Author(s): HYUNSHIK, K., JIAMENG, M., SAYOKO, F., BEOMJIN, C., HIROKO, S., Institution: SENDAI UNIVERSITY, Country: JAPAN, Abstract-ID: 816

INTRODUCTION:
Early childhood is a critical period for establishing healthy movement behaviors, including physical activity (PA), screen time (ST), and sleep duration (SD), which are collectively addressed in the World Health Organization’s 24-hour movement guidelines (24-h MGs). Parental factors, particularly parenting stress, may play an important role in shaping these behaviors during toddlerhood. However, evidence regarding the association between parenting stress and adherence to the 24-h MGs in toddlers remains limited, especially from a cross-national perspective in Asian countries. This study aimed to examine the associations between parenting stress and adherence to the 24-h MGs among toddlers aged 18 months to under 3 years across four Asian countries.
METHODS:
This cross-sectional study included caregivers and their children from Japan (n=550), China (n=550), Korea (n=700), and Singapore (n=500). Parenting stress was assessed using the Parenting Stress Index–Short Form (PSI-SF), including total stress and three subscales: Parental Distress (PD), Parent–Child Dysfunctional Interaction (P-CDI), and Difficult Child (DC). Children’s PA, ST, and SD were assessed using validated parent-reported questionnaires. Adherence to the 24-h MGs was categorized based on the number of recommendations met (0, 1, 2, or 3). Ordinal and multinomial logistic regression models were used to examine associations between parenting stress and guideline adherence, including country interaction terms and adjusting for child and parental covariates.
RESULTS:
Higher levels of parenting stress were consistently associated with lower odds of meeting a greater number of the 24-h MGs. Overall, each one-unit increase in total PSI score was associated with a 1–2% reduction in the odds of meeting one, two, or three guidelines (adjusted odds ratios [aORs] ≈ 0.98–0.99). Clear cross-national differences were observed: associations were strongest in China (aORs ≈ 0.93–0.98), particularly for meeting two or three recommendations, and more modest in Japan (aORs ≈ 0.96–0.99), while they were weak or non-significant in Korea and largely absent in Singapore. Among stress subscales, P-CDI and DC showed the most robust associations, with approximately 4–8% lower odds of adherence per unit increase in stress. Interaction analyses confirmed significant heterogeneity across countries (p < 0.001).
CONCLUSION:
Parenting stress is inversely associated with adherence to the 24-h MGs in toddlers, with notable cross-national differences among Asian countries. These findings highlight the importance of considering parental psychosocial factors when promoting integrated movement behaviors in early childhood. Culturally tailored interventions addressing parenting stress may be essential for improving adherence to PA, ST, and SD recommendations during this critical developmental period.