Related Experiment Video
Updated: May 3, 2026

Accessing the Cytotoxicity and Cell Response to Biomaterials
Published on: July 8, 2021
Investigating the Compliance With the 24-h Movement Behaviours Guidelines in Preschoolers: Insights From the SUNRISE
Ricardo Amaral1, Luís Lemos2, Kar Hau Chong3
1Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.
Insights
Portuguese children
Area of Science:
- Pediatric Health
- Public Health
- Child Development
Background:
- World Health Organization (WHO) established guidelines for children under 5 in 2019.
- The SUNRISE Study provides evidence on guideline adherence and child development.
- This study focuses on a Portuguese pilot of the SUNRISE protocol.
Purpose of the Study:
- Assess the prevalence of 3- to 4-year-old Portuguese children meeting WHO physical activity, sedentary behavior, and sleep guidelines.
- Evaluate the feasibility and acceptability of the SUNRISE protocol in Portugal.
Main Methods:
- Recruited 115 preschool children from urban and rural centers in Portugal.
- Collected parent-reported data on screen time and sleep.
- Used accelerometers (wGT3X) for objective movement behavior measurement.
- Assessed anthropometrics, motor skills, physical fitness, and executive functions via the SUNRISE protocol.
Main Results:
- 77 children provided valid accelerometer data.
- Compliance varied: highest for parent-reported sleep (89.7%), lowest for physical activity (53.3%).
- 66.3% met screen time recommendations; no child was non-compliant with restrained time recommendations.
Conclusions:
- Adherence to WHO guidelines in Portuguese children depends on sleep assessment methods and inclusion of restrained time.
- The SUNRISE protocol is feasible in Portugal, with high response rates for data collection.
- Valuable insights gained for future implementation of the SUNRISE protocol.
Background:
In 2019, the World Health Organization (WHO) established guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Since then, the SUNRISE Study has been producing evidence on the proportion of children meeting the guidelines and their association with healthy development.
Objectives:
This SUNRISE Portugal pilot study aimed to (a) report the prevalence of 3- to 4-year-old Portuguese children meeting the WHO guidelines and (b) assess the feasibility and acceptability of implementing the SUNRISE protocol in the Portuguese context.
Methods:
A total of 115 preschool children were recruited from three urban and three rural public early childcare and education centres in Portugal. Parents answered questions on the children's screen time and sleep patterns. Movement behaviours were objectively measured using accelerometers wGT3X. Anthropometrics, gross and fine motor skills, physical fitness and executive functions were assessed using the SUNRISE protocol. Children were categorized as compliant or not with the guidelines, and descriptive statistics were used to summarize the protocol's feasibility.
Results:
From those recruited, 77 children provided valid accelerometer data. Compliance was slightly higher when considering parent-reported sleep data instead of device-based measurements of sleep (33.8% and 31.2%, respectively). When considering the restrained time recommendation, no child was classified as non-compliant. The highest compliance rate was observed for parent-reported sleep time (89.7%), whereas the lowest was for physical activity (53.3%). A total of 66.3% of the children complied with screen time recommendations. Response rates to the protocol were consistently high, exceeding 70% across all measures.
Conclusion:
Compliance with the WHO guidelines among Portuguese children varies depending on the protocol used to assess sleep duration and the inclusion or not of the restrained time recommendation. The SUNRISE protocol proved to be feasible for implementation in the Portuguese context, and valuable lessons were learned regarding response rates for both accelerometer data and the parent questionnaire.
Related Concept Videos
Naturalistic Observations
Socioemotional Development during Infancy
Primary Temperament Types