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Greve KT, Foster TL, Pancoast R, Yarber C, Adams H, Patel R. Change in BMI in Children Over the First 30 Months After the Start of the SARS-CoV-2 Pandemic. Clin Pediatr (Phila) 2024; 63:902-913. [PMID: 37840288 DOI: 10.1177/00099228231204481] [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] [Indexed: 10/17/2023]
Abstract
Our study aim was to assess body mass index (BMI) change in children in the immediate 6 months of the pandemic, to follow longitudinal BMI change up to 30 months after the pandemic start, and to identify sociodemographic factors associated with these changes. Our study included a retrospective chart review of 1298 children 2 to 18 years old with office visits at an Indianapolis primary care clinic. Body mass index and sociodemographic information were collected at visits during 3 time periods: Prepandemic (March 1, 2019-February 28, 2020), Early Pandemic (June 1, 2020-November 30, 2020), and Late Pandemic (December 1, 2020-September 30, 2022). Data analysis indicated statistically significant increases in BMI monthly rate of change from Prepandemic to Early Pandemic periods. Interestingly, BMI rate of change stabilized from Early Pandemic to Late Pandemic periods but remained positive, suggesting children had slower, but persistent, continued BMI increase after the pandemic initiation.
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Affiliation(s)
- Katherynne T Greve
- Peyton Manning Children's Hospital at Ascension St. Vincent, Ascension, Indianapolis, IN, USA
- Ascension St. Vincent Hospital-Indianapolis, Ascension, Indianapolis, IN, USA
| | - Todd L Foster
- Ascension St. Vincent Hospital-Indianapolis, Ascension, Indianapolis, IN, USA
| | - Rayanne Pancoast
- College of Osteopathic Medicine, Marian University, Indianapolis, IN, USA
| | - Courtney Yarber
- College of Osteopathic Medicine, Marian University, Indianapolis, IN, USA
| | - Heather Adams
- Adams Statistics & Risk Consulting, LLC, Indianapolis, IN, USA
| | - Rita Patel
- Peyton Manning Children's Hospital at Ascension St. Vincent, Ascension, Indianapolis, IN, USA
- Ascension St. Vincent Hospital-Indianapolis, Ascension, Indianapolis, IN, USA
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Bonner J, Xiong W, Velasquez C, Nienhuis N, Wallace B, Friedman A, Lee D, Perry A. A Novel Summer Camp Integrating Physical, Psychological, and Educational Health in Youth: The THINK Program. Nutrients 2024; 16:1838. [PMID: 38931193 PMCID: PMC11206397 DOI: 10.3390/nu16121838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Numerous youth summer programs focus upon physical fitness, nutritional health, psychological well-being, or education. Few, however, have integrated all of these elements into a single program. The Translational Health in Nutrition and Kinesiology (THINK) program provides an integrative nutrition and exercise science curriculum that is interfaced with social emotional learning (SEL) and STEM education to enhance healthy behaviors in youth. The purpose of this study was to determine whether the THINK program could improve physical fitness, nutrition habits, SEL, and STEM education in a 6-week summer program covering a 3-year period. Participants from South Miami were enrolled in THINK (n = 108, 58 males, 50 females, 12.03 + 0.56 years). Physical fitness assessments, the Positive Youth Development Inventory (PYDI), the Students' Attitude Towards STEM Survey, and the Adolescent Food Habits Checklist (ADFH) were recorded at baseline and post-testing. Means and standard error values were evaluated for all dependent variables. Paired samples t-tests (SPSS version 27) were used to determine changes. Improvements in cardiorespiratory fitness (p < 0.001), power (p < 0.006), flexibility (p < 0.001), agility (p < 0.001), muscular endurance (p < 0.001), lean body mass (p < 0.001), ADFH (p < 0.001), and PYDI (p = 0.038) were found. An integrative summer fitness program can result in improvements in physical fitness, nutrition habits, and SEL in as little as six weeks.
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Affiliation(s)
- Joseph Bonner
- Department of Kinesiology and Sport Sciences, University of Miami, 5202 SW University Drive, Coral Gables, FL 33146, USA; (W.X.); (C.V.); (N.N.); (B.W.); (A.F.); (D.L.); (A.P.)
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Parker H, Burkart S, Reesor-Oyer L, von Klinggraeff L, Pfledderer CD, Adams E, Weaver RG, Beets MW, Armstrong B. The Day-Level Association Between Child Care Attendance and 24-Hour Movement Behaviors in Preschool-Aged Children. J Phys Act Health 2024; 21:616-623. [PMID: 38580305 DOI: 10.1123/jpah.2023-0656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/22/2023] [Accepted: 02/22/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Twenty-four hour movement behaviors (ie, physical activity [PA], screen time [ST], and sleep) are associated with children's health outcomes. Identifying day-level contextual factors, such as child care, that positively influence children's movement behaviors may help identify potential intervention targets, like improving access to child care programs. This study aimed to examine the between- and within-person effects of child care on preschoolers' 24-hour movement behaviors. METHODS Children (N = 74, 4.7 [0.9] y, 48.9% girls, 63.3% White) wore an Axivity AX3 accelerometer on their nondominant wrist 24 hours per day for 14 days to measure PA and sleep. Parents completed surveys each night about their child's ST and child care attendance that day. Linear mixed effects models predicted day-level 24-hour movement behaviors from hours spent in child care. RESULTS Children spent an average of 5.0 (2.9) hours per day in child care. For every additional hour of child care above their average, children had 0.3 hours (95% CI, -0.3 to -0.2) less ST that day. Between-person effects showed that compared with children who attended fewer overall hours of child care, children who attended more hours had less overall ST (B = -0.2 h; 95% CI, -0.4 to 0.0). Child care was not significantly associated with PA or sleep. CONCLUSIONS Child care attendance was not associated with 24-hour PA or sleep; however, it was associated with less ST. More research utilizing objective measures of ST and more robust measures of daily schedules or structure is necessary to better understand how existing infrastructure may influence preschool-aged children's 24-hour movement behaviors. In addition, future research should consider how access to child care may influence child care attendance.
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Affiliation(s)
- Hannah Parker
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Layton Reesor-Oyer
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, USA
| | | | - Christopher D Pfledderer
- School of Public Health, Austin Regional Campus, University of Texas Health Science Center at Houston, Austin, TX, USA
| | - Elizabeth Adams
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Robert G Weaver
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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Orgilés M, Delvecchio E, Francisco R, Mazzeschi C, Godinho C, Pedro M, Espada JP, Morales A. Daily Activities in European Children and Adolescents During COVID-19 School Closure: A Longitudinal Study Exploring Physical Activity, Use of Screens, and Sleep Patterns. JOURNAL OF PREVENTION (2022) 2024; 45:467-482. [PMID: 38564144 DOI: 10.1007/s10935-024-00778-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/04/2024]
Abstract
This longitudinal study aimed to analyze the evolution of patterns of daily activities (physical activity time, screen usage time, and sleep hours) in European youth during school closure due to the COVID-19 health crisis. Participants were 624 caregivers of children and adolescents aged 3-18 from Italy, Spain, and Portugal. Evaluations were online, and four time-points were considered: retrospective measurement of daily activities before confinement (T1), and two (T2), five (T3), and eight (T4) weeks after starting the lockdown. Generally accepted international guidelines on physical activity time, screen usage time, and hours of sleep by age group were used to determine whether the pattern might increase the risk for ill health or not. To estimate the evolution of daily activities, generalized estimating equations (GEE) were used. The percentage of children who practiced less than 60 min of daily exercise increased significantly from before home confinement (47.8%) to T2 (86.4%); it slightly decreased at T3 (79.8%), and remained stable at T4 (76.1%). The percentage of children who made excessive use of screens (according to their age group) significantly increased from T1 to T2 and remained stable and high in the rest of the evaluations. The percentage of children who slept fewer or more hours than recommended for their age group remained stable between T1 and T4, although there was a significant increase at T3. In general, results found unhealthier behaviors as confinement was extended. Results are discussed in order to find strategies for promoting healthy daily activities for future pandemics.
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Affiliation(s)
- Mireia Orgilés
- Universidad Miguel Hernández, Alicante, Spain.
- Università degli Studi di Perugia, Perugia, Italy.
| | | | | | | | | | - Marta Pedro
- Universidade Católica Portuguesa, Lisbon, Portugal
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Darkhawaja R, Hänggi J, Bringolf-Isler B, Kayser B, Suggs LS, Kwiatkowski M, Probst-Hensch N. Weekend physical activity profiles and their relationship with quality of life: The SOPHYA cohort of Swiss children and adolescents. PLoS One 2024; 19:e0298890. [PMID: 38820541 PMCID: PMC11142694 DOI: 10.1371/journal.pone.0298890] [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: 09/13/2023] [Accepted: 01/31/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION Quality of life (QoL) is an important health indicator among children and adolescents. Evidence on the effect of physical activity (PA)-related behaviors on QoL among youth remains inconsistent. Conventional accelerometer-derived PA metrics and guidelines with a focus on whole weeks may not adequately characterize QoL relevant PA behavior. OBJECTIVE This study aims to a) identify clusters of accelerometer-derived PA profiles during weekend days among children and adolescents living in Switzerland, b) assess their cross-sectional and predictive association with overall QoL and its dimensions, and c) investigate whether the associations of QoL with the newly identified clusters persist upon adjustment for the commonly used PA metrics moderate-to-vigorous physical activity (MVPA) and time spent in sedentary behavior (SB). METHODS The population-based Swiss children's Objectively measured PHYsical Activity (SOPHYA) cohort among children and adolescents aged 6 to 16 years was initiated at baseline in 2013. PA and QoL information was obtained twice over a five-year follow-up period. The primary endpoint is the overall QoL score and its six dimension scores obtained by KINDL® questionnaire. The primary predictor is the cluster membership of accelerometer-derived weekend PA profile. Clusters were obtained by applying the k-medoid algorithm to the distance matrix of profiles obtained by pairwise alignments of PA time series using the Dynamic Time Warping (DTW) algorithm. Secondary predictors are accelerometer-derived conventional PA metrics MVPA and SB from two combined weekend days. Linear regression models were applied to assess a) the cross-sectional association between PA cluster membership and QoL at baseline and b) the predictive association between PA cluster membership at baseline and QoL at follow-up, adjusting for baseline QoL. RESULTS The study sample for deriving PA profile clusters consisted of 51.4% girls and had an average age of 10.9 [SD 2.5] years). The elbow and silhouette methods indicated that weekend PA profiles are best classified in two or four clusters. The most differentiating characteristic for the two-clusters classification ("lower activity" and "high activity"), and the four-clusters classification ("inactive", "low activity", "medium activity", and "high activity"), respectively was the participant's mean counts per 15-seconds epoch. Participants assigned to high activity clusters were younger and more often male. Neither the clustered PA profiles nor MVPA or SB were cross-sectionally or predictively associated with overall QoL. The only association of a conventional PA metrics with QoL while adjusting for cluster membership was observed between MVPA during the weekend days and social well-being with a mean score difference of 2.4 (95%CI: 0.3 to 4.5; p = 0.025). CONCLUSION The absence of strong associations of PA metrics for the weekend with QoL, except for the positive association between MVPA during the weekend days and social well-being, is in line with results from two randomized studies not showing efficacy of PA interventions on youth QoL. But because PA decreases with age, its promotion and relevance to QoL remain important research topics. Larger longitudinal study samples with more than two follow-up time points of children and adolescents are needed to derive new novel accelerometer-derived PA profiles and to associate them with QoL dimensions.
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Affiliation(s)
- Ranin Darkhawaja
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Johanna Hänggi
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bettina Bringolf-Isler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - L. Suzanne Suggs
- Institute for Public Health and Institute of Communication and Public Policy, Università della SvizzeraItaliana, Lugano, Switzerland
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Abed Alah M, Abdeen S, Bougmiza I, Selim N. COVID-19 lockdowns weigh heavily on youth: an analysis of the impact on BMI for Age Z scores in children and adolescents. J Public Health (Oxf) 2024; 46:209-222. [PMID: 38291903 PMCID: PMC11141597 DOI: 10.1093/pubmed/fdad287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted the lifestyle and health of children and adolescents. This study aimed to assess the lifestyle changes brought about by COVID-19-related school closures and their impact on the Body Mass Index for Age Z (BAZ) scores of governmental school students in Qatar. METHODS An analytical cross-sectional study was conducted between June and August 2022 targeting students aged 8-15 years. Data on lifestyle behaviors were gathered through telephone interviews with parents of selected students. The BAZ scores before and after school closures that were automatically calculated by the electronic health records system were extracted. RESULTS We completed 1546 interviews. We found a significant increase in unhealthy food categories, a reduction in physical activity and an increase in the screen time over the period of schools' closure. The BAZ increased significantly by 0.30 (95% CI 0.26-0.35). The increase in BAZ scores was significantly higher among male students and the younger age group compared to females and older counterparts, respectively. The student's age group, sex, nationality and change in physical activity were significant predictors of the change in BAZ scores. CONCLUSIONS School closures during the COVID-19 pandemic negatively impacted the lifestyle of students in Qatar and resulted in a significant increase in the BAZ scores.
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Affiliation(s)
- Muna Abed Alah
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Sami Abdeen
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Iheb Bougmiza
- Community Medicine Department, Primary Health Care Corporation (PHCC), Doha, Qatar
- Community Medicine Department, College of Medicine, Sousse University, Sousse, Tunisia
| | - Nagah Selim
- Community Medicine Department, Primary Health Care Corporation (PHCC), Doha, Qatar
- Public Health and Preventive Medicine, Cairo University, Cairo, Egypt
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Klein CC, Modi AC, Welge JA, Fornari VM, Kurtz B, Blom TJ, Higdon C, Correll CU, DelBello MP. Adherence Rates and Barriers to Second-Generation Antipsychotic Medication Use in Youth with Bipolar Spectrum Disorders Who Have Overweight/Obesity. J Child Adolesc Psychopharmacol 2024. [PMID: 38770645 DOI: 10.1089/cap.2024.0011] [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] [Indexed: 05/22/2024]
Abstract
Objective: Youth with bipolar spectrum disorders (BSD) are frequently prescribed second-generation antipsychotics (SGAs). Nonadherence to treatment often results in increased mood symptoms and diminished quality of life. We examined SGA adherence rates and adherence barriers among youth who have overweight/obesity and are diagnosed with BSD enrolled in a multisite pragmatic clinical trial. Methods: SGA adherence and adherence barriers at baseline via patient- and caregiver report was assessed. Adherence was defined as taking ≥70% of prescribed SGA doses in the past week. The weighted Kappa statistic was used to measure child-caregiver agreement about adherence rates, barriers, and caregiver assistance. Regression analyses were used to examine associations of caregiver assistance, age, sex, race, insurance status, dosing frequency, and number of concomitant medications with adherence. Barriers to adherence were analyzed separately for youth and their caregivers, using logistic regression to assess associations between informant-reported barriers and informant-reported adherence. Results: Participants included 1485 patients and/or caregivers. At baseline, 88.6% of patients self-reported as adherent; 92.0% of caregivers reported their child was adherent. Concordance between patients and caregivers was moderate (k = 0.42). Approximately, 50% of the sample reported no adherence barriers. Frequently endorsed barriers included forgetting, side effects, being embarrassed to take medications, and preferring to do something else. Concordance between informants regarding adherence barriers was weak (k = 0.05-0.36). Patients and caregivers who did not endorse adherence barriers reported higher adherence than those who endorsed barriers. Male sex and having once daily dosing of medications were associated with lower adherence. Discussion: One-week patient- and caregiver-reported adherence was high in this sample. Half of the sample reported adherence barriers. Most commonly endorsed barriers were forgetting, side effects, being embarrassed, and preferring to do something else. Caregivers and patients have unique perspectives regarding adherence barriers. Understanding and addressing treatment barriers in clinical practice may facilitate adherence.
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Affiliation(s)
- Christina C Klein
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
| | - Jeffrey A Welge
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Victor M Fornari
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Brian Kurtz
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
| | - Thomas J Blom
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Claudine Higdon
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Center for Mental Health (DZPG), Berlin, Germany
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Pfledderer CD, Brown DMY, Ranjit N, Springer AE, Malkani RI, Salvo D, Hoelscher DM. Examining associations between physical activity context and children meeting daily physical activity guidelines: the role of outdoor play, sports, and other organized activities. Front Public Health 2024; 12:1352644. [PMID: 38832232 PMCID: PMC11144898 DOI: 10.3389/fpubh.2024.1352644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/22/2024] [Indexed: 06/05/2024] Open
Abstract
Background Less than one-quarter of US children meet physical activity (PA) guidelines. Understanding the context in which PA occurs and how these contexts may play a role in meeting PA guidelines is an essential step toward developing effective behavioral interventions. The purpose of this study was to examine associations between PA context (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines in a representative sample of children living in Texas. Methods We analyzed cross-sectional data from a statewide sample of fourth-grade children in Texas who completed the 2019-2020 Texas School Physical Activity and Nutrition (Texas SPAN) survey. The Texas SPAN survey was designed to monitor the statewide prevalence of overweight/obesity among school children and assess habitual self-reported obesity-related behaviors, including diet and PA. Weighted Poisson regression models were employed to examine the associations between PA contexts (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines, adjusting for sex, race/ethnicity, overweight/obesity, urban-rural status, and economic disadvantage. Results A total of 16.7% of fourth-grade children met physical activity guidelines every day during the week (mean age = 9.4 ± 0.6 years; female = 48.7, 51.8% Hispanic, mean days meeting PA guideline = 3.6 ± 2.3 days). One in ten (11.2%) children did not meet daily PA guidelines on any day of the week, and 72.1% met them between 1 and 6 days. Participating in sports (b = 0.22, 95%CI:0.14, 0.30), any other organized physical activities (b=0.13, 95%CI:0.017, 0.19), and playing outdoors 1-3 days (b = 0.25, 95%CI:0.04, 0.46) and 4-7 days in the past week (b = 0.77, 95%CI:0.57, 0.97) was significantly and positively associated with the number of days children met PA guidelines. Conclusion Participating in sports, participating in other organized physical activities, and playing outdoors may beneficially influence the number of days children meet PA guidelines. PA programs should consider these contextual factors and investigate how to promote organized activities and outdoor play effectively and appropriately among children.
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Affiliation(s)
- Christopher D. Pfledderer
- Department of Health Promotion and Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center Houston (UTHealth Houston) School of Public Health in Austin, Austin, TX, United States
| | - Denver M. Y. Brown
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Nalini Ranjit
- Department of Health Promotion and Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center Houston (UTHealth Houston) School of Public Health in Austin, Austin, TX, United States
| | - Andrew E. Springer
- Department of Health Promotion and Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center Houston (UTHealth Houston) School of Public Health in Austin, Austin, TX, United States
| | - Raja I. Malkani
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center Houston School of Public Health in Austin, Austin, TX, United States
| | - Deborah Salvo
- Department of Kinesiology and Health Education, College of Education, The University of Texas at Austin, Austin, TX, United States
| | - Deanna M. Hoelscher
- Department of Health Promotion and Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center Houston (UTHealth Houston) School of Public Health in Austin, Austin, TX, United States
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Teich P, Golle K, Kliegl R. Association between time of assessment within a school year and physical fitness of primary school children. Sci Rep 2024; 14:11500. [PMID: 38769417 PMCID: PMC11106081 DOI: 10.1038/s41598-024-61038-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/30/2024] [Indexed: 05/22/2024] Open
Abstract
The dissociation of effects of age, time of assessment and cohort is a well-known challenge in developmental science. We examined effects of time of assessment in the school year on children's physical fitness using data from 75,362 German third-graders from seven cohorts. Children were tested once either in the first or second school term of third grade. Tests examined cardiorespiratory endurance (6-min run), coordination (star-run), speed (20-m sprint), lower (standing long jump) and upper (ball-push test) limbs muscle power, and flexibility (stand-and-reach test). We estimated the effect of time of assessment using a regression discontinuity design specified in a linear mixed model with random factors child and school and adjusted for age, sex, and cohort effects. Coordination, speed, and upper limbs muscle power were better in second compared to first school term, with boys exhibiting a larger increase of upper limbs muscle power than girls. There was no evidence for changes in cardiorespiratory endurance, lower limbs muscle power, and flexibility between assessments. Previously reported age and sex effects as well as secular fitness trends were replicated. There is thus evidence for improvement of some physical fitness components beyond age and cohort effects that presumably reflects the benefit of physical activity in physical education and other settings. Effects of assessment time should be taken into consideration in performance-based grading or norm-based selection of children.
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Affiliation(s)
- Paula Teich
- Division of Training and Movement Science, Research Focus Cognitive Sciences, University of Potsdam, Am Neuen Palais 10, Building 12, 14469, Potsdam, Germany.
| | - Kathleen Golle
- Division of Training and Movement Science, Research Focus Cognitive Sciences, University of Potsdam, Am Neuen Palais 10, Building 12, 14469, Potsdam, Germany
| | - Reinhold Kliegl
- Division of Training and Movement Science, Research Focus Cognitive Sciences, University of Potsdam, Am Neuen Palais 10, Building 12, 14469, Potsdam, Germany
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Gebre A, Hawley N, Carskadon MA, Raynor H, Jelalian E, Owens J, Wing RR, Hart CN. Child routines moderate a brief behavioral intervention to enhance sleep in school-aged children. J Pediatr Psychol 2024; 49:365-371. [PMID: 38553029 PMCID: PMC11098045 DOI: 10.1093/jpepsy/jsae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE To examine whether child routines (the consistency or variation in children's daily routines, household responsibilities, discipline routines, and homework routines) moderated the effectiveness of a brief behavioral intervention to enhance sleep in school-aged children. METHODS Secondary analysis was conducted with a subset of 66 families with short sleeping (≤9.5 hr/day) children, 8-11 years old (female = 68%; mean age = 9.76, SD = 1.02) who completed the Child Routines Inventory at baseline and were then randomized to receive a behavioral sleep intervention (n = 32) or to control (n = 34). Sleep period was objectively measured using wrist actigraphy at baseline and 2 months post-randomization. Moderation analysis was performed using ordinary least squares regression using the PROCESS macro for SPSS. RESULTS Controlling for sleep period at baseline, treatment condition was significantly related to the sleep period at 2 months post-randomization, with the intervention group achieving a longer sleep period compared to the usual sleep period group (control) (b = 46.30, p < .01). Intervention response was moderated by child routines (b = 1.43, p < .05). Specifically, the intervention produced the greatest change in sleep period for children who engaged in greater routine behaviors at baseline than those who engaged in fewer routine behaviors. CONCLUSIONS Families that engage in routine behaviors may be better equipped to adopt the behavioral modifications required to get a good night's sleep. The findings highlight the importance of working with families to establish routine behaviors to improve responses to behavioral sleep interventions.
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Affiliation(s)
- Azeb Gebre
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Nicola Hawley
- Department of Chronic Disease Epidemiology, Yale University, New Haven, CT, United States
| | - Mary A Carskadon
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, United States
| | - Hollie Raynor
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, TN, United States
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, United States
| | - Judith Owens
- Department of Neurology and Center for Pediatric Sleep Disorders, Boston Children’s Hospital, Boston, MA, United States
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, United States
| | - Chantelle N Hart
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, United States
- Department of Social and Behavioral Science, College of Public Health, Temple University, Philadelphia, PA, United States
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11
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Cardoso S, Correia D, Vilela S. Associations between chronotype, diet quality and timing of energy intake in Portuguese children and adolescents: The potential role of summer holidays. Chronobiol Int 2024; 41:647-657. [PMID: 38606916 DOI: 10.1080/07420528.2024.2339970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
Later chronotypes may be associated with lower diet quality and later timing of energy intake in paediatric age. Period of data collection of these variables may affect these parameters and inter-relationship. We aimed to assess the cross-sectional association of chronotype with a diet quality score (HEI) and caloric midpoint (time of achieving 50% of total daily energy intake), considering summer holidays, using data from the National Food, Nutrition and Physical Activity Survey 2015-2016 for 578 participants (6-14 years of age). Chronotype was estimated by the midpoint of sleep and categorized as Early, Intermediate and Late, using physical activity diaries, while outcomes using two food diaries/24 h recalls. Associations of chronotype with outcomes were assessed by linear regressions adjusted for sex, age, parental education (model 1), BMI, sports practice (model 2), and summer holidays (no/yes) (model 3). In model 2, a Late vs. Early chronotype was negatively associated with HEI (β ˆ = -0.74; 95% CI: -1.47, -0.07) and positively with caloric midpoint (β ˆ = 0.35; 95% CI: 0.02, 0.69). However, associations lost significance in model 3. The association between chronotype and dietary habits may be benefit from being studied considering school terms and summer holidays. Future larger prospective studies are needed to clarify the role of summer holidays on this inter-relationship.
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Affiliation(s)
- Sofia Cardoso
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Daniela Correia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
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12
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Scott AG, Johnson BJ, Hunter SC. Exploring the influence of context on social norms around Australian parents' food provision using story completion. Public Health Nutr 2024; 27:e110. [PMID: 38576146 PMCID: PMC11036444 DOI: 10.1017/s1368980024000806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 03/13/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To explore the differences in social norms around parents' food provision in different provision contexts and by demographics. DESIGN Qualitative study using story completion methodology via an online survey in September 2021. Adults 18+ with or without children were randomised to one of three story stems focusing on food provision in different contexts; food provision at home (non-visitor), with visitors present and with the involvement of sport. Stories were coded and themed using thematic analysis. A content analysis was performed to determine count and frequency of codes in stories by participant demographics and story assumptions. SETTING Australia. PARTICIPANTS Adults (n 196). RESULTS Nine themes were identified from the data resulting in four social norms around providing healthy foods and justifying non-adherence to healthy eating guidelines, evolution of family life and mealtime values, the presence of others influencing how we engage with food provision and unhealthy foods used as incentives/rewards in sport. Following content analysis, no differences of themes or norms by participant demographics or story assumptions were found. CONCLUSIONS We identified pervasive social norms around family food provision and further identified how contextual factors resulted in variations or distinct norms. This highlights the impact context may have on the social norms parents face when providing food to their children and the opportunities and risks of leveraging these social norms to influence food choice in these contexts. Public health interventions and practitioners should understand the influence of context and social environments when promoting behaviour change and providing individualised advice. Future research could explore parents' experiences of these norms and to what extent they impact food choice.
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Affiliation(s)
- Amelia G Scott
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Tarntanya, GPO Box 2100, Adelaide, SA5001, Australia
| | - Brittany J Johnson
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Tarntanya, GPO Box 2100, Adelaide, SA5001, Australia
| | - Sarah C Hunter
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Tarntanya, GPO Box 2100, Adelaide, SA5001, Australia
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13
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Weaver RG, White JW, Finnegan O, Armstrong B, Beets MW, Adams EL, Burkart S, Dugger R, Parker H, von Klinggraeff L, Bastyr M, Zhu X, Bandeira AS, Reesor-Oyer L, Pfledderer CD, Moreno JP. Understanding Accelerated Summer Body Mass Index Gain by Tracking Changes in Children's Height, Weight, and Body Mass Index Throughout the Year. Child Obes 2024; 20:155-168. [PMID: 37083520 PMCID: PMC10979692 DOI: 10.1089/chi.2023.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Background: Drivers of summer body mass index (BMI) gain in children remain unclear. The Circadian and Circannual Rhythm Model (CCRM) posits summer BMI gain is biologically driven, while the Structured Days Hypothesis (SDH) proposes it is driven by reduced structure. Objectives: Identify the mechanisms driving children's seasonal BMI gain through the CCRM and SDH. Methods: Children's (N = 147, mean age = 8.2 years) height and weight were measured monthly during the school year, and once in summer (July-August). BMI z-score (zBMI) was calculated using CDC growth charts. Behaviors were measured once per season. Mixed methods regression estimated monthly percent change in children's height (%HΔ), weight (%WΔ), and monthly zBMI for school year vs. summer vacation, seasonally, and during school months with no breaks vs. school months with a break ≥1 week. Results: School year vs. summer vacation analyses showed accelerations in children's %WΔ (Δ = 0.9, Standard Error (SE) = 0.1 vs. Δ = 1.4, SE = 0.1) and zBMI (Δ = -0.01, SE = 0.01 vs. Δ = 0.04, SE = 0.3) during summer vacation, but %HΔ remained relatively constant during summer vacation compared with school (Δ = 0.3, SE = 0.0 vs. Δ = 0.4, SE = 0.1). Seasonal analyses showed summer had the greatest %WΔ (Δ = 1.8, SE = 0.4) and zBMI change (Δ = 0.05, SE = 0.03) while %HΔ was relatively constant across seasons. Compared with school months without a break, months with a break showed higher %WΔ (Δ = 0.7, SE = 0.1 vs. Δ = 1.6, SE = 0.2) and zBMI change (Δ = -0.03, SE = 0.01 vs. Δ = 0.04, SE = 0.01), but %HΔ was constant (Δ = 0.4, SE = 0.0 vs. Δ = 0.3, SE = 0.1). Fluctuations in sleep timing and screen time may explain these changes. Conclusions: Evidence for both the CCRM and SDH was identified but the SDH may more fully explain BMI gain. Interventions targeting consistent sleep and reduced screen time during breaks from school may be warranted no matter the season.
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Affiliation(s)
- R. Glenn Weaver
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - James W. White
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Olivia Finnegan
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Bridget Armstrong
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Michael W. Beets
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Elizabeth L. Adams
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Sarah Burkart
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Roddrick Dugger
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Hannah Parker
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Lauren von Klinggraeff
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Meghan Bastyr
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Xuanxuan Zhu
- Arnold School of Public Health, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Alexsandra S. Bandeira
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Layton Reesor-Oyer
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Christopher D. Pfledderer
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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14
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Neville RD, Hopkins WG, McArthur BA, Draper CE, Madigan S. Associations Between Changes in 24-Hour Movement Behaviors in Children and Adolescents During the COVID-19 Pandemic: A Systematic Review and Mediation-Based Meta-Analysis. J Phys Act Health 2024; 21:323-332. [PMID: 38194951 DOI: 10.1123/jpah.2023-0346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/25/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Although 24-hour movement behaviors are known to be interconnected, limited knowledge exists about whether change in one behavior during the COVID-19 pandemic (eg, increased screen time) was associated with change in another (eg, reduced physical activity or sleep). This review estimates mediational associations between changes in children's physical activity, screen time, and sleep during the COVID-19 pandemic. METHODS We included studies published between January 1, 2020 and June 27, 2022, in the PubMed/MEDLINE, Embase, PsycINFO, SPORTDiscus, and Web of Science databases. Summary data were extracted from included studies and analyzed with random-effects meta-regression. RESULTS This review included 26 studies representing 18,959 children across 18 mid-high-income countries (53% male; mean age, 11.5 [2.9] y). There was very good evidence of decreased total daily physical activity (factor change, 0.62; 90% CI, 0.47-0.81) and strong evidence of increased screen time (1.56; 90% CI, 1.38-1.77). There was very good evidence of decreased moderate to vigorous physical activity (0.75; 90% CI, 0.62-0.90) and weak evidence of increased sleep (1.02; 90% CI, 1.00-1.04). Mediational analysis revealed strong evidence that most of the reduction in total daily physical activity from before, to during, the pandemic was associated with increased screen time (0.53; 90% CI, 0.42-0.67). We observed no further mediational associations. CONCLUSION Increased reliance on and use of screen-based devices during the COVID-19 pandemic can be linked with reduced child and adolescent physical activity. This finding links COVID-related restrictions to potential displacement effects within child and adolescent 24-hour movement behavior.
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Affiliation(s)
- Ross D Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - William G Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, AL, Canada
- Alberta Children's Hospital Research Institute, Calgary, AL, Canada
| | - Catherine E Draper
- South African Medical Research Council Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AL, Canada
- Alberta Children's Hospital Research Institute, Calgary, AL, Canada
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15
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Gutema BT, Tariku EZ, Melketsedik ZA, Levecke B, De Henauw S, Abubakar A, Abbeddou S. Assessing the influence of COVID-19 lockdown measures on cognition and behavior in school age children in Arba Minch Health and Demographic Surveillance site, Southern Ethiopia: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002978. [PMID: 38512931 PMCID: PMC10956753 DOI: 10.1371/journal.pgph.0002978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/07/2024] [Indexed: 03/23/2024]
Abstract
Ethiopian schools were closed for nearly 40 weeks as a measure to control the COVID-19 pandemic. The objective of the study was to evaluate the role of COVID-19 pandemic's restrictive measures on cognition and behavioral difficulties of schoolchildren in Arba Minch Health and Demographic Surveillance Site. Two cross-sectional surveys were conducted in November 2019 (pre-COVID-19-lockdown) and November 2020 (post-COVID-19 lockdown). Data were collected both at the school and homes of the children. Cognitive development of the children was assessed using digit span, Raven's coloured progressive matrices (RCPM) and Visual search using cancellation task. Behavioral difficulties score of the children was assessed using Strengths and Difficulties Questionnaire. Analysis of covariance (ANCOVA) was used to compare between the cognition outcomes and behavioral difficulties score pre- and post-COVID-19-lockdown. In a sub-group of children who provided data in both surveys, the difference in cognitive and behavioral outcomes was tested using a mixed effect model. Compared to the pre-COVID-19-lockdown, schoolchildren post-COVID-19-lockdown scored lower in the standardized performance index for the visual search task, which measures attention (0.27 SD, 95% confidence intervals (95%CI): -0.40, -0.13). However, they scored higher by 0.26 SD (95%CI: 0.13, 0.40) and 0.36 SD (95%CI: 0.22, 0.49) in digit span and RCPM, respectively, measuring working memory and non-verbal intelligence. There was no significant difference in total difficulties score between pre- and post-COVID-19-lockdown (0.01 SD, 95%CI: -0.12, 0.15). The subgroup analysis showed a significant increase in digit span among children post-COVID-19-lockdown while the other domains did not show a significant change. Factors contributing to the improvement of children's cognitive domains while away from the school environment should be explored and utilized to enhance child development. This study was registered at clinicaltrials.gov as NCT04137354 on October 14, 2019.
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Eshetu Zerihun Tariku
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Bruno Levecke
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Amina Abubakar
- Kenya Medical Research Institute (KMRI)–Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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16
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Jackson D, Park JH, Patterson MS, Umstattd Meyer MR, Prochnow T. Identifying Social Network Characteristics Associated With Youth Physical Activity Skill Competency at a Summer Care Program. Health Promot Pract 2024:15248399241237961. [PMID: 38500007 DOI: 10.1177/15248399241237961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
While literature suggests that youth physical activity (PA) behaviors are affected by network influences, less is known about network influences on perceived skill competency, a component of physical literacy and self-efficacy. This study aims to provide an understanding of potential network characteristics which are associated with youth PA skill competency. Youth (n = 158) between the ages of 8 and 12 years recruited from two summer care programs (i.e., Boys & Girls Clubs) participated in researcher-administered surveys. Youth self-reported their age, sex, involvement in team sports, weekly PA, and skill competency assessed using a version of the PLAYself measure. Youth were also asked to report up to five people in the summer program and five out of the program with whom they interacted the most. Linear regression was used to evaluate associations between skill competency and demographics, PA, and social network characteristics. Skill competency was significantly associated (R2 = .17) with age (β = -.06, p = .01), sex (β = -.06, p = .01), sports team involvement (β = .16, p < .001), and weekly PA (β = -.20, p < .001). Skill competency was also significantly associated with the number of connections with whom the youth played frequently (β = .09, p < .001), the number of connections that helped the youth to be active (β = .18, p < .001), and the heterogeneity of the type of relationships within the youth's network (β = .11, p < .001). Skill competency scores were significantly associated with both individual variables and social network composition. In addition, youth with networks comprising several types of relationships (heterogeneity) reported a significantly high skill competency. PA interventions can be most effective when considering the reinforcing aspects of networks and skill competency.
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17
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Singh K, Armstrong SC, Wagner BE, Counts J, Skinner A, Kay M, Li JS, Shah S, Zucker N, Neshteruk C, Story M, Suarez L, Kraus WE, Zizzi AR, Dunn J. Physical activity and sleep changes among children during the COVID-19 pandemic. NPJ Digit Med 2024; 7:70. [PMID: 38493216 PMCID: PMC10944532 DOI: 10.1038/s41746-024-01041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/14/2024] [Indexed: 03/18/2024] Open
Abstract
Daily routines, including in-person school and extracurricular activities, are important for maintaining healthy physical activity and sleep habits in children. The COVID-19 pandemic significantly disrupted daily routines as in-person school and activities closed to prevent spread of SARS-CoV-2. We aimed to examine and assess differences in objectively measured physical activity levels and sleep patterns from wearable sensors in children with obesity before, during, and after a period of school and extracurricular activity closures associated with the COVID-19 pandemic. We compared average step count and sleep patterns (using the Mann-Whitney U Test) before and during the pandemic-associated school closures by using data from activity tracker wristbands (Garmin VivoFit 3). Data were collected from 94 children (aged 5-17) with obesity, who were enrolled in a randomized controlled trial testing a community-based lifestyle intervention for a duration of 12-months. During the period that in-person school and extracurricular activities were closed due to the COVID-19 pandemic, children with obesity experienced objectively-measured decreases in physical activity, and sleep duration. From March 15, 2020 to March 31, 2021, corresponding with local school closures, average daily step count decreased by 1655 steps. Sleep onset and wake time were delayed by about an hour and 45 min, respectively, while sleep duration decreased by over 12 min as compared with the pre-closure period. Step counts increased with the resumption of in-person activities. These findings provide objective evidence for parents, clinicians, and public health professionals on the importance of in-person daily activities and routines on health behaviors, particularly for children with pre-existing obesity. Trial Registration: Clinical trial registration: NCT03339440.
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Affiliation(s)
- Karnika Singh
- Duke University Department of Biomedical Engineering, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Durham, NC, USA
| | - Sarah C Armstrong
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Brooke E Wagner
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Julie Counts
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Asheley Skinner
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Melissa Kay
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Jennifer S Li
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Svati Shah
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Nancy Zucker
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Psychiatry and Behavioral Science, Durham, NC, USA
| | - Cody Neshteruk
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Mary Story
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Lilianna Suarez
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - William E Kraus
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Alexandra R Zizzi
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Jessilyn Dunn
- Duke University Department of Biomedical Engineering, Durham, NC, USA.
- Duke Center for Childhood Obesity Research, Durham, NC, USA.
- Duke University Department of Biostatistics, Durham, NC, USA.
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18
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Pereira S, Katzmarzyk PT, Garbeloto F, Chaput JP, Hedeker D, Barreira TV, Borges R, Garganta R, Santos C, Farias C, Stodden DF, Tani G, Maia J. Individual and school correlates of body mass index and cardiorespiratory fitness in primary school children from the REACT project: A multivariate multilevel analysis. Am J Hum Biol 2024:e24065. [PMID: 38476020 DOI: 10.1002/ajhb.24065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE This paper examines the relationship between body mass index (BMI) and cardiorespiratory fitness (CRF) using a multivariate multilevel approach and investigates the links between individual and school-related correlates with children's BMI and CRF. METHODS This cross-sectional sample included 1014 children (6-10 years) from 25 Portuguese primary schools. BMI was calculated, and CRF was assessed with the PACER test. Fundamental movement skills (FMS) included five object control tasks. Moderate-to-vigorous physical activity (MVPA), sleep, and sedentary time were assessed with the ActiGraph wGT3X-BT accelerometer. Socioeconomic status (SES) and school variables were also obtained. A multivariate multilevel model was used, and alpha was set at 5%. RESULTS BMI and CRF systematically increased with age. Most of the joint variance (94.4%) was explained at the child level, and BMI and CRF were correlated at this level (ρ = -.37). More active children demonstrated higher CRF levels and had lower BMI levels; sedentary and sleep time were not significantly associated with BMI or CRF. FMS were positively associated with CRF but were not significantly associated with BMI. Children at higher SES were more fit and had lower BMI than their peers of lower SES. Finally, school-level variables were not significantly related to BMI and CRF. CONCLUSION BMI and CRF had a low but statistically significant negative correlation in this sample of children. Most of the variation in BMI and CRF was explained by child-level characteristics.
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Affiliation(s)
- Sara Pereira
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
- Research Center in Sport, Physical Education, and Exercise and Health (CIDEFES), Faculty of Physical Education and Sports, Lusófona University, Lisboa, Portugal
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Fernando Garbeloto
- Motor Behavior Laboratory, School of Physical Education and Sports, University of São Paulo, São Paulo, Brazil
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Tiago V Barreira
- Exercise Science Department, Syracuse University, Syracuse, New York, USA
| | - Renata Borges
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Rui Garganta
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Santos
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
- Research Center in Sport, Physical Education, and Exercise and Health (CIDEFES), Faculty of Physical Education and Sports, Lusófona University, Lisboa, Portugal
| | - Cláudio Farias
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - David F Stodden
- Department of Educational and Developmental Sciences, University of South Carolina, Columbia, South Carolina, USA
| | - Go Tani
- Motor Behavior Laboratory, School of Physical Education and Sports, University of São Paulo, São Paulo, Brazil
| | - José Maia
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
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19
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Piesch L, Stojan R, Zinner J, Büsch D, Utesch K, Utesch T. Effect of COVID-19 Pandemic Lockdowns on Body Mass Index of Primary School Children from Different Socioeconomic Backgrounds. SPORTS MEDICINE - OPEN 2024; 10:20. [PMID: 38429549 PMCID: PMC10907325 DOI: 10.1186/s40798-024-00687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Childhood obesity is associated with various health outcomes. Restrictive measures to contain the spread of the Coronavirus Disease 2019 (COVID-19) pandemic, like lockdowns and school closures, affected children's daily structure, physical activity, dietary habits, and sleep quality, possibly exacerbating risk factors for childhood obesity and higher body mass index (BMI) in children. Poor socioeconomic conditions may have led to relatively higher risk for elevated BMI levels following pandemic measures. In this study, the impact of measures related to the COVID-19 pandemic on the BMI of third graders was investigated regarding children's socioeconomic background (SEB). METHODS Data from 41,728 children (8.84 ± 0.56 years, 20,431 female) were collected in the context of a cohort study. Children were tested either before the pandemic (preCOVID: Sept2017-March2020, n = 26,314), or following the first (postLDI: Aug2020-Dec2020, n = 6657) or second lockdown in Germany (postLDII: Aug2021-Jan2022, n = 8757). SEB was based on the official school type classification of the state of Berlin. Outcome was BMI standard deviation scores (SDS). RESULTS Significant effects of Time and SEB revealed elevated BMIs in postLDI (M = 0.23, p = 0.011) and postLDII (M = 0.22, p = 0.011) compared to preCOVID (M = 0.17) cohorts and higher BMIs for children with lower SEB (b = - 0.13, p < 0.001). A significant Time × SEB interaction indicated that the effect of SEB on children's BMI increased in response to lockdowns, especially in postLDII (b = - 0.05, p = 0.006). Results suggest that the COVID-19-related measures lead to increased BMI in children, and that children of lower SEB were at particular risk for higher BMIs following lockdowns. CONCLUSIONS These findings highlight the dependency of children's BMI on societal circumstances. Over the course of two lockdowns in Germany, children have experienced BMI increments, particularly in low socioeconomic areas. Authorities are called into action to counteract increasing rates of childhood weight by promoting physical activity of children and establishing related post-pandemic offers.
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Affiliation(s)
- Ludwig Piesch
- Institute of Educational Sciences, University of Münster, Bispinghof 5/6, 48143, Münster, Germany
- Institute of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Robert Stojan
- Institute of Educational Sciences, University of Münster, Bispinghof 5/6, 48143, Münster, Germany
| | - Jochen Zinner
- Deutsche Hochschule für Gesundheit und Sport, Berlin, Germany
| | - Dirk Büsch
- Universität Oldenburg, Oldenburg, Germany
| | - Katharina Utesch
- Institute of Psychology, University of Münster, Münster, Germany
| | - Till Utesch
- Institute of Educational Sciences, University of Münster, Bispinghof 5/6, 48143, Münster, Germany.
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20
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Kostopoulou E. The Interplay Between COVID-19 and Pediatric Endocrine Disorders. What have we Learned After More than Three Years of the Pandemic? Horm Metab Res 2024; 56:181-192. [PMID: 37673081 DOI: 10.1055/a-2152-4590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
As an increased body of COVID-19 related research is now available, it becomes apparent that the effects of COVID-19 extend beyond that of the respiratory system. Among others, the endocrine system is particularly vulnerable to perturbation from the COVID-19 infection. The present scoping review summarizes the bidirectional relationship between COVID-19 and endocrine system in children and adolescents, by describing both the possible susceptibility of children and adolescents without endocrinopathies to endocrine disorders following COVID-19 infection, but also the potential susceptibility to COVID-19 infection and severe infection, or the aggravation of endocrine dysfunction in patients with pre-existing endocrine diseases. Data suggest increased obesity and diabetes rates, as well as increased severity and frequency of diabetic ketoacidosis following COVID-19 infection. Conversely, patients with diabetes and obesity may experience a more severe course of COVID-19 infection. However, in the majority of cases, children and adolescents with well-managed and regulated endocrine disorders do not appear to be at increased risk of infection or severe infection from COVID-19. Thus, adhering to the appropriate "sick day management rules", maintaining adequate supply of medications and supplies, keeping close contact with the therapeutic team and seeking medical help without delay when needed, are the main recommendations for a safe outcome. Additional lessons learnt during the pandemic include the risk for mental health diseases caused by children's disrupted routine due to COVID-19 related protective measures and the importance of adopting alternative communication options, such as telehealth visits, in order to ensure uninterrupted endocrine care.
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Affiliation(s)
- Eirini Kostopoulou
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Patras School of Medicine, Patras, Greece
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21
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Burns RD. Public health implications of replacing screen time with physical activity and sleep in Brazilian children. J Pediatr (Rio J) 2024; 100:121-123. [PMID: 38048894 PMCID: PMC10943282 DOI: 10.1016/j.jped.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Affiliation(s)
- Ryan D Burns
- University of Utah, Department of Health and Kinesiology, Utah, USA.
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22
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Liu Y, Wadey CA, Barker AR, Williams CA. Process evaluation of school-based high-intensity interval training interventions for children and adolescents: a systematic review and meta-analysis of randomized controlled trials. BMC Public Health 2024; 24:348. [PMID: 38308213 PMCID: PMC10835840 DOI: 10.1186/s12889-024-17786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Several systematic reviews have been published to investigate the effectiveness of high-intensity interval training (HIIT) in schools. However, there has been limited attention given to understanding the functioning of the intervention processes, which is of paramount importance for interpreting and translating the intervention effectiveness. The aim of this systematic review is to determine the extent to which process evaluation is measured in school-based HIIT interventions and to explore the effects of process evaluation and intervention characteristics on cardiorespiratory fitness (CRF), body composition, muscular strength, and blood pressure. METHODS A comprehensive search was conducted in SPORT Discus (EBSCOhost), Web of Science, Scopus, Medline (Ovid) and Cochrane Central Register of Controlled Trials. The extent to which process evaluation is measured was narratively reported, alongside with the guidance of process evaluation of complex interventions by UK Medical Research Council. Meta-analyses and meta-regressions were conducted to determine the effects of process evaluation and intervention characteristics to the intervention outcomes. RESULTS The literature search identified 77 studies reporting on 45 school-based HIIT interventions. In total, five interventions reported process evaluation in a section or in a separate study, and only one intervention adopted a process evaluation framework. On average, 6 out of 12 process evaluation measures were reported in all interventions. Subgroup analyses did not indicate any beneficial treatment effects for studies with process evaluation group, whereas all pooled data and studies without process evaluation group showed significant improvement for CRF and body composition. CONCLUSION Process evaluation is frequently omitted in the literature of school-based HIIT in children and adolescents. Although reporting of process evaluation measures may not directly associate with better intervention outcomes, it allows accurate interpretation of intervention outcomes, thereby enhancing the generalisability and dissemination of the interventions.
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Affiliation(s)
- Yong Liu
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, Devon, EX1 2LU, UK
| | - Curtis A Wadey
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, Devon, EX1 2LU, UK
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, Devon, EX1 2LU, UK
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, Devon, EX1 2LU, UK.
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23
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Bridges Hamilton CN, Ylitalo KR, Wende ME, Sharkey JR, Umstattd Meyer MR. Depressive Symptoms and Their Longitudinal Impact on Physical Activity and Sedentary Behaviors Among Mexican-Heritage Youth. FAMILY & COMMUNITY HEALTH 2024; 47:20-31. [PMID: 37747840 DOI: 10.1097/fch.0000000000000388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
The purpose of this study is to examine the longitudinal impact of depressive symptoms on physical activity (PA) levels, sedentary behavior, and screen time among first-generation, Mexican-heritage youth. Mexican-heritage families were recruited by promotoras de salud from colonias in Hidalgo County, Texas. Participants (n = 200 youth, 116 families in final sample) completed at-home, interviewer-administered surveys once during the summer (June-July) and once during the fall (August-December). Youth PA and sedentary behaviors were assessed using a validated 7-day recall instrument. The validated Center for Epidemiology Studies-Depression Child scale was used to assess depression symptoms. Linear mixed-effects models were used to analyze the relationships of PA and sedentary behavior with depressive symptoms. Results showed that those depression symptoms were significantly associated with decreased number of self-reported minutes of sitting and screen time over time in the full sample and among male youth. Depression symptoms also significantly decreased the number of self-reported active and moderate to vigorous PA minutes over time among male youth. Researchers can build on our findings by identifying the mechanisms driving the relationships between depression and PA/sedentary behavior. Public health-programing efforts should intentionally consider the impact that depressive symptoms have on PA.
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Affiliation(s)
- Christina N Bridges Hamilton
- Department of Kinesiology, College of Health and Human Sciences, Kansas State University, Manhattan, Kansas (Dr Bridges Hamilton); Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas (Drs Ylitalo, Wende, and Umstattd Meyer); and Professor Emeritus, Texas A&M University, College Station, Texas (Dr Sharkey)
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24
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Sekartini R, Aditya CJ, Pramatirta B, Gosal S, Tjoa K. Primary School-Aged Children's Physical Activity Level, Eating Habit, and Sleeping Pattern Changes During the COVID-19 Pandemic in Indonesia. Cureus 2024; 16:e53354. [PMID: 38439919 PMCID: PMC10911643 DOI: 10.7759/cureus.53354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
Background and objective This study aims to explore the effect of physical distancing on physical activity, eating habits, and sleeping patterns among Indonesian primary schoolchildren during the COVID-19 pandemic. Methodology This cross-sectional study was conducted from October to December 2020, involving 489 primary schoolchildren. Parents/caregivers were queried about changes in their children's physical activity (utilizing the Physical Activity Questionnaire for Older Children - PAQ-C), eating habits (via a questionnaire modified from Southeast Asian Nutrition Surveys - SEANUTS), and sleeping patterns (assessed using the Children's Sleep Habits Questionnaire - CSHQ) both before and during the pandemic. Various sociodemographic characteristics and income status were also obtained. Paired univariate and multivariate analyses were conducted where applicable. Results In comparison to the period before the pandemic, both the PAQ-C score and active proportion significantly decreased during the pandemic (P = 0.000). Children consumed more snacks (322, 65.8%) but less canned and processed foods (180, 36.8%, and 128, 26.2%, respectively). Sleep duration and sufficiency increased significantly, with a CSHQ score mean of 48.62 ± 9.88 (P = 0.000, P = 0.004), and sleep disturbance was observed in 391 (79.96%) subjects. Conclusions Children were physically less active during the COVID-19 pandemic. They also experienced variable changes in eating habits based on parental employment, family income and expenses, and the presence of governmental support. While more children had longer sleep duration and more achieved the recommended sleep time, sleep disturbance happened in most subjects.
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Affiliation(s)
- Rini Sekartini
- Department of Pediatrics, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, IDN
| | - Clarissa J Aditya
- Department of Pediatrics, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, IDN
| | | | | | - Kevin Tjoa
- Faculty of Medicine, Universitas Indonesia, Jakarta, IDN
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25
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Dou N, Deitch R, Kowalski AJ, Kuhn A, Lane H, Parker EA, Wang Y, Zafari Z, Black MM, Hager ER. Studying the impact of COVID-19 mitigation policies on childhood obesity, health behaviors, and disparities in an observational cohort: Protocol for the COVID-19 Family Study. Contemp Clin Trials 2024; 136:107408. [PMID: 38072192 PMCID: PMC10922699 DOI: 10.1016/j.cct.2023.107408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND COVID-19 pandemic control policies, including school closures, suspended extra-curricular activities, and social distancing, were introduced to prevent viral transmission, and disrupted children's daily routines, health behaviors, and wellness. This observational cohort study among 697 families with children or adolescents, based on the Family Stress Model, aims to: 1) evaluate pre- to during-pandemic changes in child health behaviors (diet, physical activity, sleep) and weight gain, 2) identify mechanisms explaining the changes, and 3) determine projected healthcare costs on weight gain and obesity. Each aim includes an examination by racial and ethnic, socioeconomic, and geographic disparities. METHODS The study employs a mixed methods design, recruiting children and their caregivers from two obesity prevention trials halted in 2020. Enrolled participants complete annual surveys to assess child health behaviors, family resources, routines, and demographics, and home environment in 2020-2022. Height and weight are measured annually in 2021-2022. Annual semi-structured interviews are conducted within a subsample to understand mechanisms of observed changes. Multilevel mixed models and mediation analyses are used to examine changes in child health behaviors and weight gain and mechanisms underlying the changes. Qualitative data are analyzed within and across time points and integrated with quantitative findings to further explain mechanisms. Markov models are used to determine healthcare costs for unhealthy child behaviors and weight gain. CONCLUSION Findings from this study will aid in understanding pandemic-related changes in child health behaviors and weight status and will provide insights for the implementation of future programs and policies to improve child and family wellness.
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Affiliation(s)
- Nan Dou
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Rachel Deitch
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Alysse J Kowalski
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Ann Kuhn
- Department of Exercise and Nutrition Sciences, University at Buffalo, The State University of New York, 401 Kimball Tower, Buffalo, NY 14214, USA.
| | - Hannah Lane
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701, USA.
| | - Elizabeth A Parker
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science, 100 Penn Street, Baltimore, MD 21201, USA.
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Washington, DC 20052, USA.
| | - Zafar Zafari
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, 20 North Pine Street, Baltimore, MD 21201, USA.
| | - Maureen M Black
- University of Maryland School of Medicine, Department of Pediatrics, 737 West Lombard Street, Baltimore, MD 21201, USA; RTI International, Research Triangle Park, NC 27709, USA.
| | - Erin R Hager
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
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26
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Reid RER, Henderson M, Barnett TA, Kakinami L, Tremblay A, Mathieu ME. Children and chrono-exercise: Timing of physical activity on school and weekend days depends on sex and obesity status. Chronobiol Int 2024; 41:72-80. [PMID: 38083868 DOI: 10.1080/07420528.2023.2292097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/02/2023] [Indexed: 01/16/2024]
Abstract
Recommendations for physical activity (PA) typically focus on frequency, intensity, duration, and type, but timing (chrono-exercise) is also important. The objective of this study is to describe when children are active on school and weekend days and explore PA timing across sex and body mass index (BMI) categories. 359 children (53% male), aged 9.6 (0.9) y, were categorized as normal weight (≥-1 standard deviations (SD) and <1SD; n = 193), overweight (≥1SD and <2SD; n = 80), or obese (≥2SD; n = 86) using WHO BMIz. Moderate-to-vigorous PA (MVPA) was assessed using ActiGraph LS-7164. The results are described as Mean(SD). ANOVA evaluated MVPA across sexes and BMI categories. Normal weight boys were more active than boys with obesity on school (Δ20.33 min; p < 0.001) and weekend days (Δ15.04 min; p < 0.05). On school days, significant differences existed between 9:00 h-11:00 h and 12:00 h-14:00 h (p < 0.017), while on weekends, smaller differences existed throughout the day. Girls' MVPA was similar across BMI categories, on all days (p > 0.05). On school days, 12:00 h-13:00 h represented the most active hour for all participants (~14% total daily MVPA). Peak weekend MVPA was distributed across multiple hours. Differences in MVPA timing emerged on school-days and weekends. Timing may be important when examining the nuances of MVPA in relation to sex and bodyweight in children.
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Affiliation(s)
- Ryan E R Reid
- Department of Human Kinetics, Saint Francis Xavier University, Antigonish, Canada
| | - Mélanie Henderson
- Department of Pediatrics, Research Center, Sainte-Justine University Hospital Research Center and Université de Montréal, Montréal, Canada
| | - Tracie A Barnett
- Department of Family Medicine, McGill University, Montréal, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, Montréal, Canada
| | | | - Marie-Eve Mathieu
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Canada
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27
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Evans EW, Darling KE, Egbert A, Hayes JF, Jelalian E, Warnick J, Topor LS, Goldschmidt AB. Leveraging seasonality and timing to optimize pediatric weight management interventions: Novel directions for future research. Obes Sci Pract 2023; 9:688-695. [PMID: 38090686 PMCID: PMC10712410 DOI: 10.1002/osp4.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 02/01/2024] Open
Abstract
National estimates suggest that more than 35% of American children, ages 2-19 years, are overweight or obese, which increases their risk for weight-related comorbidities including diabetes, cancer, cardiovascular disease risk factors, depression, and anxiety. While obesity prevention is most cost-effective, for youth with existing obesity, the United States Preventive Services Task Force recommends ≥26 h of comprehensive lifestyle intervention over 6-12 months. This include standard behavioral therapy, dietary counseling, and an emphasis on physical activity. Although such programs are effective in reducing weight status, there are many barriers to completing these programs. A novel consideration for both the prevention and treatment of childhood obesity is the recognition that the timing of intervention, both duration and time of the year, can impact family engagement and intervention effectiveness. This paper discusses the potential of targeting high-risk periods for weight gain and offering brief behavioral intervention, in hopes of inspiring research on novel approaches to the prevention and treatment of childhood obesity.
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Affiliation(s)
- E. Whitney Evans
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Katherine E. Darling
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Amy Egbert
- Department of Psychological SciencesUniversity of ConnecticutStorrsConnecticutUSA
| | - Jacqueline F. Hayes
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Elissa Jelalian
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Jennifer Warnick
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Lisa Swartz Topor
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
- Pediatric Endocrinology and Diabetes CenterHasbro Children's HospitalProvidenceRhode IslandUSA
| | - Andrea B. Goldschmidt
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
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Hopkins L, Schier H, May L, Westrick M, O'Piela D, Mazurek Melnyk B, Smith L, Gunther C. Patterns of participation in summer programming among United States' elementary children from low-income urban households: Results from the project SWEAT study. Prev Med Rep 2023; 36:102475. [PMID: 37886725 PMCID: PMC10598049 DOI: 10.1016/j.pmedr.2023.102475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
Food insecurity increases among marginalized children during the summer when school is out of session. Summer programming that offers access to healthy meals and snacks may reduce the risk. There is a national call in the US for more research to assure equitable access to summer programming. The objective of this prospective observational study was to characterize patterns of participation in summer programming among elementary children from low-income urban neighborhoods of metropolitan[Blinded]. Summer programming was broadly defined (e.g., church, school, recreation center, community center). Caregivers(n = 100) received weekly text messages via TextIt during the summer (Jun-Aug 2017). They were asked: "How many days this week did [ChildName] attend a summer program? Please respond with a number from 0 to 5, where 0 - no days, 2 - 2 days, etc." Weekly counts were summed. Stepwise logistic and linear regression models were conducted to examine differences in patterns of attendance according to key sociodemographic characteristics. Mean age was 7.03 ± 0.23. 52 % identified as female, 70 % were low-income, and 80.0 % identified as Black. 51 % attended summer programming at least once; 49 % never attended. Those who attended at least once vs. not at all were more likely to be male(p < 0.01); 62.75 % males vs. 37.25 % females attended summer programming at least once, whereas 67.35 % females compared to 32.65 % males never attended. Overall mean attendance was 10.40 ± 1.43 days(out of 50). Mean + SE attendance was lower for females (7.52 + 1.76) vs. males (13.52 + 2.21)(p < 0.05), and non-Black (4.30 + 1.97) vs. Black (11.93 + 1.67)(p = 0.01) children. Future research is needed to understand barriers to participation in summer programming.
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Affiliation(s)
- Laura Hopkins
- Department of Public Health and Prevention Science, College of Education and Health Sciences, Baldwin Wallace University, USA
| | - Heather Schier
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Leah May
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Miranda Westrick
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Devin O'Piela
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Bernadette Mazurek Melnyk
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Laureen Smith
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Carolyn Gunther
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
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29
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Brazendale K, Gurnurkar S, Hunt ET, Burkart S, Armstrong B, Weaver RG, Beets MW, Sikder A, McClean C. Free Summer Day Camp to Address Childhood Obesity: Is There Demand? Child Obes 2023; 19:560-564. [PMID: 36315438 DOI: 10.1089/chi.2022.0181] [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] [Indexed: 11/12/2022]
Abstract
Children from low-income households, and who are overweight or obese (OWOB), are at risk of accelerated weight gain during summer. Summer day camps (SDCs) have the potential to mitigate accelerated weight gain during summer as these settings can positively influence children's obesogenic behaviors (i.e., increase physical activity); however, barriers exist to attending, most notably cost. Little is known on whether low-income caregivers of children with OWOB would be interested in having their child attend SDC for free. Caregivers (n = 109, 82% mother respondents, >75% Medicaid and Minority Household) with a child attending pediatric endocrinology clinics completed a one-page survey to explore demand. Approximately 66% of respondents expressed interest for their child to attend SDC for free. Providing free SDC for children with OWOB and from low-income households is a possible strategy to tackle childhood obesity during summer.
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Affiliation(s)
- Keith Brazendale
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | | | - Ethan T Hunt
- Health Promotion and Behavioral Sciences, The University of Texas Health Science Center, Austin, TX, USA
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Aniqa Sikder
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Carina McClean
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
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30
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Burkart S, Beets MW, Pfledderer CD, von Klinggraeff L, Zhu X, St Laurent CW, van Hees VT, Armstrong B, Weaver RG, Adams EL. Are parent-reported sleep logs essential? A comparison of three approaches to guide open source accelerometry-based nocturnal sleep processing in children. J Sleep Res 2023:e14112. [PMID: 38009378 PMCID: PMC11128474 DOI: 10.1111/jsr.14112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 11/28/2023]
Abstract
We examined the comparability of children's nocturnal sleep estimates using accelerometry data, processed with and without a sleep log. In a secondary analysis, we evaluated factors associated with disagreement between processing approaches. Children (n = 722, age 5-12 years) wore a wrist-based accelerometer for 14 days during Autumn 2020, Spring 2021, and/or Summer 2021. Outcomes included sleep period, duration, wake after sleep onset (WASO), and timing (onset, midpoint, waketime). Parents completed surveys including children's nightly bed/wake time. Data were processed with parent-reported bed/wake time (sleep log), the Heuristic algorithm looking at Distribution of Change in Z-Angle (HDCZA) algorithm (no log), and an 8 p.m.-8 a.m. window (generic log) using the R-package 'GGIR' (version 2.6-4). Mean/absolute bias and limits of agreement were calculated and visualised with Bland-Altman plots. Associations between child, home, and survey characteristics and disagreement were examined with tobit regression. Just over half of nights demonstrated no difference in sleep period between sleep log and no log approaches. Among all nights, the sleep log approach produced longer sleep periods (9.3 min; absolute mean bias [AMB] = 28.0 min), shorter duration (1.4 min; AMB = 14.0 min), greater WASO (11.0 min; AMB = 15.4 min), and earlier onset (13.4 min; AMB = 17.4 min), midpoint (8.8 min; AMB = 15.3 min), and waketime (3.9 min; AMB = 14.8 min) than no log. Factors associated with discrepancies included smartphone ownership, bedroom screens, nontraditional parent work schedule, and completion on weekend/summer nights (range = 0.4-10.2 min). The generic log resulted in greater AMB among sleep outcomes. Small mean differences were observed between nights with and without a sleep log. Discrepancies existed on weekends, in summer, and for children with smartphones and screens in the bedroom.
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Affiliation(s)
- Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christopher D Pfledderer
- University of Texas Health Science Center (UTHealth) at Houston, School of Public Health in Austin, Austin, Texas, USA
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, Texas, USA
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xuanxuan Zhu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christine W St Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Elizabeth L Adams
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Guedria A, Slama H, Fredj MB, Miladi S, Kefi HE, Gatti S, Oumaya A. Assessing parents' and children's psychological well-being and its associated factors during the COVID-19 lockdown in a Tunisian-North African population. BMC Public Health 2023; 23:2280. [PMID: 37978377 PMCID: PMC10657148 DOI: 10.1186/s12889-023-17206-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The rapidly emerging Coronavirus infectious disease 2019 (COVID-19) has spread around the world yielding in significant changes in almost every aspect of daily life. While primary research of the epidemic COVID-19 has focused on the psychological impact on the general population and health professionals, no survey of the pandemic-resulting containment on parents and their children has been yet addressed in the Tunisian-North African population. This study aimed to assess the psychological profile of parents and youth in Tunisia during a period of COVID 19 lockdown, and to identify associated factors to parental anxiety symptoms. METHODS This is an analytical cross-sectional study composed of a total of 538 adults including 464 mothers and 74 fathers. Parents of children aged less than 18 years completed an online survey (Google Forms) on the Psychological Impact of Confinement which includes the Generalized Anxiety Scale (GAD-7), the Parental Burnout Assessment (PBA), and the infantile trait-anxiety scale. The survey was initiated in May 2020 on a population of the Tunisian-North African citizens and lasted for more than 6 weeks. RESULTS The median GAD-7 score was 11 corresponding to a moderate anxiety with 27.8% reporting severe anxiety. The median PBA score was 31 corresponding to a moderate risk of burnout, with 19.5% being affected. The children's anxiety scores were associated with their parents' anxiety ratings with 24% of the children reported signs of moderate anxiety. CONCLUSIONS The COVID-19 pandemic affected parental and their children' psychological behavior due to a direct social isolation and distancing. Pediatricians need to be alerted on this issue and future measures are essential to avoid parental emotional burnout and anxiety disorder in similar situations.
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Affiliation(s)
- Asma Guedria
- University of Monastir, Monastir, Tunisia
- Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Hela Slama
- University of Monastir, Monastir, Tunisia
- Military Hospital of Tunis, Tunis, Tunisia
| | - Manel Ben Fredj
- University of Monastir, Monastir, Tunisia.
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University, Hospital, University of Monastir, Monastir, Tunisia.
- Department of Community Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
| | - Shayma Miladi
- Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Hamdi El Kefi
- Military Hospital of Tunis, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Syrine Gatti
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Abdelaziz Oumaya
- Military Hospital of Tunis, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Awn MA, Mohroofi AD, Alsaqer JK, Aljowder AA, Mohroofi AD, Alsuliti MA. Impact of covid-19 outbreak on the behavior of children and adolescents in the Kingdom of Bahrain. Medicine (Baltimore) 2023; 102:e35925. [PMID: 37960760 PMCID: PMC10637495 DOI: 10.1097/md.0000000000035925] [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: 07/02/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
With coronavirus disease-2019 (COVID-19) pandemic restrictions and lockdown, children and adolescents have experienced emotional and physical isolation from family and community members. This isolation has a negative impact on children's and adolescents' mental health, physical health, and behavior. An online cross-sectional study of children and adolescents aged 5 to 11 years was conducted to assess the effect of the COVID-19 pandemic on their behavior, emotions, and sleep routines. A total of 413 participants, with a mean age of seven (217 boys and 195 girls), were included in the study. Most of the children were in primary school and lived with both parents. Boys and older children were found to have been fatigued during the pandemic. A significant association was found between the participants' age and regression, opposition, and adaptation behaviors. A significant increase in screen usage and decrease in children's physical activity after the outbreak were noted. The COVID-19 pandemic has negatively affected children's and adolescents' psychosocial, behavioral, and physical habits. Government programs to support the mental and psychological well-being of children and adolescents should be encouraged. Social communication, physical activity, and collaborative games are also important factors.
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Affiliation(s)
- Muna A. Awn
- Family Medicine Department, Royal Medical Service – Bahrain Defense Force Hospital, Riffa, Bahrain
| | - Abdulrahman D. Mohroofi
- Pediatric Department, Royal Medical Service – King Hamad University Hospital, Muharraq, Bahrain
| | | | - Ahmed A. Aljowder
- Anesthesia Resident, Royal Medical Service – Mohammed Bin Khalid Bin Salman Al Khalifa Cardiac Center, Awali, Bahrain
| | | | - Mariam A. Alsuliti
- Family Medicine Department, Royal Medical Service – Bahrain Defense Force Hospital, Riffa, Bahrain
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Olds T, Dumuid D, Eglitis E, Golley R, Fraysse F, Miatke A, Tomkinson GR, Watson A, Munzberg M, Maher C. Changes in fitness and fatness in Australian schoolchildren during the summer holidays: fitness lost, fatness regained? A cohort study. BMC Public Health 2023; 23:2094. [PMID: 37880621 PMCID: PMC10601165 DOI: 10.1186/s12889-023-17009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Emerging evidence suggests that children's fatness increases and fitness declines at a greater rate during the summer holiday period, compared with the school year. The aim of this study was to compare rates of change in fitness and fatness over the in-term and summer holiday periods among Australian schoolchildren. A secondary aim was to explore whether rates of change differed according to the child's sex, socio-economic status (SES), pubertal status and weight status. METHODS Children (n = 381) initially in Grade 4 (age 9) were recruited for this 2-year longitudinal study. Fatness (% body fat, BMI z-score, waist-to-height ratio) and fitness (20-m shuttle run and standing broad jump) were measured at the start and end of two consecutive years. Rates of change were calculated for the two in-school periods (Grades 4 and 5) and for the summer holiday period. Rates of change in fatness and fitness between in-school and holiday periods were compared, and differences in rates of change according to sex, socio-economic status, and weight status were explored. RESULTS During the holidays, percentage body fat increased at a greater rate (annualised rate of change [RoC]: +3.9 vs. Grade 4 and + 4.7 vs. Grade 5), and aerobic fitness declined at a greater rate (RoC - 4.7 vs. Grade 4 and - 4.4 vs. Grade 5), than during the in-school periods. There were no differences in rates of change for BMI z-score, waist-to-height ratio or standing broad jump. Body fatness increased faster in the holidays (relative to the in-school period) in children who are overweight and from low-SES families. Aerobic fitness declined more rapidly in the holidays in children who are overweight. CONCLUSION This study highlights that during the summer holiday period, children experience greater increases in fatness and declines in fitness, with children who live with low-SES families and are overweight being more affected. The findings suggest the need for targeted interventions during this period to address these negative health trends. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry, identifier ACTRN12618002008202. Retrospectively registered on 14 December 2018.
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Affiliation(s)
- Tim Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia
- Murdoch Children's Research Institute, Parkville, 3052, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia
- Murdoch Children's Research Institute, Parkville, 3052, Australia
| | - Emily Eglitis
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia
| | - Rebecca Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, 5042, Australia
| | - François Fraysse
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia
| | - Aaron Miatke
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia
- Murdoch Children's Research Institute, Parkville, 3052, Australia
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia
| | - Amanda Watson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia
| | - Mason Munzberg
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, 5000, Australia.
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Fretes G, Corvalán C, Economos CD, Wilson NLW, Cash SB. Ultra-processed food consumption is associated with variations in daily routines in elementary schoolchildren during the COVID-19 pandemic in Chile. Public Health Nutr 2023; 26:1956-1967. [PMID: 37528627 PMCID: PMC10564603 DOI: 10.1017/s1368980023001593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/06/2023] [Accepted: 07/17/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE To assess the association between child ultra-processed food (UPF) consumption and home-school learning environment characteristics during school closures due to the COVID-19 pandemic in schoolchildren with low- and middle income in Chile. DESIGN Cross-sectional. UPF consumption was collected using the Nova screener. We apply the structured days hypothesis (SDH) to assess home-school learning environment characteristics with three constructs that summarised school preparedness for online teaching and learning, school closure difficulties for caregivers and child routine. We explored associations between child UPF consumption and home-school environment characteristics using multivariate linear regression analyses after controlling for child demographic and school characteristics. SETTING Low- and middle-income neighbourhoods in southeastern Santiago, Chile. PARTICIPANTS Children from the Food Environment Chilean Cohort (n 428, 8-10 years old). RESULTS Based on the Nova score, child mean consumption of UPF was 4·3 (sd 1·9) groups. We found a statistically significant negative association between child routine for eating, play and study and child UPF consumption when we adjusted for child sociodemographic (model 1: β = -0·19, (95 % CI -0·40, 0·02)) and school characteristics (model 2: β = -0·20, (95 % CI -0·41, 0·00)). Associations between school preparedness for online teaching or school closure difficulties and UPF were not statistically significant. CONCLUSIONS Variations in child routines during the COVID-19 pandemic were negatively associated with UPF intake in schoolchildren with low- and middle income. Our findings are consistent with the SDH, suggesting the school environment helps regulate eating behaviours. Future research should evaluate what happens when children return to in-person classes at school.
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Affiliation(s)
- Gabriela Fretes
- International Food Policy Research Institute (IFPRI), 1201 Eye St NW, Washington, DC20005, USA
| | - Camila Corvalán
- Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Avda. Macul 5524, Santiago7830489, Chile
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA02111, USA
| | - Norbert LW Wilson
- Duke Divinity School, Sanford School of Public Policy, and World Food Policy Center, Duke University, 407 Chapel Drive, Durham, NC, 27708-0968, USA
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA02111, USA
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Dunn J, Singh K, Armstrong S, Wagner B, Counts J, Skinner A, Kay M, Li J, Shah S, Zucker N, Neshteruk C, Suarez L, Kraus W, Zizzi A. Physical activity and sleep changes among children with obesity during a period of school closures related to the COVID-19 pandemic. RESEARCH SQUARE 2023:rs.3.rs-3293474. [PMID: 37790374 PMCID: PMC10543530 DOI: 10.21203/rs.3.rs-3293474/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Daily routines, including in-person school and extracurricular activities, are important for maintaining healthy physical activity and sleep habits in children. The COVID-19 pandemic significantly disrupted daily routines as in-person school and activities closed to prevent spread of SARS-CoV-2. We aimed to examine and assess differences in objectively measured physical activity levels and sleep patterns from wearable sensors in children with obesity before, during, and after a period of school and extracurricular activity closures associated with the COVID-19 pandemic. We compared average step count and sleep patterns (using the Mann Whitney U Test) before and during the pandemic-associated school closures by using data from activity tracker wristbands (Garmin VivoFit 3). Data was collected from 94 children (aged 5-17) with obesity, who were enrolled in a randomized controlled trial testing a community-based lifestyle intervention for a duration of 12-months. During the period that in-person school and extracurricular activities were closed due to the COVID-19 pandemic, children with obesity experienced objectively-measured decreases in physical activity, and sleep duration. From March 15, 2020 to March 31, 2021, corresponding with local school closures, average daily step count decreased by 1,655 steps. Sleep onset and wake time were delayed by about an hour and 45 minutes, respectively, while sleep duration decreased by over 12 minutes as compared with the pre-closure period. Step counts increased with the resumption of in-person activities. These findings provide objective evidence for parents, clinicians, and public health professionals on the importance of in-person daily activities and routines on health behaviors, particularly for children with pre-existing obesity. We demonstrate the utility of wearable sensors in objectively measuring longitudinal physical activity and sleep behavior patterns in children with obesity and in quantifying changes in their health behaviors due to disruption of structured, daily routines following in-person school closures during the COVID-19 pandemic. Trial Registration Clinical trial registration: NCT03339440.
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Yardeni M, Shaked OZ, Pienik R, Ben-Ami M, Stern E, Golan H, Waldman D, Gothelf D, Modan-Moses D. Impact of COVID-19 on Lifestyle Habits and Emotional State of Childhood Cancer Survivors and Their Parents. Nutrients 2023; 15:3932. [PMID: 37764717 PMCID: PMC10537817 DOI: 10.3390/nu15183932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic and associated social distancing measures affected the physical and emotional state of children and parents worldwide. Survivors of childhood cancer may be particularly vulnerable to these effects. We aimed to evaluate the lifestyle habits and emotional states of childhood cancer survivors and their parents during the COVID-19 outbreak. METHODS Lifestyle habits and emotional distress were assessed in 43 childhood cancer survivors (aged 8-21 years) and their parents before and during the COVID-19 lockdown, using the PROMIS anxiety and depression modules and the "Mabat Youth" questionnaire. RESULTS Most parents (80.5%) reported eating more family meals during home confinement compared to their usual routine. Patients' physical activity levels did not change significantly during confinement, leisure-related screen time nearly doubled (p < 0.001), and sleep duration increased (p = 0.006). Anxiety levels of children (p = 0.045) and parents (p = 0.02) increased during confinement compared to pre-pandemic levels, with no significant changes in depression levels. CONCLUSIONS Contrary to concerns regarding lifestyle habits during the COVID-19 lockdown, eating behaviors of childhood cancer survivors improved, sleep duration increased, and physical activity remained unchanged. Still, screen time increased significantly. Parents of childhood cancer survivors reported higher anxiety levels for themselves and their children during home confinement. Our findings may assist medical and psycho-social teams in guiding parents of cancer survivors during similar circumstances in the future.
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Affiliation(s)
- Maya Yardeni
- Division of Pediatric Hemato-Oncology, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (H.G.)
| | - Omer Zvi Shaked
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
| | - Reut Pienik
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
| | - Michal Ben-Ami
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
| | - Eve Stern
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
| | - Hana Golan
- Division of Pediatric Hemato-Oncology, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (H.G.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Dalia Waldman
- Division of Pediatric Hemato-Oncology, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (H.G.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Doron Gothelf
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
- The Child Psychiatry Division, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Dalit Modan-Moses
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
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Colreavy E, Keenan L, Downes M. The impact of the COVID-19 pandemic on sleep in children with Tourette syndrome in Ireland and the United Kingdom. J Clin Sleep Med 2023; 19:1485-1493. [PMID: 37132250 PMCID: PMC10394359 DOI: 10.5664/jcsm.10628] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 05/04/2023]
Abstract
STUDY OBJECTIVES The aim of this mixed-methods study was to gain an insight through qualitative and quantitative means into the impact of the coronavirus disease 2019 (COVID-19) pandemic on children with and without Tourette syndrome (TS). METHODS Parents/guardians of children and adolescents with TS (n = 95; mean age = 11.2 years, standard deviation = 2.68 years) and typically developing controls (n = 86; mean age = 10.7 years, standard deviation = 2.8 years) in the United Kingdom and Ireland completed an online questionnaire examining sleep, with open-ended questions pertaining to their perceived impact of COVID-19 on the sleep of their children. Nine items from the Sleep Disturbance Scale for Children were used to supplement qualitative data. RESULTS A negative impact of the pandemic on the sleep of both groups was observed, including exacerbated tics, sleep deprivation, and anxiety, with particular disruption for children with TS. Parents of children with TS reported poorer sleep patterns than parents of typically developing children on the Sleep Disturbance Scale for Children. Analyses showed that group and age predicted 43.8% of variance in sleep duration: F (4, 176) = 34.2, P < .001. CONCLUSIONS Findings suggest that sleep patterns of children with TS may be more impacted by the pandemic than the average child. Given that there are generally more sleep issues reported in children with TS, further research is warranted in relation to the sleep health of children with TS in a postpandemic era. By identifying sleep issues potentially persisting after COVID-19, the true impact of the pandemic on the sleep of children and adolescents with Tourette syndrome may be ascertained. CITATION Colreavy E, Keenan L, Downes M. The impact of the COVID-19 pandemic on sleep in children with Tourette syndrome in Ireland and the United Kingdom. J Clin Sleep Med. 2023;19(8):1485-1493.
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Affiliation(s)
- Eleanor Colreavy
- University College Dublin, UCD School of Psychology, Dublin, Ireland
| | - Lisa Keenan
- University College Dublin, UCD School of Psychology, Dublin, Ireland
| | - Michelle Downes
- University College Dublin, UCD School of Psychology, Dublin, Ireland
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Stackpole KMW, Kharofa RY, Tucker JM, Novick MB, Fals AM, Bernier AV, Tammi EM, Khoury PR, Siegel R, Paul S, Naramore SK, Moore JM. Telehealth Use in a National Pediatric Weight Management Sample During the COVID-19 Pandemic. Child Obes 2023. [PMID: 37440173 DOI: 10.1089/chi.2023.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Background: This study aimed to assess the implementation and access to telehealth-delivered pediatric weight management (PWM) during the initial phase of the COVID-19 pandemic at six US PWM programs (PWMP) using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Methods: The COVID-19 period (COVID) was defined in this retrospective, multisite study as the time when each site closed in-person care during 2020. The Pre-COVID period (Pre-COVID) was an equivalent time frame in 2019. Patients were stratified by visit completion status. Patient characteristics for COVID and Pre-COVID were compared to examine potential changes/disparities in access to care. Results: There were 3297 unique patients included across the six sites. On average, telehealth was initiated 4 days after in-person clinic closure. Compared with Pre-COVID, COVID (mean duration: 9 weeks) yielded fewer total completed visits (1300 vs. 2157) and decreased revenue (mean proportion of nonreimbursed visits 33.30% vs. 16.67%). Among the completed visits, COVID included a lower proportion of new visits and fewer patients who were male, non-English speaking, Hispanic, or Asian and more patients who were Black or lived ≥20 miles from the program site (p < 0.05 for all). Among no-show/canceled visits, COVID included more patients who had private insurance, older age, or a longer time since the last follow-up. Conclusion: Rapid implementation of telehealth during COVID facilitated continuity of PWM care. Clinic volume and reimbursement were lower during COVID and differences in the patient population reached by telehealth emerged. Further characterization of barriers to telehealth for PWM is needed.
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Affiliation(s)
- Kristin M W Stackpole
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Roohi Y Kharofa
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jared M Tucker
- Health Optimization Services, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Marsha B Novick
- Department of Pediatrics and Family and Community Medicine, Rush Medical College, Chicago, IL, USA
- Healthy Weight Program for Children and Teens, Penn State Hershey Children's Hospital, Hershey, PA, USA
| | - Angela M Fals
- AdventHealth for Children/AdventHealth Medical Group Pediatric Weight and Wellness, Orlando, FL, USA
| | - Angelina V Bernier
- Metabolic & Obesity Program, Pediatric Endocrinology, UF Health Shands Hospital, Gainesville, FL, USA
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Erin M Tammi
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Philip R Khoury
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Robert Siegel
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Suzanne Paul
- Department of Pediatrics, Section of Nutrition, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Children's Hospital Colorado, Aurora, CO, USA
| | - Sara K Naramore
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Indiana University School of Medicine, IN, USA
- Riley Hospital for Children at IU Health, Indianapolis, IN, USA
| | - Jaime M Moore
- Department of Pediatrics, Section of Nutrition, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Children's Hospital Colorado, Aurora, CO, USA
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Scales J, Chavda J, Ikeda E, Tsocheva I, Dove RE, Wood HE, Kalsi H, Colligan G, Griffiths L, Day B, Crichlow C, Keighley A, Fletcher M, Newby C, Tomini F, Balkwill F, Mihaylova B, Grigg J, Beevers S, Eldridge S, Sheikh A, Gauderman J, Kelly F, Randhawa G, Mudway IS, van Sluijs E, Griffiths CJ. Device-Measured Change in Physical Activity in Primary School Children During the UK COVID-19 Pandemic Lockdown: A Longitudinal Study. J Phys Act Health 2023; 20:639-647. [PMID: 37142406 PMCID: PMC7614900 DOI: 10.1123/jpah.2022-0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Lockdown measures, including school closures, due to the COVID-19 pandemic have caused widespread disruption to children's lives. The aim of this study was to explore the impact of a national lockdown on children's physical activity using seasonally matched accelerometry data. METHODS Using a pre/post observational design, 179 children aged 8 to 11 years provided physical activity data measured using hip-worn triaxial accelerometers worn for 5 consecutive days prepandemic and during the January to March 2021 lockdown. Multilevel regression analyses adjusted for covariates were used to assess the impact of lockdown on time spent in sedentary and moderate to vigorous physical activity. RESULTS A 10.8-minute reduction in daily time spent in moderate to vigorous physical activity (standard error: 2.3 min/d, P < .001) and a 33.2-minute increase in daily sedentary activity (standard error: 5.5 min/d, P < .001) were observed during lockdown. This reflected a reduction in daily moderate to vigorous physical activity for those unable to attend school (-13.1 [2.3] min/d, P < .001) during lockdown, with no significant change for those who continued to attend school (0.4 [4.0] min/d, P < .925). CONCLUSION These findings suggest that the loss of in-person schooling was the single largest impact on physical activity in this cohort of primary school children in London, Luton, and Dunstable, United Kingdom.
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Affiliation(s)
- James Scales
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Jasmine Chavda
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Institute for Health Research, University of Bedfordshire, Luton,United Kingdom
| | - Erika Ikeda
- MRC Epidemiology Unit, University of Cambridge, Cambridge,United Kingdom
| | - Ivelina Tsocheva
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Institute for Health Research, University of Bedfordshire, Luton,United Kingdom
| | - Rosamund E Dove
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Helen E Wood
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Harpal Kalsi
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Grainne Colligan
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Lewis Griffiths
- MRC Epidemiology Unit, University of Cambridge, Cambridge,United Kingdom
| | - Bill Day
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
| | - Cheryll Crichlow
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
| | - Amanda Keighley
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
| | - Monica Fletcher
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Usher Institute, The University of Edinburgh, Edinburgh,United Kingdom
| | - Chris Newby
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- University of Nottingham, Nottingham,United Kingdom
| | - Florian Tomini
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Fran Balkwill
- Centre of the Cell, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Borislava Mihaylova
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Jonathan Grigg
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Sean Beevers
- MRC Centre for Environment and Health, Imperial College London, London,United Kingdom
| | - Sandra Eldridge
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
| | - Aziz Sheikh
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Usher Institute, The University of Edinburgh, Edinburgh,United Kingdom
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, London,United Kingdom
| | - James Gauderman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA,USA
| | - Frank Kelly
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- MRC Centre for Environment and Health, Imperial College London, London,United Kingdom
| | - Gurch Randhawa
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Institute for Health Research, University of Bedfordshire, Luton,United Kingdom
| | - Ian S Mudway
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- MRC Centre for Environment and Health, Imperial College London, London,United Kingdom
| | - Esther van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge,United Kingdom
| | - Christopher J Griffiths
- Asthma and Lung UK Centre for Applied Research, Edinburgh,United Kingdom
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London,United Kingdom
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, London,United Kingdom
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Kong KL, Anzman-Frasca S, Burgess B, Serwatka C, White HI, Holmbeck K. Systematic Review of General Parenting Intervention Impacts on Child Weight as a Secondary Outcome. Child Obes 2023; 19:293-308. [PMID: 35925814 PMCID: PMC10316528 DOI: 10.1089/chi.2022.0056] [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] [Indexed: 11/13/2022]
Abstract
General parenting interventions have improved parent-child relationships and child behavior, with emerging evidence that they may also reduce prevalence of pediatric overweight/obesity. We conducted a systematic review on interventions that were designed to promote positive parenting and examined child weight post-hoc. We searched for studies published through January 2022 that promoted positive parenting among parents of children ages 0-18 years and reported effects on body weight as an ancillary outcome, with no intervention content focused on energy balance (e.g., feeding, physical activity). This search was carried out within ClinicalTrials.gov, ISRCTN Registry, PubMed, PsycINFO, Web of Science, and Connected Papers. Studies were imported into EndNote X9 and assessed independently by two investigators. In total, 753 clinical trials and 723 publications were assessed, and six publications met inclusion criteria. All cohorts were low-income and interventions targeted expectant mothers up through parents of adolescents. Follow-ups occurred when participants were between 2 and 25 years. Significant improvements in weight-related outcomes were observed across all studies for the intervention arm as a whole or for certain subgroups, and reasons underlying these gains tended to differ by participants' age. The magnitude of effect sizes ranged from medium to large. Interventions focused on general positive parenting are efficacious at lowering risk of overweight/obesity without focusing on physical health. Promoting attachments among infants, restructuring a toddler's home environment, praising preschoolers, and communicating with adolescents may optimize weight outcomes in parenting interventions adapted for obesity prevention.
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Affiliation(s)
- Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA
- Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
| | - Stephanie Anzman-Frasca
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, USA
| | - Brenda Burgess
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Catherine Serwatka
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, USA
| | - Hope I. White
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Psychology, University at Buffalo, Buffalo, NY, USA
| | - Katherine Holmbeck
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Neuroscience Program, Bucknell University, Lewisburg, PA, USA
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Dungan M, Lincoln M, Aichele S, Clark ELM, Harvey A, Hoyer L, Jiao Y, Joslin S, Russell F, Biringen Z. Mother-Child and Father-Child Emotional Availability during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1044. [PMID: 37371275 DOI: 10.3390/children10061044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
While the body of literature on COVID-19's impacts on family life is rapidly expanding, most studies are based entirely on self-report data, leaving a critical gap in observational studies of parent-child interactions. The goal of this study was to evaluate parent-child relationships during the COVID-19 pandemic using the observational emotional availability (EA) construct. Parents (n = 43) were assessed using the Epidemic-Pandemic Impacts Inventory (EPII), the Flourishing Scale (FLS), and the adverse childhood experiences (ACEs) questionnaires. The subcategories of the EPII were used to develop an EPII negative and an EPII positive for each parent. EA (sensitivity, structuring, nonhostility, nonintrusiveness, child responsiveness, and child involvement) was coded from filmed parent-child interactions. Separate hierarchical multiple regressions (HMRs) were run to evaluate each of the variables of interest (EPII and FLS) as predictive of EA. Child age (M = 6, SD = 4.68) and ACEs were added in subsequent steps for EPII negative and positive if the initial step was significant. For mothers (n = 25), results demonstrated EPII negative as a significant predictor of EA with child age and ACEs adding only small amount of variance to the prediction. The same HMR process was repeated for flourishing, with the covariate child age alone. For fathers (n = 18), flourishing was a significant predictor of EA and child age added only a small amount of variance to the prediction. Results indicate that experiencing high COVID-19-related stressors is associated with lower EA for mothers, but not fathers. Having high levels of flourishing during the pandemic was predictive of higher EA for fathers, but not mothers.
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Affiliation(s)
- Maggie Dungan
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Michael Lincoln
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Stephen Aichele
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Emma L M Clark
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Ashley Harvey
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Lillian Hoyer
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Yuqin Jiao
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Steffany Joslin
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Frances Russell
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
| | - Zeynep Biringen
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO 80528, USA
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Nigg C, Petersen E, MacIntyre T. Natural environments, psychosocial health, and health behaviors in a crisis - A scoping review of the literature in the COVID-19 context. JOURNAL OF ENVIRONMENTAL PSYCHOLOGY 2023; 88:102009. [PMID: 37065613 PMCID: PMC10082968 DOI: 10.1016/j.jenvp.2023.102009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
The COVID-19 outbreak led to major restrictions globally, affecting people's psychosocial health and their health behaviors. Thus, the purpose of this scoping review was to summarize the available research regarding nature and health in the COVID-19 context. Keywords relating to natural environments and COVID-19 were combined to conduct a systematic online search in six major databases. Eligibility criteria were a) published since 2020 with data collected in the COVID-19 context b) peer-reviewed, c) original empirical data collected on human participants, d) investigated the association between natural environments and psychosocial health or health behaviors, and e) English, German, or Scandinavian languages. Out of 9126 articles being screened, we identified 188 relevant articles, representing 187 distinct studies. Most research focused on adults in the general population and was predominantly conducted in the USA, Europe, and China. Overall, the findings indicate that nature may mitigate the impact of COVID-19 on psychological health and physical activity. Through a systematic thematic analysis of the extracted data, three primary themes were identified: 1) type of nature assessed, 2) psychosocial health and health behaviors investigated, and 3) heterogeneity in the nature-health relationship. Research gaps in the COVID-19 context were identified regarding I) nature characteristics that promote psychosocial health and health behaviors, II) investigations of digital and virtual nature, III) psychological constructs relating to mental health promotion, IV) health-promoting behaviors other than physical activity, V) underlying mechanisms regarding heterogeneity in the nature-health relationship based on human, nature, and geographic characteristics, and VI) research focusing on vulnerable groups. Overall, natural environments demonstrate considerable potential in buffering the impact of stressful events on a population level on mental health. However, future research is warranted to fill the mentioned research gaps and to examine the long-term effects of nature exposure during COVID-19.
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Affiliation(s)
- Carina Nigg
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Evi Petersen
- Department of Sports, Physical Education and Outdoor Life, University of South-Eastern Norway, 3800, Bø i, Telemark, Norway
- Department of Early Childhood Education, Oslo Metropolitan University, Pilestredet 42, 0167, Oslo, Norway
| | - Tadhg MacIntyre
- Department of Psychology, Faculty of Science & Engineering, Maynooth University, North Campus, W23 F2K8, Maynooth, Ireland
- Insight SFI Research Centre for Data Analytics, Maynooth University, North Campus, W23 F2k8, Maynooth, Ireland
- TechPA Research Group, Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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43
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Moreno JP, Wood AC, Reichek B, Dadabhoy H, Baranowski T, Thompson D, O'Connor TM. Examination of parent-reported differences in children's daily screen use, sleep, and sleep hygiene behaviors during the school year and summer and their association with BMI. Sleep Health 2023; 9:306-313. [PMID: 36781355 PMCID: PMC10293069 DOI: 10.1016/j.sleh.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE The current study examined school-summer differences in children's sleep patterns and sleep hygiene. Cross-sectional relationships with children's sleep, sleep hygiene, and weight status were explored during the school year and summer. METHODS Children (5-8 years) and their parents (n = 197 dyads) were recruited from 4 schools in southeastern Texas and via Facebook. Parents reported children's school year and summer sleep, sleep hygiene, and screen media use. Children's body mass index (BMI) was objectively assessed at the beginning and end of the summer. Associations between children's sleep hygiene and screen media use, sleep duration, and weight status were explored. RESULTS Children's sleep midpoint was earlier during the school year (1:54 AM ± 0.03) than in the summer (2:06 AM ± 0.03; t = 4.07, p < .0001). During summer, children increased their screen media use by 38 minutes (t = 2.32, p = .023) and decreased their caffeine intake from 7.43 to 7.0 (with scores ranging from 3 to 15; t = 2.83, p = .006). Greater sleep-inhibiting (β = 0.40, p = .011) and fewer sleep-promoting (β = -0.28, p = .049) behaviors during the school year were associated with having a higher BMI. There were no associations among sleep patterns, sleep hygiene and BMI during summer. CONCLUSIONS More positive school year sleep hygiene behaviors were supportive of having a healthier weight status. Changes in these behaviors during the summer did not portend worse weight outcomes. Supporting families in the establishment of sleep-promoting behaviors, particularly during the school year may help address the child obesity epidemic.
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Affiliation(s)
- Jennette P Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Brooke Reichek
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Hafza Dadabhoy
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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Drenowatz C, Ferrari G, Greier K, Chen S, Hinterkörner F. Physical fitness in Austrian elementary school children prior to and post-COVID-19. AIMS Public Health 2023; 10:480-495. [PMID: 37304593 PMCID: PMC10251054 DOI: 10.3934/publichealth.2023034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/13/2023] Open
Abstract
Background With the emergence of the COVID-19 pandemic, many countries implemented policies that included movement restrictions, social distancing and school closures in order to control the spread of the virus. Even though these actions may have been necessary to save lives, there have been some unintended consequences that could affect future public health. Methods The present study uses data from more than 24,500 Austrian elementary school children (51.2% male) that participated in a state-wide fitness evaluation program, which was initiated in the 2016/17 school year. In addition to body weight and height, data on cardiorespiratory endurance, muscular power, speed, agility, flexibility and object control were collected from three cohorts prior to the implementation of movement restrictions (school years: 2016/17, 2017/18, 2018/19) and one cohort in 2022, after the majority of COVID-19 policies had been lifted. Results Body mass index percentiles were significantly higher in children post-COVID-19 (p < 0.01). Further, cardiorespiratory endurance, agility and flexibility were significantly lower post-COVID-19 compared to the years preceding movement restrictions (p ≤ 0.01), while absolute muscular strength was higher in the year 2022 (p < 0.01). Conclusion Given the detrimental effects of COVID-19 policies on physical fitness in children, additional efforts are necessary that include versatile opportunities for physical activity and the promotion of physical fitness in order to modify the observed negative health trajectories and ensure future public health.
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Affiliation(s)
- Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH) Santiago 7500618, Chile
| | - Klaus Greier
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Division of Physical Education, Private Educational College (KPH-ES) 6422 Stams, Austria
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
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Weaver RG, Armstrong B, Adams E, Beets MW, White J, Flory K, Wilson D, McLain A, Tennie B. Feasibility and preliminary efficacy of structured programming and a parent intervention to mitigate accelerated summer BMI gain: a pilot study. Pilot Feasibility Stud 2023; 9:83. [PMID: 37189190 PMCID: PMC10184061 DOI: 10.1186/s40814-023-01312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/02/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND This study assessed the initial feasibility and preliminary efficacy of providing children a free summer day camp and a parent intervention to improve self-regulation and mitigate accelerated summer BMI gain. METHODS This pilot 2x2 factorial randomized control trial used a mixed-methods design to evaluate providing children a free summer day camp (SCV), a parent intervention (PI), and the combination of these two strategies (SCV+PI) to mitigate accelerated summer body mass index (BMI) gain. Progression criteria for feasibility and efficacy were assessed to determine if a full-scale trial was warranted. Feasibility criteria included recruitment capability (≥80 participants recruited) retention (≥70% participants retained), compliance (≥80% of participants attending the summer program with children attending ≥60% of program days, and ≥80% of participants completing goal setting calls with ≥60% of weeks syncing their child's Fitbit), and treatment fidelity (≥80% of summer program days delivered for ≥9 h/day, and ≥80% of participant texts delivered). Efficacy criteria were assessed via achieving a clinically meaningful impact on zBMI (i.e., ≥0.15). Changes in BMI were estimated using intent-to-treat and post hoc dose-response analyses via multilevel mixed-effects regressions. RESULTS For recruitment, capability and retention progression criteria were met with a total of 89 families participating and 24 participants randomized to the PI group, 21 randomized to the SCV group, 23 randomized to the SCV+PI group, and 21 randomized to the control. However, fidelity and compliance progression criteria were not achieved due to COVID-19 and lack of transportation. Progression criteria for efficacy was also not achieved as intent-to-treat analyses did not show changes in BMI gain that were clinically meaningful. Post hoc dose-response analyses showed that for each day (0 to 29) of summer programming children attended they gained -0.009 (95CI= -0.018, -0.001) less in BMI z score. CONCLUSIONS Engagement in both the SCV and PI was not ideal due to COVID-19 and lack of transportation. Providing children with structured summer programming to mitigate accelerated summer BMI gain may be an effective strategy. However, because feasibility and efficacy progression criteria were not met, a larger trial is not warranted until further pilot work is completed to ensure children attend the programming. TRIAL REGISTRATION The trial reported herein was prospectively registered at ClinicalTrials.gov. Trial #: NCT04608188.
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Affiliation(s)
- R G Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA.
| | - B Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA
| | - E Adams
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA
| | - M W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA
| | - J White
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA
| | - K Flory
- Department of Psychology, University of South Carolina, Columbia, USA
| | - D Wilson
- Department of Psychology, University of South Carolina, Columbia, USA
| | - A McLain
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA
| | - B Tennie
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA
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Molleri N, Gomes Junior SC, Marano D, Zin A. Survey of the Adequacy of Brazilian Children and Adolescents to the 24-Hour Movement Guidelines before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095737. [PMID: 37174254 PMCID: PMC10178683 DOI: 10.3390/ijerph20095737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
The 24-Hour Movement Guidelines provide specific recommendations on movement behaviors for children and adolescents. The objective of this study was to verify the adequacy of children and adolescents to the guidelines for moderate to vigorous physical activity, recreational screen time, and sleep duration, and the overall adequacy to the guidelines, before and during the COVID-19 pandemic. A cross-sectional study was conducted with parents or guardians of children or adolescents from different regions of Brazil using a digital interview form including sociodemographic characteristics of families, moderate to vigorous physical activity, recreational screen time, and sleep duration before and during the pandemic. Statistically significant variation was observed in both groups in relation to moderate to vigorous physical activity and recreational screen time between the two periods evaluated. Overall adequacy to the guidelines before the pandemic was 19.28% for children from Group 1 (0-5 years old) and 39.50% for those from Group 2 (6 to 17 years old). During the pandemic, it corresponded to 3.58% in Group 1 and 4.94% in Group 2 (p-value between periods ≤0.001). This study showed the significant impact of pandemic restrictions on reducing overall compliance and physical activity, and increasing screen time among Brazilian children and adolescents.
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Affiliation(s)
- Natália Molleri
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Saint Clair Gomes Junior
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Daniele Marano
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Andrea Zin
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
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Lazaridis A, Syrmpas I, Tsatalas T, Krommidas C, Digelidis N. Adolescents' Out-of-School Physical Activity Levels and Well-Being during the COVID-19 Restrictions in Greece: A Longitudinal Study. J Funct Morphol Kinesiol 2023; 8:jfmk8020055. [PMID: 37218851 DOI: 10.3390/jfmk8020055] [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: 03/16/2023] [Revised: 04/14/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023] Open
Abstract
The present study aimed to identify the impact of social distancing measures on adolescents' physical activity (PA) levels and well-being during the implementation of COVID-19 restrictive measures. There were 438 participants (207 boys and 231 girls), aged 12 to 15 years old (M = 13.5, SD = 0.55). They completed online questionnaires on well-being and PA in three waves (December 2020, February 2021, and June 2021). Correlation analyses were conducted to examine the relationship between well-being and PA variables in the three measurements. Additionally, separate three-way repeated-measures ANOVAs were conducted to capture possible differences in students' moderate to vigorous physical activity (MVPA) levels, life satisfaction, and subjective vitality among the three measurements due to gender, age, and interaction between gender and age. A significant relation emerged between the MVPA variables and well-being. In all measurements, adolescents' PA levels did not meet the World Health Organization (WHO) recommendations of at least 60 min per day in MVPA. Students' MVPA levels, life satisfaction, and subjective vitality were significantly higher in the third measurement compared to the first and second ones. Moreover, significant differences emerged in life satisfaction and subjective vitality between boys and girls in the first and third measurements, respectively. The COVID-19 restrictions appeared to negatively influence adolescents' PA and well-being. Policymakers aimed at facilitating adolescents' well-being in a similar situation in the future should not adopt measures restricting the participation of adolescents in PA.
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Affiliation(s)
- Alexandros Lazaridis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Ioannis Syrmpas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Themistoklis Tsatalas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Charalampos Krommidas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Nikolaos Digelidis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
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Larose D, Chih-Shing Chen M, Panahi S, Yessis J, Tremblay A, Drapeau V. Interventions to promote healthy lifestyle behaviors in children and adolescents in summer day camps: a scoping review. BMC Public Health 2023; 23:773. [PMID: 37101170 PMCID: PMC10134537 DOI: 10.1186/s12889-023-15521-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/24/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Children and adolescents have suboptimal physical activity and eating habits during summer breaks. Unlike the school setting, there is little evidence on interventions to promote healthy lifestyle behaviors in Summer Day Camps (SDCs). METHODS The aim of this scoping review was to examine physical activity, healthy eating, and sedentary behavior interventions in the SDCs. A systematic search on four platforms (EBSCOhost, MEDLINE, EMBASE, and Web of Science) was performed in May 2021 and was updated in June 2022. Studies related to promoting healthy behaviors, physical activity, sedentary behaviors and/or healthy eating among campers aged 6 to 16 in Summer Day Camps were retained. The protocol and writing of the scoping review were done according to the guidelines of the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR)". RESULTS Most interventions had a positive effect on the behavioral determinants or the behaviors themselves (i.e., physical activity, sedentary behaviors, or healthy eating). Involving counsellors and parents, setting camp goals, gardening, and education are all relevant strategies in promoting healthy lifestyle behaviors in SDCs. CONCLUSIONS Since only one intervention directly targeted sedentary behaviors, it should strongly be considered for inclusion in future studies. In addition, more long-term and experimental studies are needed to establish cause-and-effect relationships between healthy behavior interventions in SDCs and behaviors of children and young adolescents.
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Affiliation(s)
- David Larose
- Department of Kinesiology, Université Laval, Québec, G1V 0A6, Canada
- Quebec Heart and Lung Institute Research Center, Université Laval, Québec, G1V 0A6, Canada
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, G1V 0A6, Canada
- Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Université Laval, Québec, G1V 0A6, Canada
| | | | - Shirin Panahi
- Department of Kinesiology, Université Laval, Québec, G1V 0A6, Canada
- Quebec Heart and Lung Institute Research Center, Université Laval, Québec, G1V 0A6, Canada
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, G1V 0A6, Canada
- Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Université Laval, Québec, G1V 0A6, Canada
- Department of Physical Education, Université Laval, Québec, G1V 0A6, Canada
| | - Jennifer Yessis
- School of Public Health Sciences, University of Waterloo, Waterloo, N2L 3G1, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Université Laval, Québec, G1V 0A6, Canada
- Quebec Heart and Lung Institute Research Center, Université Laval, Québec, G1V 0A6, Canada
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, G1V 0A6, Canada
- Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Université Laval, Québec, G1V 0A6, Canada
| | - Vicky Drapeau
- Quebec Heart and Lung Institute Research Center, Université Laval, Québec, G1V 0A6, Canada.
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, G1V 0A6, Canada.
- Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Université Laval, Québec, G1V 0A6, Canada.
- Department of Physical Education, Université Laval, Québec, G1V 0A6, Canada.
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Bond DM, Seimon R, Schneuer FJ, Baur LA, Craig M, Alexander S, Garnett SP, Henderson J, Nassar N. Impact and recovery of the COVID-19 pandemic on weight status of children and adolescents. Clin Obes 2023; 13:e12579. [PMID: 36682362 PMCID: PMC10909548 DOI: 10.1111/cob.12579] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/27/2022] [Accepted: 01/08/2023] [Indexed: 01/24/2023]
Abstract
Recent evidence suggests the immediate effects of the COVID-19 lockdowns and restrictions have resulted in increased weight in children and adolescents. However, the longer-term effects have not been assessed. The aim of this study was to examine the impact and longer-term effects of the COVID-19 pandemic on BMI and weight status of children and adolescents. This study used routinely collected clinical data from the Sydney Children's Hospitals Network, comprising two socio-demographically diverse children's hospitals in New South Wales, Australia from 2018 to 2021. Of 245 836 individuals ≤18-years assessed, mean BMI percentile increased from 58.7 (SD 31.6) pre-COVID-19 to 59.8 (SD 31.7) (p < .05) post-restrictions and overweight/obesity increased by 5.5% (obesity alone 6.3%), predominantly in children <12-years and from lower socioeconomic backgrounds. The trend in BMI percentile was steady pre-COVID-19 (β = -0.03 [95% CI -0.07, 0.01]), peaked immediately following COVID-19 restrictions (β = 1.28 [95% CI 0.24, 2.32]) and returned to pre-pandemic levels over ensuing 21 months (β = -0.04 [95% CI -0.13, 0.04]). Routine anthropometric measurement facilitates ongoing monitoring and evaluation of the weight status of children and adolescents, helping to identify those at-risk. Despite initial BMI and weight increases among children and adolescents, longer-term follow-up highlighted a return to pre-pandemic rates, possibly attributed to state-wide policies aimed at reducing childhood obesity.
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Affiliation(s)
- Diana M. Bond
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Radhika Seimon
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Francisco J. Schneuer
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Louise A. Baur
- Weight Management ServicesThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
- Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
| | - Maria Craig
- Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
- Paediatric EndocrinologyThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Shirley Alexander
- CHISM and Weight Management Services, Auburn Clinical SchoolUniversity of Notre DameSydneyNew South WalesAustralia
| | - Sarah P. Garnett
- SCHN Human Research Ethics Committee, Institute of Endocrinology and Diabetes, Discipline of Child and Adolescent HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Joanne Henderson
- Sydney Children's Hospitals NetworkThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
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50
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Faucher J, Khanafer N, Chauliac N, Essadek A, Galia P, Mamimoue E, Leroux ML, Pollet MP, Imler-Weber F, Gillet Y, Fourneret P, Espi P. Factors Associated with Increased or Decreased Stress Level in French Children during the First COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4667. [PMID: 36901677 PMCID: PMC10001992 DOI: 10.3390/ijerph20054667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
In spring 2020, governments of many countries implemented lockdown measures to prevent the spread of the COVID-19 pandemic. Worldwide, the pandemic forced about 1.5 billion children to stay at home for several weeks and to experience homeschooling. The objective of this study was to assess the variation in stress levels and associated factors in school-aged children in France during the first COVID-19 lockdown. A cross-sectional study using an online questionnaire was designed by an interdisciplinary team involving hospital child psychiatrists and school doctors. Between 15 June and 15 July 2020, Educational Academy of Lyon (France) invited the parents of school-aged children to participate in this survey. The first part of the questionnaire concerned the children with data on lockdown conditions, socio-demographic data, daily rhythms (eating and sleeping), perceived stress variations, and feelings. The second part assessed parental perspectives on their child's psychological state and use of the mental health care system. Multivariate logistic regression was performed to identify factors associated with stress variation (increased or decreased). A total of 7218 questionnaires were fully completed by children from elementary school to high school with a balanced sex ratio. In summary, 29% of children reported a higher stress level during the lockdown, 34% reported a lower stress level, and 37% reported no stress variation in the usual situation prior to COVID-19. Parents were most often able to identify signs of increased stress levels in their children. The most influential factors in the variation of stress for children were academic pressure, family relationships, and fear of being infected or infecting a family member with SARS-CoV-2. Our study underlines the high impact of school attendance stressors on children in usual conditions and encourages vigilance for children whose stress levels have decreased during the lockdown but who may have increased difficulty re-exposing themselves upon deconfinement.
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Affiliation(s)
- Juliette Faucher
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Nagham Khanafer
- Service d’Hygiène, Épidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
| | - Nicolas Chauliac
- Regional Center for Psychotraumatism, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
| | - Aziz Essadek
- Interpsy EA4432, University of Lorraine, 54000 Nancy, France
| | - Perrine Galia
- Regional Center for Psychotraumatism, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
| | - Elise Mamimoue
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | | | | | | | - Yves Gillet
- Department of Pediatric Emergency, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Pierre Fourneret
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Pauline Espi
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
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