analysis of Cross-Sectional Data from 2018-2021

Associations between 24-h movement behaviors and health-related quality of life(HRQoL) in preschool children: a cross-sectional study

PURPOSE

To investigate the association between preschool children's 24-h movement behaviors and health-related quality of life (HRQoL), exploring the impact of time reallocation among these behaviors and examining gender differences.

METHODS

This study analysed HRQoL and 24-h movement behaviors of 349 preschool children in three kindergartens in Beijing, China, selected through convenience sampling using a cross-sectional study design. A t-test and multivariate analysis of variance methods were used to investigate gender differences. The study examined the relationship between 24-h movement behaviors and HRQoL using component data analysis and component isochronic substitution model methods, with an investigation into gender differences in the overall association.

RESULTS

The study found a negative correlation between sedentary behavior (SB) and overall HRQoL score (γ = - 11.92, p < 0.05) in the entire sample, particularly affecting physical health score (γ = - 14.39, p < 0.01). Among boys, SB was negatively correlated with the HRQoL total score (γ = - 15.83, p < 0.05), while sleep was positively correlated with psychosocial health scores (γ = 17.814, p = 0.01). However, there was no significant association found between 24-h movement behaviors and HRQoL in girls. When using the component isochronic substitution model, reallocating 30 min from sedentary behavior to sleep increased the total HRQoL score of preschool children by 0.865 points (95% CI 0.071, 1.658). In contrast, reallocating 30 min from sleep to sedentary behavior resulted in a decrease of 0.850 points (95% CI - 1.638, - 0.062) in the total HRQoL score.

CONCLUSIONS

To improve preschool children's HRQoL, it is recommended to reduce their sedentary behavior time and increase their sleep time. Public health policymakers should consider this when developing 24-h movement behavior guidelines for preschoolers.

Recent trends and disparities in 24-hour movement behaviors among US youth with mental, behavioral and neurodevelopmental conditions

BACKGROUND

Meeting 24-h movement behaviors (24-HMB: physical activity [PA], screen time [ST], and sleep [SL]) recommendations may be associated with positive health outcomes among youth with specific mental, behavioral, and neurodevelopmental (MBD) conditions. However, temporal trends and disparities in meeting 24-HMB guidelines in these higher-risk groups have not been investigated, hampering the development of evidence-based clinical and public health interventions.

METHODS

Serial, cross-sectional analyses of nationally National Survey of Children's Health (NSCH) data (including U.S. youth aged 6-17 years with MBD conditions) were conducted. The time-trends survey data was conducted between 2016 and 2021. The prevalence of 24-HMB adherence estimates were reported for the overall sample and for various sociodemographic subgroups. The subgroups analyzed included: age group (children[aged 6 to 13 years], adolescents[aged 14 to 17 years]), sex, socioeconomic status, and ethnicity.

RESULTS

Data on 52,634 individuals (mean age, 12.0 years [SD,3.5]; 28,829 [58.0 %] boys) were analyzed. From 2016 to 2021 the estimated trend in meeting PA + ST + SL guidelines declined (-0.8 % [95%CI, -1.0 % to -0.5 %], P for trend <0.001), whereas meeting none of 24-HMB guidelines increased (2.2 % [1.8 % to 2.6 %], P for trend <0.001). White participants, children, and boys reported higher estimated prevalence of meeting full integrated (PA + ST + SL) guidelines.

DISCUSSION

The temporal trends observed in this study highlight the importance of consistently monitoring movement behavior among MBD youth and identifying variations by sociodemographic groups in meeting 24-HMB guidelines for health promotion within these vulnerable groups.

A systematic review of research reporting practices in observational studies examining associations between 24-h movement behaviors and indicators of health using compositional data analysis

Background

Compositional data analysis (CoDA) techniques are well suited for examining associations between 24-h movement behaviors (i.e., sleep, sedentary behavior, physical activity) and indicators of health given they recognize these behaviors are co-dependent, representing relative parts that make up a whole day. Accordingly, CoDA techniques have seen increased adoption in the past decade, however, heterogeneity in research reporting practices may hinder efforts to synthesize and quantify these relationships via meta-analysis. This systematic review described reporting practices in studies that used CoDA techniques to investigate associations between 24-h movement behaviors and indicators of health.

Methods

A systematic search of eight databases was conducted, in addition to supplementary searches (e.g., forward/backward citations, expert consultation). Observational studies that used CoDA techniques involving log-ratio transformation of behavioral data to examine associations between time-based estimates of 24-h movement behaviors and indicators of health were included. Reporting practices were extracted and classified into seven areas: (1) methodological justification, (2) behavioral measurement and data handling strategies, (3) composition construction, (4) analytic plan, (5) composition-specific descriptive statistics, (6) model results, and (7) auxiliary information. Study quality and risk of bias were assessed by the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies.

Results

102 studies met our inclusion criteria. Reporting practices varied considerably across areas, with most achieving high standards in methodological justification, but inconsistent reporting across all other domains. Some items were reported in all studies (e.g., how many parts the daily composition was partitioned into), whereas others seldom reported (e.g., definition of a day: midnight-to-midnight versus wake-to-wake). Study quality and risk of bias was fair in most studies (85%).

Conclusions

Current studies generally demonstrate inconsistent reporting practices. Consistent, clear and detailed reporting practices are evidently needed moving forward as the field of time-use epidemiology aims to accurately capture and analyze movement behavior data in relation to health outcomes, facilitate comparisons across studies, and inform public health interventions and policy decisions. Achieving consensus regarding reporting recommendations is a key next step.

Supplementary Information

The online version contains supplementary material available at 10.1186/s44167-024-00062-8.

Association between meeting 24-hour movement behavior guidelines and quality of life in adolescents with idiopathic scoliosis

BACKGROUND

Meeting the 24-hour movement behavior (24-HMB) guideline helps enhance quality of life (QOL) of adolescents. This study aimed to assess the associations between the 24-HMB (physical activity, screen time, sleep) and QOL among adolescents with idiopathic scoliosis.

METHODS

A cross-sectional study was conducted between September 2021 and September 2023. 24-HMB, QOL and demographic variables were collected through a self-reported questionnaire. Linear regression models and stratified analyses were used to explore statistical associations between the 24-HMB and QOL.

RESULTS

A total of 1073 participants aged 10-18 years with a spinal Cobb angle between 10° and 40° were included. Overall, 20 participants (1.9%) met all three behavioral guidelines, and 272 participants (25.3%) met none. Compared to those who did not meet any of the guidelines, adolescents meeting both screen time and sleep duration (β = 4.10, 95% CI: 2.02-6.18, P < 0.001) and all 3 guidelines (β = 4.39, 95% CI: 0.27-8.51, P = 0.037) had higher QOL scores. Stratified analyses showed that the above associations were more pronounced in adolescents without back pain or with good self-image.

CONCLUSIONS

These findings highlight the importance of adopting and maintaining healthy behavioral habits in order to improve QOL among adolescents with idiopathic scoliosis, especially in those without back pain or with good self-image.

Associations between Parental Educational Attainment, Children's 24-h Behaviors and Children's Hyperactivity Behavior in the COVID-19 Pandemic

BACKGROUND

Parental Educational Attainment and children's 24-h behaviors significantly influenced children's hyperactivity symptoms. This study aimed to examine the mediating role of children's 24-h behavior changes due to the COVID-19 pandemic between Parental Educational Attainment and children's hyperactivity index. It also aimed to investigate the associations between Children's Physical Activity, digital media use, sleep, and hyperactivity index between two clusters of Parental Educational Attainments. The goal was to provide targeted behavioral optimization recommendations for caregivers to reduce the risk of children's hyperactivity.

METHODS

The study was a collaborative extension of the International iPreschooler Surveillance Study Among Asians and otheRs project and the Chinese Children and Adolescent Sports Health Promotion Action Project. The Parent-Surveillance of Digital Media in Childhood Questionnaire® and the Abbreviated Rating Scales from the Conners Parent Symptom Questionnaire were used to measure Parental Educational Attainment, children's behavior changes during the COVID-19 pandemic, and hyperactivity indexes. A total of 11,190 parents of 6-to-12-year-old children completed the online surveys in mainland China. A structural equation model was established by using Smart-PLS, and the linear regression model, and isotemporal substitution models were established by using a Compositional Data Analysis package with R program to achieve the research objectives.

RESULTS

Changes in children's 24-h behaviors due to the COVID-19 pandemic had a significant mediation effect on the negative associations between Parental Educational Attainment and children's hyperactivity index (β = 0.018, T = 4.521, p < 0.001) with a total effect (β = -0.046, T = 4.521, p < 0.001) and a direct effect (β = -0.064, T = 6.330, p < 0.001). Children's Digital Media use was significantly and negatively associated with hyperactivity index among all children. Reallocated time from digital media use to both sleep and physical activity decreased the hyperactivity index, and vice-versa. For parents without tertiary education (R2 = 0.09, p < 0.001), sleep was significantly and negatively associated with the hyperactivity index (βilr-CSL = -0.06, p < 0.001); for parents with tertiary education (R2 = 0.07, p < 0.001), physical activity was significantly and negatively associated with the hyperactivity index (βilr-CPA = -0.05, p < 0.001), and sleep was significantly and positively associated with the hyperactivity index (βilr-CSL = 0.03, p < 0.001). A significant increase in the hyperactivity index was detected when physical activity time was reallocated to sleep, with a significant decrease in the opposite direction.

CONCLUSIONS

Parental Educational Attainment and children's 24-h behaviors directly influenced children's hyperactivity index. However, a purposeful and targeted optimization of children's 24-h behaviors-namely, physical activity, digital media use, and sleep-could assist parents with different educational attainments to reduce their children's hyperactivity index and mitigate the risk of hyperactivity.