Adherence to 24-hour movement guidelines by long-term health condition in Canadian children and youth

BACKGROUND: There is limited understanding of how well Canadian children and youth with long-term health conditions adhere to the 24-hour movement guideline recommendations. OBJECTIVE: This study compared adherence to 24-hour movement guidelines between Canadian children and youth with and without long-term health conditions. METHODS: Cross-sectional data from the 2023 Canadian Health Survey on Children and Youth (CHSCY), conducted by Statistics Canada, were used for this national study (n=22,142). Long-term health condition status included responses of "yes" or "no" for 11 conditions. Adherence to physical activity (≥60 minutes/day of moderate-to-vigorous physical activity [MVPA]), recreational screen time (≤2 hours/day), and sleep duration (9-11 hours/night for children aged 5-13 years or 8-10 hours/night for adolescents aged 14-17 years) recommendations were parent-reported (children aged 5-11 years) or self-reported (youth aged 12-17 years). Logistic regression analyses examined the association between status of long-term health conditions and adherence to 24-hour movement guideline recommendations, with adjustments for covariates. RESULTS: Children and youth without long-term health conditions were more likely to meet guidelines for MVPA (adjusted odds ratio [aOR]: 1.29, 95% confidence interval [CI]: 1.18-1.41), recreational screen time (aOR: 1.21, 95% CI: 1.10-1.34), and all three guideline recommendations combined (aOR: 1.35, 95% CI: 1.21-1.52). Subgroup analyses stratified by long-term health conditions showed that individuals without anxiety disorders, mood disorders, learning disabilities, attention deficit disorder, or autism spectrum disorder had better adherence to movement behaviour guidelines. CONCLUSION: There is a significant gap in adherence to the 24-hour movement guidelines among children and youth with long-term health conditions. Future research is needed to better understand the factors influencing adherence to the different movement behaviours.