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Investigating the Compliance With the 24‐h Movement Behaviours Guidelines in Preschoolers: Insights From the SUNRISE Pilot Study in Portugal

ABSTRACT

Background

In 2019, the World Health Organization (WHO) established guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Since then, the SUNRISE Study has been producing evidence on the proportion of children meeting the guidelines and their association with healthy development.

Objectives

This SUNRISE Portugal pilot study aimed to (a) report the prevalence of 3- to 4-year-old Portuguese children meeting the WHO guidelines and (b) assess the feasibility and acceptability of implementing the SUNRISE protocol in the Portuguese context.

Methods

A total of 115 preschool children were recruited from three urban and three rural public early childcare and education centres in Portugal. Parents answered questions on the children’s screen time and sleep patterns. Movement behaviours were objectively measured using accelerometers wGT3X. Anthropometrics, gross and fine motor skills, physical fitness and executive functions were assessed using the SUNRISE protocol. Children were categorized as compliant or not with the guidelines, and descriptive statistics were used to summarize the protocol’s feasibility.

Results

From those recruited, 77 children provided valid accelerometer data. Compliance was slightly higher when considering parent-reported sleep data instead of device-based measurements of sleep (33.8% and 31.2%, respectively). When considering the restrained time recommendation, no child was classified as non-compliant. The highest compliance rate was observed for parent-reported sleep time (89.7%), whereas the lowest was for physical activity (53.3%). A total of 66.3% of the children complied with screen time recommendations. Response rates to the protocol were consistently high, exceeding 70% across all measures.

Conclusion

Compliance with the WHO guidelines among Portuguese children varies depending on the protocol used to assess sleep duration and the inclusion or not of the restrained time recommendation. The SUNRISE protocol proved to be feasible for implementation in the Portuguese context, and valuable lessons were learned regarding response rates for both accelerometer data and the parent questionnaire.

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Posted in: Guidelines Plus on 03/30/2026 | Link to this post on IFP |
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