Urban versus rural differences in meeting 24-hour movement behaviour guidelines among 3-4-year-olds : an analysis of SUNRISE pilot study data from 10 low- and middle-income countries

Background: Insufficient physical activity, excessive screen time, and short sleep duration among young children are global public health concerns, however, data on prevalence of meeting World Health Organization 24-hour movement behaviour guidelines for 3–4-year-olds children in low- and middle-income countries (LMICs) are limited, and it is unknown whether urbanisation is related to young children’s movement behaviours. The present study examined differences in prevalence of meeting 24-hour movement behaviour guidelines among 3–4-year-old children living in urban vs rural settings in LMICs. Methods: The SUNRISE Study recruited 429, 3–4-year-old child/parent dyads from 10 LMICs. Children wore activPALTM accelerometers continuously for at least 48 hours to assess their physical activity and sleep duration. Screen time and time spent restrained were assessed via parent questionnaire. Differences in prevalence of meeting guidelines between urban and rural dwelling children were examined using chi-square tests. Results: Physical activity guidelines were met by 17% of children (14% urban vs 18% rural), sleep guidelines by 57% (61% urban vs 54% rural), screen time guidelines by 50% (50% urban vs 50% rural), restrained guidelines by 84% (81% urban vs 86 % rural), and all guidelines combined by 4% (4% urban vs 4% rural). We found no significant differences in meeting the guidelines between urban and rural areas. Conclusions: Only a small proportion of children in both rural and urban settings met the WHO 24-hour movement guidelines. Strategies to improve movement behaviours in LMICs should consider including both rural and urban settings.