Abstract
<p>Background: The early years are a critical window for establishing healthy 24-hour movement behaviours, encompassing physical activity, sedentary behaviour (including screen time), and sleep. Stakeholder views are essential for understanding the multilevel barriers and enablers to promoting 24-hour movement behaviours that benefit health, as they are ultimately responsible for the dissemination and implementation of guidelines and interventions.Methods: Data were collected in 2021 during the COVID-19 pandemic restrictions. A qualitative design was used, consisting of semi-structured focus groups (n = 4) with stakeholders (n = 18). This included researchers, public health professionals, and individuals from the private sector and third sector organisations. Focus group data were analysed using a codebook thematic analysis.Results: Stakeholders discussed (1) their desire for a shared holistic vision for early years movement – agreeing that physical activity, sedentary behaviour and sleep are interconnected across the 24-hour day and calling for the early years to be centred in multisector collaborations; (2) the complexity of communicating guidance on 24-hour movement behaviours clearly and without stigma; (3) the central role of community and informal networks in communicating guidelines and supporting 24-hour movement behaviours; (4) the constraint realities of family life in determining what families can realistically do regardless of what guidelines recommend; (5) hidden determinants of behaviours including adult mental health, relational well-being and social economic inequalities; and (6) structural barriers such as policy fragmentation, under investment in early-years services, geographical inequalities, and lasting disruptions of the COVID-19 restrictions.Conclusion: Stakeholders understood 24-hour movement behaviours in early childhood as shaped by interacting influences across the levels of the socio-ecological model (intrapersonal, interpersonal, community, institutional and public policy). Effective communication requires a coordinated, multi-level response that addresses structural barriers and systemic inequalities, supports families as actors in constrained circumstances, and moves beyond approaches that place the burden of change solely at the intrapersonal level.</p>