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

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.

Association between meeting 24-h movement guidelines and health in children and adolescents aged 5–17 years: a systematic review and meta-analysis

“…A total of 39 studies ( 16 – 75 ) reported overall adherence to 24-h movement guidelines. Regarding age group, 26 studies ( 16 , 20 , 21 , 23 – 25 , 27 , 28 , 31 , 33 – 37 , 48 , 54 , 56 , 59 – 62 , 66 , 67 , 70 , 71 , 74 ) focused on children and 22 studies ( 20 , 22 , 26 , 28 , 30 – 32 , 38 , 46 , 48 , 52 , 53 , 56 – 58 , 62 , 64 , 66 , 69 , 72 – 74 ) focused on adolescents. In terms of gender, 19 studies ( 15 , 20 , 29 , 30 , 32 , 33 , 36 , 37 , 41 , 42 , 45 , 47 , 51 , 53 , 55 , 62 , 63 , 65 , 75 ) included both boys and girls.…”

“…In terms of gender, 19 studies ( 15 , 20 , 29 , 30 , 32 , 33 , 36 , 37 , 41 , 42 , 45 , 47 , 51 , 53 , 55 , 62 , 63 , 65 , 75 ) included both boys and girls. In terms of geographical region, 18 different countries were identified, including 3 in Africa ( 16 , 25 , 54 ), 20 in Asia ( 16 , 22 , 30 , 34 , 37 , 39 , 41 , 44 , 51 – 53 , 55 , 56 , 58 , 59 , 62 , 70 – 72 , 75 ), 10 in Europe ( 16 , 26 , 42 , 48 , 50 , 60 , 62 , 63 , 68 , 70 ), 4 in Oceania ( 16 , 35 , 43 , 45 ), and 22 in North America ( 16 – 20 , 23 , 24 , 28 , 29 , 31 – 33 , 38 , 40 , 46 , 47 , …”

Compliance with the 24‐h movement behaviors guidelines among urban and rural Brazilian preschoolers

“…Similarly to other low-middle income countries, Brazil has been experiencing a rapid urbanization in recent decades, that may impact on movement behaviors levels, and that could be partially responsible for the high prevalence of Brazilian rural young children affected by overweight and obesity (Saúde, 2019). For instance, a study conducted among Kenyan middle childhood children from urban and rural areas showed that compliance with the combined movement behaviors guidelines was low overall (7%), and higher among rural (10%) than urban (5%) children (Swindell et al, 2022), supporting similar findings from Mozambican children (17.7% vs. 3.6% for rural and urban setting, respectively) (Manyanga et al, 2019). The authors suggest that urban environment characteristics, such as lack of walkability, and safety concerns may be negative linked to an active childhood (Manyanga et al, 2019).…”