Recent Trends and Disparities in 24-hour Movement Behaviors among US Youth with Mental, Behavioral and Neurodevelopmental Conditions

Background Meeting 24-hour movement behaviors (24-HMB: physical activity [PA], screen time [ST], and sleep [SL]) recommendations may be associated with positive health outcomes among youth with specific mental, behavioral, and neurodevelopmental (MBD) conditions. However, temporal trends and disparities in meeting 24-HMB guidelines in these higher-risk groups have not been investigated, hampering the development of evidence-based clinical and public health interventions. Methods Serial, cross-sectional analyses of nationally representative data (including U.S. youth aged 6–17 years with MBD conditions) were conducted. The time-trends survey data was conducted between 2016 and 2021. Meeting single-behavior and integrated 24-HMB guidelines were operationalized as follows: PA ≥ 60 min/d moderate-to-vigorous-intensity PA, no more than 2 h/d of ST, and a sleep duration of 9 to 11 h/d for those aged 6 to 13 years (children) and 8 to 10 h/d for those aged 14 to 17 years (adolescents). Results Data on 52,634 individuals (mean age, 12.0 years [SD,3.5]; 28,829 [58.0%] boys) were analyzed. From 2016 to 2021, the estimated trend of meeting SL guideline alone increased (3.7% [95%CI,3.2–4.9%], P for trend < 0.001), whereas meeting ST guideline alone decreased (-2.0% [-2.4% to -1.5%], P for trend < 0.001). The estimated trend in meeting integrated (PA + ST + SL) guidelines declined (-0.8% [95%CI, -1.0% to -0.5%], P for trend < 0.001), whereas meeting none of 24-HMB guidelines increased (2.2% [1.8–2.6%], P for trend < 0.001). White participants, children, and boys reported higher estimated prevalence of meeting full integrated (PA + ST + SL) guidelines. Discussion The temporal trends observed in this study highlight the importance of consistently monitoring physical behavior among MBD youth and identifying variations by sociodemographic groups in meeting 24-HMB guidelines for health promotion within these vulnerable groups.