When gender matters: How parents help their children meet the 24-hour movement behavior guidelines

When gender matters: How parents help their children meet the 24-hour movement behavior guidelines | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article When gender matters: How parents help their children meet the 24-hour movement behavior guidelines Dagmar Sigmundová, Jaroslava Voráčová, Jan Dygrýn, Michal Vorlíček, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6900057/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 27 Nov, 2025 Read the published version in BMC Public Health → Version 1 posted 10 You are reading this latest preprint version Abstract Background Family is important for the support and promotion of healthy movement behaviors of children. Therefore, the aim of this study was to identify the roles of mothers and fathers in supporting their young children to meet the World Health Organization (WHO) guidelines on 24-hour movement behavior (24hMB), based on accelerometer data from the daily lives of both parents and their families. Methods The 24-hour movement behavior (24hMB) of 217 family triads was continuously monitored over a 7-day period using ActiGraph accelerometers placed on the non-dominant wrist of each participant. Children's compliance with the WHO 24hMB guidelines (sleep, sedentary behavior, physical activity) was analyzed using backward logistic regression analysis separately for the daughter-mother-father and son-mother-father models. Results Without significant gender differences, 25.2% DAUGHTERS and 26.7% SONS (or 71.7% DAUGHTERS and 78.1% SONS ) met all 3 (or a combination of ≥ 2) 24hMB guidelines, although the contributions of mothers and fathers differed. For daughters only, fathers' overweight/obesity significantly reduced the chances of achieving the recommended amount of sedentary behavior/a combination of ≥ 2 24hMB guidelines (p = 0.03/0.003). Mother's overweight/obesity significantly reduced the odds ratio of meeting the recommended amount of sedentary behavior for both daughters/sons (p = 0.04/0.002), achieving the recommended amount of moderate-to-vigorous physical activity in daughters (p = 0.03), and meeting a combination of ≥ 2 24hMB guidelines in sons (p = 0.03). Maternal university education significantly contributed to achieving the recommended sedentary behavior in both daughters/sons (p = 0.03/0.02) and to fulfilling a combination of ≥ 2 24hMB guidelines in daughters (p = 0.04). Conclusions Mothers are more proactive than fathers in helping both daughters and sons achieve each of the WHO 24hMB guidelines. The role of mothers is indispensable in shaping their offspring's daily health-promoting 24hMB. sedentary behavior physical activity sleep daughter son mother father BACKGROUND Sleep, sedentary behavior (SB) and physical activity (PA) together shape our 24-hour movement behavior (24hMB), and maintaining an appropriate balance of these components contributes to overall health [ 1 , 2 ]. Particularly for children, the family is a key source of influence that can affect their 24hMB [ 3 ]. The family can support children and adolescents in achieving healthy PA, SB and sleep behaviors by encouraging, facilitating, modeling, setting expectations and actively engaging in these behaviors with them [ 3 ]. Parents also serve as gatekeepers in deciding which activities children will engage in and what resources and access, they have available [ 4 ]. Nowadays, however, there are many types of families and caregiving arrangements, which can be generally categorized into single-parent households (single parenting) and two-parent households (couple parenting). Based on this classification, it was found that 5–11-year-old children from couple-parent families engaged in less SB than children from single-parent families [ 3 ]. Additionally, boys from couple-parent households had more sleep compared to boys from single-parent households, and girls from couple-parent households participated in more organized PA (OPA) than girls from single-parent households [ 3 ]. Although it has been shown previously that children benefit emotionally and socially when fathers are involved in couple parenting [ 5 – 7 ], later and even current studies do not distinguish parental gender in analyses of the relationship between parents and 24hMB in children [ 8 – 10 ], or they select only mothers as representatives of school-age children in families [ 11 – 14 ]. Studies that differentiated parental gender when examining associations between parents' behavior and their children revealed that parents seemed to play a stronger role in supporting 8-9-year-old sons than daughters [ 15 ]. Also, stronger associations were observed in families where both parents shared an equal role in supporting their child [ 15 ]. Fathers' moderate to vigorous PA (MVPA) tended to have stronger correlations with children's MVPA compared with mothers', as did the association of SB between parents and sons [ 16 ]. In analyses of the parent-child associations in 'screen time' (ST), SB, MVPA, and light PA on weekdays and weekends, correlations appeared to be stronger in most cases for same-sex parent-child pairs compared with opposite-sex parent-child pairs [ 16 ]. However, deeper linear regression analyses did not reveal parent gender as a significant factor in these relationships [ 16 ]. Thus, there is still a lack of valid information on the role of both parents in relation to their children's 24hMB, and in particular, on whether they help their children meet the 24hMB guidelines [ 1 , 17 , 18 ]. The FAMIly Physical Activity, Sedentary behaviour and Sleep study (FAMIPASS) [ 19 ] is a scientific research response to the calls of the Czech national health and well-being related strategies "Health 2020" and "Concept of Sport Promotion 2016–2025" to add relevant information on 24hMB of preschool and school-age children. The absence of a national system to monitor PA, SB or sleep in children and adolescents has so far led to conflicting results on exercise behavior and its correlates [ 20 ]. Previous FAMIPASS studies have indicated the important role of maternal PA and sleep behaviors in helping 3-10-year-old children meet recommended PA and sleep guidelines [ 21 , 22 ], including the absence of ST devices in the bedroom and a reduction in SB to achieve healthy sleep durations [ 22 ]. In addition, significant associations were found between MVPA and total PA in parent-child dyads across all gender combinations [ 21 ]. Significantly higher odds of children meeting at least two or all three of the 24hMB guidelines [ 1 , 17 , 18 ] were associated with mothers having a normal body weight, adherence to at least two 24hMB guidelines, and completion of more than primary education, as well as with fathers having higher levels of education and being younger in age [ 23 ]. However, all previous FAMIPASS studies [ 21 – 23 ] have only analyzed family relationships separately as family dyads (i.e., mother-child or father-child), rather than examining couple parenting dynamics involving the mother, father, and child simultaneously. Therefore, the present study fills the research gap in distinguishing the role of mothers and fathers in promoting compliance with the 24hMB guidelines and bridges the missing correlates of 24hMB in 3–10-year-old offspring in couple parenting families. METHODS Study design and inclusion criteria The FAMIPASS study is a nationally representative longitudinal study aimed at analyzing 24hMB of families with children aged 3–10 years in the context of the preschool/elementary school and family environment [ 23 ]. Participating families were selected by stratified sampling of preschools and elementary schools from rural and urban areas of Bohemia, Moravia and Silesia to cover all permanently inhabited districts of Czechia. The first wave of data collection ran from March 21, 2022 to May 20, 2023 during the regular school week of preschools/elementary schools excluding multi-day and public holidays. Inclusion criteria for families in the study were: a) having at least one child of their own aged 3–10 years, b) absence of illness/limitations preventing active daily participation at the preschool/elementary school, c) willingness to participate in the study voluntarily and free of charge, and d) providing written informed consent from parents/guardians [ 23 ]. Participants and Dataset Of the 860 (100%) families recruited and contacted, 552 (64.2%) provided written informed consent to participate in the study and 502 (58.4%) families initiated weekly continuous 24hMB monitoring. A total of 472 (54.9%) families completed the full weekly monitoring and 217 (25.2%) family triads (mother and father with at least one child) provided valid 24hMB accelerometer data, anthropometric characteristics and questionnaire data to determine the families’ socioeconomic status (SES) and participants’ ST. Reasons for excluding 124 families from the final data set were as follows: insufficient minimum number of days of accelerometer wear, defined as at least 3 school days and 1 weekend day (n = 65), missing anthropometric data or data to determine families' SES (n = 26), and missing data to capture children's participation in organized forms of PA (n = 33). Weekly 24-hour monitoring with complete and valid 24hMB (resp. anthropometric and SES-related) data were completed by 255 (29.7%) families with at least one child aged 3–10 years. Of the 255 families, 38 were single-parent families or families with valid dyad-only data (that is, one parent-child), while 217 were couple-parent families whose anthropometric data are shown in Table 1 . Participating children and their parents were predominantly white Caucasian (> 92%), which is representative of the ethnic demographics of Czechia [ 24 ]. Table 1 Basic characteristics of families - couple parenting (mother-father-child simultaneously) Family members Number of participants Calendar age M/SD Height (cm) M/SD Weight (kg) M/SD BMI (kg/m 2 ) M/SD Daughters N = 104 75.17*/20.64 119.46/12.20 22.35/6.11 15.42/2.15 Sons N = 113 77.76*/19.48 120.58/11.60 22.59/5.11 15.39/1.63 Mothers N = 217 36.99 # /3.97 167.51/6.18 65.88/11.32 23.47/3.84 Fathers N = 217 39.94 # /5.22 181.10/6.99 85.23/12.82 26.00/3.59 Note: N – number, M – mean, SD – standard deviation, */ # – indicates calendar months/years, cm – centimeters, kg – kilograms, BMI – Body Mass Index (kg/m 2 ) Anthropometric characteristics, socioeconomic status and 'screen' time of participants During a joint meeting involving researchers, parents and preschool/elementary school administrators and teachers, the researchers presented the study design and detailed procedures. These included instructions for measuring body weight and height at home using graphic instructions, the method of attaching and wearing the accelerometer on the non-dominant wrist, and recording time data in the family diary [ 19 , 21 , 22 ]. The researchers also explained how to record ST and SES data to the family diary [ 19 , 21 , 22 ], as well as the process for delivering individual feedback using graphic sheets for each participant. Parents were instructed to measure their own and their children's body weight and height in the morning before breakfast, while wearing underwear. Parents recorded body weight/height to the nearest 0.1 kg/0.5 cm [ 25 ]. Parents' measurement of their children's body weight and height in the home environment has been confirmed to be sufficiently valid for calculating body mass index (BMI) and subsequent detection of excess body weight in 4-10-year-old children [ 26 , 27 ]. Family SES was measured by the summary scores of responses to six questions about the family's material background that were part of the family diary [ 19 , 21 , 22 ]. The content of each question (with categorized response options) was as follows: having one’s own bedroom for each child in the family (0/1); number of bathrooms in the household (0/1/2/≥3); number of computers in the household (0/1/2/≥3); number of cars owned for family use (0/1/≥2); number of foreign vacations taken in the past year (0/1/2/≥3); ownership of a dishwasher in the household (0/1) [ 28 ]. According to the summary scores of the responses to the above questions, three categories of families regarding SES (low, medium, high) were identified as follows: the lowest/highest 20% of the summary scores characterized families with low/high SES, while the range of 21–79% characterized families with medium SES [ 23 , 28 ]. The summary score was positively correlated with reported parental income with an Eta-squared close to 0.30. The summary test-retest reliability correlation was r = 0.90 (28). In the socioeconomic conditions of Czechia, the summary score was validated in relation to disposable household income (Pearson correlation r = 0.77, p < 0.001) [ 29 ]. Children's daily ST was calculated from parents' responses to questions about the use of screen-based devices, originally adapted from the "Health Behaviour in School-aged Children" study. Specifically, parents were asked: 'How many hours a day do you usually spend in your leisure time on weekdays/weekends watching TV, DVDs, videos (including YouTube or similar online services)?' and 'How many hours a day do you usually spend in your leisure time on weekdays/weekends playing games on a computer, games console (PlayStation, Xbox etc.), smartphone, tablet or similar electronic device?' [ 19 , 23 ]. The questions were categorized based on weekdays and weekends. For each question, there were nine different response options (none/half an hour/1/2/3/4/5/6/ and 7 or more hours per day). Validity and reliability of the 7-day recall questions have been verified in comparison with the 7-day 24-hour diaries for both weekdays and weekends [ 30 ]. Total ST was calculated as the sum of the weighted arithmetic means of weekday and weekend ST {weighted mean=[(average weekday×5)+(average weekend×2)]/7}. Accelerometer-based monitoring of 24hMB The 24hMB was monitored using accelerometers (wGT3X-BT in children and GT9X Link in parents; ActiGraph LLC, Pensacola, FL, USA) placed on the wrist of the non-dominant hand in both parents and their offspring. To anchor the 24-hour accelerometer recording, parents recorded daily time data in a family diary, including morning wake-up, arrival at and departure from preschool/school, start and end of OPA (such as practices and coach/leader-led lessons), and bedtime. The 24-hour monitoring started at midnight on the day of the joint meeting between parents and researchers. All accelerometers were individually initialized via ActiLife software version 6.13.4 (ActiGraph LLC, Pensacola, FL, USA) for each family member separately based on the information provided in the written informed consent. Accelerometers recorded triaxial acceleration data at a sampling rate of 100 Hz. All accelerometer data sets were analyzed using the R GGIR version 2.7-1 package, applying previously established cut-off values for participants' 24hMB intensity. Specifically, SB was defined as acceleration values of less than 36 milligrams (m g ); light PA as 36–200 m g ; MVPA as 201–706 m g ; and intense PA as values equal to or greater than 707 m g [ 31 , 32 ]. The default setting for wear-free time detection in part 1 of the GGIR package in R was used. Specifically, the algorithm required that the standard deviation of the sliding window signal be close to the sensor’s noise level. If this condition was met, GGIR classified the middle 15 minutes of this 60-minute window as non-wear time [ 31 ]. The sleep time, i.e., the time from lying down to waking up, was determined using the default setting of a heuristic algorithm analyzing the distribution of angular changes [ 32 ]. To be included in the final data set, accelerometer data had to be observed on at least three preschool/school days and one weekend day for at least 16 h per day, and accelerometer data had to be available for each 15-min interval of the 24-h cycle [ 32 ]. Average daily sleep time, SB, light PA, MVPA, vigorous PA, and total PA were calculated as the weighted arithmetic mean of these activities performed during preschool/school and weekend days {weighted mean=[(average weekday×5)+(average weekend×2)]/7}. Classification of participants according to 24hMB guidelines Family offspring aged 3–4 years with a cumulative PA of at least 180 minutes per day, including MVPA of at least 60 minutes per day, ST limited to a maximum of 1 hour per day, and an average sleep duration of 10–13 hours per day were classified as meeting the 24hMB guidelines for preschool children [ 33 ]. Family offspring aged 5 years and older who cumulatively performed 60 minutes of MVPA while having a maximum of 2 hours of ST per day and sleeping 9–11 hours per day met the 24hMB guidelines [ 1 , 34 ]. Adult parents aged 18 years and older were classified as meeting 24hMB guidelines if their SB did not exceed 8 hours per day while also realizing at least 150 minutes of MVPA per week and sleeping 7–9 hours per day [ 2 ]. Data processing and statistical analysis The 24hMB data along with anthropometric and sociodemographic data of the participants were analyzed using Statistical Package for the Social Sciences (SPSS) for Windows, version 26 (IBM Corp, Armonk, NY, USA). After applying the inclusion criteria, all data were checked for outliers and obvious errors and any affected cases were discarded. Calendar age was calculated as the difference between the study start date and date of birth. Participants' BMI was calculated as the ratio of reported body weight (kg) to the square of body height (m 2 ). Children with BMI z-scores > 1 standard deviation (SD) and 2 SD were classified as obese according to the WHO reference data for that sex and age [ 35 – 37 ]. A BMI range of 25-29.9 kg/m 2 (or ≥ 30 kg/m 2 ) represented overweight (or obese) in parents [ 38 ]. Basic descriptive characteristics of individual family members are presented as arithmetic means and SDs separately for daughters, sons, mothers and fathers (Table 1 ). Kolmogorov-Smirnov test confirmed a normal distribution for the variables: time spent in PA, SB and sleep. The daily duration (or representation) of each component of PA, SB and sleep during 24hMB monitoring for each family member is shown as arithmetic means (or %) (Fig. 1 ). Adherence to the 24hMB guidelines is presented as a percentage, separately for each family member (Fig. 2 ). The Pearson chi-square test (χ 2 ) was used to test for differences in adherence to the 24hMB guidelines (separately for all three guidelines, any combination of any two guidelines, only one guideline, and none) between daughters and sons (or mothers and fathers). Associations between child and parent characteristics and children's adherence to the 24hMB guidelines were revealed by multiple logistic regression analysis in the daughter-mother-father and son-mother-father models (Table 2 ). The results of the logistic regression analyses were expressed using odds ratios (ORs) and 95% confidence intervals (95% CIs). The alpha significance level was set at a minimum of 0.05. RESULTS Sleep accounted for the longest part of the day for 3–10-year-olds living in couple families, followed by SB and PA, with no statistically significant differences between daughters and sons (Fig. 1 ). Excluding a few minutes, daughters and sons spent almost 7 hours per day in PA, with sons and daughters averaging 86.4 and 73.2 minutes per day, respectively, in MVPA. Even the approximately 13-minute difference in daily MVPA between daughters and sons was not statistically significant. Consistent with the results for children, we found no statistically significant differences between mothers and fathers in average daily sleep duration, SB, or PA. However, in contrast to children, SB represented the longest component of 24hMB for parents, averaging more than 10 hours for mothers and more than 11 hours per day for fathers (Fig. 1 ). On average, over a quarter of the 3–10-year-old offspring (25.2% of daughters and 26.7% of sons) met all 3 of the 24hMB guidelines, and even more than two-thirds of the children (71.7% of daughters and 78.1% of sons) achieved any combination of at least 2 of the 3 24hMB guidelines with no statistically significant differences between genders (Fig. 2 ). Obrázek 2 For parents, daily high rates of SB resulted in very low proportions of mothers (2.5%) and fathers (1.5%) meeting all 3 24hMB guidelines. The 8.8% difference between mothers and fathers who achieved any combination of 2 of the 3 24hMB guidelines (69.1% vs. 60.3%) was marginally significant (p = 0.0551) according to the χ 2 test (Fig. 2 ). A negligible percentage of children and no parents met none of the 24hMB guideline, mainly due to MVPA levels, which averaged 133.2 minutes per day for mothers and 131.4 minutes for fathers. With no significant differences between genders, 25.2% of daughters and 26.7% of sons (or 71.7% of daughters and 78.1% of sons) met all 3 (or a combination of ≥ 2) 24hMB guidelines, but with different contributions from mothers and fathers (Table 2 ). In daughters only, the prevalence of excess body weight in fathers significantly reduced the odds ratio of achieving the recommended SB/a combination of ≥ 2 24hMB guidelines (p = 0.03/0.003). Maternal excess body weight significantly reduced the odds ratio of fulfilling the recommended amount of ST in daughters (p = 0.04) and sons (p = 0.002), and furthermore, significantly lowered the odds of achieving the recommended amount of MVPA in daughters (p = 0.03) and a combination of ≥ 2 WHO 24hMB guidelines in sons (p = 0.03). In addition, university maternal education significantly contributed to compliance with the recommended amount of ST in both daughters (p = 0.03) and sons (p = 0.02) and to achieving a combination of ≥ 2 24hMB guidelines in daughters (p = 0.04). Mothers’ adherence to a combination of ≥ 2 24hMB guidelines significantly increased the odds of their daughters meeting the same combination of the 24hMB guidelines (p = 0.006). Active participation in OPA during leisure time was the only offspring-related variable that significantly helped children achieve the MVPA guideline, daughters met any combination of at least 2 of the 3 WHO 24hMB guidelines, and sons met the ST-related guideline (Table 2 ). 51.5% of sons and 43.0% of daughters from couple parenting families actively engaged in OPA in their leisure time. Table 2 Odds ratio of children achieving the 24hMBGs - binary logistic regression Backward method (A - MVPA guideline, B - ST guideline, C - any combination of at least 2 or more guidelines) WHO’s 24hMB guidelines Model: family triads Variable/ref. OR (p) 95% CI A – guidelines for daily MVPA (moderate to vigorous physical activity) Daughter parents (Step 6) overweight + obesity mother /NO 0.348 (0.031) 0.133–0.910 child's participation in OPA/NO 2.555 (0.044) 1.024–6.377 university education father /NO 0.521 (0.150) 0.214–1.266 Son - parents (Step 6) socioeconomic status of families/LOW 2.710 (0.026) 1.124–6.534 child's participation in OPA/NO 2.858 (0.033) 1.090–7.492 university education mother /NO 0.401 (0.086) 0.142–1.136 B – guidelines on time spent sitting in front of a screen/display device per day Daughter parents (Step 6) overweight + obesity father /NO 0.222 (0.003) 0.082–0.602 university education mother /NO 2.784 (0.032) 1.090–7.112 overweight + obesity mother /NO 0.326 (0.041) 0.111–0.958 socioeconomic status of families/LOW 1.530 (0.308) 0.676–3.464 Son parents (Step 7) overweight + obesity mother /NO 0.171 (0.002) 0.055–0.535 university education mother /NO 3.173 (0.017) 1.232–8.173 child's participation in OPA/NO 2.826 (0.037) 1.063–7.513 age category of child/LOW 0.439 (0.106) 0.162–1.191 C – meeting any combination of at least 2 or more 24hMB guidelines (sleep, MVPA, ST) Daughter parents (Step 6) child's participation in OPA/NO 5.409 (0.013) 1.427–20.51 overweight + obesity child/NO 5.525 (0.077) 0.829–36.83 Meeting ≥ 2 WHO guidelines mother /NO 6.258 (0.006) 1.686–23.22 university education mother /NO 3.352 (0.036) 1.081–10.39 overweight + obesity father /NO 0.237 (0.027) 0.066–0.849 Son parents (Step 7) socioeconomic status of families/LOW 1.217 (0.693) 0.458–3.239 child's participation in OPA/NO 2.266 (0.134) 0.778–6.604 overweight + obesity mother /NO 0.284 (0.031) 0.090–0.892 Meeting ≥ 2 WHO guidelines father /NO 1.387 (0.570) 0.448–4.294 Note: 24hMB – 24hour movement behavior; WHO – World Health Organization; Binary logistic regression models included independent variables for children: age category (3-5.9/6–10 years), overweight + obesity (no/yes), child's participation in OPA (no/yes), socioeconomic status (low-high) and for parents (mothers and fathers separately): university education (no/yes), overweight + obesity (no/yes), achieving the WHO’s guidelines for 24-hour movement behavior ( A for MVPA (no/yes), B for 'screen time' (no/yes), C ≥ 2 (no/yes); PA – physical activity; OPA – leisure organized PA; MVPA – moderate to vigorous physical activity; ST – 'screen time'; OR – odds ratio (logistic regression method Backward); % – percentage; CI – confidence interval; p – level of significance; Results statistically significant at the p level less than 0.05 are shown in bold. Step - using the backward method, models with variables that did not have a statistically insignificant constant in the last step were selected. DISCUSSION A key finding of the study was that, on average, ¼ of children aged 3–10 years (25.2% of daughters and 26.7% of sons), or nearly ¾ of offspring (71.7% of daughters and 78.1% of sons) met either all 3 WHO 24hMB guidelines or at least a combination of any 2. There were no significant differences by gender or age of the children, but notable differences were observed in the contributions of mothers and fathers in couple-parented families. Not only was there no apparent gender preference in offspring’s compliance with the 24hMB guidelines linked to mothers, as was observed with fathers, but mothers' anthropo-social and behavioral characteristics were more frequently and significantly associated with the likelihood of offspring achieving the 24hMB guidelines than those of fathers. Greater assistance from mothers in meeting the 24hMB guidelines is consistent with findings that mothers tend to structure, lead, teach, and engage in empathic conversations, whereas fathers are more inclined to engage in physical play, adopt a peer-like role, follow the child’s lead, and offer challenges [ 39 ]. While parents have been shown to play a greater role in helping daughters than sons adhere to the 24hMB guidelines, this contrasts with findings from a study (15) of 8-9-year-old English children, in which parents were more likely to encourage sons to be more physically active than daughters. Overall, mothers had a greater tendency than fathers to encourage their children to be physically active during the week [ 15 ]. However, children were most physically active when both parents shared a supportive role [ 15 ]. In our study, it is very likely that a common or complementary role of fathers and mothers in promoting the 24hMB guidelines compliance in their offspring can be found through their offspring's participation in OPA. Regular active participation in OPA during leisure time significantly helped daughters and sons meet the recommended levels of MVPA. It also supported sons in meeting the recommended ST guidelines, and daughters in achieving any combination of at least 2 or more components of the 24hMB guidelines, regardless of their age or body weight. In line with a Danish prospective study [ 40 ], regular active participation in OPA has been shown to contribute to higher overall levels of MVPA and to meeting the daily recommendation of at least 60 min of MVPA in both girls and boys [ 40 ]. In addition, participation in OPA during leisure time positively supports meeting additional components of the 24hMB guidelines, thus helping to "harmonize" the movement behaviors of young children. This finding is consistent with a previous study related to the FAMIPASS project, which confirmed a significantly higher likelihood of 3-10-year-old children from family days (mother-child or father-child) achieving a combination of at least 2 of 3 24hMB guidelines when participating in OPA during leisure time, compared with non-participants in OPA [ 41 ]. Because this study analyzed families with young children, it is likely that in many cases parents accompanied their children to and from OPA in their free time. However, it was not possible to determine from family diary entries which parent primarily provided logistical support to their children. Nevertheless, given that the research included family triads whose members fully completed the seven-day monitoring, we hypothesize that both parents may have had a more equal role in providing logistical support to their children in OPA. This study of families with couple parenting provides a ‘springboard’ for examining parental support for the 24hMB guidelines in single-parent and socially disadvantaged families, to determine whether children from these families lag behind those from couple-parent families in meeting the 24hMB guidelines. In follow-up research, the 24hMB patterns of parents and children in single-parent families will be examined, especially since 20,800 married couples, representing 40% of all married couples, divorced in Czechia in 2024. Divorces were most common after 4 to 7 years of marriage and 58% of divorced couples had a minor child in common. This means that a total of 19,300 minor children were affected by divorce [ 42 ]. Strengths and limitations of the study The strength of the study is the detailed assessment of the main movement components within the 24-hour cycle through continuous instrumental monitoring that captures the typical school/work routines of all family members. The study’s strength also includes the effort to represent families from all socioeconomic backgrounds in urban and rural areas of Bohemia, Moravia and Silesia. An additional strength of this study is the fact that 90% of the final sample of families agreed to participate in the follow-up monitoring of 24hMB during 2025–2026. A notable limitation of the study is its reliance on participants’ interest, willingness, and unpaid voluntary participation in the research. It can reasonably be assumed that participation in the research was confirmed by those with intrinsic motivation and interest, who may have been more prone to healthy behaviors than those without interest in participating in the research. However, in terms of the prevalence of overweight/obesity as calculated by BMI, the sample of parents we analyzed did not differ from the average values of the adult population in this age group [ 43 ]. Another limitation is the lack of identification of the reasons for incomplete families (i.e., widowhood, divorce, or religious beliefs) due to concerns that collecting this sensitive information might reduce the number of families willing to participate in the study. The cross-sectional research design does not, of course, allow us to formulate the observed relationships causally, but with the support of theoretical foundations [ 3 – 5 ] we interpret the relationships in the parent-child direction, not the other way around. CONCLUSIONS 25.2% of daughters and 26.7% of sons, and almost 75% the offspring (71.7% of daughters and 78.1% of sons) met all 3 of the WHO 24hMB guidelines for sleep, PA and SB, or at least a combination of any 2 of the 3 guidelines, with no significant differences between gender or age, but with very different contributions from mothers and fathers from couple-parenting families. Mothers were more proactive than fathers in helping both daughters and sons achieve each of the WHO 24hMB guidelines. A mother's normal body weight and university education significantly increased the odds of children reaching the WHO 24hMB guidelines. The role of mothers is indispensable in shaping their offspring's daily health-promoting 24hMB. Fathers were directly involved to a lesser extent than mothers in supporting their offspring to meet the 24hMB guidelines. Their supportive role was likely hidden in the logistical responsibilities associated with their children's OPA. Regular active participation in OPA significantly assisted both daughters and sons in meeting the recommended MVPA; it also supported sons in meeting the recommended ST and daughters in achieving any combination of at least 2 or more 24hMB guidelines, regardless of children's age or body weight level. A possible indicator of a healthy lifestyle in families with young children seems to be non-excessive parental body weight (especially in mothers), which helps children to meet the 24hMB guidelines (especially in reducing excessive daily ST). Abbreviations BMI, Body Mass Index; cm, centimeter; CI, Confidence interval; FAMIPASS, Family physical activity, Sedentary behaviour and Sleep Study; m, meter; M, mean; MVPA, Moderate-to-vigorous physical activity; N, number; OPA, Organized physical activity; OR, Odds ratio; p, level of significance; PA, Physical activity; r, Pearson correlation; Ref., Reference group; SB, Sedentary behavior; SES, Socioeconomic status; SD, Standard deviation; ST, Screen time; WHO, World Health Organization; 24hMB, 24-hour movement behavior; χ 2 , Pearson Chi-square test; %, percentages Declarations Ethics approval and consent to participate The present study is part of a longitudinal research whose methodological protocol for the initial and subsequent waves of data collection was approved by the institutional ethics committee for research at the Faculty of Physical Culture of Palacký University in Olomouc (initial wave: protocol code 25/2024 on 28 February 2021 and subsequent wave: protocol code 102/2023 in November 2023). The ethics committee's approval of the research protocol included assurances of anonymity, the format of informed written consent, and rules for data security and storage. The accelerometers used were disinfected and sealed in an anonymous envelope with a family code before each start of the 7-day 24hMB monitoring, along with the family diary. Participation in the study was voluntary and free of charge. No participant was penalized in any way for premature termination of 24hMB monitoring, damage or loss of the accelerometer, or failure to return the family diary. Each participating family received their own individualized feedback on the 24hMB results of all their members in the form of printed graphic sheets with accompanying explanatory commentary. Schools received a letter of thanks and a certificate acknowledging their participation in the FAMIPASS study. Consent for publication Not applicable. Availability of data and materials The datasets analyzed during the current study are not publicly available because this study is part of a longitudinal research project. The baseline phase data are subject to privacy and ethical restriction as participants in this study have signed consent forms stipulating that individual data will not be made publicity available until five years after the completion of the follow-up phase. Aggregated data can be provided by the corresponding author of the study based on a professional scientific query with a clear objective and focus for which the data are queried (10.5281/zenodo.15674732). Competing Interests The authors declare no conflict of interest. Funders have no role in data collection, analysis and interpretation of results, and publication. The authors have no relevant financial interests to disclose. Funding This work was supported by the project of the Czech Science Foundation titled “A longitudinal study of 24-hour changes in movement behavior of families with young school-age children” (No: 25-18101S) and „Research of Excellence on Digital Technologies and Wellbeing CZ.02.01.01/00/22_008/0004583“, which is co-financed by the European Union. Authors' Contributions ES and DS conceptualized and designed the study, drafted the original manuscript and coordinated the writing of the manuscript with JV, JD and MV. DS, JD and MV validated the research protocol and conducted data collection. DS and ES performed statistical analysis of the data and interpreted the results. All authors critically read the original manuscript, commented on all parts of the manuscript, and approved the final version of the manuscript. Acknowledgments We would like to thank all the children and parents who participated in our research and especially the families with preschoolers. Special thanks go to all the teachers and school/kindergarten management members who helped facilitate the research. References Tremblay MS, Carson V, Chaput JP, Gorber SC, Dinh T, Duggan M, et al. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. Appl Physiol Nutr Metab. 2016;41(6 Suppl 3):S311–27. Ross R, Chaput JP, Giangregorio LM, Janssen I, Saunders TJ, Kho M, et al. Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab. 2020;45(10 Suppl 2):S57–102. Rhodes RE, Guerrero MD, Vanderloo LM, Barbeau K, Birken CS, Chaput JP, et al. Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth. Int J Behav Nutr Phys Act. 2020;17(74). https://doi.org/10.1186/s12966-020-00973-0 . Welk GJ, Wood K, Morss G. Parental Influences on Physical Activity in Children: An Exploration of Potential Mechanism. Ped Exerc Sci. 2003;15(1):19–33. Frosch CA, Schoppe-Sullivan SJ, O'Banion DD. Parenting and Child Development: A Relational Health Perspective. Am J Lifestyle Med. 2019;15(1):45–59. Sarkadi A, Kristiansson R, Oberklaid F, Bremberg S. Fathers' involvement and children's developmental outcomes: a systematic review of longitudinal studies. Acta Paediatr. 2008;97:153–8. Amato PR, Gilbreth JG. Nonresident fathers and children's well-being: A meta-analysis. J Marriage Family. 1999;61(3):557–73. Howard M, Akhund SA. Parents’ knowledge, perceptions and support around appropriate physical activity, screen time and sleep time levels for children. ICEP. 2024;18(2). https://doi.org/10.1186/s40723-024-00129-8 . Leung YW, Lin SH, Wanyi LJ, Capio CM. The relationship of parents’ attributes and practices with the promotion of recommended movement behaviours in young children during school suspensions. Early Child Dev Care. 2024;194(15–16):1526–39. Rhodes RE, Stearns J, Berry T, Faulkner G, Latimer-Cheung AE, O'Reilly N, et al. Predicting parental support and parental perceptions of child and youth movement behaviors. Psychol Sport Exerc. 2019;41:80–90. Rachmawati P, Krisnana I, Pradanie R, Qur’aniati N, Arief YS, Biru MMDT, et al. Parental support and influencing factors for school-age children's healthy movement behavior: a cross-sectional study. Jurnal Ners. 2024;19(4):500–8. Tooth LR, Mielke GI, Moss KM. Adherence to 24-h movement behaviour guidelines in families with multiple children. Child Care Health Dev. 2024;50:e13213. https://doi.org/10.1111/cch.13213 . Rhodes RE, Berry T, Craig CL, Faulkner G, Latimer-Cheung A, Spence JC, et al. Understanding parental support of child physical activity behavior. Am J Health Behav. 2013;37(4):469–77. Doepke M, Zilibotti F. The role of parenting in child development. Oxfor Open Econ. 2024;3:i741–48. Moore-Solomon E, Toumpakari Z, Sebire SJ, Thompson JL, Lawlor DA, Jago R. Roles of mothers and fathers in supporting child physical activity: a cross-sectional mixed-methods study. BMJ Open. 2018;8:e019732. Carson V, Langlois K, Colley R. Associations between parent and child sedentary behaviour and physical activity in early childhood. Health Rep. 2020;31(2):3–10. WHO. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva: World Health Organization. 2019. [cited 2025 June 6]. Available from: https://www.who.int/publications/i/item/9789241550536 WHO. WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization. 2020. [cited 2025 June 6]. Available from: https://www.who.int/publications/i/item/9789240015128 Sigmundová D, Dygrýn J, Vorlíček M, Banátová K, Voráčová J, Sigmund E. FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study: protocol for a cross-sectional study. BMJ Open. 2023;13(8):e073244. Gába A, Baďura P, Dygrýn J, Hamřík Z, Kudláček M, Rubín L et al. Národní zpráva o pohybové aktivitě českých dětí a mládeže 2022 [National Report on Physical Activity of Czech Children and Youth 2022]. Olomouc: Univerzita Palackého; 2022. Czech [cited 2025 June 6]. Available from: https://doi.org/10.5507/ftk.22.24461069 Sigmundová D, Voráčová J, Dygrýn J, Vorlíček M, Sigmund E. Parent-Child Associations in Accelerometer-Measured Physical Activity and Sedentary Behaviour: The FAMIPASS Study. Child (Basel). 2024;11(6):710. Voráčová J, Sigmund E, Vorlíček M, Dygrýn J, Sigmundová D. Accelerometer-measured sleep behaviour and parent-child sleep guideline adherence and sleep quality in Czech families with children aged 3–8 years: the FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study. J Sleep Res. 2024;33(6):e14242. Sigmundová D, Vorlíček M, Voráčová J, Dygrýn J, Sigmund E. Parental impact on adherence of young children to 24-h movement behaviour guidelines: the Czech FAMIly Physical Activity, Sedentary behaviour and Sleep study. Eur J Public Health. 2025;35(2):295–301. Vachuška J, Kurkin R. The First Results for the Population Characteristics of the 2021 Census in Czechia. Demografie. 2022;64(4):335–52. Zborilova V, Pridalova M, Sigmundova D, Kaplanova T. The validity of parental-reported body height and weight: a comparison with objective measurements of 7-8-year-old Czech children. Anthrop Rev. 2018;81(3):278–88. Chai LK, Collins CE, May C, Holder C, Burrows TL. Accuracy of Parent-Reported Child Height and Weight and Calculated Body Mass Index Compared with Objectively Measured Anthropometrics: Secondary Analysis of a Randomized Controlled Trial. J Med Internet Res. 2019;21(9):e12532. Chan NPT, Choi KC, Nelson EAS, Sung RYT, Chan JCN, Kong APS. Self-reported body weight and height: an assessment tool for identifying children with overweight/obesity status and cardiometabolic risk factors clustering. Matern Child Health J. 2013;17(2):282–91. Torsheim T, Cavallo F, Levin KA, Schnohr C, Mazur J, Niclasen B, et al. Psychometric Validation of the Revised Family Affluence Scale: a Latent Variable Approach. Child Indic Res. 2016;9:771–84. Hobza V, Hamrik Z, Bucksch J, De Clerq B. The family affluence scale as an indicator for socioeconomic status: validation on regional income differences in the Czech Republic. Int J Environ Res Public Health. 2017;14(12):E1540. Schmitz KH, Harnack L, Fulton JE, Jacobs DR, Gao S, Lytle LA, et al. Reliability and validity of a brief questionnaire to assess television viewing and computer use by middle school children. J Sch Health. 2009;74(9):370–77. Migueles JH, Rowlands AV, Huber F, Sabia S, van Hees VT. GGIR: A Research community–driven open source R package for generating physical activity and sleep outcomes from multi-day raw accelerometer data. J Meas Phys Behav. 2019;2(3):188–96. van Hees VT, Sabia S, Jones SE, Wood AR, Anderson KN, Kivimäki M, et al. Estimating sleep parameters using an accelerometer without sleep diary. Sci Rep. 2018;8:12975. WHO. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva: World Health Organization. 2019. [cited 2025 June 6]. Available from: https://www.who.int/publications/i/item/9789241550536 WHO. WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization. 2020. [cited 2025 June 6]. Available from: https://www.who.int/publications/i/item/9789240015128 de Onis M, WHO Multicentre Growth Reference Study Group, de Onis M. WHO child growth standards based on length/height, weight and age. Acta Pædiatr. 2006;95:76–85. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660–67. Woynarowska B, Palczewska I, Oblacińska A. Standardy who rozwoju fizycznego dzieci w wieku 0–5 lat. Siatki centylowe dlugosci/wysokosci masy ciala wskaznika masy BMI I obwodu glowy [WHO child growth standards for children 0–5 years. Percentile charts of length/height, weight, body mass index and head circumference]. Pol Med Wieku Rozwoj. 2012;16(3):232–39. WHO. Obesity and overweight. 2024. [cited 2025 June 6]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight John A, Halliburton A, Humphrey J. Child-mother and child-father play interaction patterns with preschoolers. Early Child Dev Care. 2013;183(3–4):483–97. Hebert J, Møller NC, Andersen LB, Wedderkopp N. Organized sport participation is associated with higher levels of overall health-related physical activity in children (CHAMPS Study-DK). PLoS ONE. 2015;10(8):e0134621. Sigmund E, Sigmundová D, Voráčová J, Vorlíček M, Dygrýn J. Does active participation in organised physical activity contribute to children’s achievement of the 24-hour movement guidelines? findings from the family physical activity, sedentary behaviour, and sleep (FAMIPASS) study. BMC Public Health. 2025;25:1930. ČSÚ. Pohyb obyvatelstva – rok 2024. Ročník narozených 2024 je nejslabší v historii. [Population movement - year 2024. The year of birth 2024 is the weakest in history]. Czech. 2025;130080-24. [cited 2025 June 6]. Available from: https://csu.gov.cz/rychle-informace/pohyb-obyvatelstva-4-ctvrtleti-2024 Měřínská S. Kvalita života a zdraví Čechů. [Quality of life and health of the Czechs]. Czech. Statistika & My. 2023. [cited 2025 June 6]. https://statistikaamy.csu.gov.cz/kvalita-zivota-a-zdravi-cechu Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6900057","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":477904610,"identity":"087cb77e-03e0-4d6f-b273-edd818019c93","order_by":0,"name":"Dagmar Sigmundová","email":"","orcid":"","institution":"Palacký University, Olomouc","correspondingAuthor":false,"prefix":"","firstName":"Dagmar","middleName":"","lastName":"Sigmundová","suffix":""},{"id":477904611,"identity":"313c8cad-a02f-437f-ab45-51b270b0c43c","order_by":1,"name":"Jaroslava Voráčová","email":"","orcid":"","institution":"Palacký University, Olomouc","correspondingAuthor":false,"prefix":"","firstName":"Jaroslava","middleName":"","lastName":"Voráčová","suffix":""},{"id":477904613,"identity":"809cfb99-059f-4445-9f5e-8bca39cbee1f","order_by":2,"name":"Jan Dygrýn","email":"","orcid":"","institution":"Palacký University, Olomouc","correspondingAuthor":false,"prefix":"","firstName":"Jan","middleName":"","lastName":"Dygrýn","suffix":""},{"id":477904614,"identity":"783d4737-fd23-4f1c-951f-d8e4ed4b0ea4","order_by":3,"name":"Michal Vorlíček","email":"","orcid":"","institution":"Palacký University, Olomouc","correspondingAuthor":false,"prefix":"","firstName":"Michal","middleName":"","lastName":"Vorlíček","suffix":""},{"id":477904615,"identity":"300bd973-81ae-4613-8cef-e11b44e27de1","order_by":4,"name":"Erik Sigmund","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA40lEQVRIiWNgGAWjYFACxmYgIQFmSnwAEnwkaZGcASTYiLCGGc6S5iFGC7/04WYDhj8Wdmtn5B68bdt2R46NgfnxB3xaJPsSmxMY2ySSt93IS7bObXtmzMbAZmCAT4vBGcbmA4wNEslmN3LMpHPbDie2MfAwJODTYg/SwvAHqsUSquUAXlt4GJsTGNgk7MBaGCFaGBvwaZEA2mKQ2CaRYHbmjbFlzzmgX5jZjPHpYODvYX8s8eFPnb3Z8RzDGz/K7sjxszfjDzEwSGBgSIS65QByPOEH9gxwLaNgFIyCUTAK0AAAhxdCnpSQIY4AAAAASUVORK5CYII=","orcid":"","institution":"Palacký University, Olomouc","correspondingAuthor":true,"prefix":"","firstName":"Erik","middleName":"","lastName":"Sigmund","suffix":""}],"badges":[],"createdAt":"2025-06-15 20:08:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6900057/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6900057/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-025-25497-9","type":"published","date":"2025-11-27T15:58:07+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":97178761,"identity":"b018ef26-bb81-4eee-bc22-b0ab1db1cab8","added_by":"auto","created_at":"2025-12-01 16:13:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":983303,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6900057/v1/95d656af-f382-4d39-8919-051be0733bf9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"When gender matters: How parents help their children meet the 24-hour movement behavior guidelines","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eSleep, sedentary behavior (SB) and physical activity (PA) together shape our 24-hour movement behavior (24hMB), and maintaining an appropriate balance of these components contributes to overall health [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Particularly for children, the family is a key source of influence that can affect their 24hMB [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The family can support children and adolescents in achieving healthy PA, SB and sleep behaviors by encouraging, facilitating, modeling, setting expectations and actively engaging in these behaviors with them [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Parents also serve as gatekeepers in deciding which activities children will engage in and what resources and access, they have available [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Nowadays, however, there are many types of families and caregiving arrangements, which can be generally categorized into single-parent households (single parenting) and two-parent households (couple parenting). Based on this classification, it was found that 5\u0026ndash;11-year-old children from couple-parent families engaged in less SB than children from single-parent families [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Additionally, boys from couple-parent households had more sleep compared to boys from single-parent households, and girls from couple-parent households participated in more organized PA (OPA) than girls from single-parent households [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlthough it has been shown previously that children benefit emotionally and socially when fathers are involved in couple parenting [\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], later and even current studies do not distinguish parental gender in analyses of the relationship between parents and 24hMB in children [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], or they select only mothers as representatives of school-age children in families [\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Studies that differentiated parental gender when examining associations between parents' behavior and their children revealed that parents seemed to play a stronger role in supporting 8-9-year-old sons than daughters [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Also, stronger associations were observed in families where both parents shared an equal role in supporting their child [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Fathers' moderate to vigorous PA (MVPA) tended to have stronger correlations with children's MVPA compared with mothers', as did the association of SB between parents and sons [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In analyses of the parent-child associations in 'screen time' (ST), SB, MVPA, and light PA on weekdays and weekends, correlations appeared to be stronger in most cases for same-sex parent-child pairs compared with opposite-sex parent-child pairs [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. However, deeper linear regression analyses did not reveal parent gender as a significant factor in these relationships [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Thus, there is still a lack of valid information on the role of both parents in relation to their children's 24hMB, and in particular, on whether they help their children meet the 24hMB guidelines [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe FAMIly Physical Activity, Sedentary behaviour and Sleep study (FAMIPASS) [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] is a scientific research response to the calls of the Czech national health and well-being related strategies \"Health 2020\" and \"Concept of Sport Promotion 2016\u0026ndash;2025\" to add relevant information on 24hMB of preschool and school-age children. The absence of a national system to monitor PA, SB or sleep in children and adolescents has so far led to conflicting results on exercise behavior and its correlates [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Previous FAMIPASS studies have indicated the important role of maternal PA and sleep behaviors in helping 3-10-year-old children meet recommended PA and sleep guidelines [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], including the absence of ST devices in the bedroom and a reduction in SB to achieve healthy sleep durations [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. In addition, significant associations were found between MVPA and total PA in parent-child dyads across all gender combinations [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Significantly higher odds of children meeting at least two or all three of the 24hMB guidelines [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] were associated with mothers having a normal body weight, adherence to at least two 24hMB guidelines, and completion of more than primary education, as well as with fathers having higher levels of education and being younger in age [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. However, all previous FAMIPASS studies [\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] have only analyzed family relationships separately as family dyads (i.e., mother-child or father-child), rather than examining couple parenting dynamics involving the mother, father, and child simultaneously. Therefore, the present study fills the research gap in distinguishing the role of mothers and fathers in promoting compliance with the 24hMB guidelines and bridges the missing correlates of 24hMB in 3\u0026ndash;10-year-old offspring in couple parenting families.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and inclusion criteria\u003c/h2\u003e \u003cp\u003eThe FAMIPASS study is a nationally representative longitudinal study aimed at analyzing 24hMB of families with children aged 3\u0026ndash;10 years in the context of the preschool/elementary school and family environment [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Participating families were selected by stratified sampling of preschools and elementary schools from rural and urban areas of Bohemia, Moravia and Silesia to cover all permanently inhabited districts of Czechia. The first wave of data collection ran from March 21, 2022 to May 20, 2023 during the regular school week of preschools/elementary schools excluding multi-day and public holidays. Inclusion criteria for families in the study were: a) having at least one child of their own aged 3\u0026ndash;10 years, b) absence of illness/limitations preventing active daily participation at the preschool/elementary school, c) willingness to participate in the study voluntarily and free of charge, and d) providing written informed consent from parents/guardians [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eParticipants and Dataset\u003c/h3\u003e\n\u003cp\u003e Of the 860 (100%) families recruited and contacted, 552 (64.2%) provided written informed consent to participate in the study and 502 (58.4%) families initiated weekly continuous 24hMB monitoring. A total of 472 (54.9%) families completed the full weekly monitoring and 217 (25.2%) family triads (mother and father with at least one child) provided valid 24hMB accelerometer data, anthropometric characteristics and questionnaire data to determine the families\u0026rsquo; socioeconomic status (SES) and participants\u0026rsquo; ST. Reasons for excluding 124 families from the final data set were as follows: insufficient minimum number of days of accelerometer wear, defined as at least 3 school days and 1 weekend day (n\u0026thinsp;=\u0026thinsp;65), missing anthropometric data or data to determine families' SES (n\u0026thinsp;=\u0026thinsp;26), and missing data to capture children's participation in organized forms of PA (n\u0026thinsp;=\u0026thinsp;33). Weekly 24-hour monitoring with complete and valid 24hMB (resp. anthropometric and SES-related) data were completed by 255 (29.7%) families with at least one child aged 3\u0026ndash;10 years. Of the 255 families, 38 were single-parent families or families with valid dyad-only data (that is, one parent-child), while 217 were couple-parent families whose anthropometric data are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Participating children and their parents were predominantly white Caucasian (\u0026gt;\u0026thinsp;92%), which is representative of the ethnic demographics of Czechia [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBasic characteristics of families - couple parenting (mother-father-child simultaneously)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily members\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of participants\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCalendar age\u003c/p\u003e \u003cp\u003eM/SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHeight (cm)\u003c/p\u003e \u003cp\u003eM/SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWeight (kg)\u003c/p\u003e \u003cp\u003eM/SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003cp\u003eM/SD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaughters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75.17*/20.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e119.46/12.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22.35/6.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15.42/2.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSons\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77.76*/19.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e120.58/11.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22.59/5.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15.39/1.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMothers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.99\u003csup\u003e#\u003c/sup\u003e/3.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e167.51/6.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e65.88/11.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e23.47/3.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFathers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39.94\u003csup\u003e#\u003c/sup\u003e/5.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e181.10/6.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e85.23/12.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e26.00/3.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: N \u0026ndash; number, M \u0026ndash; mean, SD \u0026ndash; standard deviation, */\u003csup\u003e#\u003c/sup\u003e \u0026ndash; indicates calendar months/years, cm \u0026ndash; centimeters, kg \u0026ndash; kilograms, BMI \u0026ndash; Body Mass Index (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eAnthropometric characteristics, socioeconomic status and 'screen' time of participants\u003c/h3\u003e\n\u003cp\u003eDuring a joint meeting involving researchers, parents and preschool/elementary school administrators and teachers, the researchers presented the study design and detailed procedures. These included instructions for measuring body weight and height at home using graphic instructions, the method of attaching and wearing the accelerometer on the non-dominant wrist, and recording time data in the family diary [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The researchers also explained how to record ST and SES data to the family diary [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], as well as the process for delivering individual feedback using graphic sheets for each participant.\u003c/p\u003e \u003cp\u003eParents were instructed to measure their own and their children's body weight and height in the morning before breakfast, while wearing underwear. Parents recorded body weight/height to the nearest 0.1 kg/0.5 cm [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Parents' measurement of their children's body weight and height in the home environment has been confirmed to be sufficiently valid for calculating body mass index (BMI) and subsequent detection of excess body weight in 4-10-year-old children [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFamily SES was measured by the summary scores of responses to six questions about the family's material background that were part of the family diary [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The content of each question (with categorized response options) was as follows: having one\u0026rsquo;s own bedroom for each child in the family (0/1); number of bathrooms in the household (0/1/2/\u0026ge;3); number of computers in the household (0/1/2/\u0026ge;3); number of cars owned for family use (0/1/\u0026ge;2); number of foreign vacations taken in the past year (0/1/2/\u0026ge;3); ownership of a dishwasher in the household (0/1) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. According to the summary scores of the responses to the above questions, three categories of families regarding SES (low, medium, high) were identified as follows: the lowest/highest 20% of the summary scores characterized families with low/high SES, while the range of 21\u0026ndash;79% characterized families with medium SES [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The summary score was positively correlated with reported parental income with an Eta-squared close to 0.30. The summary test-retest reliability correlation was r\u0026thinsp;=\u0026thinsp;0.90 (28). In the socioeconomic conditions of Czechia, the summary score was validated in relation to disposable household income (Pearson correlation r\u0026thinsp;=\u0026thinsp;0.77, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eChildren's daily ST was calculated from parents' responses to questions about the use of screen-based devices, originally adapted from the \"Health Behaviour in School-aged Children\" study. Specifically, parents were asked: 'How many hours a day do you usually spend in your leisure time on weekdays/weekends watching TV, DVDs, videos (including YouTube or similar online services)?' and 'How many hours a day do you usually spend in your leisure time on weekdays/weekends playing games on a computer, games console (PlayStation, Xbox etc.), smartphone, tablet or similar electronic device?' [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The questions were categorized based on weekdays and weekends. For each question, there were nine different response options (none/half an hour/1/2/3/4/5/6/ and 7 or more hours per day). Validity and reliability of the 7-day recall questions have been verified in comparison with the 7-day 24-hour diaries for both weekdays and weekends [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Total ST was calculated as the sum of the weighted arithmetic means of weekday and weekend ST {weighted mean=[(average weekday\u0026times;5)+(average weekend\u0026times;2)]/7}.\u003c/p\u003e\n\u003ch3\u003eAccelerometer-based monitoring of 24hMB\u003c/h3\u003e\n\u003cp\u003eThe 24hMB was monitored using accelerometers (wGT3X-BT in children and GT9X Link in parents; ActiGraph LLC, Pensacola, FL, USA) placed on the wrist of the non-dominant hand in both parents and their offspring. To anchor the 24-hour accelerometer recording, parents recorded daily time data in a family diary, including morning wake-up, arrival at and departure from preschool/school, start and end of OPA (such as practices and coach/leader-led lessons), and bedtime. The 24-hour monitoring started at midnight on the day of the joint meeting between parents and researchers.\u003c/p\u003e \u003cp\u003eAll accelerometers were individually initialized via ActiLife software version 6.13.4 (ActiGraph LLC, Pensacola, FL, USA) for each family member separately based on the information provided in the written informed consent. Accelerometers recorded triaxial acceleration data at a sampling rate of 100 Hz. All accelerometer data sets were analyzed using the R GGIR version 2.7-1 package, applying previously established cut-off values for participants' 24hMB intensity. Specifically, SB was defined as acceleration values of less than 36 milligrams (m\u003cem\u003eg\u003c/em\u003e); light PA as 36\u0026ndash;200 m\u003cem\u003eg\u003c/em\u003e; MVPA as 201\u0026ndash;706 m\u003cem\u003eg\u003c/em\u003e; and intense PA as values equal to or greater than 707 m\u003cem\u003eg\u003c/em\u003e [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. The default setting for wear-free time detection in part 1 of the GGIR package in R was used. Specifically, the algorithm required that the standard deviation of the sliding window signal be close to the sensor\u0026rsquo;s noise level. If this condition was met, GGIR classified the middle 15 minutes of this 60-minute window as non-wear time [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. The sleep time, i.e., the time from lying down to waking up, was determined using the default setting of a heuristic algorithm analyzing the distribution of angular changes [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. To be included in the final data set, accelerometer data had to be observed on at least three preschool/school days and one weekend day for at least 16 h per day, and accelerometer data had to be available for each 15-min interval of the 24-h cycle [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Average daily sleep time, SB, light PA, MVPA, vigorous PA, and total PA were calculated as the weighted arithmetic mean of these activities performed during preschool/school and weekend days {weighted mean=[(average weekday\u0026times;5)+(average weekend\u0026times;2)]/7}.\u003c/p\u003e\n\u003ch3\u003eClassification of participants according to 24hMB guidelines\u003c/h3\u003e\n\u003cp\u003eFamily offspring aged 3\u0026ndash;4 years with a cumulative PA of at least 180 minutes per day, including MVPA of at least 60 minutes per day, ST limited to a maximum of 1 hour per day, and an average sleep duration of 10\u0026ndash;13 hours per day were classified as meeting the 24hMB guidelines for preschool children [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Family offspring aged 5 years and older who cumulatively performed 60 minutes of MVPA while having a maximum of 2 hours of ST per day and sleeping 9\u0026ndash;11 hours per day met the 24hMB guidelines [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Adult parents aged 18 years and older were classified as meeting 24hMB guidelines if their SB did not exceed 8 hours per day while also realizing at least 150 minutes of MVPA per week and sleeping 7\u0026ndash;9 hours per day [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData processing and statistical analysis\u003c/h2\u003e \u003cp\u003eThe 24hMB data along with anthropometric and sociodemographic data of the participants were analyzed using Statistical Package for the Social Sciences (SPSS) for Windows, version 26 (IBM Corp, Armonk, NY, USA). After applying the inclusion criteria, all data were checked for outliers and obvious errors and any affected cases were discarded. Calendar age was calculated as the difference between the study start date and date of birth. Participants' BMI was calculated as the ratio of reported body weight (kg) to the square of body height (m\u003csup\u003e2\u003c/sup\u003e). Children with BMI z-scores\u0026thinsp;\u0026gt;\u0026thinsp;1 standard deviation (SD) and \u0026lt;\u0026thinsp;2 SD were classified as overweight, whereas children with BMI z-scores\u0026thinsp;\u0026gt;\u0026thinsp;2 SD were classified as obese according to the WHO reference data for that sex and age [\u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. A BMI range of 25-29.9 kg/m\u003csup\u003e2\u003c/sup\u003e (or \u0026ge;\u0026thinsp;30 kg/m\u003csup\u003e2\u003c/sup\u003e) represented overweight (or obese) in parents [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBasic descriptive characteristics of individual family members are presented as arithmetic means and SDs separately for daughters, sons, mothers and fathers (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Kolmogorov-Smirnov test confirmed a normal distribution for the variables: time spent in PA, SB and sleep. The daily duration (or representation) of each component of PA, SB and sleep during 24hMB monitoring for each family member is shown as arithmetic means (or %) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Adherence to the 24hMB guidelines is presented as a percentage, separately for each family member (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The Pearson chi-square test (χ\u003csup\u003e2\u003c/sup\u003e) was used to test for differences in adherence to the 24hMB guidelines (separately for all three guidelines, any combination of any two guidelines, only one guideline, and none) between daughters and sons (or mothers and fathers). Associations between child and parent characteristics and children's adherence to the 24hMB guidelines were revealed by multiple logistic regression analysis in the daughter-mother-father and son-mother-father models (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The results of the logistic regression analyses were expressed using odds ratios (ORs) and 95% confidence intervals (95% CIs). The alpha significance level was set at a minimum of 0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eSleep accounted for the longest part of the day for 3\u0026ndash;10-year-olds living in couple families, followed by SB and PA, with no statistically significant differences between daughters and sons (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eExcluding a few minutes, daughters and sons spent almost 7 hours per day in PA, with sons and daughters averaging 86.4 and 73.2 minutes per day, respectively, in MVPA. Even the approximately 13-minute difference in daily MVPA between daughters and sons was not statistically significant. Consistent with the results for children, we found no statistically significant differences between mothers and fathers in average daily sleep duration, SB, or PA. However, in contrast to children, SB represented the longest component of 24hMB for parents, averaging more than 10 hours for mothers and more than 11 hours per day for fathers (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e On average, over a quarter of the 3\u0026ndash;10-year-old offspring (25.2% of daughters and 26.7% of sons) met all 3 of the 24hMB guidelines, and even more than two-thirds of the children (71.7% of daughters and 78.1% of sons) achieved any combination of at least 2 of the 3 24hMB guidelines with no statistically significant differences between genders (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eObr\u0026aacute;zek 2\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e For parents, daily high rates of SB resulted in very low proportions of mothers (2.5%) and fathers (1.5%) meeting all 3 24hMB guidelines. The 8.8% difference between mothers and fathers who achieved any combination of 2 of the 3 24hMB guidelines (69.1% vs. 60.3%) was marginally significant (p\u0026thinsp;=\u0026thinsp;0.0551) according to the χ\u003csup\u003e2\u003c/sup\u003e test (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). A negligible percentage of children and no parents met none of the 24hMB guideline, mainly due to MVPA levels, which averaged 133.2 minutes per day for mothers and 131.4 minutes for fathers.\u003c/p\u003e \u003cp\u003eWith no significant differences between genders, 25.2% of daughters and 26.7% of sons (or 71.7% of daughters and 78.1% of sons) met all 3 (or a combination of \u0026ge;\u0026thinsp;2) 24hMB guidelines, but with different contributions from mothers and fathers (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e In daughters only, the prevalence of excess body weight in fathers significantly reduced the odds ratio of achieving the recommended SB/a combination of \u0026ge;\u0026thinsp;2 24hMB guidelines (p\u0026thinsp;=\u0026thinsp;0.03/0.003). Maternal excess body weight significantly reduced the odds ratio of fulfilling the recommended amount of ST in daughters (p\u0026thinsp;=\u0026thinsp;0.04) and sons (p\u0026thinsp;=\u0026thinsp;0.002), and furthermore, significantly lowered the odds of achieving the recommended amount of MVPA in daughters (p\u0026thinsp;=\u0026thinsp;0.03) and a combination of \u0026ge;\u0026thinsp;2 WHO 24hMB guidelines in sons (p\u0026thinsp;=\u0026thinsp;0.03). In addition, university maternal education significantly contributed to compliance with the recommended amount of ST in both daughters (p\u0026thinsp;=\u0026thinsp;0.03) and sons (p\u0026thinsp;=\u0026thinsp;0.02) and to achieving a combination of \u0026ge;\u0026thinsp;2 24hMB guidelines in daughters (p\u0026thinsp;=\u0026thinsp;0.04). Mothers\u0026rsquo; adherence to a combination of \u0026ge;\u0026thinsp;2 24hMB guidelines significantly increased the odds of their daughters meeting the same combination of the 24hMB guidelines (p\u0026thinsp;=\u0026thinsp;0.006).\u003c/p\u003e \u003cp\u003eActive participation in OPA during leisure time was the only offspring-related variable that significantly helped children achieve the MVPA guideline, daughters met any combination of at least 2 of the 3 WHO 24hMB guidelines, and sons met the ST-related guideline (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). 51.5% of sons and 43.0% of daughters from couple parenting families actively engaged in OPA in their leisure time.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eOdds ratio of children achieving the 24hMBGs - binary logistic regression Backward method (A - MVPA guideline, B - ST guideline, C - any combination of at least 2 or more guidelines)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHO\u0026rsquo;s 24hMB guidelines\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModel: family triads\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVariable/ref.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR (p)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eA\u003c/b\u003e \u0026ndash; guidelines for daily MVPA (moderate to vigorous physical activity)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eDaughter\u003c/b\u003e\u003c/p\u003e \u003cp\u003eparents\u003c/p\u003e \u003cp\u003e(Step 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eoverweight\u0026thinsp;+\u0026thinsp;obesity \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.348 (0.031)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.133\u0026ndash;0.910\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003echild's participation in OPA/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.555 (0.044)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.024\u0026ndash;6.377\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003euniversity education \u003cb\u003efather\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.521 (0.150)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.214\u0026ndash;1.266\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eSon\u003c/b\u003e-\u003c/p\u003e \u003cp\u003eparents\u003c/p\u003e \u003cp\u003e(Step 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003esocioeconomic status of families/LOW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.710 (0.026)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.124\u0026ndash;6.534\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003echild's participation in OPA/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.858 (0.033)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.090\u0026ndash;7.492\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003euniversity education \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.401 (0.086)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.142\u0026ndash;1.136\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003e\u003cb\u003eB\u003c/b\u003e \u0026ndash; guidelines on time spent sitting in front of a screen/display device per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eDaughter\u003c/b\u003e\u003c/p\u003e \u003cp\u003eparents\u003c/p\u003e \u003cp\u003e(Step 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eoverweight\u0026thinsp;+\u0026thinsp;obesity \u003cb\u003efather\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.222 (0.003)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.082\u0026ndash;0.602\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003euniversity education \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.784 (0.032)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.090\u0026ndash;7.112\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eoverweight\u0026thinsp;+\u0026thinsp;obesity \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.326 (0.041)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.111\u0026ndash;0.958\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003esocioeconomic status of families/LOW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.530 (0.308)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.676\u0026ndash;3.464\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eSon\u003c/b\u003e\u003c/p\u003e \u003cp\u003eparents\u003c/p\u003e \u003cp\u003e(Step 7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eoverweight\u0026thinsp;+\u0026thinsp;obesity \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.171 (0.002)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.055\u0026ndash;0.535\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003euniversity education \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.173 (0.017)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.232\u0026ndash;8.173\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003echild's participation in OPA/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.826 (0.037)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.063\u0026ndash;7.513\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eage category of child/LOW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.439 (0.106)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.162\u0026ndash;1.191\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003eC\u003c/b\u003e \u0026ndash; meeting any combination of at least 2 or more 24hMB guidelines (sleep, MVPA, ST)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cb\u003eDaughter\u003c/b\u003e\u003c/p\u003e \u003cp\u003eparents\u003c/p\u003e \u003cp\u003e(Step 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003echild's participation in OPA/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e5.409 (0.013)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.427\u0026ndash;20.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eoverweight\u0026thinsp;+\u0026thinsp;obesity child/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.525 (0.077)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.829\u0026ndash;36.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMeeting\u0026thinsp;\u0026ge;\u0026thinsp;2 WHO guidelines \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e6.258 (0.006)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.686\u0026ndash;23.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003euniversity education \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.352 (0.036)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.081\u0026ndash;10.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eoverweight\u0026thinsp;+\u0026thinsp;obesity \u003cb\u003efather\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.237 (0.027)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.066\u0026ndash;0.849\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eSon\u003c/b\u003e\u003c/p\u003e \u003cp\u003eparents\u003c/p\u003e \u003cp\u003e(Step 7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003esocioeconomic status of families/LOW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.217 (0.693)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.458\u0026ndash;3.239\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003echild's participation in OPA/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.266 (0.134)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.778\u0026ndash;6.604\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eoverweight\u0026thinsp;+\u0026thinsp;obesity \u003cb\u003emother\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.284 (0.031)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.090\u0026ndash;0.892\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMeeting\u0026thinsp;\u0026ge;\u0026thinsp;2 WHO guidelines \u003cb\u003efather\u003c/b\u003e/NO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.387 (0.570)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.448\u0026ndash;4.294\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNote: 24hMB \u0026ndash; 24hour movement behavior; WHO \u0026ndash; World Health Organization; Binary logistic regression models included independent variables for children: age category (3-5.9/6\u0026ndash;10 years), overweight\u0026thinsp;+\u0026thinsp;obesity (no/yes), child's participation in OPA (no/yes), socioeconomic status (low-high) and for parents (mothers and fathers separately): university education (no/yes), overweight\u0026thinsp;+\u0026thinsp;obesity (no/yes), achieving the WHO\u0026rsquo;s guidelines for 24-hour movement behavior (\u003cb\u003eA\u003c/b\u003e for MVPA (no/yes), \u003cb\u003eB\u003c/b\u003e for 'screen time' (no/yes), \u003cb\u003eC\u003c/b\u003e\u0026thinsp;\u0026ge;\u0026thinsp;2 (no/yes); PA \u0026ndash; physical activity; OPA \u0026ndash; leisure organized PA; MVPA \u0026ndash; moderate to vigorous physical activity; ST \u0026ndash; 'screen time'; OR \u0026ndash; odds ratio (logistic regression method Backward); % \u0026ndash; percentage; CI \u0026ndash; confidence interval; p \u0026ndash; level of significance; Results statistically significant at the p level less than 0.05 are shown in bold. Step - using the backward method, models with variables that did not have a statistically insignificant constant in the last step were selected.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003e A key finding of the study was that, on average, \u0026frac14; of children aged 3\u0026ndash;10 years (25.2% of daughters and 26.7% of sons), or nearly \u0026frac34; of offspring (71.7% of daughters and 78.1% of sons) met either all 3 WHO 24hMB guidelines or at least a combination of any 2. There were no significant differences by gender or age of the children, but notable differences were observed in the contributions of mothers and fathers in couple-parented families.\u003c/p\u003e \u003cp\u003e Not only was there no apparent gender preference in offspring\u0026rsquo;s compliance with the 24hMB guidelines linked to mothers, as was observed with fathers, but mothers' anthropo-social and behavioral characteristics were more frequently and significantly associated with the likelihood of offspring achieving the 24hMB guidelines than those of fathers. Greater assistance from mothers in meeting the 24hMB guidelines is consistent with findings that mothers tend to structure, lead, teach, and engage in empathic conversations, whereas fathers are more inclined to engage in physical play, adopt a peer-like role, follow the child\u0026rsquo;s lead, and offer challenges [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. While parents have been shown to play a greater role in helping daughters than sons adhere to the 24hMB guidelines, this contrasts with findings from a study (15) of 8-9-year-old English children, in which parents were more likely to encourage sons to be more physically active than daughters. Overall, mothers had a greater tendency than fathers to encourage their children to be physically active during the week [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, children were most physically active when both parents shared a supportive role [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In our study, it is very likely that a common or complementary role of fathers and mothers in promoting the 24hMB guidelines compliance in their offspring can be found through their offspring's participation in OPA.\u003c/p\u003e \u003cp\u003eRegular active participation in OPA during leisure time significantly helped daughters and sons meet the recommended levels of MVPA. It also supported sons in meeting the recommended ST guidelines, and daughters in achieving any combination of at least 2 or more components of the 24hMB guidelines, regardless of their age or body weight. In line with a Danish prospective study [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], regular active participation in OPA has been shown to contribute to higher overall levels of MVPA and to meeting the daily recommendation of at least 60 min of MVPA in both girls and boys [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. In addition, participation in OPA during leisure time positively supports meeting additional components of the 24hMB guidelines, thus helping to \"harmonize\" the movement behaviors of young children. This finding is consistent with a previous study related to the FAMIPASS project, which confirmed a significantly higher likelihood of 3-10-year-old children from family days (mother-child or father-child) achieving a combination of at least 2 of 3 24hMB guidelines when participating in OPA during leisure time, compared with non-participants in OPA [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Because this study analyzed families with young children, it is likely that in many cases parents accompanied their children to and from OPA in their free time. However, it was not possible to determine from family diary entries which parent primarily provided logistical support to their children. Nevertheless, given that the research included family triads whose members fully completed the seven-day monitoring, we hypothesize that both parents may have had a more equal role in providing logistical support to their children in OPA.\u003c/p\u003e \u003cp\u003e This study of families with couple parenting provides a \u0026lsquo;springboard\u0026rsquo; for examining parental support for the 24hMB guidelines in single-parent and socially disadvantaged families, to determine whether children from these families lag behind those from couple-parent families in meeting the 24hMB guidelines. In follow-up research, the 24hMB patterns of parents and children in single-parent families will be examined, especially since 20,800 married couples, representing 40% of all married couples, divorced in Czechia in 2024. Divorces were most common after 4 to 7 years of marriage and 58% of divorced couples had a minor child in common. This means that a total of 19,300 minor children were affected by divorce [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations of the study\u003c/h2\u003e \u003cp\u003eThe strength of the study is the detailed assessment of the main movement components within the 24-hour cycle through continuous instrumental monitoring that captures the typical school/work routines of all family members. The study\u0026rsquo;s strength also includes the effort to represent families from all socioeconomic backgrounds in urban and rural areas of Bohemia, Moravia and Silesia. An additional strength of this study is the fact that 90% of the final sample of families agreed to participate in the follow-up monitoring of 24hMB during 2025\u0026ndash;2026. A notable limitation of the study is its reliance on participants\u0026rsquo; interest, willingness, and unpaid voluntary participation in the research. It can reasonably be assumed that participation in the research was confirmed by those with intrinsic motivation and interest, who may have been more prone to healthy behaviors than those without interest in participating in the research. However, in terms of the prevalence of overweight/obesity as calculated by BMI, the sample of parents we analyzed did not differ from the average values of the adult population in this age group [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. Another limitation is the lack of identification of the reasons for incomplete families (i.e., widowhood, divorce, or religious beliefs) due to concerns that collecting this sensitive information might reduce the number of families willing to participate in the study. The cross-sectional research design does not, of course, allow us to formulate the observed relationships causally, but with the support of theoretical foundations [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] we interpret the relationships in the parent-child direction, not the other way around.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e 25.2% of daughters and 26.7% of sons, and almost 75% the offspring (71.7% of daughters and 78.1% of sons) met all 3 of the WHO 24hMB guidelines for sleep, PA and SB, or at least a combination of any 2 of the 3 guidelines, with no significant differences between gender or age, but with very different contributions from mothers and fathers from couple-parenting families.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e Mothers were more proactive than fathers in helping both daughters and sons achieve each of the WHO 24hMB guidelines. A mother's normal body weight and university education significantly increased the odds of children reaching the WHO 24hMB guidelines. The role of mothers is indispensable in shaping their offspring's daily health-promoting 24hMB.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e Fathers were directly involved to a lesser extent than mothers in supporting their offspring to meet the 24hMB guidelines. Their supportive role was likely hidden in the logistical responsibilities associated with their children's OPA.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e Regular active participation in OPA significantly assisted both daughters and sons in meeting the recommended MVPA; it also supported sons in meeting the recommended ST and daughters in achieving any combination of at least 2 or more 24hMB guidelines, regardless of children's age or body weight level.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e A possible indicator of a healthy lifestyle in families with young children seems to be non-excessive parental body weight (especially in mothers), which helps children to meet the 24hMB guidelines (especially in reducing excessive daily ST).\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBMI, Body Mass Index; cm, centimeter; CI, Confidence interval; FAMIPASS, Family physical activity, Sedentary behaviour and Sleep Study; m, meter; M, mean; MVPA, Moderate-to-vigorous physical activity; N, number; OPA, Organized physical activity; OR, Odds ratio; p, level of significance; PA, Physical activity; r, Pearson correlation; Ref., Reference group; SB, Sedentary behavior; SES, Socioeconomic status; SD,\u0026nbsp;Standard deviation;\u0026nbsp;ST, Screen time; WHO, World Health Organization;\u0026nbsp;24hMB, 24-hour movement behavior; χ\u003csup\u003e2\u003c/sup\u003e, Pearson Chi-square test; %, percentages\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study is part of a longitudinal research whose methodological protocol for the initial and subsequent waves of data collection was approved by the institutional ethics committee for research at the Faculty of Physical Culture of Palacký University in Olomouc (initial wave: protocol code 25/2024 on 28 February 2021 and subsequent wave: protocol code 102/2023 in November 2023). The ethics committee's approval of the research protocol included assurances of anonymity, the format of informed written consent, and rules for data security and storage. The accelerometers used were disinfected and sealed in an anonymous envelope with a family code before each start of the 7-day 24hMB monitoring, along with the family diary. Participation in the study was voluntary and free of charge. No participant was penalized in any way for premature termination of 24hMB monitoring, damage\u0026nbsp;or loss of the accelerometer, or failure to return the family diary. Each participating family received their own individualized feedback on the 24hMB results of all their members in the form of printed graphic sheets with accompanying explanatory commentary. Schools received a letter of thanks and a certificate acknowledging their participation in the FAMIPASS study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets analyzed during the current study are not publicly available because this study is part of a longitudinal research project. The baseline phase data are subject to privacy and ethical restriction as participants in this study have signed consent forms stipulating that individual data will not be made publicity available until five years after the completion of the follow-up phase.\u003c/p\u003e\n\u003cp\u003eAggregated data can be provided by the corresponding author of the study based on a professional scientific query with a clear objective and focus for which the data are queried\u0026nbsp;(10.5281/zenodo.15674732).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest. Funders have no role in data collection, analysis and interpretation of results, and publication. The authors have no relevant financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the project of the Czech Science Foundation titled “A longitudinal study of 24-hour changes in movement behavior of families with young school-age children” (No: 25-18101S) and „Research of Excellence on Digital Technologies and Wellbeing CZ.02.01.01/00/22_008/0004583“, which is co-financed by the European Union.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eES and DS conceptualized and designed the study, drafted the original manuscript and coordinated the writing of the manuscript with JV, JD and MV. DS, JD and MV validated the research protocol and conducted data collection. DS and ES performed statistical analysis of the data and interpreted the results. All authors critically read the original manuscript, commented on all parts of the manuscript, and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all the children and parents who participated in our research and especially the families with preschoolers. Special thanks go to all the teachers and school/kindergarten management members who helped facilitate the research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eTremblay MS, Carson V, Chaput JP, Gorber SC, Dinh T, Duggan M, et al. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. Appl Physiol Nutr Metab. 2016;41(6 Suppl 3):S311\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoss R, Chaput JP, Giangregorio LM, Janssen I, Saunders TJ, Kho M, et al. 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[cited 2025 June 6]. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://statistikaamy.csu.gov.cz/kvalita-zivota-a-zdravi-cechu\u003c/span\u003e\u003cspan address=\"https://statistikaamy.csu.gov.cz/kvalita-zivota-a-zdravi-cechu\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"sedentary behavior, physical activity, sleep, daughter, son, mother, father","lastPublishedDoi":"10.21203/rs.3.rs-6900057/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6900057/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eFamily is important for the support and promotion of healthy movement behaviors of children. Therefore, the aim of this study was to identify the roles of mothers and fathers in supporting their young children to meet the World Health Organization (WHO) guidelines on 24-hour movement behavior (24hMB), based on accelerometer data from the daily lives of both parents and their families.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe 24-hour movement behavior (24hMB) of 217 family triads was continuously monitored over a 7-day period using ActiGraph accelerometers placed on the non-dominant wrist of each participant. Children's compliance with the WHO 24hMB guidelines (sleep, sedentary behavior, physical activity) was analyzed using backward logistic regression analysis separately for the daughter-mother-father and son-mother-father models.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eWithout significant gender differences, 25.2%\u003csub\u003eDAUGHTERS\u003c/sub\u003e and 26.7%\u003csub\u003eSONS\u003c/sub\u003e (or 71.7%\u003csub\u003eDAUGHTERS\u003c/sub\u003e and 78.1%\u003csub\u003eSONS\u003c/sub\u003e) met all 3 (or a combination of \u0026ge;\u0026thinsp;2) 24hMB guidelines, although the contributions of mothers and fathers differed. For daughters only, fathers' overweight/obesity significantly reduced the chances of achieving the recommended amount of sedentary behavior/a combination of \u0026ge;\u0026thinsp;2 24hMB guidelines (p\u0026thinsp;=\u0026thinsp;0.03/0.003). Mother's overweight/obesity significantly reduced the odds ratio of meeting the recommended amount of sedentary behavior for both daughters/sons (p\u0026thinsp;=\u0026thinsp;0.04/0.002), achieving the recommended amount of moderate-to-vigorous physical activity in daughters (p\u0026thinsp;=\u0026thinsp;0.03), and meeting a combination of \u0026ge;\u0026thinsp;2 24hMB guidelines in sons (p\u0026thinsp;=\u0026thinsp;0.03). Maternal university education significantly contributed to achieving the recommended sedentary behavior in both daughters/sons (p\u0026thinsp;=\u0026thinsp;0.03/0.02) and to fulfilling a combination of \u0026ge;\u0026thinsp;2 24hMB guidelines in daughters (p\u0026thinsp;=\u0026thinsp;0.04).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003e Mothers are more proactive than fathers in helping both daughters and sons achieve each of the WHO 24hMB guidelines. The role of mothers is indispensable in shaping their offspring's daily health-promoting 24hMB.\u003c/p\u003e","manuscriptTitle":"When gender matters: How parents help their children meet the 24-hour movement behavior guidelines","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-01 13:02:42","doi":"10.21203/rs.3.rs-6900057/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-19T07:13:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-15T18:04:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"94999111075754553908768404392521661408","date":"2025-08-21T07:59:00+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-12T20:08:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"75821011876629861512106806547679761","date":"2025-06-29T08:30:03+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-26T18:19:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-23T06:25:37+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-06-18T14:47:35+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-18T13:58:30+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-06-18T13:29:29+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"283c7ecb-8f60-451c-9832-4f4d56cbe3b4","owner":[],"postedDate":"July 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-01T16:07:20+00:00","versionOfRecord":{"articleIdentity":"rs-6900057","link":"https://doi.org/10.1186/s12889-025-25497-9","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2025-11-27 15:58:07","publishedOnDateReadable":"November 27th, 2025"},"versionCreatedAt":"2025-07-01 13:02:42","video":"","vorDoi":"10.1186/s12889-025-25497-9","vorDoiUrl":"https://doi.org/10.1186/s12889-025-25497-9","workflowStages":[]},"version":"v1","identity":"rs-6900057","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6900057","identity":"rs-6900057","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}