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Kilkelly TJ, Palmer J, Kreashko L. Improving Mental Health Outcomes in Adolescent Patients With Universal Anxiety Screening in an Outpatient Pediatric Primary Care Office: A Quality Improvement Project. J Pediatr Health Care 2023; 37:688-695. [PMID: 37715758 DOI: 10.1016/j.pedhc.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 09/18/2023]
Abstract
INTRODUCTION In the wake of the cultural and mental health consequences that arose since the COVID-19 pandemic, primary care providers must be able to assess and initiate treatment of anxiety disorders in the pediatric population. Only 59% of children with a diagnosable anxiety disorder are identified and receive treatment. This quality improvement project aimed to evaluate the implementation of universal anxiety screening using the General Anxiety Disorder-7 tool in pediatric primary care. METHODS Screening was performed on adolescents (aged 12-18 years) to evaluate the frequency and acceptability of tool administration and identification of anxiety and referrals to mental health care for treatment. Employing a pretest-posttest design, the effect of universal anxiety screening for adolescents was measured at well-child visits. RESULTS Anxiety screening and anxiety diagnosis rates were significantly increased post-implementation. DISCUSSION Universal screening for anxiety was efficacious in the project setting for identifying cases of anxiety.
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von Suchodoletz A, Bélanger J, Bryan C, Ali R, Al Nuaimi SR. COVID-19's shadow on families: A structural equation model of parental stress, family relationships, and child wellbeing. PLoS One 2023; 18:e0292292. [PMID: 37824497 PMCID: PMC10569562 DOI: 10.1371/journal.pone.0292292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/15/2023] [Indexed: 10/14/2023] Open
Abstract
The present study seeks to contribute to developmental science in emergencies by investigating associations between COVID-19 pandemic-related stressors, parents' stress, family relationships, and child wellbeing. In doing so, we build on recent research that generalizes the assumptions of the Family Stress Model beyond direct economic stressors of households to macro-contextual stressors that operate at the societal level. In the case of our study, these stressors relate to the COVID-19 pandemic, such as health risks and confinement-related stresses. Participants were 783 parents of young children (75% female, Mage = 34.61 years) residing in the United Arab Emirates. They completed an online survey in Fall 2020 and Spring 2021, measuring how the pandemic impacted their lives and the lives of their child (Mage = 47.54 months). A subsample of parents (n = 96) completed the survey for two children. Structural equation modeling showed that pandemic-related stressors contributed to higher stress among parents which, in turn, resulted in lower parent-reported child wellbeing at various times during the pandemic. Family relationships mediated the association between parents' stress and child wellbeing. The present study contributes to our understanding on how large-scale disruption due to COVID-19 pandemic-related stressors gets inside the family, the strength and direction of associations (concurrently and over time), and the timing of mechanisms that impact family processes. The results highlight the need to support families with young children in managing disruptions due to emergencies, such as a global public health crisis, and to determine ways of preventing longstanding consequences on family structures and children's lives.
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Affiliation(s)
- Antje von Suchodoletz
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- New York University Global TIES for Children Research Center, Abu Dhabi, United Arab Emirates
| | - Jocelyn Bélanger
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- New York University Global TIES for Children Research Center, Abu Dhabi, United Arab Emirates
| | - Christopher Bryan
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Rahma Ali
- New York University Global TIES for Children Research Center, Abu Dhabi, United Arab Emirates
| | - Sheikha R. Al Nuaimi
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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Vasile CM, Padovani P, Rujinski SD, Nicolosu D, Toma C, Turcu AA, Cioboata R. The Increase in Childhood Obesity and Its Association with Hypertension during Pandemics. J Clin Med 2023; 12:5909. [PMID: 37762850 PMCID: PMC10531996 DOI: 10.3390/jcm12185909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
There has been a major ongoing health impact of the COVID-19 pandemic on children's lives, including lifestyle and overall health. Enforcement of prevention measures, such as school closures and social distancing, has significantly affected children's daily routines and activities. This perspective manuscript aims to explore the rise in childhood obesity and its association with hypertension during pandemics. The COVID-19 pandemic has led to significant disruptions in children's routines, including reduced physical activity, increased sedentary behavior, and changes in dietary patterns. These factors, coupled with the psychological impact of the pandemic, have contributed to an alarming increase in childhood obesity rates. This paper has highlighted the concerning increase in childhood obesity and hypertension during pandemics. The disruptions caused by the COVID-19 pandemic, including reduced physical activity, increased sedentary behaviors, and changes in dietary patterns, have contributed to the rise in these health conditions. It is crucial to recognize the long-term consequences of childhood obesity and hypertension and the urgent need for a comprehensive approach to address them.
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Affiliation(s)
- Corina Maria Vasile
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, F-33600 Bordeaux, France;
| | - Paul Padovani
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PreciCare, F-44000 Nantes, France;
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, F-44000 Nantes, France
| | | | - Dragos Nicolosu
- Pneumology Department, Victor Babes University Hospital Craiova, 200515 Craiova, Romania; (D.N.); (R.C.)
| | - Claudia Toma
- Pneumology Department, University of Medicine Carol Davila, 020021 Bucharest, Romania;
| | - Adina Andreea Turcu
- Faculty of Dentistry, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
| | - Ramona Cioboata
- Pneumology Department, Victor Babes University Hospital Craiova, 200515 Craiova, Romania; (D.N.); (R.C.)
- Pneumology Department, University of Medicine and Pharmacy, 200349 Craiova, Romania
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Li B, Ng K, Tong X, Zhou X, Ye J, Yu JJ. Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2023; 17:92. [PMID: 37468975 DOI: 10.1186/s13034-023-00629-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/12/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) and universal mitigation strategies have fundamentally affected peoples' lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID-19 pandemic. METHODS Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2-24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size. RESULTS A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher's z = - 0.198, p < 0.001) and positive (Fisher's z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information. CONCLUSIONS PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).
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Affiliation(s)
- Bowen Li
- Department of Sport and Exercise Science, College of Education, Zhejiang University, Hangzhou, China
| | - Kwok Ng
- Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Faculty of Education, University of Turku, Rauma, Finland
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Xiuhong Tong
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Jiangchuan Ye
- Department of Sport and Exercise Science, College of Education, Zhejiang University, Hangzhou, China
| | - Jane Jie Yu
- Department of Sport and Exercise Science, College of Education, Zhejiang University, Hangzhou, China.
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Peng B, Reeves KKL, Lee SWY, Chung THY, Hui HWL, Leung AHL, Pang JCY. Physical, psychological, and behavioral problems among children and adolescents in countries with different economic statuses during the COVID-19 pandemic: a systematic review and meta-analysis. Front Pediatr 2023; 11:1181186. [PMID: 37342536 PMCID: PMC10277820 DOI: 10.3389/fped.2023.1181186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/02/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction The COVID-19 pandemic has impacted children and adolescents' physical activity (PA), sleeping patterns, and psychological and behavioral health. Yet, little is known about the differences between those in countries with various economic statuses. Methods Articles published from database inception through 16 March 2022 were retrieved using CINAHL Complete, Cochrane Library, EMBASE, Medline, PubMed, and PsycINFO. High-quality studies that reported the number of participants with parameters associated with PA, sleeping patterns, and psychological and behavioral problems in young people aged under 18 years during the pandemic were included. We referenced the Canadian 24-Hour Movement Guidelines for PA and sleep duration to provide the event rate for young people who were not compliant with the guidelines. The event rate of young people who had decreased sleep quality and experienced psychological and behavioral problems were also investigated. A subgroup analysis was conducted to identify the differences in those in countries with diverse economic statuses. Funnel plot analysis and Egger's test were also conducted to identify any risk of publication bias. Result A total of 66 studies with 1,371,168 participants aged between 0 and 18 years, involving 27 countries, were included. During the pandemic, we identified that 41% (95% CI: 39%, 43%; I2 = 96.62) and 43% (95% CI: 34%, 52%; I2 = 99.42) of young people did not meet the PA and sleep duration recommendation guidelines. In addition, 31% (95% CI: 28%, 35%; I2 = 99.66) of young people had decreased their sleep quality. Yet, no significant difference was found across countries with different economic statuses. However, the event rates of participants with psychological and behavioral problems were 32% (95% CI: 28%, 36%; I2 = 99.85) and 19% (95% CI: 14%, 25%; I2 = 99.72), respectively. In addition, the rate of psychological problems was more severe in those who live in lower middle-income countries (p < 0.001), while the rate of behavioral problems was more severe in those who live in high-income countries (p = 0.001). Discussion During the pandemic, the discouragement of PA, poor sleep quality, and high risk of psychological and behavioral problems are concerning. A large number of young people did not comply with the recommendation guidelines. Timely implementation of recovery plans is critical to address the adverse effects on young people. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=309209, identifier CRD42022309209.
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Affiliation(s)
- Bo Peng
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Kara K. L. Reeves
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
- Research Rehab Centre Limited, Hong Kong SAR, China
| | - Shara W. Y. Lee
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Tina H. Y. Chung
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
| | - Heidi W. L. Hui
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
| | - Alfred H. L. Leung
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
| | - Johnson C. Y. Pang
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR, China
- Research Rehab Centre Limited, Hong Kong SAR, China
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Eaton A, Ball GDC, Hwang Y, Carson V, Gokiert R, Dennett L, Rajani H, Zhang M, Dyson MP. The Impacts of COVID-19 Restrictions on Physical Activity in Children and Youth: A Systematic Review of Qualitative Evidence. J Phys Act Health 2023; 20:423-437. [PMID: 36965492 DOI: 10.1123/jpah.2022-0350] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/16/2022] [Accepted: 01/11/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND The objectives of this systematic review were to synthesize qualitative evidence on the impacts of COVID-19 restrictions on physical activity (PA) for children and youth, and explore factors perceived to influence those impacts. METHODS Five databases (MEDLINE, Embase, SPORTDiscus, ERIC, and CINAHL) were searched initially in June 2021 and updated in December 2021 to locate qualitative articles considering COVID-19 restrictions and PA for children and youth (≤18 y old), in any setting. Eligibility, quality assessments, and data extraction were completed by 2 independent reviewers. Data were synthesized using meta-aggregation with confidence of findings rated using ConQual. RESULTS After screening 3505 records, 15 studies were included. Curriculum-based PA, organized sport, and active transportation were negatively impacted by COVID-19 restrictions. Negative changes were affected by COVID-19 exposure risks, inadequate instruction, poor access, screen time, and poor weather. Unstructured PA was inconsistently impacted; outdoor unstructured PA increased for some. Positive changes were facilitated by family co-participation, availability of outdoor space, and perceived mental health benefits. CONCLUSION Qualitative data indicated restrictions had a predominantly negative impact on PA for children and youth, but inconsistent impacts on unstructured PA. The improved contextual understanding offered by our review will be foundational knowledge for health strategies moving forward.
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Affiliation(s)
- Andrea Eaton
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
| | - Yeongho Hwang
- Faculty of Kinesiology, Sport & Recreation, University of Alberta, Edmonton, AB,Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport & Recreation, University of Alberta, Edmonton, AB,Canada
| | - Rebecca Gokiert
- School of Public Health, University of Alberta, Edmonton, AB,Canada
| | | | - Hasu Rajani
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
- Northeast Community Health Centre, Edmonton, AB,Canada
| | - Mona Zhang
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
- Northeast Community Health Centre, Edmonton, AB,Canada
| | - Michele P Dyson
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB,Canada
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Pang JCY, Chan ELS, Lau HMC, Reeves KKL, Chung THY, Hui HWL, Leung AHL, Fu ACL. The impacts of physical activity on psychological and behavioral problems, and changes in physical activity, sleep and quality of life during the COVID-19 pandemic in preschoolers, children, and adolescents: A systematic review and meta-analysis. Front Pediatr 2023; 11:1015943. [PMID: 36969271 PMCID: PMC10038232 DOI: 10.3389/fped.2023.1015943] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/21/2023] [Indexed: 03/29/2023] Open
Abstract
Background The COVID-19 pandemic has greatly affected the level of physical activity (PA). However, little is known about its effect on health outcomes. Methods Articles without language restrictions published from the database inception through March 16, 2022, were retrieved using the CINAHL Complete, Cochrane Library, EMBASE, Medline, PubMed, and PsycINFO databases. High-quality articles assessing the effect of PA on psychological and behavioral problems. Additionally, PA, QoL, and/or sleep problems before and during the pandemic were included. Articles without data regarding PA or involving non-general populations were excluded. The PRISMA and MOOSE guidelines were followed. Data quality of the selected articles was assessed using the Newcastle-Ottawa Scale and GRADE approach. Data were pooled using a random-effects model and sensitivity analysis if heterogenicity was high (I 2 ≥ 50%). The relationship between PA and psychological and behavioral problems; and changes in PA, QoL, and sleeping patterns before and during the pandemic in preschoolers, children, and adolescents were investigated. A meta-analysis was conducted; odds ratios (ORs), mean differences (MD), and standardized MDs (SMDs) were calculated. Results Thirty-four articles involving 66,857 participants were included. The results showed an overall significant protective effect between PA and psychological and/or behavioral problems (OR = 0.677; 95% CI = 0.630, 0.728; p-value <0.001; I 2 = 59.79%). This relationship was also significant in the subgroup analysis of children (OR = 0.690; 95% CI = 0.632, 0.752; p-value <0.001; I 2 = 58.93%) and adolescents (OR = 0.650; 95% CI = 0.570, 0.741; p-value <0.001; I 2 = 60.85%); however, no data on the relationship in preschoolers were collected. In addition, the overall time spent on PA significantly decreased by 23.2 min per day during the COVID-19 pandemic (95% CI = -13.5, -32.9; p-value <0.001; I 2 = 99.82%). Moreover, the results showed an overall significant decrease in QoL (SMD = -0.894, 95% CI = -1.180, -0.609, p-value <0.001, I 2 = 96.64%). However, there was no significant difference in sleep duration during the COVID-19 pandemic (MD = 0.01 h per day, 95% CI = -0.027, 0.225; p-value = 0.125; I 2 = 98.48%). Conclusion During the pandemic, less PA was contributed to poor QoL and sleep quality. However, increases in PA are associated with reduced occurrences of psychological and behavioral problems. Implementing recovery plans to address the health effect of the pandemic is essential.
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Affiliation(s)
- Johnson C. Y. Pang
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Eric L. S. Chan
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Herman M. C. Lau
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Kara K. L. Reeves
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Tina H. Y. Chung
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Heidi W. L. Hui
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Alfred H. L. Leung
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Allan C. L. Fu
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- China Studies Centre, The University of Sydney, Sydney, NSW, Australia
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Hammersen J, Tittel SR, Khodaverdi S, Reschke F, Flury M, Menzel U, Mönkemöller K, Meissner T, Karges B, Holl RW. Metabolic control during the first two years of the COVID-19 pandemic in pediatric patients with type 1 diabetes: results from the German DPV initiative. Acta Diabetol 2023; 60:757-766. [PMID: 36871116 PMCID: PMC9985474 DOI: 10.1007/s00592-023-02050-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/04/2023] [Indexed: 03/06/2023]
Abstract
AIM To assess effects of the SARS-CoV2 pandemic on metabolic control in youth with type 1 diabetes (T1D) in Germany in a population-based analysis. METHODS Data from 33,372 pediatric T1D patients from the Diabetes Prospective Follow-up (DPV) registry, with face-to-face visits or telemedicine contacts in the years 2019-2021, were available. Datasets from eight time periods between March 15, 2020, and December 31, 2021, according to SARS-CoV2 incidence waves, were compared to those from five control time periods. Parameters of metabolic control were assessed with adjustment for sex, age, diabetes duration, and repeated measurements. Laboratory-measured HbA1c values and those estimated from CGM were aggregated into a combined glucose indicator (CGI). RESULTS There was no clinically relevant difference in metabolic control between pandemic and control time periods with adjusted CGI values ranging from 7.61% [7.60-7.63] (mean [95% confidence interval (CI)]) in the third quarter of 2019 to 7.83% [7.82-7.85] in the time period from January 1 to March 15 2020, in the other control periods, and during the pandemic, CGI values lay between these values. BMI-SDS rose during the pandemic from 0.29 [0.28-0.30] (mean [95% CI]) in the third quarter of 2019 to 0.40 [0.39-0.41] during the fourth wave. Adjusted insulin dose rose during the pandemic. Event rates for hypoglycemic coma and diabetic ketoacidosis remained unchanged. CONCLUSIONS We found no clinically relevant change of glycemic control or incidence of acute diabetes complications during the pandemic. The observed BMI increase may represent an important health risk for youth with T1D.
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Affiliation(s)
- Johanna Hammersen
- Department of Pediatrics, University Hospital Erlangen, Loschgestr. 15, 91054, Erlangen, Germany.
| | - Sascha R Tittel
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Semik Khodaverdi
- Clinic for Children and Adolescent Medicine, Clinical Centre Hanau, Hanau, Germany
| | - Felix Reschke
- Diabetes Center for Children and Adolescents, Children's Hospital Auf Der Bult, Hannover, Germany
| | - Monika Flury
- Children's Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Ulrike Menzel
- Department of Paediatric Endocrinology, AKK Altonaer Kinderkrankenhaus, Hamburg, Germany
| | - Kirsten Mönkemöller
- Department of Pediatrics, Kinderkrankenhaus Amsterdamer Strasse, Cologne, Germany
| | - Thomas Meissner
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital, Duesseldorf, Germany
| | - Beate Karges
- Division of Endocrinology and Diabetology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Department of Pediatrics, Bethlehem Hospital Stolberg, Stolberg, Germany
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Raine LB, Erickson KI, Grove G, Watrous JNH, McDonald K, Kang C, Jakicic JM, Forman DE, Kramer AF, Burns JM, Vidoni ED, McAuley E, Hillman CH. Cardiorespiratory fitness levels and body mass index of pre-adolescent children and older adults during the COVID-19 pandemic. Front Public Health 2023; 10:1052389. [PMID: 36733279 PMCID: PMC9888666 DOI: 10.3389/fpubh.2022.1052389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/22/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction The social and behavioral effects of the COVID-19 pandemic have impacted the health and physiology of most people, including those never diagnosed with COVID-19. While the impact of the pandemic has been felt across the lifespan, its effects on cardiorespiratory fitness (commonly considered a reflection of total body health) of older adults and children may be particularly profound due to social distancing and stay-at-home advisories, as well as the closure of sport facilities and non-essential businesses. The objective of this investigation was to leverage baseline data from two ongoing clinical trials to determine if cardiorespiratory fitness and body mass index were different during COVID-19 relative to before COVID-19 in older adults and children. Methods Healthy older individuals (N = 593; 65-80 years) and 200 typically developing children (8-10 years) completed a graded maximal exercise test and had their height and weight measured. Results Results revealed that older adults and children tested during COVID-19 had significantly lower cardiorespiratory fitness levels than those tested before COVID-19 shutdowns (older adults: 30% lower; children: 53% lower; p's ≤ 0.001). In addition, older adults and children tested during COVID-19 had significantly higher BMI (older adults: 31.34 ± 0.57 kg/m2, p = 0.004; children: 19.27 ± 0.44 kg/m2, p = 0.05) than those tested before COVID-19 shutdowns (older adults: 29.51 ± 0.26 kg/m2, children: 18.13 ± 0.35 kg/m2). However, these differences in BMI did not remain significant when controlling for cardiorespiratory fitness. Discussion Results from this investigation indicate that the COVID-19 pandemic, and behavior changes taken to reduce potential exposure, may have led to lower cardiorespiratory fitness levels in older adults and children, as well as higher body mass index. These findings provide relevant public health information as lower cardiorespiratory fitness levels and higher body mass indexes recorded during the pandemic could have far-reaching and protracted health consequences. Public health guidance is needed to encourage physical activity to maintain cardiorespiratory fitness and healthy body composition. Clinical trial registration Older adults: https://clinicaltrials.gov/ct2/show/NCT02875301, identifier: NCT02875301; Children: https://clinicaltrials.gov/ct2/show/NCT03592238, identifier: NCT03592238.
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Affiliation(s)
- Lauren B. Raine
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, United States
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Research Institute, AdventHealth, Orlando, FL, United States
| | - George Grove
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Katherine McDonald
- Department of Psychology, Northeastern University, Boston, MA, United States
| | - Chaeryon Kang
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States
| | - John M. Jakicic
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Daniel E. Forman
- Department of Medicine and Veterans Affairs Pittsburgh Healthcare System, Geriatrics, Research, Education and Clinical Care (GRECC), University of Pittsburgh, Pittsburgh, PA, United States
| | - Arthur F. Kramer
- Department of Psychology, Northeastern University, Boston, MA, United States
- Beckman Institute, University of Illinois, Urbana, IL, United States
| | - Jeffrey M. Burns
- Alzheimer's Disease Research Center, University of Kansas Medical Center Fairway, Fairway, KS, United States
| | - Eric D. Vidoni
- Alzheimer's Disease Research Center, University of Kansas Medical Center Fairway, Fairway, KS, United States
| | - Edward McAuley
- Beckman Institute, University of Illinois, Urbana, IL, United States
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, United States
| | - Charles H. Hillman
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, United States
- Department of Psychology, Northeastern University, Boston, MA, United States
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McGuine T, Biese K, Hetzel S, Schwarz A, Reardon C, Bell DR, Brooks A, Dickman J, Watson AM. A Multiyear Assessment of the Effect of Sport Participation on the Health of Adolescent Athletes During the COVID-19 Pandemic. J Athl Train 2023; 58:44-50. [PMID: 35380683 PMCID: PMC9913056 DOI: 10.4085/1062-6050-0679.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Sport cancellations early in the COVID-19 pandemic had a significant negative effect on the health of US adolescents. The effect of restarting sports during the pandemic has not been described. OBJECTIVE To identify the effect of sport participation on the health of adolescents before and during the COVID-19 pandemic. DESIGN Cross-sectional study. SETTING Sample recruited via social media. PATIENTS OR OTHER PARTICIPANTS Wisconsin adolescent athletes. MAIN OUTCOME MEASURE(S) Participants provided information regarding their age, sex, and sport(s) involvement and completed the Patient Health Questionnaire-9 Item to assess depression symptoms, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to measure physical activity, and the Pediatric Quality of Life Inventory 4.0 to measure quality of life (QoL). Data were collected in spring 2021 (Spring21; n = 1906, age = 16.0 ± 1.2 years, females = 48.8%), when interscholastic sports had fully resumed, and were compared with similar cohorts of adolescent athletes at 2 time points: (1) spring 2020 (Spring20; n = 3243, age = 16.2 ± 1.2 years, females = 57.9%) when sports were cancelled and (2) 2016-2018 (PreCOVID-19) before the pandemic (n = 5231, age = 15.7 ± 1.1 years, females = 65.0%). Comparisons were conducted via analysis-of-variance models and ordinal regressions with age and sex as covariates. RESULTS The prevalence of moderate to severe depression was lower in Spring21 than in Spring20 but higher than in PreCOVID-19 (PreCOVID-19 = 5.3%, Spring20 = 37.8%, Spring21 = 22.8%; P < .001). Physical activity scores (mean [95% CI]) were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 23.1 [22.7, 23.5], Spring20 = 13.5 [13.3, 13.7], Spring21 = 21.9 [21.6, 22.2]). Similarly, QoL scores were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 92.8 [92.5, 93.1], Spring20 = 80.7 [80.3, 81.1], Spring21 = 84.3 [83.8, 84.8]). CONCLUSIONS Although sports have restarted, clinicians should be aware that physical activity, mental health, and QoL are still significantly affected in adolescent athletes by the ongoing pandemic.
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Affiliation(s)
- Timothy McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison
| | | | - Scott Hetzel
- Clinical Science Center, University of Wisconsin-Madison
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Popescu F, Sommer EC, Mahoney MR, Adams LE, Barkin SL. Effect of a Virtual Home-Based Behavioral Intervention on Family Health and Resilience During the COVID-19 Pandemic: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2247691. [PMID: 36538328 PMCID: PMC9856707 DOI: 10.1001/jamanetworkopen.2022.47691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Virtual home-based interventions may bolster protective factors, such as family health and resilience, during stressors such as the COVID-19 pandemic; however, their effectiveness is unknown. OBJECTIVE To examine the effectiveness of a virtual health coaching intervention on family health and resilience during the pandemic. DESIGN, SETTING, AND PARTICIPANTS In this parallel-group, single-site randomized clinical trial, 123 parents and their 2- to 8-year-old children were enrolled at a pediatric clinic or community partner site in Tennessee from March 10 to August 11, 2021. Follow-up surveys were completed between June 29 and November 11, 2021. INTERVENTIONS All participants received 11 weekly cooking videos and associated home-delivered groceries. The intervention group also received 12 weekly, 30-minute virtual health coach sessions. MAIN OUTCOMES AND MEASURES The primary outcome was the validated 6-item (range, 6-30) Family Healthy Lifestyle Subscale (FHLS) scores. The secondary outcome was the validated 6-item (range, 0-6) Family Resilience and Connection Index (FRCI) scores. Outcomes were determined a priori and evaluated at baseline and 12-week follow-up. A priori independent t tests and multivariable tobit regression models assessed intervention effects, and post hoc, secondary interaction models assessed whether effects differed over baseline outcomes. RESULTS Among the 123 enrolled families, 110 (89%) were included in the primary analyses (parent mean [SD] age, 35.1 [8.2] years; 104 [95%] female; 55 [50%] non-Hispanic Black; child mean [SD] age, 5.2 [1.7] years; 62 [56%] male). Intervention-control group mean differences were nonsignificant for follow-up FHLS scores (0.7; 95% CI, -0.6 to 2.0; P = .17) and FRCI scores (0.1; 95% CI, -0.5 to 0.6; P = .74). Tobit regression model intervention effects were nonsignificant for FHLS scores (0.9; 95% CI, -0.3 to 2.2; P = .15) and FRCI scores (0.4; 95% CI, -0.2 to 1.1; P = .17). Post hoc, secondary models found no significant interaction for FHLS scores (1.3 increase per 5-point decrease; 95% CI, -0.2 to 2.7; P = .09), with significant intervention associations for baseline scores of 6 to 23. The interaction was significant for FRCI scores (0.4 increase per 1-point decrease; 95% CI, 0.01 to 0.8; P = .047), with significant intervention associations for baseline scores of 0 to 3. CONCLUSIONS AND RELEVANCE In this randomized clinical trial of families with young children, weekly virtual health coaching did not detectably improve family health and resilience. Post hoc, secondary results provided preliminary evidence of potential effectiveness among families with low baseline scores. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05328193.
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Affiliation(s)
- Filoteia Popescu
- The University of Tennessee Health Science Center College of Medicine, Memphis
| | - Evan C. Sommer
- Department of Academic General Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Laura E. Adams
- Department of Academic General Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shari L. Barkin
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond
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12
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Spaggiari S, Forlini V, Carraro S, Ferraro VA, Zanconato S, Montanaro M, Cecinati V, Zaffani S, Maffeis C, Di Riso D. Spending Time with Mothers as a Resource for Children with Chronic Diseases: A Comparison of Asthma, Type 1 Diabetes, and Cancer during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14126. [PMID: 36361022 PMCID: PMC9654079 DOI: 10.3390/ijerph192114126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Due to the COVID-19 pandemic, many families had to manage new difficulties, especially those of chronically ill children. More and more research has focused on the negative effects of the pandemic on psychological wellbeing, while less is known about the resources. The present study aimed to explore the role of time spent with mothers in chronically ill children's populations during the COVID-19 pandemic. Moreover, it explored the differences in mothers' and children's psychosocial functioning in three clinical populations. Four groups were recruited and compared: 7-15 year old children with asthma (45), type 1 diabetes (52), and cancer (33), as well as their healthy counterparts (41), and their respective mothers. They were administered standardized questionnaires and ad hoc surveys assessing psychological wellbeing and worries. Children of the four groups scored significantly differently with respect to the concerns for contagion, internalizing symptoms, and prosocial behaviors; mothers had worries about the consequences of their children's contagion related to the chronic illness, as well as time with the child. The multiple linear regression model showed an association of being affected by cancer, suffering from type 1 diabetes, and spending less time with the child with an increase in children's internalizing problems. Time with mothers seemed to be a resource for psychological wellbeing during the pandemic. Clinical implications are discussed.
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Affiliation(s)
- Silvia Spaggiari
- Department of Developmental and Socialization Psychology (DPSS), University of Padua, 35131 Padova, Italy
| | - Virginia Forlini
- Department of Developmental and Socialization Psychology (DPSS), University of Padua, 35131 Padova, Italy
| | - Silvia Carraro
- Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
| | | | - Stefania Zanconato
- Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
| | - Maria Montanaro
- Complex Structure of Pediatrics and Pediatric Oncohematology “Nadia Toffa”, Central Hospital Santissima Annunziata, 74121 Taranto, Italy
| | - Valerio Cecinati
- Complex Structure of Pediatrics and Pediatric Oncohematology “Nadia Toffa”, Central Hospital Santissima Annunziata, 74121 Taranto, Italy
| | - Silvana Zaffani
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, 37134 Verona, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, 37134 Verona, Italy
| | - Daniela Di Riso
- Department of Developmental and Socialization Psychology (DPSS), University of Padua, 35131 Padova, Italy
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Influences of the COVID-19 Pandemic on Obesity and Weight-Related Behaviors among Chinese Children: A Multi-Center Longitudinal Study. Nutrients 2022; 14:nu14183744. [PMID: 36145119 PMCID: PMC9504407 DOI: 10.3390/nu14183744] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/03/2022] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
COVID-19-related lockdown measures have been affecting children’s weight status and weight-related behaviors, which are often associated with an increase in childhood obesity. However, large-scale longitudinal studies are lacking. Our study aimed to analyze changes in obesity and weight-related behaviors in Chinese children before and during the COVID-19 pandemic and provide references for addressing the high prevalence of childhood obesity. A prospective multi-center longitudinal survey was conducted among Chinese children (n = 5963), collecting data on weight status, COVID-19-related measures, and lifestyle behaviors. Changes were assessed using t-tests and χ2 tests for paired samples, or the Wilcoxon signed-rank test, according to the type and distribution of data. The Generalized Estimating Equations model was used to explore influential factors of obesity. The prevalence of overweight and obesity increased from 9.2% and 8.6% before the pandemic to 10.5% and 10.6% during the pandemic (p < 0.001), respectively. Daily physical activity, sleep duration, and sugar-sweetened beverage consumption decreased while screen time increased. The results of the generalized estimating equations showed that ethnic minority, older age, less daily physical activity, reduced sleep duration, and longer screen time were positively associated with obesity. There is an intensifying trend of obesity in children in the context of the COVID-19 pandemic, to which altered weight-related behaviors might have contributed largely. Maintaining a healthy lifestyle, especially in social crises, should be highlighted to ease the burden of childhood obesity.
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14
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Gilbert AS, Jabbari J, Hernández R. How Do Perceived Changes in Child and Adolescent Activities Relate to Perceptions of Health during COVID-19? Exploring Heterogeneity during the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11206. [PMID: 36141476 PMCID: PMC9517598 DOI: 10.3390/ijerph191811206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
COVID-19 affected child/adolescent activities (e.g., extra-curricular, screen time), along with physical health (PH) and mental health (MH); however, less is known about the relationship between changes in activities and PH and MH in the United States and how these relationships vary by race/ethnicity. To address this gap, data were used from a national survey (Socio-Economic Impacts of COVID-19 Survey) administered May-June 2021 (n = 853). Multinomial logistic regression explored changes in outdoor, school, extracurricular, friend, and screen time activities with changes in PH and MH; interactions explored moderation by race/ethnicity. Results showed increases in outdoor (RRR 2.36, p = 0.003), school (RRR 3.07, p < 0.001), and extracurricular activities (RRR 3.05, p < 0.001), which were associated with increases in chances of better PH. Better MH was more likely for children/adolescents where friend activities (RRR 3.34, p < 0.001) and extracurriculars (RRR 4.48, p < 0.001) increased. Except for extracurriculars, heterogeneous relationships were observed (e.g., increases and decreases in activities were simultaneously related to better and worse health). The relationship between outdoor activities and screen time with health were moderated by race/ethnicity. Findings support facilitating outdoor, school, extracurricular, and friend activities, which were positively related to health. Given heterogeneity and variation by race/ethnicity, more research is needed to understand the complex relationship between activities and health during COVID-19.
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Teramoto K, Otoki K, Muramatsu E, Oya C, Kataoka Y, Igawa S. Determining total energy expenditure in 3–6-year-old Japanese pre-school children using the doubly labeled water method. J Physiol Anthropol 2022; 41:28. [PMID: 35932089 PMCID: PMC9354372 DOI: 10.1186/s40101-022-00301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/19/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractThe doubly labeled water (DLW, 2H218O) method for calculating the total production of CO2 over several days is currently considered to be the most accurate technique for the measurement of total energy expenditure (TEE), and the results obtained using this method have been used to review energy requirements. Presently, there is limited data available on TEE in Japanese children. The objective of this study was to assess the TEE in pre-school Japanese children using the DLW method. We used a cross-sectional population of 140 children (69 boys and 71 girls) aged 3–6 years. TEE was measured using the DLW method over 8 days under free-living conditions. The average weights (kg) of the boys and girls were 15.6 ± 2.5 and 15.0 ± 2.1 for the 3–4 years old and 19.8 ± 3.8 and 19.6 ± 2.7 for the 5–6 years old, respectively. The corresponding TEE (kcal/day) was 1260.9 ± 357.8 and 1265.2 ± 408.0, and 1682.3 ± 489.0 and 1693.1 ± 473.3, respectively, showing a significant difference with respect to age. Furthermore, TEE per body weight (kcal/kg/day) was 83.2 ± 29.2 and 84.9 ± 26.6, and 85.4 ± 23.2 and 86.7 ± 22.6, respectively. However, when TEE was adjusted for body weight or fat-free mass, there were no age or sex differences. We conclude that in Japanese children, TEE in those aged 3–4 years was similar to the current Ministry of Health recommendations. However, TEE in children aged 5–6 years was slightly higher than the recommendations. Based on these findings, the present results obtained from a large number of participants will provide valuable reference data for Japanese children.
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Hecht AA, Dunn CG, Kinsey EW, Read MA, Levi R, Richardson AS, Hager ER, Seligman HK. Estimates of the Nutritional Impact of Non-Participation in the National School Lunch Program during COVID-19 School Closures. Nutrients 2022; 14:1387. [PMID: 35406001 PMCID: PMC9003403 DOI: 10.3390/nu14071387] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic resulted in widespread school closures, reducing access to school meals for millions of students previously participating in the US Department of Agriculture (USDA) National School Lunch Program (NSLP). School-prepared meals are, on average, more nutritious than home-prepared meals. In the absence of recent data measuring changes in children's diets during the pandemic, this article aims to provide conservative, back-of-the-envelope estimates of the nutritional impacts of the pandemic for school-aged children in the United States. We used administrative data from the USDA on the number of NSLP lunches served in 2019 and 2020 and nationally representative data from the USDA School Nutrition and Meal Cost Study on the quality of school-prepared and home-prepared lunches. We estimate changes in lunchtime calories and nutrients consumed by NSLP participants from March to November 2020, compared to the same months in 2019. We estimate that an NSLP participant receiving no school meals would increase their caloric consumption by 640 calories per week and reduce their consumption of nutrients such as calcium and vitamin D. Because 27 to 78 million fewer lunches were served per week in March-November 2020 compared to the previous year, nationally, students may have consumed 3 to 10 billion additional calories per week. As students return to school, it is vital to increase school meal participation and update nutrition policies to address potentially widening nutrition disparities.
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Affiliation(s)
- Amelie A. Hecht
- Institute for Research on Poverty, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Caroline Glagola Dunn
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Eliza W. Kinsey
- Department of Family Medicine & Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | | | - Ronli Levi
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA 94143, USA; (R.L.); (H.K.S.)
| | | | - Erin R. Hager
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Hilary K. Seligman
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA 94143, USA; (R.L.); (H.K.S.)
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Carneiro LL, Vieira EWR, Duarte ED, da Rocha NB, Velasquez-Melendez G, Caminhas W. COVID-19 pandemic impact on follow-up of child growth and development in Brazil. Front Pediatr 2022; 10:947493. [PMID: 36405844 PMCID: PMC9669785 DOI: 10.3389/fped.2022.947493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES This study investigated the impact of the COVID-19 pandemic on the primary health care (PHC) services to follow-up the child growth and development (CGD) in Brazil. METHODS A cross-sectional study was conducted using secondary data related visits to assess the growth and development of children up to five years between Apr-2017 to Mar-2021. Differences between monthly rate of visits (per thousand inhabitants up to five) during the pandemic (Apr-2020 to Mar-2021) and before (Apr-2017 to Mar-2020) were analyzed using paired t test and control diagrams (averages ± 1.96 standard deviation). RESULTS A total of 39,599,313 visits for monitoring CGD was studied. The average monthly rate of visits dropped from 61.34 (per thousand) before the pandemic to 39.70 in the first 12 months of the pandemic (p < 0.001). In all states, except Rio Grande do Sul, there was a significant reduction, with differences ranging from -14.21% in São Paulo to -59.66% in Ceará. The Northeast region was the most impacted, being lower than expected in all 12 first months of pandemic. CONCLUSIONS The number of visits to follow-up the CGD in PHC in Brazil decreased during the first year of the COVID-19 pandemic, varying over the months and between states and regions.
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Affiliation(s)
- Lucas Lima Carneiro
- Department of Electrical Engineering, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ed Wilson Rodrigues Vieira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Elysângela Dittz Duarte
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Najara Barbosa da Rocha
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gustavo Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Walmir Caminhas
- Department of Electrical Engineering, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Children and Adolescents' Psychological Well-Being Became Worse in Heavily Hit Chinese Provinces during the COVID-19 Epidemic. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6. [PMID: 34888418 PMCID: PMC8653505 DOI: 10.20900/jpbs.20210020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In light of the novel coronavirus’s (COVID-19’s) threat to public health worldwide, we sought to elucidate COVID-19’s impacts on the mental health of children and adolescents in China. Through online self-report questionnaires, we aimed to discover the psychological effects of the pandemic and its associated risk factors for developing mental health symptoms in young people. We disseminated a mental health survey through online social media, WeChat, and QQ in the five Chinese provinces with the most confirmed cases of COVID-19 during the late stage of the country-wide lockdown. We used a self-made questionnaire that queried children and adolescents aged 6 to 18 on demographic information, psychological status, and other lifestyle and COVID-related variables. A total of 17,740 children and adolescents with valid survey data participated in the study. 10,022 (56.5%), 11,611 (65.5%), 10,697 (60.3%), 6868 (38.7%), and 6225 (35.1%) participants presented, respectively, more depressive, anxious, compulsive, inattentive, and sleep-related problems compared to before the outbreak of COVID-19. High school students reported a greater change in depression and anxiety than did middle school and primary school students. Despite the fact that very few children (0.1%) or their family members (0.1%) contracted the virus in this study, the psychological impact of the pandemic was clearly profound. Fathers’ anxiety appeared to have the strongest influence on a children’s psychological symptoms, explaining about 33% of variation in the child’s overall symptoms. Other factors only explained less than 2% of the variance in symptoms once parents’ anxiety was accounted for. The spread of COVID-19 significantly influenced the psychological state of children and adolescents in participants’ view. It is clear that children and adolescents, particularly older adolescents, need mental health support during the pandemic. The risk factors we uncovered suggest that reducing fathers’ anxiety is particularly critical to addressing young people’s mental health disorders in this time.
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