Cross-sectional examination of 24-hour movement behaviours among 3- and 4-year-old children in urban and rural settings in low-income, middle-income and high-income countries: the SUNRISE study protocol

Abstract

Introduction24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap.Methods and analysisSUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study.Ethics and disseminationThe SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions.

Associations between meeting the Canadian 24-hour movement guidelines and physical, cognitive, social-emotional, and overall development in early childhood

“…Though the variety of developmental indicators measured could make replication difficult. Ideally, a future synthesis of the literature could help identify universal core measures to be included when assessing development, similar to efforts underway in the SUNRISE study [44]. Further, this study used device-based measures of physical activity and sleep, and the total screen time measure included screen viewing and video game playing on a variety of mediums (e.g., tablet, cell phones, television), instead of only the traditional television viewing.…”

Levels and Correlates of Objectively Measured Sedentary Behavior in Young Children: SUNRISE Study Results from 19 Countries

“…Data used in this study were a subset of the SUNRISE pilot study sample ( 20 ), an international cross-sectional study of movement behaviors and associated health and developmental outcomes in the early years. Recruitment occurred using convenience cluster sampling through either early childhood education or care services or from the community, at a village level.…”

“…Because of the absence of an internationally harmonized definition of degree of urbanization ( 27 ), locally relevant criteria (e.g., distance from town, service availability, and population density) were used to classify settings as urban or rural. The World Bank’s country income level classifications were used to categorize countries as LLMIC, UMIC, or HIC ( 20 ). These variables served both a descriptive purpose and were utilized as exposure variables in the analysis of the correlates of sedentary behavior patterns.…”

Parental Views on the Acceptability and Feasibility of Measurement Tools Used to Assess Movement Behaviour of Pre-School Children: A Qualitative Study

“…Although the key measurement properties (validity and reliability) are fundamental when selecting a measurement tool, the acceptability (whether individuals are willing to do something) and feasibility (whether individuals are able to do something) of a tool may determine success of the study [ 15 , 16 ]. The measurement tool of choice can affect retention in research studies and the amount of usable data, including through low compliance with accelerometer wearing protocols [ 17 , 18 , 19 ], with some research suspending the use of accelerometers during data collection for these reasons [ 20 , 21 ]. For example, the SUNRISE study, an international project using multiple measurement tools to collect data on movement behaviours of pre-school children, has suspended use of an accelerometer and modified existing parental reported tools due to feasibility and acceptability concerns [ 21 ].…”

“…The measurement tool of choice can affect retention in research studies and the amount of usable data, including through low compliance with accelerometer wearing protocols [ 17 , 18 , 19 ], with some research suspending the use of accelerometers during data collection for these reasons [ 20 , 21 ]. For example, the SUNRISE study, an international project using multiple measurement tools to collect data on movement behaviours of pre-school children, has suspended use of an accelerometer and modified existing parental reported tools due to feasibility and acceptability concerns [ 21 ].…”