Proportion and Correlates of Children in the US-Affiliated Pacific Region Meeting Sleep, Screen Time, and Physical Activity Guidelines

Introduction: Limited data on 24-hour movement behaviors of children aged 5–8 years exist globally. We describe the prevalence and sociodemographic associations of meeting physical activity (PA), sedentary recreational screen time (ST), and sleep guidelines among children from 11 jurisdictions in the US-Affiliated Pacific region.
Methods: Cross-sectional representative data from 1192 children aged 5–8 years living in the US-Affiliated Pacific region were drawn from the baseline 2012–2014 Children’s Healthy Living Program. Sleep and moderate- to vigorous-intensity PA were calculated from accelerometry. ST and sociodemographic data were collected from caregiver surveys. The percentage of children meeting the Asia-Pacific 24-hour movement guidelines for PA (≥60 min/d of moderate- to vigorous-intensity PA), sleep (≥9 and ≤ 11 h/d) and ST (≤2 h/d) were calculated. Generalized linear mixed models were used to examine associations with adiposity and sociodemographic variables.
Results: Twenty-seven percent (95% confidence interval, 24.6–30.0) of children met integrated guidelines; 98% (96.2–98.0) met
PA, 78% (75.4–80.0) met sleep, and 35% (32.6–38.0) met ST guidelines. Females (adjusted odds ratio = 1.40 [95% confidence
interval, 1.03–1.91]) and those living in lower-middle-income jurisdictions (2.29 [1.49–3.54]) were more likely to meet ST
guidelines. Overweight children (0.62 [0.40–0.96]), those aged 8 years (0.39 [0.22–0.69]), and children with caregivers of an
education level of high school or beyond (0.44 [0.29–0.68]) were less likely to achieve ST guidelines. Children from midrange
annual household incomes were less likely to meet combined guidelines (0.60 [0.39–0.92]). Conclusions: Three-quarters of
children are not meeting integrated Asia-Pacific 24-hour movement guidelines. Future strategies for reducing ST and increasing integrated guidelines compliance are needed.