477 Twenty-Four-Hour Movement Practice Guidelines for Saudi Arabia using a modified RAND Appropriateness Method, and Evaluation (GRADE)‑ADOLOPMENT approach: An Integration of Physical Activity, Sedentary Behaviour, and Sleep Duration
Authors: Dobia A , BaHammam A 
Published: April 2023

Abstract

Introduction
Physical activity, sedentariness, and sleep. are strongly interrelated; however, several international guidelines regarding factors associated with movement focus on each activity separately, which, when taken in isolation, may be insufficient for the purpose of developing and implementing recommendations needed to achieve optimal physical and mental health [1‑2]. The absence of national guidelines on physical activity, sedentary behaviour, and sleep that incorporate cultural differences has prompted the development of the Saudi 24-Hour Movement Guideline.

Aim
The aim of the study is to provide policymakers, health‑care providers, researchers, sports professionals, and members of the public with recommendations on the duration of time they should spend engaged in physical activity, sedentary behaviour, and sleep throughout all age groups.

Methods
A modified RAND appropriateness method and the “GRADE‑ADOLOPMENT” approach of guideline recommendations were used by a guideline development panel to develop the recommendations. The Panel identified clear criteria to choose the best practice guidelines for the set objectives after evaluation, based on GRADE table evidence, findings table summaries, and draft recommendations. Updating of the selected practice guidelines was performed, and the Consensus Panels separately reviewed the evidence for each behaviour and decided to adopt or adapt the selected practice guideline recommendations or create de novo recommendations. Two rounds of voting were conducted to reach a consensus for each behaviour. The answers were aggregated, and frequencies and percentages were calculated for the answers using the online questionnaire itself before the data were tabulated with the qualitative responses as feedback for round 2.

Results
The recommendations were based on the integrated needs of the following age groups: children (0–2 years), pre-schoolers (3–5 years), children and adolescents (6–17 years), adults (18–64 years), and older adults (≥65 years). The guidelines also include special considerations for sleep duration in the Saudi culture, such as dawn prayer and Ramadan

Conclusion
These new guidelines provided recommendations for healthy Saudis on physical activity, sedentary behaviour, and sleep duration over 24-hour periods for all age groups and reflect international best practice and national evidence taking into account local customs and practice. Several research gaps were identified and highlighted by the guideline development panel for potential future research.

References
1. Cappuccio FP, Cooper D, D’Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: A systematic review and meta‑analysis of prospective studies. Eur Heart J 2011;32:1484‑92.
2. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 2007;116:1081‑93.