Adherence to 24-h movement guidelines among rural and regional children in Australia: an observational study

Adhering to 24-h movement guidelines protects children's health and wellbeing. We investigated adherence among a sample of children in regional and rural Victoria, Australia. Analysis was conducted using baseline data from RESPOND, a large community-based obesity prevention intervention conducted in regional and rural Victoria, Australia. Children (aged approx. 9-12 years) self-reported screen time and wore a wrist-worn accelerometer for seven days to determine the mean daily time spent on moderate to vigorous physical activity (MVPA), light physical activity (LPA), sedentary and sleeping. Multi-level linear and logistic regressions were used to estimate associations between accelerometry outcomes and individual and school level demographics overall and by gender, accounting for school level clustering. Valid accelerometry data were obtained for 1,264 students. Twenty-two percent (22%) of boys and 16% of girls met all three movement guidelines and 11% boys and 9% of girls met none of the guidelines. Boys engaged in more MVPA, and less LPA than girls. Compared to those in grade 4 (aged approx. 9-10 years), students in grade 6 (aged approx. 11-12 years) had significantly reduced MVPA minutes (- 7.8; 95%CI -12.3, - 3.4); increased sedentary minutes (31.0; 95%CI 22.7, 39.3), and reduced odds of meeting screen time guidelines (odds ratio, 0.65; 95%CI 0.50, 0.84). Stratification by gender found these results to be consistent for boys and girls. Living in a medium or large rural town was associated with having 6.4 (95%CI 0.0, 12, 8) more minutes in MVPA (boys) and greater odds of adhering to screen time guidelines (OR, 1.96 (95%CI 1.02, 3.79) (girls) compared to living in regional centers. Sleep minutes were lower for students who spoke a language other than English at home (- 21.0 95%CI - 32.5, - 9.5). Only screen-time adherence for girls was associated with socioeconomic status.

This study highlights low adherence to three Australian movement behavior guidelines among this large sample of regional and rural Victorian children. Large gender-differences in duration and adherence to MVPA and screen-time guidelines and declines with increasing age (all guidelines), highlight the need for population-wide interventions.

• Time spent in movement behaviors (moderate-to-vigorous physical activity, light-intensity physical activity, sedentary behavior and sleep are important for children's health. • Few studies have examined device-measured movement behaviors and adherence to 24-h movement guidelines among regional children and whether this varies by gender, rurality and socioeconomic background.

• This study found 22% of boys and 16% of girls met the 24-h movement recommendations, with 11% of boys and 9% of girls meeting no guideline. • Living in a medium or large rural town was associated with more moderate to vigorous physical activity in boys, and less screen-time among girls compared to those living in regional centers. Higher socioeconomic status was associated with less screen-time among girls.