The Efficacy of Interventions Targeting 24-h Movement Behaviours in Children and Adolescents: A Systematic Review and Meta-analysis.

BACKGROUND: While the concept of "24-h movement behaviours" has gained attention, and correlational studies have shown its importance for health outcomes among children and adolescents, there is still no comprehensive review summarising the efficacy of such interventions in changing specific behaviour. This systematic review, therefore, aimed to examine the efficacy of interventions targeting 24-h movement behaviours on physical activity, sedentary behaviour/screen time, and sleep duration. METHODS: A systematic search was conducted on February 1, 2024, across six databases (MEDLINE, PsycINFO, EMBASE, PubMed, Web of Science, and SPORTDiscus). Included articles were interventions targeting 24-h movement behaviours simultaneously (physical activity, sedentary behaviour/screen time, and sleep duration) in children and adolescents aged under 18 years. Data were analysed using random effects meta-analysis, and the risk of bias was assessed using the Cochrane risk-of-bias tool. RESULTS: The literature search identifed 1849 articles, and 20 studies met the inclusion criteria, with 9 of them included in the meta-analysis. A pooled 26-min decrease was observed in screen time (95% CI =  - 48.52, - 3.91, I2 = 86%), and an 8-min increase was found in sleep duration (95% CI = 3.52, 12.33, I2 = 27%), while no significant changes were observed in physical activity and total sedentary behaviour. CONCLUSION: Interventions targeting a combination of 24-h movement behaviours have demonstrated efficacy in decreasing screen time and improving sleep duration, while the efficacy in physical activity and total sedentary behaviour warrants further exploration. The findings from this systematic review on 24-h movement behaviour interventions highlight the potential to leverage the interconnectedness of different movement behaviours, particularly in targeting screen time reduction and sleep duration enhancement. These insights can inform the development of more effective, holistic interventions and policies that promote comprehensive approaches to physical activity, sedentary behaviour, and sleep duration among children and adolescents.