Global research on 24-hour movement behaviours guidelines in children and adolescents: a systematic review.

Background: Compliance with 24-hour movement behaviours (24-h MB) guidelines, which encompass moderate-to-vigorous physical activity (MVPA), recreational screen time (ST), and sleep, is associated with various health and developmental outcomes in children and adolescents. Despite growing research interest, a comprehensive synthesis of global research focusing on school-aged youth (5-17 years) is lacking. This systematic review mapped global research on 24-h MB guidelines in youth aged 5-17 years, charted publication trends, geographical spread, and summarised reported outcomes to inform research priorities.

Methods: A systematic search (June 2016-July 2024) across six databases (PubMed, Scopus, Web of Science, SPORTDiscus, APA PsycInfo, Embase) identified 32,832 articles. Overall, 148 articles from 32 countries met inclusion criteria. Extracted data covered publication details, movement behaviours measures, article focus, and headline conclusion. 'Compliance' was defined as simultaneous adherence to all 24-h MB guidelines. Guided by the Behavioural Epidemiology Framework, articles were classified as prevalence, health and well-being, correlates, academic performance, intervention focused. Article quality was assessed with National Institute of Health tools.

Results: Global research on 24-h MB guidelines has grown rapidly since 2016 but remains methodologically modest, with 68% articles (n = 132) originated on six high- or upper-middle-income countries. Most articles were cross-sectional (n = 128, 87%) and investigated prevalence (n = 141, 95%) or health and well-being (n = 79, 53%), followed by correlates (n = 40, 27%), academic performance (n = 8, 5%), and interventions (n = 3, 2%). Only 3% of observational and no intervention articles were rated high quality. Globally, compliance rates with 24-h MB guidelines were low (0-53.6%), with 87% (n = 122) articles reporting below 10%. Compliance with 24-h MB guidelines was associated with lower likelihood of obesity, mental health and cardiometabolic problems, and higher physical fitness, academic performance, and cognitive function. Correlates of 24-h MB guidelines compliance included age, gender, weight status, socioeconomic status, environmental pollution, parental support, and in-person schooling. Interventions promoting 24-h MB guidelines showed promising outcomes.

Conclusions: Current research on 24-h MB guidelines is geographically skewed, with only 7% of articles on low- and middle-income countries data. Most evidence was cross-sectional, and no article achieved high methodological quality Future research should focus on under-represented regions, use longitudinal and experimental designs, and assess key outcomes such as academic performance to inform policy and practice for improving youth health and well-being globally.