Regional differences in access to the outdoors and outdoor play of Canadian children and youth during the COVID-19 outbreak

Prolonged increase in psychotropic drug use among young women following the COVID-19 pandemic: a French nationwide retrospective study

BACKGROUND

The COVID-19 pandemic has had a significant impact on mental health, with evidence suggesting an enduring mental health crisis. Studies worldwide observed increased usage of antidepressants, anxiolytics, and hypnotics during the pandemic, notably among young people and women. However, few studies tracked consumption post-2021. Our study aimed to fill this gap by investigating whether the surge in the number psychotropic drug consumers in France persisted 2 years after the first lockdown, particularly focusing on age and gender differences.

METHODS

We conducted a national retrospective observational study based on the French national insurance database. We retrieved all prescriptions of anxiolytics, hypnotics, and antidepressants dispensed in pharmacies in France for the period 2015-2022. We performed interrupted time series analyses based on Poisson models for five age classes (12-18; 19-25; 26-50; 51-75; 76 and more) to assess the trend before lockdown, the gap induced and the change in trend after.

RESULTS

In the overall population, the number of consumers remained constant for antidepressants while it decreased for anxiolytics and hypnotics. Despite this global trend, a long-term increase was observed in the 12-18 and 19-25 groups for the three drug classes. Moreover, for these age classes, the increases were more pronounced for women than men, except for hypnotics where the trends were similar.

CONCLUSIONS

The number of people using antidepressants continues to increase more than 2 years after the first lockdown, showing a prolonged effect on mental health. This effect is particularly striking among adolescents and young adults confirming the devastating long-term impact of the pandemic on their mental health.

Development and implementation of a municipal outdoor play policy for children and youth in Nova Scotia, Canada: a community case study

Background: Children and youth benefit from outdoor play; however, environments and policies to support outdoor play are often limited. The purpose of this paper is to describe a case study of the development of a municipal outdoor play policy in Nova Scotia, Canada. The outdoor play policy was developed by the Town of Truro with support from the UpLift Partnership, a School-Community-University Partnership in Nova Scotia, Canada. UpLift supports the health and well-being of school-aged children and youth using a Health Promoting Schools approach which identifies the important role of municipal government in creating healthy school communities. The UpLift Partnership and the municipality hosted online workshops for municipal staff, community leaders and partners that included content about the importance of outdoor play, barriers and facilitators to outdoor play, best practices for youth engagement, the policy development process, and how policy actions can support outdoor play. Workshop participants developed policy actions for their community of Truro, Nova Scotia to increase opportunities for outdoor play for children and youth. Following the workshops, a small team from the municipality and UpLift drafted an outdoor play policy and submitted it to Truro town council for approval. The outdoor play policy was adopted in Fall 2021 and has since informed recreation and municipal planning decisions. By presenting a case study of the development of this outdoor play policy, we hope other communities may be inspired to develop and adopt their own outdoor play policies to benefit children and youth in their communities.

Correlates of Active School Transportation During the COVID-19 Pandemic Among Canadian 7- to 12-Year-Olds: A National Study

BACKGROUND

Active school transportation (AST) is an important source of physical activity for children and a potentially important climate change mitigation strategy. However, few studies have examined factors associated with AST in the context of the COVID-19 pandemic.

METHODS

We used baseline data from a longitudinal survey to investigate correlates of AST during the second wave of COVID-19 (December 2020). We collected survey data from 2291 parents of 7- to 12-year-olds across Canada and linked this information with data on neighborhood walkability and weather from national databases. We assessed potential correlates representing multiple levels of influence of the social-ecological model. We used gender-stratified binary logistic regression models to determine the correlates of children's travel mode to/from school (dichotomized as active vs motorized), while controlling for household income. We examined the correlates of travel mode for both the morning and afternoon trips.

RESULTS

Consistent correlates of AST among Canadian children during the COVID-19 pandemic included greater independent mobility, warmer outdoor temperature, having a parent who actively commuted to work or school, living in a household owning fewer vehicles, and living in a more walkable neighborhood. These findings were largely consistent between boys and girls and between morning and afternoon school trips.

CONCLUSIONS

Policymakers, urban planners, and public health workers aiming to promote AST should focus on these correlates while ensuring that neighborhoods are safe for children. Future research should monitor the prevalence and correlates of AST as COVID-19 restrictions are removed.

Social Media Behaviors and Lifestyle Changes in Young Adults (Ages 18-28 years) During the COVID-19 Pandemic: Analysis From an International Cross-Sectional Study

BACKGROUND

Screen time (ST), mainly social media (SM), has increased during the coronavirus 2019 (COVID-19) pandemic, impacting mental and physical health. This study aims to analyze SM use in young adults ages 18 to 28 years and lifestyle changes during COVID-19 to provide a baseline on pandemic habits in the younger population.

METHODS

An international cross-sectional observational study was conducted from September 2020 to January 2021. Participants responded about their SM behavior, and activities they noticed they did less and more during COVID-19. A total of 183 responses were analyzed.

RESULTS

The top reason respondents increased SM was for entertainment. Many respondents increased ST, physical activity (PA), and sleeping habits during COVID-19, while many decreased socialization, PA, and going outdoors. PA had mixed results among participants, indicating some increased PA and some decreased. Evidence suggests that timing of quarantining during the pandemic significantly influenced variables, like ST (P = .004) and socialization (P = .037).

DISCUSSION AND CONCLUSION

Respondents generally noticed increased SM use for various reasons, including socialization, potentially explaining why respondents feel they socialize less. ST use increased; some people reported increased PA while others reported a decrease. Altogether, this provides vital context on young adults' SM and lifestyle habits, highlighting potential areas for further research.

Outdoor Physical Activity and Play Among Canadian Children and Youth With Disabilities During the COVID-19 Pandemic: Findings From the National Physical Activity Measurement Study

This study explored the association between socioecological factors and outdoor physical activity (PA) and play in children with disabilities during the COVID-19 pandemic. Parents (N = 133) completed a survey to report changes in their child's outdoor PA and play during the pandemic (from prepandemic levels), and child, household, and neighborhood environment factors. Children with a PA-supporting parent and from multichild and White households had lower odds of reporting decreased outdoor PA. Children from multichild, higher income, married couple households and a PA-supporting parent had lower odds of decreased outdoor play. Living in neighborhoods with higher urbanization (i.e., high dwelling density, street intersections, and land-use mix) was associated with greater odds of decreased outdoor PA and play. Future research that uses larger and more representative samples of children with disabilities is needed to test for the multivariate effects of socioecological variables on outdoor PA and play.

Psychotropic drugs consumption during 2020 COVID-19 pandemic and lockdowns: Evidence of a surprising resilience of the drugs delivery system in France

The COVID-19 pandemic imposed two lockdowns of eight and six weeks in France. While access to care was reduced during lockdown periods, these stressful situations with the pandemic and lockdown periods may have a negative impact on mental health, especially in vulnerable subgroups. Monitoring of psychotropic drugs consumption in France is a comprehensive and reliable tool for indirectly analyzing the mental health of French people. This historical cohort study (n = 767 147) investigated the short-term and long-term evolution of the weekly trend of psychotropic drugs users in 2020 by performing a Seasonal Trend decomposition time series analysis. Rate of progression of consumers per week increased from 186 in the last week of 2019 to 261 per week in the last week of 2020 (+40.3%). Our results did not show a significant break in psychotropic drugs consumption trends during the year 2020 and its two lockdowns. The increase in trend regarding psychotropic drugs consumptions was greatest in young people (<15 years) and patients not being socially deprived. Despite the increase in consumers with restrictive health measures, the French drugs delivery system has been able to adapt with the support of government and pharmacy network. This point should be kept in mind as the necessary reforms to the health care system are undertaken. The COVID-19 pandemic has a negative impact on mental health and two lockdowns occurred in France with reduced access to care. In this context, monitoring of psychotropic drugs consumption is a comprehensive and reliable tool for analyzing the mental health of French people. We hypothesized that the psychotropic drugs consumption has increased during the 2020 COVID-19 pandemic, testifying to French people mental health deterioration, with psychotropic drugs consumption breaks during lockdowns, especially during the first "grand national lockdown", due to the closure or difficulties for accessing to health care structures. By carrying out a historical cohort study among Pays de la Loire residents (n = 767 147), we investigated evolution of the weekly trend of psychotropic drugs users in 2020 compared to 2019 by performing a Seasonal Trend decomposition time series analysis. Between 2019 to 2020, we found a + 40.3% rate of progression of consumers per week. During the year 2020, changes in trend regarding psychotropic drugs consumptions was observed in various sub-groups, e.g. greater in the youngest (< 15 years), which may indicate a vulnerable group strongly impacted by COVID-19 negative consequences, and patients not being socially deprived, which may indicate a group with probably an easier access to care. Lockdown periods were not associated with a significant change in psychotropic drug use, suggesting a form of resilience in the French health care system to maintain its capacity to deliver psychotropic treatments. We mainly discussed that despite the increase in consumers and the policies of restricting access to care during lockdown periods, the French drugs delivery system has been able to adapt thanks to supportive policy actions (extension of the prescriptions validity without the need for a renewal by a physician during periods of lockdowns), an efficient pharmacy network with a collaborative practice of health actors that need to be developed and/or conserved to face potential future health crises.

Play as a Stress-Coping Method Among Children in Light of the COVID-19 Pandemic: A Review

The COVID-19 pandemic, which started in early 2020, has been a great source of stress for almost every person all around the world. However, this is particularly true for children. It is necessary to fully address the stress-related psychosocial issues connected with the pandemic, solely in children. Play is important for children's development, as it is a natural activity for every child. Through play and play-based interventions, children can communicate non-verbally, symbolically, and in an action-oriented manner. Therefore, play-based interventions may have the potential to be one of the coping strategies used by children who experience stress, especially during the COVID-19 pandemic. The aim of this narrative review was to show how play-based activities could help children deal with stress related to the COVID-19 pandemic in the non-clinical population. A systematic search of the literature in various databases was performed. The initial search provided 5,004 potentially eligible studies in various databases, and 42,201 records identified from Google Scholar. After excluding studies not meeting the inclusive criteria, nine papers were selected for this narrative review. This narrative review showed findings that play-based activities can have a positive effect during the COVID-19 pandemic on different stress levels in the children population. Additionally, the findings of this review highlight the importance of further research and implementation of play into many aspects of children's life.

The 2022 ParticipACTION Report Card on Physical Activity for Children and Youth: Focus on the COVID-19 pandemic impact and equity-deserving groups

Introduction

The ParticipACTION Report Card on Physical Activity for Children and Youth is the most comprehensive national assessment of physical activity and related behaviors, characteristics, and opportunities for children and youth. The 2022 Report Card assigned grades based on data gathered during the COVID-19 pandemic to reflect this extraordinary time-period in Canada. Further, while not graded, efforts were made to summarize key findings for early years children and those identifying as: having a disability, Indigenous, 2SLGBTQ+, newcomers to Canada, racialized, or girls. The purpose of this paper is to summarize the 2022 ParticipACTION Report Card on Physical Activity for Children and Youth.

Methods

The best available physical activity data captured during the whole COVID-19 pandemic was synthesized across 14 different indicators in four categories. The 2022 Report Card Research Committee assigned letter grades (i.e., A-F) based on expert consensus of the evidence.

Synthesis

Grades were assigned for: Daily Behaviors (Overall Physical Activity: D; Active Play: D-; Active Transportation: C-; Organized Sport: C+; Physical Education: Incomplete [INC]; Sedentary Behaviors: F; Sleep: B; 24-Hour Movement Behaviors: F), Individual Characteristics (Physical Literacy: INC; Physical Fitness: INC), Spaces and Places (Household: C, School: B-, Community and Environment: B), and Strategies and Investments (Government: B-). Compared to the 2020 Report Card, the COVID-19 specific grades increased for Active Play and Active Transportation; and decreased for Overall Physical Activity, Sedentary Behaviors, Organized Sport, and Community and Environment. There were many data gaps for equity-deserving groups.

Conclusion

During the COVID-19 pandemic, the grade for Overall Physical Activity decreased from a D+ (2020) to a D, coinciding with decreases in grades reflecting fewer opportunities for sport and community/facility-based activities as well as higher levels of sedentary behaviors. Fortunately, improvements in Active Transportation and Active Play during COVID-19 prevented a worse shift in children's health behaviors. Efforts are needed to improve physical activity for children and youth during and post-pandemic, with a greater emphasis on equity-deserving groups.

Relative Importance of Well-Being Determinants in Atlantic Canadian Families During the Pandemic

Framed by the socio-ecological model of well-being, we examined the relative importance of factors contributing to three dimensions of well-being (child, parent, and family) during the COVID-19 pandemic. A sample of 536 participants from the Atlantic provinces of Canada answered a cross-sectional survey in 2021, covering experiences during the pandemic (eg, changes in family life and well-being). Well-being was assessed with 3 single-item measures on positive change in the life of children, parents, and families during the pandemic. This study involved 21 predictor variables (eg, change in time spent on various family activities). Using multiple regression and measures of relative importance based on the Lindeman, Merenda and Gold (lmg) method, we identified the variables most important to predicting well-being. Twenty-one predictors accounted for 21% of the variance in child well-being, 25% in parent well-being, and 36% in family well-being. Well-being at all 3 levels (child, parent, and family) shared the same top predictor (family closeness). The top 6 predictors of well-being at each level were related to leisure (eg, play) and time-use (eg, to prepare meals, engage in self-care, and rest). The effect sizes were smaller for child well-being than at the parent or family level, suggesting there may be important predictors of child well-being not accounted for in these analyses. This study may inform family-level programing and policy that seeks to promote well-being for children and their families.

An overview and trend analysis of research on the relationship between urban streets and residents' health in China pre- and post COVID-19 pandemic

Introduction

After the outbreak of COVID-19, the international community has been faced with various problems it has brought to cities. A large number of research projects and corresponding management measures were launched globally, trying to reduce the impact of COVID-19 on society. Among them, exploring how to maintain the health of residents by managing and updating the design of urban streets is one of the important issues regarding urban sustainability in the post-epidemic era.

Methods

This study uses bibliometric analysis techniques to obtain an overview of the knowledge structure of 898 Chinese urban streets and residents' health relationship studies from the China National Knowledge Infrastructure (CNKI) database for two periods (1999-2019 and 2020-2022). Five aspects were analyzed in terms of the keyword domain co-occurrence network, topic evolution path, emergent terms, hierarchical clustering, and confusion matrix.

Results and discussion

The findings revealed that studies focused on six broad themes: community residents, health surveys, health education, COVID-19, healthy city, and public health. Based on these findings, the paper compares and discusses research priorities before and after the outbreak and highlights areas for further research and attention.

Scoping review of children's and youth's outdoor play publications in Canada

INTRODUCTION

Since 2015, interest in the benefits of outdoor play for physical, emotional, social and environmental health, well-being and development has been growing in Canada and elsewhere.

METHODS

This scoping review aims to answer the question, "How, and in what context, is children's and youth's outdoor play being studied in Canada?" Included were studies of any type on outdoor play published after September 2015 in English or French by authors from Canadian institutions or assessing Canadian children and/or youth. Articles retrieved from MEDLINE, CINAHL and Scopus by March 2021 were organized according to eight priority areas: health, well-being and development; outdoor play environments; safety and outdoor play; cross-sectoral connections; equity, diversity and inclusion; professional development; Indigenous Peoples and land-based outdoor play; and COVID-19. Within each priority, study design and measurement method were tallied.

RESULTS

Of the 275 articles included, the most common priority area was health, wellbeing and development (n = 239). The least common priority areas were COVID-19 (n = 9) and Indigenous Peoples and land-based outdoor play (n = 14). Cross-sectional studies were the most common; the least common were rapid reviews. Sample sizes varied from one parent's reflections to 999 951 data points from health databases. More studies used subjective than objective measurement methods. Across priorities, physical health was the most examined outcome, and mental/emotional development the least.

CONCLUSION

A wealth of knowledge on outdoor play in Canada has been produced since 2015. Further research is needed on the relationship between outdoor play and mental/emotional development among children and youth.

Children's Physical Activity during COVID-19 in Ontario, Canada: Parents' Perspectives

The COVID-19 pandemic has had a large influence on children's physical activity (i.e., play and sport) opportunities. The purpose of this study was to describe parents' perspectives of their children's (ages 0-12) physical activity experiences during the pandemic (i.e., since the onset in March 2020 until follow-up survey completion date [between August to December 2021]). As part of the 'Return to Play' study conducted in Ontario, Canada, two-parent report surveys were completed online via Qualtrics. Surveys measured parents' perspectives regarding their children's physical activity since the onset of the pandemic (n = 17 items) and collected demographic information (n = 16 items). Open-ended questions were included to gather a rich understanding of parents' experiences (i.e., supports, challenges) with facilitating their children's physical activity. Descriptive statistics were calculated to describe parents' perspectives of their children's physical activity experiences and to determine parent demographics. Open-ended questions were analyzed via deductive content analysis. Parents (n = 382) reported that they noticed behavior changes in their children because of the pandemic (65.9%), and most (73.7%) reported challenges with supporting their children's activity during periods when public health measures were in place. Many parents (44.5%) stated that their children asked about returning to play/sport more than three times per week during periods when play/sport facilities were closed in Ontario. Qualitative data identified common supports parents used (e.g., getting active outdoors, forming mini social 'bubbles'), and challenges they faced (e.g., work, children's increased screen time, and home schooling), pertaining to their children's physical activity.

An overview and thematic analysis of research on cities and the COVID-19 pandemic: Toward just, resilient, and sustainable urban planning and design

Since early 2020, researchers have made efforts to study various issues related to cities and the pandemic. Despite the wealth of research on this topic, there are only a few review articles that explore multiple issues related to it. This is partly because of the rapid pace of publications that makes systematic literature review challenging. To address this issue, in the present study, we rely on bibliometric analysis techniques to gain an overview of the knowledge structure and map key themes and trends of research on cities and the pandemic. Results of the analysis of 2,799 articles show that research mainly focuses on six broad themes: air quality, meteorological factors, built environment factors, transportation, socio-economic disparities, and smart cities, with the first three being dominant. Based on the findings, we discuss major lessons that can be learned from the pandemic and highlight key areas that need further research.

Global Changes in Child and Adolescent Physical Activity During the COVID-19 Pandemic: A Systematic Review and Meta-analysis

IMPORTANCE

Numerous physical distancing measures were implemented to mitigate the spread of the COVID-19 virus, which could have negatively affected child and adolescent physical activity levels.

OBJECTIVES

To conduct a systematic review and meta-analysis of the literature that used validated measures to document changes in child and adolescent physical activity during the COVID-19 pandemic and to estimate whether changes in physical activity differed between participant-level, contextual, and methodological moderators.

DATA SOURCES

PubMed, PsycInfo, SPORTDiscus, Web of Science, Scopus, CINAHL, and MEDLINE were searched (from January 1, 2020, to January 1, 2022). A total of 1085 nonduplicate records were retrieved.

STUDY SELECTION

Studies were included if they reported (1) changes in the duration of physical activity at any intensity for children or adolescents (age ≤18 years) comparing before and during the COVID-19 pandemic using validated physical activity measurement tools and were (2) from general population samples, (3) peer-reviewed, and (4) published in English.

DATA EXTRACTION AND SYNTHESIS

A total of 126 articles underwent full-text review. Data were analyzed using a random-effects meta-analysis, which was conducted in January 2022.

MAIN OUTCOMES AND MEASURES

Change in the duration of engagement in physical activity at any intensity comparing before and during COVID-19.

RESULTS

Twenty-two studies including 46 independent samples and 79 effect sizes from 14 216 participants (median age, 10.5 years; range, 3-18 years) were included. The percentage change in the duration of engagement in total daily physical activity from before to during COVID-19 was -20% (90% CI, -34% to -4%). Moderation analyses revealed that changes were larger for higher-intensity activities (-32%; 90% CI, -44% to -16%), corresponding to a 17-minute reduction in children's daily moderate-to-vigorous physical activity levels. The reduction in physical activity was also larger for samples located at higher latitudes (37%; 90% CI, -1% to 89%) and for studies with a longer duration between physical activity assessments (25%; 90% CI, -0.5% to 58%).

CONCLUSIONS AND RELEVANCE

Children and adolescents have experienced measurable reductions in physical activity during the COVID-19 pandemic. Findings underscore the need to provide bolstered access to support and resources related to physical activity to ensure good health and social functioning among children and adolescents during pandemic recovery efforts.

Parents' Attitudes Regarding Their Children's Play and Sport During COVID-19

The COVID-19 pandemic and associated public health measures have interrupted the daily routines of parents and children. The purpose of this study was to explore parents' attitudes regarding their children's play/sport during COVID-19. A secondary objective was to explore the influence of parent demographics and parent-reported physical activity levels and risk tolerance on these attitudes. Ontario parents of children aged 12 and younger completed an online survey (August-December 2020) that assessed their attitudes (grouped by support, safety and socialization-related attitudes; n = 14 items) regarding their child(ren)'s play/sport, their physical activity levels (n = 2 items), and demographic details (n = 16 items). Two open-ended items were used to gather a deeper understanding of attitudes. Parents' tolerance for risk was measured via the validated Tolerance of Risk in Play Scale. Descriptive statistics were calculated to describe attitudes and risk tolerance. Least Absolute Shrinkage and Selection Operator regressions were conducted to examine factors influencing parents' attitudes. Multiple linear models were computed using the identified predictors for each attitude category. Deductive content analysis was undertaken on open-ended responses. Participants (n = 819) reported the highest scores for safety-related attitude items (M = 3.54, SD = .63) followed by socialization and support, which all influenced attitudes regarding children's play/sport (p < .05). Demographics and parents' physical activity levels were identified as important predictors of parents' attitudes. Qualitative data revealed that parents had mixed levels of comfort with respect to their children's return to play/sport. Findings from this study reveal that increased support is needed to guide future play/sport decision-making.

Regional differences in movement behaviours of children and youth during the second wave of the COVID-19 pandemic in Canada: follow-up from a national study

Objectives

Public health restrictions varied by region during the COVID-19 pandemic and reduced opportunities for children to be physically active. The purpose of this study was to assess regional differences in movement behaviours of Canadian children and youth during the second wave of the COVID-19 pandemic.

Methods

A national sample of Canadian parents (n=1568; 58% women) of children and youth (5–17 years of age) completed an online survey. Participants were classified based on region of residence (British Columbia, Prairies, Ontario, Quebec, or Atlantic Canada). Differences in movement and play behaviours (physical activity, outdoor play, sleep, screen time) between children and youth living in different regions were examined.

Results

Compared to children and youth in Quebec (the region with the highest COVID-19 prevalence), children and youth in the Prairies (F_(1,1563)=9.0, p=0.01) and Atlantic Canada (F_(1,1563)=17.1, p<0.001) participated in more moderate-to-vigorous physical activity (MVPA). Compared to Quebec, living in Atlantic Canada increased the odds of meeting the MVPA guideline (odds ratio (OR)=2.1, p=0.02), living in Ontario decreased the odds of meeting the sleep guideline (OR=0.6, p=0.01), and living in Ontario (OR=0.7, p=0.04) or Atlantic Canada (OR=0.6, p=0.049) decreased the odds of meeting the screen time guideline. Children and youth in Atlantic Canada demonstrated smaller declines in outdoor play than their counterparts in Quebec.

Conclusion

Movement and play behaviours varied between regions of Canada where the highest COVID-19 prevalence corresponded to lower odds of meeting the physical activity guidelines. Low compliance with 24-hour movement guidelines suggests that regional pandemic recovery plans need to prioritize opportunities for healthy movement.

Nurturing care during COVID-19: a rapid review of early evidence

OBJECTIVES

The COVID-19 pandemic has brought significant changes to family life, society and essential health and other services. A rapid review of evidence was conducted to examine emerging evidence on the effects of the pandemic on three components of nurturing care, including responsive caregiving, early learning, and safety and security.

DESIGN

Two academic databases, organisational websites and reference lists were searched for original studies published between 1 January and 25 October 2020. A single reviewer completed the study selection and data extraction with verification by a second reviewer.

INTERVENTIONS

We included studies with a complete methodology and reporting on quantitative or qualitative evidence related to nurturing care during the pandemic.

PRIMARY AND SECONDARY OUTCOME MEASURES

Studies reporting on outcomes related to responsive caregiving, early learning, and safety and security were included.

RESULTS

The search yielded 4410 citations in total, and 112 studies from over 30 countries met our eligibility criteria. The early evidence base is weighted towards studies in high-income countries, studies related to caregiver mental health and those using quantitative survey designs. Studies reveal issues of concern related to increases in parent and caregiver stress and mental health difficulties during the pandemic, which was linked to harsher and less warm or responsive parenting in some studies. A relatively large number of studies examined child safety and security and indicate a reduction in maltreatment referrals. Lastly, studies suggest that fathers' engagement in caregiving increased during the early phase of the pandemic, children's outdoor play and physical activity decreased (while screen time increased), and emergency room visits for child injuries decreased.

CONCLUSION

The results highlight key evidence gaps (ie, breastfeeding support and opportunities for early learning) and suggest the need for increased support and evidence-based interventions to ensure young children and other caregivers are supported and protected during the pandemic.

The Impact of an After-School Physical Activity Program on Children's Physical Activity and Well-Being during the COVID-19 Pandemic: A Mixed-Methods Evaluation Study

Introduction: This study evaluated the impact of the Build Our Kids’ Success (BOKS) after-school program on children’s physical activity (PA) and well-being during the COVID-19 pandemic. Methods: Program leaders, children, and their parents were recruited from after-school programs in Nova Scotia, Canada, that delivered BOKS programming in Fall 2020. After participating, Grade 4–6 children (n = 14) completed the Physical Literacy Assessment for Youth Self (PLAYself), Physical Activity Questionnaire for Older Children (PAQ-C), the Physical Activity Enjoyment Scale (PACES), and 5 National Institutes of Health (NIH) Patient-Reported Outcomes Measures Information System (PROMIS) scales. Children (n = 7), parents (n = 5), and program leaders (n = 3) completed interviews, which were analyzed for themes inductively. Results: The average PAQ-C score was 2.70 ± 0.48, PLAYself was 68.23 ± 13.12, and PACES was 4.22 ± 0.59 (mean ± SD). NIH PROMIS scores were below standard means (cognitive function, family relationships) or within normal limits (peer relationships, positive affect, and life satisfaction). A thematic analysis of interviews revealed that children’s PA levels were impacted by the pandemic and that BOKS positively impacted children’s physical well-being and integrated well with school-based activities. Conclusions: Participation in BOKS provided an overall positive experience and may have mitigated COVID-19-related declines in PA in well-being. The results of this evaluation can inform future physically-active after-school programming.

'We can play tag with a stick'. Children's knowledge, experiences, feelings and creative thinking during the COVID-19 pandemic

Using a relational approach, we draw on repeated interviews with a group of 30 diverse children from Ontario to share and reflect on their knowledge, experiences and feelings early in the COVID-19 pandemic. Prioritising relational interdependence and relational agency, this paper illustrates our participants' embedded engagements with the pandemic and their contribution to the co-production of knowledge. We emphasise their thoughtful responses to the pandemic; their creative, self-reflexive strategies for managing a difficult time; and their advice to others. We thus prioritise children's viewpoints and emphasise their relational interconnections with others during a time that was marked by social isolation.

Impact of COVID-19 on physical activity: A rapid review

Background

Physical activity is a commonly prescribed medicine for people with conditions such as obesity and diabetes who are also at increased risk of being hospitalized or severely ill from COVID-19. However, many people are reporting challenges in engaging in a healthy dose of physical activity amid the pandemic.

Objective

This rapid review synthesizes the current empirical evidence about the impacts of COVID-19 on people’s outdoor physical activity and sedentary behavior while highlighting the role of community environments in promoting or hindering physical activity during the pandemic.

Methods

Literature searches were conducted using keywords related to COVID-19: physical activity, mobility, and lifestyle behaviors. Eligibility criteria were peer-reviewed empirical and quantitative studies published in English, addressing COVID-19 and using physical activity and/or sedentary behavior as the study outcomes.

Results

Out of 61 eligible studies, the majority (78.3%) were conducted in Asian and European countries, with only four (6.7%) being US studies. The results showed that COVID-19 was linked with significant decreases in mobility, walking, and physical activity, and increases in sedentary activity. A few studies also reported contradicting results including increased uses of parks/trails and increased recreational activity among certain groups of population.

Conclusions

Evidence suggests an overall negative impact of COVID-19 on physical activity, with differential effects across different sub-populations. Significant knowledge gaps are also found in the roles of social and physical attributes that can promote physical activity during pandemics with reduced safety risks.

The Effect of an After-School Physical Activity Program on Children's Cognitive, Social, and Emotional Health during the COVID-19 Pandemic in Nova Scotia

Children’s physical activity participation declined during the COVID-19 pandemic, and these negative changes could lead to longer-term impacts on children’s cognitive, social, and emotional health. Purpose: To determine parent/caregivers’ perceptions of their children’s cognitive function, peer and family relationships, life satisfaction, physical activity, sleep, positive affect, and global health, before and after participating in the Build Our Kids’ Success (BOKS) programming at after-school programs in Fall 2020. Methods: Parents of children participating in the BOKS programming at after-school programs in Nova Scotia, Canada, were recruited. At baseline, 159 parents completed the National Institutes of Health (NIH) Patient-Reported Outcomes Measures Information System (PROMIS) parent-proxy questionnaire, and 75 parents completed the measures at follow-up. Independent t-tests were used to determine if there were differences between baseline and follow-up Parent Proxy Questionnaire data. Results: All NIH PROMIS outcome variables at baseline and follow-up were within normal limits (Adjusted T-Scores: 46.67 ± 7.15 to 50.04 ± 7.13). There were no significant differences in life satisfaction (t(188) = −1.05, p = 0.30), family relationships (t(189) = 0.31, p = 0.76), cognitive function (t(199) = −1.16, p = 0.25), peer relationships (t(192) = −1.86, p = 0.06), positive affect (t(195) = 0.25, p = 0.81), global health (t(216) = −0.43, p = 0.67), physical activity (t(202) = 0.787, p = 0.732), sleep disturbance (t(193) = 1.72, p = 0.087), or psychological stress (t(196) = 1.896, p = 0.059), from baseline to follow-up. Conclusions: Parent-proxy questionnaires suggested that the BOKS programming had a protective effect on children’s health behaviours and cognitive, social, and emotional health as values remained within normal limits and were not impacted by the public health restrictions during the second wave of the COVID-19 pandemic in Nova Scotia.

Exercise frequency during the COVID-19 pandemic: A longitudinal probability survey of the US population

Regular physical activity is important for general health and reduces the risk for COVID-19 infections and for severe outcomes among infected people. However, measures to mitigate COVID-19 likely decrease population physical activity. This study aimed to examine 1) changes in exercise frequency in a representative sample of US adults during the pandemic (04/01/2020-07/21/2021), and 2) how sociodemographic characteristics, pre-COVID health-related behaviors and outcomes, and state-level stringency of COVID-19 containment measures predict exercise frequency. Self-reported exercise frequency and its individual-level predictors were determined based on 151,155 observations from 6,540 adult participants (aged ≥ 18 years) in all US states from the Understanding America Study. State-level stringency of COVID-19 control measures was examined from the Oxford COVID-19 Government Response Tracker. Exercise frequency varied significantly over 28 survey waves across 475 days of follow-up (F 1,473 = 185.5, p < 0.001, η2 = 0.28, 95% CI = 0.23-1.00), where exercise frequency decreased between April 2020 and January 2021, and then increased from January 2021 to July 2021. Those who were younger, living alone, non-White, had no college degree, lower household income, low pre-pandemic physical activity levels, obesity, diabetes, kidney disease and hypertension had lower exercise frequency. State-level stringency of COVID-19 control measures was inversely associated with exercise frequency (B = 0.002, SE = 0.001, p < 0.01) between April and December 2020 when the overall stringency level was relatively high; but the association was non-significant (B = 0.001, SE = 0.001, p > 0.05) between January and July 2021, during which the stringency index sharply declined to a low level. This longitudinal probability survey of the US population revealed significant fluctuations in exercise during COVID-19. Low exercise levels are concerning and deserve public health attention. Health inequalities from physical inactivity are likely to exacerbate because of COVID-19. Physical activity promotion in safe environments is urgently warranted, especially in at-risk population subgroups.

The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves

The global public health crisis caused by COVID-19 has lasted longer than many of us would have hoped and expected. With its high uncertainty and limited control, the COVID-19 pandemic has undoubtedly asked a lot from all of us. One important central question is: how resilient have we proved in face of the unprecedented and prolonged coronavirus pandemic? There is a vast and rapidly growing literature that has examined the impact of the pandemic on mental health both on the shorter (2020) and longer (2021) term. This not only concerns pandemic-related effects on resilience in the general population, but also how the pandemic has challenged stress resilience and mental health outcomes across more specific vulnerable population groups: patients with a psychiatric disorder, COVID-19 diagnosed patients, health care workers, children and adolescents, pregnant women, and elderly people. It is challenging to keep up to date with, and interpret, this rapidly increasing scientific literature. In this review, we provide a critical overview on how the COVID-19 pandemic has impacted mental health and how human stress resilience has been shaped by the pandemic on the shorter and longer term. The vast literature is dominated by a wealth of data which are, however, not always of the highest quality and heavily depend on online and self-report surveys. Nevertheless, it appears that we have proven surprisingly resilient over time, with fast recovery from COVID-19 measures. Still, vulnerable groups such as adolescents and health care personnel that have been severely impacted by the COVID-19 pandemic do exist. Large interindividual differences exist, and for future pandemics there is a clear need to comprehensively and integratively assess resilience from the start to provide personalized help and interventions tailored to the specific needs for vulnerable groups.

Children and parents' perspectives of the impact of the COVID-19 pandemic on Ontario children's physical activity, play, and sport behaviours

Background

The COVID-19 pandemic and associated public health measures have resulted in the closure of many physical activity-supporting facilities. This study examined Ontario parents’ and children’s perspectives of COVID-19’s impact on children’s physical activity behaviours, return to play/sport during COVID-19, as well as barriers/facilitators to getting active amid extended closures of physical activity venues.

Methods

Parents/guardians of children aged 12 years and under living in Ontario, Canada were invited to participate in an interview. 12 parent/guardian and 9 child interviews were conducted via Zoom between December 2020 – January 2021, were audio-recorded, and transcribed verbatim. Thematic content analysis was undertaken to identify pronounced themes.

Results

Themes for both parent and child interviews fell into one of three categories: 1) barriers and facilitators for getting children active amid COVID-19 closures of physical activity-supporting facilities; 2) changes in children’s activity levels; and, 3) perspectives on return to play/sport during and post-pandemic. Various subthemes were identified and varied between parents and children. The most common facilitator for dealing with children’s inactivity voiced by parents/guardians was getting active outdoors. Parents/guardians noted their willingness to have their children return to play/sport in the community once deemed safe by public health guidelines, and children’s willingness to return stemmed primarily from missing their friends and other important authority figures (e.g., coaches) and sporting events (e.g., tournaments).

Conclusions

Findings from this study could inform families of feasible and realistic strategies for increasing children’s physical activity during community closures, while also providing public health experts with information regarding what supports, or infrastructure might be needed during future lockdown periods and/or pandemics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12344-w.

Adverse Effects of the COVID-19 Pandemic on Movement and Play Behaviours of Children and Youth Living with Disabilities: Findings from the National Physical Activity Measurement (NPAM) Study

All children and youth require ample physical activity (PA), low levels of sedentary behaviour (SB), and adequate sleep to stay healthy. Children and youth living with disabilities (CYWD) tend to have fewer opportunities for participation in PA and outdoor play compared with their typically developing peers. In turn, CYWD are typically less active and more sedentary, on average, compared with their peers. The COVID-19 pandemic reduced opportunities for many children and youth to participate in PA and outdoor play. The purpose of this study was to assess parent-perceived changes in PA (including outdoor play), SB (including screen time), and sleep quality and quantity, due to COVID-19 and related restrictions, in a national cohort of Canadian CYWD. We recruited parents of school-aged CYWD (N = 151) in May 2020. In an online survey, parents reported their child's previous 7-day PA, SB, and sleep, as well as perceived changes in their child's movement and play behaviours due to COVID-19 and related restrictions. Parent-perceived parental support for their child's movement and play behaviours during the pandemic was also assessed. We used descriptive statistics to describe the child's movement behaviours and assessed the association between movement behaviours and parental factors using Pearson and point-biserial correlations. Few (5.3%) CYWD met PA recommendations and 13.2% met screen time recommendations during the acute period of the COVID-19 pandemic. More CYWD (66.2%) were meeting sleep recommendations. Overall, only 1.3% of CYWD were meeting the combined movement guidelines. Parent encouragement was positively associated with the child's outdoor PA (0.23), wheeling, walking, and biking (0.19), indoor PA (0.16), and family-based PA (0.26). Parental co-play was similarly positively associated with the child's outdoor PA (0.26), wheeling, walking, and biking (0.39), indoor PA (0.16), and family-based PA (0.26). Parents perceived their CYWD to be less active and more sedentary as a result of COVID-19 and the related restrictions. Parents of CYWD have an important role in encouraging healthy movement behaviours. Return to movement and play post-COVID guidelines should include tailored strategies for CYWD and their families to mitigate the negative impacts of the pandemic.

Exploring the impact of COVID-19 on the movement behaviors of children and youth: A scoping review of evidence after the first year

PURPOSE

The objective of this scoping review was to summarize systematically the available literature investigating the relationships between the coronavirus disease 2019 (COVID-19) pandemic and movement behaviors (physical activity, sedentary behavior, and sleep) of school-aged children (aged 5-11 years) and youth (aged 12-17 years) in the first year of the COVID-19 outbreak.

METHODS

Searches for published literature were conducted across 6 databases on 2 separate search dates (November 25, 2020, and January 27, 2021). Results were screened and extracted by 2 reviewers (DCP and KR) independently, using Covidence. Basic numeric analysis and content analysis were undertaken to present thematically the findings of included studies according to the associated impact on each movement behavior.

RESULTS

A total of 1486 records were extracted from database searches; of those, 150 met inclusion criteria and were included for analysis. Of 150 articles, 110 were empirical studies examining physical activity (n = 77), sedentary behavior/screen time (n = 58), and sleep (n = 55). Results consistently reported declines in physical-activity time, increases in screen time and total sedentary behavior, shifts to later bed and wake times, and increases in sleep duration. The reported impacts on movement behaviors were greater for youth than for children.

CONCLUSION

The COVID-19 pandemic is related to changes in the quantity and nature of physical activity, sedentary behavior, and sleep among children and youth. There is an urgent need for policy makers, practitioners, and researchers to develop solutions for attenuating adverse changes in physical activity and screen time among children and youth.

A Web-Based Risk-Reframing Intervention to Influence Early Childhood Educators' Attitudes and Supportive Behaviors Toward Outdoor Play: Protocol for the OutsidePlay Study Randomized Controlled Trial

Background

Early learning and childcare centers (ELCCs) can offer young children critical opportunities for quality outdoor play. There are multiple actual and perceived barriers to outdoor play at ELCCs, ranging from safety fears and lack of familiarity with supporting play outdoors to challenges around diverse perspectives on outdoor play among early childhood educators (ECEs), administrators, licensing officers, and parents.

Objective

Our study objective is to develop and evaluate a web-based intervention that influences ECEs’ and ELCC administrators’ perceptions and practices in support of children’s outdoor play at ELCCs.

Methods

The development of the fully automated, open-access, web-based intervention was guided by the intervention mapping process. We first completed a needs assessment through focus groups of ECEs, ELCC administrators, and licensing officers. We identified key issues, needs, and challenges; opportunities to influence behavior change; and intervention outcomes and objectives. This enabled us to develop design objectives and identify features of the OutsidePlay web-based intervention that are central to addressing the issues, needs, and challenges of ECEs and ELCC administrators. We used social cognitive theory and behavior change techniques to select methods, applications, and technology to deliver the intervention. We will use a two-parallel-group randomized controlled trial (RCT) design to evaluate the efficacy of the intervention. We will recruit 324 ECEs and ELCC administrators through a variety of web-based means, including Facebook advertisements and mass emails through our partner networks. The RCT study will be a purely web-based trial where outcomes will be self-assessed through questionnaires. The RCT participants will be randomized into the intervention group or the control group. The control group participants will read the Position Statement on Active Outdoor Play.

Results

The primary outcome is increased tolerance of risk in children’s play, as measured by the Teacher Tolerance of Risk in Play Scale. The secondary outcome is self-reported attainment of a self-developed behavior change goal. We will use mixed effects models to test the hypothesis that there will be a difference between the intervention and control groups with respect to tolerance of risk in children’s play. Differences in goal attainment will be tested using logistic regression analysis.

Conclusions

The OutsidePlay web-based intervention guides users through a personalized journey that is split into 3 chapters. An effective intervention that addresses the barriers to outdoor play in ELCC settings has the potential to improve children’s access to outdoor play and support high-quality early childhood education.

Trial Registration

ClinicalTrials.gov NCT04624932; https://clinicaltrials.gov/ct2/show/NCT04624932

International Registered Report Identifier (IRRID)

DERR1-10.2196/31041

Effects of the coronavirus disease 2019 pandemic and the policy response on childhood obesity risk factors: Gender and sex differences and recommendations for research

Childhood obesity is a public health concern globally, with generally higher prevalence rates in boys compared to girls. Although biological sex is an important determinant, gender roles and norms influence the exposure and vulnerability to risk factors for noncommunicable diseases. Norms and roles might be reinforced or change due to coronavirus disease 2019 (COVID-19) related measures as well as the exposure to risk factors for childhood obesity. COVID-19 related changes, such as home confinement, influence a child's risk of obesity. Using Dahlgren and Whitehead's model of the main determinants of health, this paper aims to provide a roadmap for future research on sex, gender, and childhood obesity during the time of COVID-19. It examines how COVID-19 has led to important changes in children's general socioeconomic, cultural, and environmental conditions, social and community networks, and individual lifestyle factors and how these may affect a child's risk for obesity. It focuses on the influence of gender and sex and outlines key considerations and indicators to examine in future studies concerned with promoting health and gender equity and equality. We need to understand the differential impact of COVID-19 related measures on girls' and boys' risk for obesity to adequately react with preventive measures, policies, and programs.

Play Behaviors in Children during the COVID-19 Pandemic: A Review of the Literature

Play is a key factor for children's healthy psychological, emotional, social, and cognitive development. During the COVID-19 pandemic, it has been postulated that children's play was affected, not only regarding the time children spent playing but also in terms of the qualitative characteristics of play. The aim of this review was to investigate how children's play has changed during the COVID-19 pandemic. A review was conducted in the PubMed, Google Scholar, EMBASE, SCOPUS, ERIC, PsycInfo, and JSTOR databases up to 6 December 2020. Furthermore, references of eligible studies as well as of relevant articles were searched using a snowballing technique. The search retrieved 17 eligible studies, conducted in Europe and North America. In general, outdoor play was reduced during the pandemic; on the other hand, there was an increase in indoor play and in videogames-screen time. COVID-19 was present in children's pretend play. Children's play was a key contributor to children's mood and wellbeing. Furthermore, teachers were especially concerned about how children's play was affected during the lockdown measures. There is evidence that children's play habits were affected during the COVID-19 pandemic; further research is required, especially cross-culturally oriented.

Few Canadian children and youth were meeting the 24-hour movement behaviour guidelines 6-months into the COVID-19 pandemic: Follow-up from a national study

Daily life has changed for families due to the COVID-19 pandemic. The aim of this repeated cross-sectional study was to describe movement behaviours in Canadian children and youth six months into the pandemic (T2; October 2020) compared with the start of the pandemic (T1, April 2020). An online survey was distributed to parents (N=1568) of children and/or youth (5-17 years; 58% girls) in October 2020. The survey assessed changes in movement behaviours [physical activity (PA) and play, sedentary behaviours (SB), and sleep] from before the pandemic to October 2020 (T2). We compared these data to spring data (T1; April 2020; Moore et al., 2020) collected using identical methodology (N=1472; 54% girls). We report correlations between movement behaviours and relevant parental factors and provide word frequency distributions for open-ended responses. During the second wave, 4.5% of children (4.6% girls; 4.3% boys) and 1.9% of youth (1.3% girls, 2.4% boys) met the movement guidelines (3.1% overall). Whereas, during the first wave, 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined guidelines (2.6% overall). Parental support was correlated with their child's movement behaviours (T1 and T2). Our study demonstrates the ongoing challenges for children and youth to engage in healthy movement during the pandemic. Novelty bullets: • Our large-scale national study demonstrates that children and youth were not meeting the 24-hour movement guidelines during the second wave of the pandemic. • Our findings illustrate the need to protect children and youth from the collateral consequences of the pandemic.

Changes in Physical Activity during the COVID-19 Pandemic-An Analysis of Differences Based on Mitigation Policies and Incidence Values in the Federal States of Germany

Measures to slow down the spread of coronavirus SARS-CoV-2 have had an impact on the daily life and physical activity (PA) of many people. Nevertheless, in Germany, mitigation policies and incidence values vary widely across the federal states (Länder). Thus, the aim of the present study was to investigate regional differences in PA during the coronavirus pandemic. This study is based on the SPOVID project (Examining physical activity and sports behavior in the face of COVID-19 pandemic: a social inequality perspective) that incorporates a large-scale, representative cross-sectional survey representing the German population (≥14 years). Based on the survey that took place in October 2020 (N = 1477), we investigated the relationships between the COVID-19 incidence values as well as the mitigation policies across the federal states in Germany and changes in PA. Pearson correlations indicated a strong negative relationship between PA change and 7-day incidence values (r = -0.688 **, p = 0.009) and a moderate negative relationship between PA changes and an index of mitigation policies (r = -0.444, p = 0.112). Higher 7-day incidence values and stricter mitigation policies were associated with a stronger decline in PA levels. Therefore, it is important to support people to stay active even if there are restrictions. In particular, in federal states and regions with high incidences and stricter mitigation policies, measures to promote health-enhancing PA are necessary.

Children's Independent Mobility and Physical Activity during the COVID-19 Pandemic: A Qualitative Study with Families

Children's independent mobility (CIM) is the freedom of children to move around their neighbourhood without adult supervision and is closely related to overall physical activity participation. The COVID-19 pandemic has impacted movement behaviours for children, with evidence indicating a decrease in physical activity. The aim of this study was to explore experiences of CIM and physical activity during the COVID-19 pandemic from the perspectives of children and their parents. We completed 21 family (at least one parent and one child aged 7-12) semi-structured interviews with 45 participants living in small urban and rural areas of British Columbia, Canada. Three themes were identified through a reflexive thematic analysis: (1) keeping everyone safe from COVID-19; (2) change in pattern and types of activity; (3) social impacts with family, friends, and community. Participants expressed a perceived increase in unstructured activity and a decrease in structured physical activity during the pandemic, which many parents viewed as a positive change. Parents and children indicated negative feelings due to spending less time with peers and reflected positively about spending more time with family. Parents and children expressed fear and anxiety in trying to keep their families safe from virus spread and creativity in adapting play behaviours. Findings highlight the impact of the pandemic on social friendship networks for families and a shift in activity patterns for children toward unstructured play.

Systematic review of the correlates of outdoor play and time among children aged 3-12 years

BACKGROUND

Due to the myriad of benefits of children's outdoor play and time, there is increasing concern over its decline. This systematic review synthesized evidence on the correlates of outdoor play and outdoor time among children aged 3-12 years.

METHODS

A total of 12 electronic databases in five different languages (Chinese, English, Korean, Spanish, Portuguese) were searched between October 28, 2019 and July 27, 2020. Covidence software was used for screening and Microsoft Excel with a predesigned coding form was used for data extraction. Evidence was synthesized and correlates were categorized using the socioecological model framework.

RESULTS

Based on 107 studies representing 188,498 participants and 422 childcare centers from 29 countries, 85 studies examined potential correlates of outdoor play while 23 studies examined that of outdoor time (one examined both). The duration of outdoor play and outdoor time ranged between 60 and 165 min/d and 42-240 min/d, respectively. Out of 287 (outdoor play) and 61 (outdoor time) potential correlates examined, 111 correlates for outdoor play and 33 correlates for outdoor time were identified as significant correlates. Thirty-three variables were identified as key/common correlates of outdoor play/time, including eight correlates at the individual level (e.g., sex/gender, race/ethnicity, physical activity), 10 correlates at the parental level (e.g., parental attitude/support/behavior, parenting practice), nine at the microsystem level (e.g., proximal home/social environment such as residence type, peer influence), three at the macrosystem/community level (e.g., availability of space children can play), and three at the physical ecology/pressure for macrosystem change level (e.g., seasonality, rurality). No key correlates were found at the institutional level.

CONCLUSIONS

Individual, parental, and proximal physical (home) and social environments appear to play a role in children's outdoor play and time. Ecological factors (i.e., seasonality, rurality) also appear to be related to outdoor play/time. Evidence was either inconsistent or lacking at institutional and macrosystem/community levels. Standardizing terminology and measures of outdoor play/time is warranted. Future work should investigate the interactions and processes of multiple variables across different levels of socioecological modelling to better understand the mechanisms through which outdoor play/time opportunities can be optimized for children while paying special attention to varying conditions in which children are born, live, and play.

"You Can't Go to the Park, You Can't Go Here, You Can't Go There": Exploring Parental Experiences of COVID-19 and Its Impact on Their Children's Movement Behaviours

The COVID-19 outbreak and related public health guidelines have changed the daily lives of Canadians and restricted opportunities for healthy movement behaviours for children. The purpose of this study was to explore how parents experienced the pandemic-related restrictions and how they impacted their children’s movement behaviours. Methods: Twenty-nine semi-structured one-on-one interviews were conducted (June–July 2020) with parents of children (5–11 years old) in Ontario and British Columbia. Interviews lasted between 24–104 min, were audio-recorded, transcribed verbatim, and thematically analyzed. Results: Findings emphasized various individual (e.g., motivation), interpersonal (e.g., parent work schedule), built (e.g., closure of parks) and natural environment (e.g., weather) factors related to children’s movement behaviours. The findings highlighted the loss of structured activities and destinations for children’s physical activity, and restricted opportunities for outdoor play exacerbated by shrinking childhood independent mobility. Conclusion: Families are adapting to many pandemic-related challenges including adhering to public health restrictions, parents juggling multiple roles, conducting work and school from home, as well as exacerbating factors like weather. It will be important to continue to encourage outdoor time, support policies and practice that facilitate independent mobility, and develop centralized resources that help families in the maintenance of healthy movement behaviours.

Healthy movement behaviours in children and youth during the COVID-19 pandemic: Exploring the role of the neighbourhood environment

This paper explores patterns of increased/ decreased physical activity, sedentary and sleep behaviours among Canadian children and youth aged 5-17 years during the COVID-19 pandemic, and examines how these changes are associated with the built environment near residential locations. A cluster analysis identified two groups who were primarily distinguished by the changes in outdoor activities. Compliance to 24-hour movement guidelines was low among both groups. For children, houses (versus apartments) was correlated with increased outdoor activities; proximity to major roads was a barrier. For youth, low dwelling density, and access to parks in high-density neighbourhoods, increased the odds of increased outdoor activities during the pandemic. Our findings can inform future urban and health crisis planning practices by providing new insights into the desirable public health messaging and characteristics of healthy and resilient communities.