The SUNRISE Study-International Study of 24-Hour Movement Behaviours in the Early Years

Background and Importance: The early years (0-5 years) is a critical and sensitive period for lifelong development, as key experiences or missed experiences can alter a child’s developmental potential. Thus, international efforts have focused on ensuring children <5 years are developmentally on track (UN SDG: 4.2.1; WHO Ending Childhood Obesity Report). Unfortunately, our understanding of childhood development is limited and predominantly informed by research on children from high-income countries and urban settings. One set of exposures with potential benefits to childhood development are physical activity, sedentary behaviour, and sleep—collectively termed movement behaviours— but are understudied worldwide. While the benefits to children’s lifelong development from single movement behaviours (e.g. physical activity) has been demonstrated, little is known about the ideal distribution or composition of movement behaviours in a 24-hour day for optimal development. Further, this lack of information is particularly pronounced in rural settings and low- and middle-income countries (LMIC), exacerbating already existing global inequities. Goal: Our goal is to explore movement behaviours (combined and integrated physical activity, sedentary behaviour, sleep) and examine the relationships between movement behaviours and physical, cognitive, and social-emotional development in urban and rural children. Methods: We will each recruit 1,000 children aged 3.0-4.9 years with equal representations by sex and rural-urban communities (500 for each), through stratified sampling. Movement behaviours will be measured using ActiGraph accelerometers that have demonstrated robust psychometrics and feasibility, worn on the waist 24 hours/day for 5 days. Primary caregivers will complete questionnaires to assess children’s screen time, sleep routines and family sociodemographic characteristics. Development will encompass physical (body mass index z-scores, gross motor skills, and fine motor skills), cognitive (response inhibition, visual-spatial working memory, general knowledge, and language development), and social-emotional (internalizing, externalizing, prosocial behaviours, communication skills, social competence, and emotional maturity) development. Expected Outcomes:  The examination will improve our understanding in rural and LMICs, ultimately leading to a richer, more global and equitable understanding of the universal and culturally specific aspects of children’s movement behaviours and development.