ImportanceThe prevalence estimates of physical activity, sedentary behavior, and sleep (collectively known as movement behaviors) in 3- and 4-year-old children worldwide remains uncertain.ObjectiveTo report the proportion of 3- and 4-year-old children who met the World Health Organization guidelines for physical activity, sedentary behavior, and sleep across 33 countries.Design, Setting, and ParticipantsPooled analysis of data from 14 cross-sectional studies (July 2008 to September 2022) identified through systematic reviews and personal networks. Thirty-three countries of varying income levels across 6 geographical regions. Each study site needed to have at least 40 children aged 3.0 to 4.9 years with valid accelerometry and parent-/caregiver-reported screen time and sleep duration data. Data were analyzed from October 2022 to February 2023.ExposuresTime spent in physical activity was assessed by reanalyzing accelerometry data using a harmonized data-processing protocol. Screen time and sleep duration were proxy reported by parents or caregivers.Main Outcomes and MeasuresThe proportion of children who met the World Health Organization guidelines for physical activity (≥180 min/d of total physical activity and ≥60 min/d of moderate- to vigorous-intensity physical activity), screen time (≤1 h/d), and sleep duration (10-13 h/d) was estimated across countries and by World Bank income group and geographical region using meta-analysis.ResultsOf the 7017 children (mean [SD] age, 4.1 [0.5] years; 3585 [51.1%] boys and 3432 [48.9%] girls) in this pooled analysis, 14.3% (95% CI, 9.7-20.7) met the overall guidelines for physical activity, screen time, and sleep duration. There was no clear pattern according to income group: the proportion meeting the guidelines was 16.6% (95% CI, 10.4-25.3) in low- and lower-middle–income countries, 11.9% (95% CI, 5.9-22.5) in upper-middle–income countries, and 14.4% (95% CI, 9.6-21.1) in high-income countries. The region with the highest proportion meeting the guidelines was Africa (23.9%; 95% CI, 11.6-43.0), while the lowest proportion was in North and South America (7.7%; 95% CI, 3.6-15.8).Conclusions and RelevanceMost 3- and 4-year-old children in this pooled analysis did not meet the current World Health Organization guidelines for physical activity, sedentary behavior, and sleep. Priority must be given to understanding factors that influence these behaviors in this age group and to implementing contextually appropriate programs and policies proven to be effective in promoting healthy levels of movement behaviors.

中文翻译：

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对来自 33 个国家/地区的儿童的身体活动、久坐行为和睡眠的汇总分析


重要性全球 3 岁和 4 岁儿童的身体活动、久坐行为和睡眠（统称为运动行为）的患病率估计仍不确定。目的报告 33 个国家/地区在身体活动、久坐行为和睡眠方面符合世界卫生组织指南的 3 岁和 4 岁儿童的比例。设计、设置和参与者对通过系统评价和个人网络确定的 14 项横断面研究（2008 年 7 月至 2022 年 9 月）的数据进行汇总分析。6 个地理区域的 33 个不同收入水平的国家。每个研究地点需要至少有 40 名年龄在 3.0 至 4.9 岁之间的儿童，他们有有效的加速度计和父母/看护人报告的屏幕时间和睡眠持续时间数据。从 2022 年 10 月到 2023 年 2 月对数据进行了分析。屏幕时间和睡眠持续时间由父母或看护人代理报告。主要结局和措施符合世界卫生组织身体活动指南（≥180 分钟/天的总身体活动和 ≥60 分钟/天的中等至高强度身体活动）、屏幕时间（≤1 小时/天）和睡眠持续时间（10-13 小时/天）的儿童比例按国家和世界银行收入组和地理区域使用荟萃分析估计。结果在这项汇总分析中，7017 名儿童 （平均 [SD] 年龄，4.1 [0.5] 岁;3585 名 [51.1%] 男孩和 3432 名 [48.9%] 女孩） 中，14.3% （95% CI，9.7-20.7） 符合身体活动、屏幕时间和睡眠时间的总体指南。根据收入组别，没有明确的模式：符合指导方针的比例为 16。低收入和中低收入国家为 6%（95% CI，10.4-25.3），中高收入国家为 11.9%（95% CI，5.9-22.5），高收入国家为 14.4%（95% CI，9.6-21.1）。符合指南要求的比例最高的地区是非洲 （23.9%;95% CI，11.6-43.0），而北美和南美的比例最低 （7.7%;95% CI，3.6-15.8）。结论和相关性在这项汇总分析中，大多数 3 岁和 4 岁儿童不符合当前世界卫生组织关于身体活动、久坐行为和睡眠的指南。必须优先考虑了解影响该年龄段这些行为的因素，并实施经证明可有效促进健康运动行为水平的适当计划和政策。