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. 2025 Oct:93:103227.
doi: 10.1016/j.ctim.2025.103227. Epub 2025 Aug 7.

Associations of 24-hour movement guidelines adherence with social function and academic performance in youth with anxiety problems

Xiwen Luo  1 , Shubo Xu  2 , Yulin Luo  2 , Siyu Pan  3 , Ailikute Aikeremu  3 , Jiaqiao Luo  4 , Jincheng Lin  5 , Yusi Wang  6 , Yanping Gao  7 , Xiang-Qin Song  8
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Free article

Associations of 24-hour movement guidelines adherence with social function and academic performance in youth with anxiety problems

Xiwen Luo et al. Complement Ther Med. 2025 Oct.
Free article

Abstract

Purpose: Anxiety problems are prevalent among children and adolescents (being referred as youth), often impairing their social and academic functioning, while healthy lifestyles as outlined in 24-hour movement (24-HBM) guidelines may offer potential benefits, yet their specific associations remain understudied. This study is to explore the associations between 24-HMB adherence and social and academic functioning in U.S. youth aged 6-17 years with anxiety problems.

Method: Data from the 2022-2023 National Survey of Children's Health was utilized in this cross-sectional study, involving 3625 children and adolescents with anxiety problems. 24-HBM guidelines include a daily moderate-to-vigorous physical activity (MVPA) duration of at least 60 min, daily recreational screen time (ST) of ≤ 2 h, and age-specific sleep duration (SP). Statistical analyses were conducted to examine the relationships between 24-HBM adherence and social functioning (e.g., difficulty keeping friends, self-regulation) and academic functioning (e.g., school engagement, grade repetition).

Results: Only 5.7 % of participants fully adhered to 24-HBM guidelines. Adhering to one or more components was associated with better social and academic functioning: physical activity (PA) guideline adherence was pivotal for reducing difficulties in making/keeping friends; ST guidline adherence was key for enhancing school engagement. Adherence to combined guidelines (e.g., PA+ST, PA+SP) showed synergistic effects, with full adherence (PA + ST +SP) linked to lower odds of grade repetition and better self-regulation.

Conclusion: Promoting 24-HBM guideline adherence, particularly PA and ST components, may enhance specific health aspects in this unique group. Future longitudinal studies should be conducted to further verify study findings.

Keywords: Academic performance; Anxiety; Movement behavior; Social functioning; Youth.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.