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Kern M, Glatz T, Mall MA, Seybold J, Kurth T, Mockenhaupt FP, Theuring S. Health-related quality of life and impact of socioeconomic status among primary and secondary school students after the third COVID-19 wave in Berlin, Germany. PLoS One 2024; 19:e0302995. [PMID: 38722991 PMCID: PMC11081372 DOI: 10.1371/journal.pone.0302995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
In the earlier phases of the COVID-19 pandemic, studies in Germany and elsewhere found an overall reduction in health-related quality of life (HRQoL) among students. However, there is little evidence on later pandemic stages as well as socioeconomic influencing factors. We aimed to (1) describe HRQoL in a Berlin student cohort at two time points in mid-2021, and to (2) analyze the effects of household income and education. We assessed HRQoL of students from 24 randomly selected primary and secondary schools in Berlin, Germany, with the KIDSCREEN-10 index in June and September 2021. To adjust for non-response bias, inverse probability weighting was applied. The potential effects of both household income and education (lower vs. higher) were estimated in generalized linear mixed models, based on prior assumptions presented in directed acyclic graphs. Our cohort comprised 660 students aged 7-19 years. In June 2021, 11.3% [95% CI = 9.0% - 14.0%] reported low HRQoL, whereas in September 2021, this increased to 13.7% [95% CI = 11.1% - 16.5%], with adolescent girls more frequently reporting low HRQoL at both time points (20% [95% CI = 17.1% - 23.3%] and 29% [95% CI = 25.5% - 32.5%]) compared to boys and younger children. While there was no statistically significant total effect of lower household income on HRQoL, a negative effect of lower household education was statistically significant (β = -2.15, SE 0.95, 95% CI = -4.01 to -0.29, p = 0.024). In summary, students' HRQoL in mid-2021 was better than that documented in other studies conducted at pandemic onset using KIDSCREEN-10. Female adolescents reported low HRQoL more often, and lower household education significantly reduced children's HRQoL. Support strategies for psychosocial wellbeing should consider socioeconomically disadvantaged children as important target groups.
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Affiliation(s)
- Mascha Kern
- Institute of Public Health, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute of International Health, Charité Center for Global Health, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Toivo Glatz
- Institute of Public Health, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marcus A. Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health (BIH) at Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Centre for Lung Research (DZL), Associated Partner, Berlin, Germany
| | - Joachim Seybold
- Medical Directorate, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Tobias Kurth
- Institute of Public Health, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frank P. Mockenhaupt
- Institute of International Health, Charité Center for Global Health, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stefanie Theuring
- Institute of International Health, Charité Center for Global Health, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Haile SR, Gunz S, Peralta GP, Ulytė A, Raineri A, Rueegg S, Yasenok V, Radtke T, Puhan MA, Kriemler S. Health-Related Quality of Life and Adherence to Physical Activity and Screen Time Recommendations in Schoolchildren: Longitudinal Cohort Ciao Corona. Int J Public Health 2023; 68:1606033. [PMID: 37538234 PMCID: PMC10394228 DOI: 10.3389/ijph.2023.1606033] [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: 03/27/2023] [Accepted: 07/07/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives: We investigated changes in adherence to physical activity (PA) and screen time (ST) recommendations of children and adolescents throughout the pandemic, and their association with health-related quality of life (HRQOL). Methods: 1,769 primary (PS, grades 1-6) and secondary (SS, 7-9) school children from Ciao Corona, a school-based cohort study in Zurich, Switzerland, with five questionnaires 2020-2022. HRQOL was assessed using the KINDL questionnaire. PA (≥60 min/day moderate-to-vigorous PA) and ST (≤2 h/day ST) recommendations followed WHO guidelines. Results: Adherence to PA recommendations dropped in 2020 (83%-59% PS, 77%-52% SS), but returned to pre-pandemic levels by 2022 (79%, 66%). Fewer children met ST recommendations in 2020 (74% PS, 29% SS) and 2021 (82%, 37%) than pre-pandemic (95%, 68%). HRQOL decreased 3 points between 2020 and 2022, and was 9.7 points higher (95% CI 3.0-16.3) in March 2021 in children who met both versus no recommendations. Conclusion: Adherence to WHO guidelines on PA and ST during the pandemic had a consistent association with HRQOL despite longitudinal changes in behavior.
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Affiliation(s)
- Sarah R. Haile
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Samuel Gunz
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Gabriela P. Peralta
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Agnė Ulytė
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Alessia Raineri
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Sonja Rueegg
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Viktoriia Yasenok
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
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Liu XQ, Guo YX, Zhang XR, Zhang LX, Zhang YF. Digital interventions empowering mental health reconstruction among students after the COVID-19 pandemic. World J Psychiatry 2023; 13:397-401. [PMID: 37383289 PMCID: PMC10294129 DOI: 10.5498/wjp.v13.i6.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/13/2023] [Accepted: 05/25/2023] [Indexed: 06/19/2023] Open
Abstract
With the gradual end of the coronavirus disease 2019 (COVID-19) pandemic, the reconstruction of students’ mental health is urgently necessary. Digital interventions offer advantages such as high accessibility, anonymity, and accurate identification, which can promote the reconstruction of students’ mental health through the provision of psychological support platforms, psychological assessment tools, and online mental health activities. However, we recognize that digital interventions must undergo many adjustments, and corresponding ethical norms require further clarification. It is crucial for different stakeholders to collaborate and work toward maximizing the effectiveness of digital interventions for the reconstruction of mental health after the COVID-19 pandemic.
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Affiliation(s)
- Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
| | - Yu-Xin Guo
- School of Education, Tianjin University, Tianjin 300350, China
| | - Xin-Ran Zhang
- School of Education, Tianjin University, Tianjin 300350, China
| | - Lin-Xin Zhang
- School of Education, Tianjin University, Tianjin 300350, China
| | - Yi-fan Zhang
- School of Education, Tianjin University, Tianjin 300350, China
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Paulus FW, Joas J, Gerstner I, Kühn A, Wenning M, Gehrke T, Burckhart H, Richter U, Nonnenmacher A, Zemlin M, Lücke T, Brinkmann F, Rothoeft T, Lehr T, Möhler E. Problematic Internet Use among Adolescents 18 Months after the Onset of the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1724. [PMID: 36360452 PMCID: PMC9689314 DOI: 10.3390/children9111724] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 01/11/2024]
Abstract
Studies in recent years and especially since the beginning of the COVID-19 pandemic have shown a significant increase in the problematic use of computer games and social media. Adolescents having difficulties in regulating their unpleasant emotions are especially prone to Problematic Internet Use (PIU), which is why emotion dysregulation has been considered a risk factor for PIU. The aim of the present study was to assess problematic internet use (PIU) in adolescents after the third wave (nearly 1.5 years after the onset in Europe) of the COVID-19 pandemic. In the German region of Siegen-Wittgenstein, all students 12 years and older from secondary-level schools, vocational schools and universities were offered a prioritized vaccination in August 2021 with an approved vaccine against COVID-19. In this context, the participants filled out the Short Compulsive Internet Use Scale (SCIUS) and two additional items to capture a possible change in digital media usage time and regulation of negative affect due to the COVID-19 pandemic. A multiple regression analysis was performed to identify predictors of PIU. The original sample consisted of 1477 participants, and after excluding invalid cases the final sample size amounted to 1268 adolescents aged 12-17 (x = 14.37 years, SD = 1.64). The average prevalence of PIU was 43.69%. Gender, age, digital media usage time and the intensity of negative emotions during the COVID-19 pandemic were all found to be significant predictors of PIU: female gender, increasing age, longer digital media usage time and higher intensity of negative emotions during the COVID-19 pandemic were associated with higher SCIUS total scores. This study found a very high prevalence of PIU among 12- to 17-year-olds for the period after the third wave of the COVID-19 pandemic, which has increased significantly compared to pre-pandemic prevalence rates. PIU is emerging as a serious problem among young people in the pandemic. Besides gender and age, pandemic-associated time of digital media use and emotion regulation have an impact on PIU, which provides starting points for preventive interventions.
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Affiliation(s)
- Frank W. Paulus
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany
| | - Jens Joas
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany
| | - Ida Gerstner
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany
| | - Anna Kühn
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Markus Wenning
- Medical Association, Westfalen-Lippe, 48151 Münster, Germany
| | - Thomas Gehrke
- Medical Association, Westfalen-Lippe, 48151 Münster, Germany
- Vaccination Center, 57072 Siegen, Germany
| | - Holger Burckhart
- School of Education and Psychology, Siegen University, 57072 Siegen, Germany
| | - Ulf Richter
- School of Education and Psychology, Siegen University, 57072 Siegen, Germany
| | | | - Michael Zemlin
- Department of General Pediatrics and Neonatology, Saarland University Hospital, 66421 Homburg, Germany
| | - Thomas Lücke
- Medical Association, Westfalen-Lippe, 48151 Münster, Germany
- Department of Pediatrics, Ruhr University, 44791 Bochum, Germany
| | - Folke Brinkmann
- Department of Pediatrics, Ruhr University, 44791 Bochum, Germany
| | - Tobias Rothoeft
- Department of Pediatrics, Ruhr University, 44791 Bochum, Germany
| | - Thorsten Lehr
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany
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Kästner A, Lücker P, Hannich A, Schmeyers L, Lücker J, Hoffmann W. COVID-19-related future anxiety is associated with the health-related quality of life in school-aged children and adolescents-A cross-sectional study. Front Public Health 2022; 10:1003876. [PMID: 36438295 PMCID: PMC9682149 DOI: 10.3389/fpubh.2022.1003876] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Over the course of the COVID-19 pandemic, previous studies have shown that the physical as well as the mental health of children and adolescents significantly deteriorated. Future anxiety caused by the COVID-19 pandemic and its associations with quality of life has not previously been examined in school children. Methods As part of a cross-sectional web-based survey at schools in Mecklenburg-Western Pomerania, Germany, two years after the outbreak of the pandemic, school children were asked about COVID-19-related future anxiety using the German epidemic-related Dark Future Scale for children (eDFS-K). Health-related quality of life (HRQoL) was assessed using the self-reported KIDSCREEN-10. The eDFS-K was psychometrically analyzed (internal consistency and confirmatory factor analysis) and thereafter examined as a predictor of HRQoL in a general linear regression model. Results A total of N = 840 8-18-year-old children and adolescents were included in the analysis. The eDFS-K demonstrated adequate internal consistency reliability (Cronbach's α = 0.77), and the confirmatory factor analysis further supported the one-factor structure of the four-item scale with an acceptable model fit. Over 43% of students were found to have low HRQoL. In addition, 47% of the students sometimes to often reported COVID-19-related fears about the future. Children with COVID-19-related future anxiety had significantly lower HRQoL (B = - 0.94, p < 0.001). Other predictors of lower HRQoL were older age (B = - 0.63, p < 0.001), and female (B = - 3.12, p < 0.001) and diverse (B = - 6.82, p < 0.001) gender. Conclusion Two years after the outbreak of the pandemic, school-aged children continue to exhibit low HRQoL, which is further exacerbated in the presence of COVID-19-related future anxiety. Intervention programs with an increased focus on mental health also addressing future anxiety should be provided.
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Affiliation(s)
- Anika Kästner
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
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Anthropometric, Lifestyle Characteristics, Adherence to the Mediterranean Diet, and COVID-19 Have a High Impact on the Greek Adolescents’ Health-Related Quality of Life. Foods 2022; 11:foods11182726. [PMID: 36140853 PMCID: PMC9497909 DOI: 10.3390/foods11182726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/20/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: The study aimed at analyzing the relationship between anthropometric characteristics, lifestyle, and dietary habits, as well as the burden of the pandemic on the health-related quality of life among Greek pupils. Research methods and procedures: On the whole, 2088 adolescents aged 12–18 years from Attica, Greece, were enlisted in this school-based cross-sectional study that took place in May–December 2021. Health-related quality of life was estimated through the KIDSCREEN-27 questionnaire, adherence to the Mediterranean diet—through the KIDMED test. For the empirical and econometric analyses, the Mann–Whitney U and Kruskal–Wallis means comparison tests were utilized; multiple linear regression was used accordingly. Results: The present study provides evidence to the fact that boys, younger adolescents, adolescents living with both parents and with highly educated mothers had a better health-related quality of life. Concerning their eating practices, positive predictors were consuming a better-quality breakfast, having all five meals daily, consuming lunch and dinner with parents, and higher adherence to the Mediterranean diet. Moreover, sufficient night sleep time, fewer hours spent on screen viewing, more frequent walks, and having hobbies were linked to the health-related quality of life with a positive sign. In contrast, negative predictors were higher body mass index and everyday life difficulties due to the COVID-19 pandemic crisis. Conclusions: Greek adolescents’ anthropometric characteristics, BMI, lifestyle and sedentary habits, eating habits, and adherence to the Mediterranean diet were significantly related to their perceived health-related quality of life during the pandemic.
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