Child-, Family-, and Community-Level Correlates of 24-Hour Movement Behaviors in Ethiopian Young Children: The SUNRISE Study

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Abstract
Background: Understanding the factors influencing 24-hour movement behaviors is important for designing appropriate health promotion strategies. We examined the multidimensional correlates of physical activity, sedentary behavior, screen time, and sleep among children under 5 years of age in Ethiopia. Methods: Cross-sectional study conducted in Adama and Lume district, Ethiopia. Children were recruited from urban kindergartens and rural villages. Physical activity, sedentary time, and sleep were assessed using accelerometry. Screen time and correlates were parent reported. Variables were selected a priori, using the social ecological model and considering country context. Linear mixed models were used to test associations between child-, family-, and community-level correlates and time spent in 24-hour movement behaviors, accounting for clustering effect. Results: Four hundred and thirty children participated (mean age 4.2 [0.6] y). Girls spent less time in total of physical activity (TPA) and moderate- to vigorous-intensity physical activity (MVPA) and more time sedentary than boys. Children who spent more time outdoors had higher TPA and MVPA, longer sleep duration, and shorter sedentary and screen time. Children of educated parents had lower TPA and MVPA and higher sedentary time than those with no formal education. Children of parents who reported using a screen device with their child for educational purposes spent less time in MVPA, had shorter sleep, and had more screen time than those who did not. Rural children had higher TPA and MVPA, longer sleep, and shorter sedentary and screen time than urban children. Conclusion: We identified key correlates of 24-hour movement behaviors in Ethiopian children. Designing tailored health promotion strategies to support healthy levels of movement behaviors, particularly in urban areas, is needed.

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