Abstract
This study investigated how children's 24-hour (24-h) movement behaviours were affected by SARS-CoV-2 (COVID-19) in the Kingdom of Saudi Arabia. Previous research examined 24-h movement behaviours in Saudi Arabia seven months after the World Health Organization (WHO) declared COVID-19 a global pandemic. This repeat cross-sectional study examined changes in 24-h movement behaviours 12 months after the WHO declaration. The Time 2 survey repeated five months (1 March - 15 May 2021) after Time 1 survey (1 October - 11 November 2020). The survey was distributed to parents of children aged 6-12 years across Saudi Arabia via an online survey. Children were classified as meeting 24-h movement guidelines if they reported uninterrupted sleep for 9-11 h per night, ≤ 2 h of recreational sedentary screen time (RST) per day and ≥ 60 min of moderate-to vigorous-intensity physical activity (MVPA) per day. A total of 1 045 parents from all regions of Saudi Arabia responded (42.4%). Only 1.8% of children met all components of the guidelines, compared to 3.4% in Time 1. In the present study, girls spent more days per week in MVPA ≥ 60 min duration than boys (3.0 vs 2.6; p = 0.025), while boys had spent more days per week engaged in activities that strengthened muscle and bone than girls (3.0 vs 2.8; p = 0.019). Healthy levels of physical activity (PA), sedentary behaviour (SB) and sleep further declined in Saudi children five months after the Time 1 survey. These challenges require urgent intervention to ensure children's movement behaviours improve as Saudi Arabia moves out of the COVID-19 pandemic.