Abstract
BACKGROUND: Adherence to the 24-hour movement behaviors (24-HMB) guidelines, which include increasing physical activity (PA), reducing screen time (ST), and ensuring adequate sleep (SL) is critical to the healthy development of children and adolescents. Compliance with these guidelines is associated with positive health outcomes (e.g., emotional, social, and academic function). Nevertheless, this correlation has yet to be investigated in children and adolescents with hearing loss. Therefore, we examined the relationship between adherence to 24-HMB guidelines and emotional, social, and academic function in children and adolescents with hearing loss. METHODS: Using data from the 2018-2022 National Survey of Children's Health (NSCH). The NSCH was conducted in all 50 states and the district of Columbia in U.S. We extracted and analyzed parent-reported data on movement behaviors (PA, ST, and SL) and outcome variables of interest for children and adolescents with hearing loss (aged 6 to 17 years). Multiple logistic regression models were employed to examine the associations between meeting the 24-HMB guidelines and emotional, social, and academic function, with odds ratios (OR) and 95% confidence intervals (CI) calculated to quantify these relationships. Children's age, children's gender, children's ethnicity, children's preterm birth status, children's overweight status, household poverty level and primary caregiver's educational background were included as covariates in the models. RESULTS: Among 1,568 children and adolescents with hearing loss, only 6.4% met all three 24-HMB guidelines. The rate of adherence to the SL guideline (27.9%) was higher compared to those who adhered to PA (3.5%) and ST (12.6%) guideline. Compared with those who did not meet any of the 24-HMB guidelines, meeting the PA + ST + SL guidelines was associated with a lower likelihood of poorer emotional function (anxiety: OR = 0.15, 95% CI [0.05-0.49]; depression: OR = 0.03, 95% CI [0.01-0.14]). Meeting ST + SL guidelines was associated with lower odds of poorer social function (being bullied: OR = 0.17, 95% CI [0.04-0.65]; arguing: OR = 0.08, 95% CI [0.03-0.23]). Additionally, meeting PA + ST + SL guidelines was linked to better academic function (caring about doing well in school: OR = 0.15, 95% CI [0.05-0.44]; doing homework: OR = 0.06, 95% CI [0.01-0.48]). CONCLUSION: Meeting 24-HMB guidelines was associated with better emotional, social, and academic function in children and adolescents with hearing loss. These findings highlight the importance of promoting adherence to the 24-HMB guidelines among children and adolescents with hearing loss.