Prevalence and correlates of compliance with 24-h movement guidelines among children from urban and rural Kenya-The Kenya-LINX project

PLoS One. 2022 Dec 30;17(12):e0279751. doi: 10.1371/journal.pone.0279751. eCollection 2022.

Abstract

Background: Like many countries in sub-Saharan Africa, Kenya has experienced rapid urbanization in recent years. Despite the distinct socioeconomic and environmental differences, few studies have examined the adherence to movement guidelines in urban and rural areas. This cross-sectional study aimed at examining compliance to the 24-hour movement guidelines and their correlates among children from urban and rural Kenya.

Method: Children (n = 539) aged 11.1 ± 0.8 years (52% female) were recruited from 8 urban and 8 rural private and public schools in Kenya. Physical activity (PA) and sleep duration were estimated using 24-h raw data from wrist-worn accelerometers. Screen time (ST) and potential correlates were self- reported. Multi-level logistic regression was applied to identify correlates of adherence to combined and individual movement guidelines.

Results: Compliance with the combined movement guidelines was low overall (7%), and higher among rural (10%) than urban (5%) children. Seventy-six percent of rural children met the individual PA guidelines compared to 60% urban children while more rural children also met sleep guidelines (27% vs 14%). The odds of meeting the combined movement guidelines reduced with age (OR = 0.55, 95% CI = 0.35-0.87, p = 0.01), was greater among those who could swim (OR = 3.27, 95% CI = 1.09-9.83, p = 0.04), and among those who did not engage in ST before school (OR = 4.40, 95% CI = 1.81-10.68, p<0.01). The odds of meeting PA guidelines increased with the number of weekly physical education sessions provided at school (OR = 2.1, 95% CI = 1.36-3.21, p<0.01) and was greater among children who spent their lunch break walking (OR = 2.52, 95% CI = 1.15-5.55, p = 0.02) or running relative to those who spent it sitting (OR = 2.33, 95% CI = 1.27-4.27, p = 0.01).

Conclusions: Prevalence of meeting movement guidelines among Kenyan children is low and of greatest concern in urban areas. Several correlates were identified, particularly influential were features of the school day, School is thus a significant setting to promote a healthy balance between sleep, sedentary time, and PA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Kenya
  • Male
  • Prevalence
  • Sedentary Behavior*
  • Sleep
  • Swimming*

Grants and funding

This research was funded by the British Academy under the urban infrastructure of wellbeing scheme https://www.thebritishacademy.ac.uk/programmes/urban-infrastructures-well-being Grant number: UWB190069 The grant was awarded to Gareth Stratton (PI), Vincent Onywera, George Owino, Lucy-Joy Wachira, Huw Summers and Sinead Brophy. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.