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Family and Home Environment Predictors of Children's 24-Hour Movement Guideline Adherence: A Mixed-Methods Study
Roddrick Dugger1,2, Taylor Williams1, Sarah Burkart1
1Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Insights
Structured home and community environments help children meet daily movement guidelines during summer. Family rules and summer program enrollment are key factors for adherence to physical activity, screen time, and sleep recommendations.
Area of Science:
- Pediatric Health
- Environmental Health
- Behavioral Science
Background:
- Children often struggle to meet 24-hour Movement Guidelines (24 hr-MGs) during summer compared to the school year.
- Structured community settings like summer programs can support adherence to physical activity, screen time, and sleep guidelines.
- Limited information exists on how structured home environments influence children's adherence to 24 hr-MGs.
Purpose of the Study:
- To investigate family, home, and community environmental factors that support children meeting 24 hr-MGs during both school year and summer.
- To identify specific features of structured environments that facilitate adherence to physical activity, screen time, and sleep guidelines.
Main Methods:
- A mixed-methods study using accelerometry for physical activity and sleep, parent-reported screen time surveys, and environmental surveys.
- Data collected over 14 days during the school year (March-April 2021) and summer (July-August 2021).
- Multilevel mixed-effects logistic regression analyzed associations between environmental factors and meeting 24 hr-MGs; qualitative interviews explored parental perceptions.
Main Results:
- Summer program enrollment was linked to higher odds of meeting physical activity guidelines (OR: 4.9).
- Bedtime rules were associated with greater odds of meeting at least two 24 hr-MGs (OR: 2.2).
- Parents identified family rules/routines as facilitators and lack of summer program access as a barrier.
Conclusions:
- Structured home and community environments are crucial for children meeting 24 hr-MGs.
- Interventions should focus on expanding access to summer programs and promoting structured home routines.
- Supporting adherence to multiple movement guidelines during summer requires a multi-faceted approach addressing both home and community factors.
Abstract:
Background: During summer, children may meet fewer 24 hours Movement Guidelines (24 hr-MGs) [moderate-vigorous physical activity (PA): ≥60 minutes/day, screen time: ≤2 hours/day, sleep: 9-11 hours/day) compared with the school year. Structured environments within community settings (e.g., summer programs) support guideline adherence. Information about the relationship between structured home environments and 24 hr-MGs is needed. This mixed-methods study examined which features of the family, home, and community environment supported children in meeting 24 hr-MGs during the school year and summer. Methods: Children's PA and sleep data were estimated from wrist-worn accelerometry, and screen time was assessed via parent-reported nightly surveys (14 days) at two time points [school year: (March-April) and summer (July-August) of 2021]. Parents completed a survey at each time point with 13 measures of the family (e.g., screen time rules), home (e.g., bed sharing), and community (e.g., summer program enrollment) environment. Multilevel mixed effect logistic regression estimated the odds of meeting 24 hr-MGs at each time point. Parents (n = 20) completed a qualitative interview and thematic analysis revealed parents perceived facilitators and barriers to guideline adherence. Results: Summer program enrollment and bedtime rules were associated with greater odds of meeting the PA [odds ratios (ORs): 4.9, 95% confidence intervals (CIs): (1.4, 17.1)] and ≥two 24 hr-MGs [OR: 2.2, 95 CI: (1.2, 4.0)] during summer, respectively. Parents perceived family rules/routines supported guideline adherence and lack of access to summer programs was a barrier. Conclusions: Structured environments at home and in the community can support children in meeting 24 hr-MGs guidelines. Interventions that expand access to summer programming and encourage implementation of structured home routines may support meeting multiple 24 hr-MGs during summer.
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