Conducting 24-hour movement behaviour research with preschool children in middle-income countries: Lessons from the SUNRISE pilot study in Mexico.

Objectives: Movement behaviour research among preschoolers is nascent in low- and middle-income countries, where levels of physical activity, sleep, and sedentary behaviour in children are largely unknown. This study aimed to adapt and assess the acceptability and feasibility of the International Study of Movement Behaviours in the Early Years (SUNRISE) in Mexico, and report on challenges and solutions while implementing the protocol. Study design: Pilot study of the SUNRISE protocol in Mexico. Methods: Safety, logistic challenges, local dynamics, and population needs were considered to adapt the SUNRISE protocol. A gender-balanced sample of 100 children aged 3-4 years from urban and rural communities were recruited through early childcare and education centres (ECECs). Measures on children's movement behaviours, anthropometry, gross and fine motor skills, and executive functions were collected. Challenges and solutions for implementing the protocol were documented. Results: The protocol was well accepted by the school community (School response rate: 83.3 %). Data were collected from 132 children (response rate: 44.4 %); 88 children had valid accelerometer data (average wear time: 766.8 min/d). Challenges faced included: stringent regulations to access ECECs, low confidence in the research team and protocol, low literacy levels among parents, lack of basic services in rural areas (e.g., electricity, transportation, accommodation), and poor compliance with accelerometer wear time. To overcome them, changes to the protocol considered: adaptions to meet ECECs dynamics, strategies to enhance trust in the research team and protocols (face-to-face communication, demonstrations, and encouraging parental engagement), seeking community leaders to facilitate access to rural areas and ensure the research team's safety and access to basic facilities, and strategies to improve accelerometer adherence. Conclusions: This study demonstrates the feasibility of conducting movement behaviour research among preschool children through ECECs in Mexico and provides relevant lessons learned that may hold relevance for researchers in settings with similar contexts to Mexico.