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

Background: Meeting 24-hour movement behaviors (24-HMB: physical activity [PA], screen time [ST], and sleep [SL]) guidelines may be associated with positive health outcomes among youth with specific mental, behavioral, and neurodevelopmental (MBD) conditions. However, temporal trends and disparities in meeting 24-HMB guidelines in these higher-risk groups have not been investigated, hampering the development of evidence-based clinical and public health interventions. The purpose of this study was to examining temporal trends and disparities (i.e., sex, age, and ethnicity) in meeting 24-HMB guidelines in youth with MBD conditions. Methods: Serial, cross-sectional analyses between 2016 and 2021 of nationally representative data (including U.S. youth aged 6 -17 years with MBD conditions) were conducted through caregiver proxy reports. Youth were categorized as meeting or not meeting different sets of PA, ST, and SL within the guidelines. Linear and Logistic regression analyses were conducted to determine the time trends and disparities. Results: Data on 52,634 individuals (mean age, 12.0 years [SD,3.5]; 28,829 [58.0%] boys) were analyzed. From 2016 to 2021, the estimated trend of meeting SL guideline alone increased (3.7% [95%CI,3.2% to 4.9%], P for trend < 0.001), whereas meeting ST guideline alone decreased (-2.0% [-2.4% to -1.5%], P for trend < 0.001). The estimated trend in meeting integrated (PA + ST + SL) guidelines declined (-0.8% [95%CI, -1.0% to -0.5%], P for trend < 0.001), whereas meeting none of 24-HMB guidelines increased (2.2% [1.8% to 2.6%], P for trend < 0.001). White participants, children, and boys reported higher estimated prevalence of meeting full integrated (PA + ST + SL) guidelines. Conclusion: The temporal trends observed in this study highlight the importance of consistently monitoring physical behavior among MBD youth and identifying variations by sociodemographic groups in meeting 24-HMB guidelines for health promotion within these vulnerable groups.