Urban Versus Rural Differences in Meeting 24-h Movement Behaviour Guidelines Among 3-4-Year-Olds: An Analysis of SUNRISE Pilot Study Data From 10 Low- and Middle-Income Countries

BACKGROUND: Insufficient physical activity, excessive screen time and short sleep duration among young children are global public health concerns; however, data on prevalence of meeting World Health Organisation 24-h movement behaviour guidelines for 3-4-year-old children in low- and middle-income countries (LMICs) are limited, and it is unknown whether urbanisation is related to young children's movement behaviours. The present study examined differences in prevalence of meeting 24-h movement behaviour guidelines among 3-4-year-old children living in urban versus rural settings in LMICs.

METHODS: The SUNRISE Study recruited 429, 3-4-year-old child/parent dyads from 10 LMICs. Children wore activPAL accelerometers continuously for at least 48 h to assess their physical activity and sleep duration. Screen time and time spent restrained were assessed via parent questionnaire. Differences in prevalence of meeting guidelines between urban- and rural-dwelling children were examined using chi-square tests.

RESULTS: Physical activity guidelines were met by 17% of children (14% urban vs. 18% rural), sleep guidelines by 57% (61% urban vs. 54% rural), screen time guidelines by 50% (50% urban vs. 50% rural), restrained guidelines by 84% (81% urban vs. 86% rural) and all guidelines combined by 4% (4% urban vs.4% rural). We found no significant differences in meeting the guidelines between urban and rural areas.

CONCLUSIONS: Only a small proportion of children in both rural and urban settings met the WHO 24-h movement guidelines. Strategies to improve movement behaviours in LMICs should consider including both rural and urban settings.