Meeting 24-hour movement guidelines among Canadian post-secondary students: temporal trends, disparities, and mental health associations.

Abstract

Background: Meeting the 24-Hour Movement Guidelines (24-HMG), comprising aerobic physical activity, sedentary behavior including recreational screen time, and sleep, is critical for post-secondary student health. However, multi-year temporal trends spanning the pandemic and post-pandemic period, as well as sociodemographic and mental health disparities, remain understudied in Canada. This limits the development of targeted interventions.

Methods: We conducted a serial cross-sectional analysis using Canadian Campus Wellbeing Survey data collected between 2019 and 2025. A self-reported questionnaire was administered annually to assess aerobic physical activity, sedentary behavior (including recreational screen time), sleep duration, sociodemographic characteristics, and mental health. Prevalence of meeting individual and integrated 24-HMG components was estimated. Temporal trends were examined using regression models with survey year treated as a continuous variable and were further stratified by sociodemographic characteristics and mental health status. Multivariable logistic regression was used to examine factors associated with meeting all guidelines and meeting none.

Results: Among 116,597 students (mean [SD] age, 23.95[8.02] years; 78,623[67.43%] women), divergent trends emerged. From 2019 to 2025, meeting physical activity and sedentary behavior guidelines increased, whereas meeting recreational screen time and sleep guidelines declined. The proportion meeting none of the guidelines significantly decreased, ranging from 7.45% to 4.44% (-0.29% [-0.30, -0.22], p < 0.001). Meeting all guidelines (14.66% in 2019, 8.92% in 2021, 11.74% in 2025) showed a positive linear trend (β = 0.30% [95% CI: 0.20, 0.40], p < 0.001) that sensitivity analyses attributed to transient COVID-19 fluctuations. Meeting none of the guidelines significantly decreased (β = -0.29% [-0.30, -0.22], p < 0.001). Disparities were observed: younger students (≤ 24 years), those identifying as non-binary/Two-Spirit or Black, those reporting lower parental education or high financial stress, and those experiencing severe mental distress or low well-being were less likely to meet integrated guidelines.

Conclusions: While post-pandemic improvements were observed in physical activity and sedentary time, prevalence of meeting recreational screen time and sleep guidelines declined over time. Overall compliance with all movement components remains low and socially patterned. Continued surveillance and focused, equity-informed campus health strategies are warranted to address persistent behavioral and mental health disparities in the digital era.