Thesis
Compliance with global 24-hour movement behaviours in 3-4 year-olds : a low-income sub-Saharan African country perspective
- Creator
- Rights statement
- Awarding institution
- University of Strathclyde
- Date of award
- 2025
- Thesis identifier
- T17445
- Person Identifier (Local)
- 202076755
- Qualification Level
- Qualification Name
- Department, School or Faculty
- Abstract
- Malawi, like other low-income sub-Saharan African (SSA) countries, is experiencing economic transition that may result in lifestyle changes, such as physical inactivity, increased sedentary behaviours, and poor nutrition. This shift may further increase the burden of movement behaviour-related non-communicable diseases (NCDs) and obesity in the country and globally. The 2019 global 24-hour movement behaviour guidelines for the under 5s were published to promote children’s healthy growth and development and to tackle NCDs and obesity globally. Despite publication over five years ago, there is limited evidence of compliance from low- and middle-income countries, particularly in SSA. Additionally, no studies have assessed feasible measurement methods for large-scale surveillance globally. Guided by the Behavioural Epidemiology Framework, this thesis provides novel evidence in the field of 24-hour movement behaviours in early childhood. Parent reports and daily step counts were validated against accelerometry for assessing total physical activity (TPA) in 3–4 year olds globally (Chapter 3). The step count threshold of 11,500 steps/day, equivalent to 180 minutes/day of TPA, provided valid measures but parent reports did not. This threshold was then used in cross-sectional studies to examine the prevalence and correlates of meeting the global guidelines (Chapters 4 and 5). Chapter 4 revealed that only 31% of 3-4 year olds from diverse backgrounds met the TPA guideline based on step counting, and compliance was influenced by sex, age, residence (urban/rural), and country income. Chapter 5, focused on Malawi, revealed relatively high prevalence (60%) of meeting all four 24-hour movement guidelines (physical activity, restrained sitting, screen time, sleep duration) among 3-4 year olds. Meeting guidelines was predominantly influenced by residential setting (23% urban versus 70% rural), suggesting that physical activity transition maybe underway particularly in urban areas. This thesis provides evidence to inform practical surveillance systems for monitoring movement behaviours among young children in resource-limited settings and can help develop tailored interventions to sustain healthy lifestyles during ongoing economic transformations, delay the physical activity transition, and reduce NCDs in Malawi and similar contexts.
- Advisor / supervisor
- Reilly, John
- Resource Type
- DOI
- Funder
- Embargo Note
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