BMC Public Health. 2025 Sep 24;25(1):3103. doi: 10.1186/s12889-025-24215-9.
ABSTRACT
BACKGROUND: Identifying preventive measures for adolescent mental health is a global public health priority, as poor mental health heightens the risk of early death from related issues, including suicide. This study examined the associations between adherence to the 24-Hour Movement Guidelines and anxiety among a nationally representative sample of South Korean adolescents, using an intersectional identity framework.
METHODS: Data from the 2020-2022 Korea Youth Risk Behavior Surveys were analyzed. Adolescents aged 12-17 years were grouped based on adherence to guidelines: none, physical activity (PA), sedentary behavior (SB), sleep, two guideline combinations, and all three. Anxiety was the mental health outcome. Logistic regression analyses were conducted by intersectional identity groups, adjusting for age, academic performance, family economic status, and body mass index.
RESULTS: Among 122,284 adolescents (48.3% female, mean age 14.8 ± 1.5 years), anxiety prevalence was higher in females. Sleep adherence was associated with lower odds of anxiety for both sexes, with stronger associations observed in males (OR: 0.50, 95% CI: 0.38-0.66) and females with high academic performance on weekdays (OR: 0.48, 95% CI: 0.36-0.64). Stronger associations were seen in females from high-income families (OR: 0.48, 95% CI: 0.37-0.63). While SB adherence alone was not linked to lower anxiety, combined adherence to sleep and SB was associated with lower odds of anxiety. PA adherence was associated with increased odds of anxiety, particularly among females across academic and economic groups.
DISCUSSION: Adherence to sleep guidelines was linked to reduced anxiety, highlighting the crucial role of sleep duration in anxiety management. This underscores the need to consider adolescents’ diverse backgrounds when recommending movement behaviors, warranting further investigation in implementation studies.
PMID:40993570 | DOI:10.1186/s12889-025-24215-9
