Adherence to 24-h movement behaviour guidelines in families with multiple children

Background: In 2019, the World Health Organization (WHO) launched the first global movement guidelines for children that combined sleep, physical activity and screen time. Our previous research showed that adherence to age-specific guidelines for screen time was challenging for families with children in different age groups. We aimed to determine whether families with children in different age-based movement guideline categories have poorer adherence to the broader 24-h movement guidelines than those with all children in the same age category.

Methods: Data were from the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health (seventh survey, 2015) and the women's three youngest children (aged ≤12) (Mothers and their Children's Health sub-study, 2016/2017). The sample was 1787 women (families) with 4064 children (mean age 7.2 [SD 2.9]). Whether children in the family were in the same or different age-based category was determined by matching children's ages in a family against age-based guideline categories for the 24-h movement behaviours. The association between children in the family being in the same or different age-based guideline category on adherence to 24-h movement guidelines, both collectively and individually, was analysed by adjusted logistic regression (binary and multinomial).

Results: Families with children in the same age guideline categories had double the odds of having all children meet 24-h movement guidelines (adjusted odds ratio [OR] 1.95 [95% confidence interval, CI: 1.32, 2.86]). Families with children in the same age categories on the screen guideline had higher odds of all children meeting (2.25 [1.73, 2.93]) and lower odds of some meeting/some failing the screen guideline (0.18 [0.14, 0.25]), than families with all children in different age categories. Families with children in the same age categories on the physical activity guideline had lower odds of all children meeting (0.57 [0.43, 0.75]) or some meeting/some failing the physical activity guideline (0.08 [0.06, 0.12]). No associations were found for sleep guidelines.

Conclusions: Families with multiple children may need practical advice and strategies on how to adhere to guidelines when children span age categories. This could form part of public health strategies that raise awareness of the guidelines and may improve guideline adherence.