How do People Spend their Day? Sociodemographic Disparities in 24-hour Movement Guideline Adherence among US Adults Using 2017-2020 NHANES Data.

Introduction: The 24-hour movement guidelines recommend that adults be physically active every day, get good sleep quality, and limit sedentary behavior to lower disease risk and improve quality of life. Adherence to these guidelines have not been evaluated among racially and ethnically diverse adults in the United States. The objectives were to: 1) estimate and compare the prevalence of guideline adherence among all adults and separated by age recommendations (ages 18-64; 65 + years); and 2) determine whether the odds of movement adherence differ by sociodemographics.

Methods: Self-reported data from 2017-2020 National Health and Nutrition Examination Survey (NHANES) were analyzed (n = 9,627) using multivariate logistic regression for all adults and age stratified. Sedentary behavior was measured by minutes of sedentary activity per day (< 480 minutes adherent). Sleep was measured by hours per night (7-9 hours adherent ages 18-64; 7-8 hours adherent ages >  = 65). Physical activity was measured by minutes of recreational activity per week (150 + minutes adherent).

Results: Guideline adherence among all adults was 23.7% (ages 18-64 = 26%: ages 65 +  = 14.7%). Guideline adherence was highest among non-Hispanic Asians (28.1%) and lowest among non-Hispanic Blacks (19.2%) (p = .0070). Males (25.8%) were more likely to meet movement guidelines than females (21.8%; p = .0009). In adjusted models, the odds of meeting movement guidelines were lower among non-Hispanic Blacks (OR = 0.81; 95%CI = 0.66-0.98) compared to Whites, females (OR = 0.84; 95%CI = 0.72-0.97) compared to males, and lower education (OR = 0.22; 95%CI = 0.14- 0.35) compared to adults with a college degree or higher.

Recommendation: Future interventions should be developed to improve guideline adherence tailored to particular at-risk groups.