Etude des comportements de mouvement sur 24h : de la méta analyse à l'étude interventionnelle

Background: Insufficient physical activity (PA), as well as high levels of sedentary behaviours (SB), are two of the most important health behavioural risks for non-communicable diseases. In 2016, an integrated theoretical framework was developed in Canada, named the 24–Hour Movement Guidelines, integrating the recommendations for PA, SB and sleep. Furthermore, this model recognized the importance of movement behaviours to improve health outcomes in children and adolescents from an integrated perspective. Nevertheless, 80% of the world’s children and youths do not meet the PA recommendations (i.e., 60 minutes of daily moderate to vigorous physical activity [MVPA]), SB take up over 50% of the waking day for children aged 7 to 10 years, and only 60% of children meet the sleep recommendations (i.e., 9-11 hours a day). Therefore, the overall aim of this doctoral thesis was to explore changes in 24-hour movement behaviours and their associations with school-based interventions among 5-12 years-old children. To achieve this objective, both a scoping review and a meta-analysis were carried out, as well as a school-based intervention.Methods: This thesis is comprised of five research papers, three of which are the protocol of a systematic review, a scoping review and a meta-analysis, and the other two are the protocol of the intervention and an original research study integrated by three surveys during the school-based intervention (i.e., October 2020, May 2021 and April 2022).Results: The scoping review included 37 studies with a total sample size of 27,145 primary school-aged children. As a whole, 62% (i.e., 23 intervention studies) effectively improved PA and/or reduced SB after the intervention, and only one study assessed sleep behaviour, PA and SB together. The meta-analysis is composed of 24 trials comprising 19,487 children (51.3% girls). Intervention studies were ineffective for improving daily MVPA but were effective for reducing ST. Furthermore, subgroup analyses for MVPA revealed that when studies had two intervention components, or high quality they were more effective in improving MVPA. The intervention study results showed significant improvements only in LPA, while a significant decrease in MVPA. In terms of the proportion of children meeting the 24-hour movement guidelines, 42% of all school children met all recommendations and 0% met none.Conclusion: This thesis has provided new evidence to advance the contribution of school-based interventions promoting 24-hour movement behaviours among children. As a main gap, we identified that current school-based interventions do not promote the whole 24-hour movement behaviours among children, because there is a lack of intervention studies addressing sleep behaviour. Second, school-based interventions have been effective to reduce children’s daily time spent in ST, although there is no evidence of overall effectiveness of school-based interventions for improving daily MVPA in children. Third, the school-based intervention program showed significant effects increasing LPA, while significant effects reducing MVPA and non-significant effects for reducing ST, reducing recreational screen time and improving sleep behaviour. Fourth, nearly half of the children participating in the school-based intervention met the 24-hour movement guidelines and there were not anyone not meeting any of the recommendations. Also, differences were found between gender as well as school stage regarding meeting the recommendations. Finally, it is encouraged for researchers to consider the recommendations provided in this thesis before designing future school-based interventions, especially if they are going to target 24-hour movement behaviours among 5-12 years-old children.

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