ABSTRACT
BACKGROUND: Contemporary 24-h movement behavior (24-HMB) guidelines provide recommendations on time spent on physical activity (PA), screen time (ST), and sleep (SL). There is evidence of physiological and psychological health benefits associated with meeting such guidelines. However, the prevalence of meeting 24-HMB guidelines among youth prescribed eyeglasses/contact lenses is less clear. The primary purpose of this cross-sectional analysis was to examine the prevalence of partially or fully meeting 24-HMB guidelines in U.S. youth prescribed eyeglasses/contact lenses, and variations in meeting the guidelines by demographic, health status, and environmental attributes. METHODS: Data from the 2021 National Survey of Children's Health (NSCH) yielded a target subpopulation of 8523 youth aged 6-17 years (54.22 % girls) prescribed eyeglasses/contact lenses. The representative sample of US children and adolescents was used to estimate the prevalence of meeting 24-HMB guidelines, and a multinomial logistic regression analysis was conducted to examine the odds of meeting 24-HMB guidelines by demographic, health status, and environmental variables. RESULTS: Overall, only 6.57 % met all three 24-HMB guidelines, 23.74 % did not meet any of the three 24-HMB guidelines, and 3.57 %, 10.88 %, and 29.98 % met single guidelines for physical activity, screen time, or sleep duration, respectively, while 25.27 % met any of two 24-HMB guidelines. Female participants were less likely to meet PA + SL guidelines (OR = 0.57, 95 % CI [0.38, 0.56]) but more likely to meet ST + SL guidelines (OR = 1.52, 95 % CI [1.20, 1.91]). Hispanic participants were less likely to meet PA + ST (OR = 0.28, 95 % CI [0.14, 0.52]) guidelines and all three guidelines (OR = 0.41, 95 % CI [0.23, 0.71]) while participants identified as black (OR = 0.33, 95 % CI [0.21, 0.51]) were significantly less likely to meet ST + SL guidelines. With respect to health status, overweight status, repeated/chronic physical pain, and born premature, were detrimentally associated with meeting two or more 24-HMB guidelines. Living in neighborhoods with parks or playgrounds and neighborhood safety were positively linked to meeting the guidelines while living in neighborhoods with sidewalks or walking paths was negatively linked to meeting PA + ST guidelines. CONCLUSION: In U.S. youth prescribed eyeglasses/contact lenses the prevalence of meeting all three 24-HMB guidelines was low, especially the low prevalence observed in female participants, Hispanic and black participants, participants with overweight status, repeated/chronic pain, born premature, living in neighborhoods with sidewalks. Policy makers should take initiative to promote integrated guidelines among this special age group for health benefits.
ABSTRACT
BACKGROUND: The 24-h movement behavior (24-HMB) guidelines suggest that the integration of adequate sleep (SL), increased physical activity (PA), and limited screen time (ST) has general health benefits. However, associations of meeting integrated guidelines with academic engagement and social-emotional functioning among obese/overweight youth have yet to be fully examined. Thus, we aimed to investigate the associations between meeting 24-HMB guidelines and the above-presented outcome measures among this unique group. METHODS: In this cross-sectional study, 2800 children and adolescents (youth aged 6-17 years old) that were retrieved from the National Survey of Children's Health (NSCH) were included for data analysis. Exposure of interests included adherence to 24-HMB guideline(s), while indicators of academic engagement and social-emotional functioning were operationalized. Furthermore, multiple logistic regression was conducted while adjusting for social-demographic variables including age, sex, ethnicity, household income, parental education level and mental health status. RESULTS: The percentages of meeting 24-HMB guidelines varied greatly across different combinations: 1399 participants (49.96 %) met 1 of the 3 guidelines, 580 participants (20.91 %) met 2 guidelines, while only 91 participants (2.94 %) met all 3 guidelines. Meeting integrated guidelines was selectively associated with higher odds of indicators (showing interest/curiosity in learning, caring about school performance, and completing all required homework) of academic engagement. Additionally, Meeting SL + ST guideline (OR = 0.52, 95%CI: 0.29-0.93, p < 00.05) was associated with lower odds of serious difficulty in concentrating, remembering, and making decisions, while meeting ST + SL guideline (OR = 1.67, 95%CI: 1.03-2.69, p < 00.05) was more likely to be good at making and keeping friendships. Furthermore, meeting all 3 guidelines was associated with less argumentative behaviors (OR = 0.58, 95%CI: 0.33-0.99, p < 00.05) and a higher level of resilience (OR = 3.51, 95%CI: 1.88-6.54, p < 00.01), while meeting any two integrated guidelines was associated with a higher level of resilience (OR = 1.72, 95%CI: 1.09-2.71, p < 00.05). CONCLUSION: Findings have indicated the role of meeting 24-HMB guidelines, especially integrated guidelines in the healthy development of obese/overweight youth. Policymakers should implement a long-term plan for this unique group to engage in physical activity, achieve enough sleep, and limit screen time.