Out-of-school Activities and Adherence to 24-Hour Movement Guidelines

Introduction: The purpose of this study was to explore associations between participation in outof-school/weekend organized activities and adherence to the 24-hour movement guidelines among US adolescents. Methods: Data from the 2022 National Survey of Children's Health (N=16,403, age=15.1 1.4 years, 48.1% female) was used for analyses in 2024. A parent/guardian completed surveys regarding adolescents' 24-hour movement behaviors (physical activity [PA], sleep [SL], and screen- time [ST]), as well as participation in out-of-school and weekend activities (sports, clubs, other organized activities, and volunteering). Weighted logistic regression models were used to examine associations between participation in out-of-school and weekend organized activities and 24-hour movement guideline adherence, adjusted for sex, age, race/ethnicity, federal poverty level status, metropolitan statistical area status, and overweight/obesity status. Results: Only 4.8% of adolescents met all three guidelines concurrently. Adolescents who participated in sports teams/lessons had higher odds of meeting PA (OR=2.11, 95% CI: 1.67-2.66), ST (OR=1.31, 95% CI: 1.12-1.53), PA+ST (OR=2.24, 95% CI: 1.63-3.07), PA+SL (OR=2.00, 95% CI: 1.53-2.63), SL+ST (OR=1.40, 95% CI; 1.19-1.66), and all three guidelines (OR=2.33, 95% CI: 1.61 - 3.39). Participation in other organized activities/lessons was associated with higher odds of meeting ST (OR=1.32, 95% CI: 1.13-1.56), and SL+ST guidelines (OR=1.39, 95% CI: 1.16-1.66). Adolescents who volunteered had higher odds of meeting ST (OR=1.68, 95% CI: 1.42-1.98), PA+ST (OR=1.75, 95% CI: 1.25-2.45), SL+ST (OR=1.64, 95% CI: 1.38-1.95), and all three guidelines (OR=1.80, 95% CI: 1.20-2.72). Conclusions: Participating in sports teams/lessons and community service/volunteer work is beneficially associated with concurrently meeting all three 24-hour movement guidelines and participating in other organized activities or lessons is associated with adherence to individual components of the 24-hour movement guidelines among US adolescents. Am J Prev Med 2025;68(1):66-74. (c) 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).