Impacts on Children and Adolescents' Lifestyle, Social Support and Their Association with Negative Impacts of the COVID-19 Pandemic

Well-being approaches targeted to improve child and youth health post-COVID-19 pandemic: a scoping review

BACKGROUND

Our previous work synthesized published studies on well-being interventions during COVID-19. As we move into a post-COVID-19 pandemic period there is a need to comprehensively review published strategies, approaches, and interventions to improve child and youth well-being beyond deleterious impacts experienced during COVID-19.

METHODS

Seven databases were searched from inception to January 2023. Studies were included if they: (1) presented original data on an approach (i.e., approach applied) or (2) provided recommendations to inform development of a future approach (i.e., approach suggested), (3) targeted to mitigate negative impacts of COVID-19 on child and youth (≤18 year) well-being, and (4) published on or after December 2019.

RESULTS

39 studies (n = 4/39, 10.3% randomized controlled trials) from 2021 to 2023 were included. Twenty-two studies applied an approach (n = 22/39, 56.4%) whereas seventeen studies (n = 17/39, 43.6%) suggested an approach; youth aged 13-18 year (n = 27/39, 69.2%) were most frequently studied. Approach applied records most frequently adopted an experimental design (n = 11/22, 50.0%), whereas approach suggested records most frequently adopted a cross-sectional design (n = 13/22, 59.1%). The most frequently reported outcomes related to good health and optimum nutrition (n = 28/39, 71.8%), followed by connectedness (n = 22/39, 56.4%), learning, competence, education, skills, and employability (n = 18/39, 46.1%), and agency and resilience (n = 16/39, 41.0%).

CONCLUSIONS

The rapid onset and unpredictability of COVID-19 precluded meaningful engagement of children and youth in strategy development despite widespread recognition that early engagement can enhance usefulness and acceptability of interventions. Published or recommended strategies were most frequently targeted to improve connectedness, belonging, and socialization among children and youth.

The impact of social media use on psychiatric symptoms and well-being of children and adolescents in the Post-COVID-19 era: a four-year longitudinal study

This longitudinal study examined the long-term effects of the COVID-19 pandemic on social media use and its impact on psychiatric symptoms and well-being of 3,697 Israeli children and adolescents aged 8 to 14. Data were collected from October 2019 to June 2023, covering four school years and five measurement points prior to, throughout and post- COVID-19. Social media usage, psychiatric symptoms (depression, anxiety, somatization, and general distress), as well as subjective well-being (positive and negative emotions, and life satisfaction) were assessed. The analysis also probed the extent to which social support and extracurricular activities moderated the associations between social media use and mental health outcomes. The results of the growth mixed-effects models indicated a significant increase in social media use and psychiatric symptoms, and a significant decrease in subjective well-being over time. Greater social media use was related to more psychiatric symptoms and negative emotions, but also to more positive emotions and life satisfaction. Social support buffered the negative effects of excessive social media use on mental health, whereas extracurricular activities increased positive emotions, but also psychiatric symptoms related to social media use. These findings highlight the need for targeted interventions to regulate social media usage, given its lasting consequences on the mental health of children and adolescents in the wake of the COVID-19 pandemic.

The effect of a training program on adolescents' stress levels and healthy lifestyle behaviors during the Covid-19 pandemic: A randomized controlled study

TOPIC

Adolescence is the period when people adopt healthy lifestyle behaviors and turn them into habits. Healthy lifestyle behaviors are a significant step toward a long and healthy life.

PURPOSE

This study investigated the effect of a training program on adolescents' stress levels and healthy lifestyle behaviors during the COVID-19 pandemic.

METHODS

This randomized controlled study was conducted between May and July 2021. The sample consisted of 100 adolescents living in a city in the south of Turkey. Participants were randomized into intervention and control groups using block randomization. The intervention group participated in an online (Zoom) training program consisting of two 45 min sessions once a week for 8 weeks. Data were collected using the adolescent stress questionnaire (ASQ) and the adolescent lifestyle profile (ALP).

RESULTS

The results showed that 73% (n: 73) of the participants had developed hygiene habits since the onset of the pandemic. However, the pandemic negatively affected participants' dietary habits (45%, n: 45), physical activity (70%, n: 70), coping mechanisms (68%, n: 68), sleep patterns (54%, n: 54), Internet/social media/video game addiction (64%, n: 64), and interpersonal relationships (57%, n: 57). The intervention group had a lower mean ASQ posttest score and a higher mean ALP posttest score than the control group. The intervention group had a lower mean ASQ posttest score than their pretest score. The intervention group also had a higher mean ALP posttest score than their pretest score.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The training program helped adolescents feel less stress and adopt more healthy lifestyle behaviors. Pediatric nurses should identify risk factors and design and implement appropriate plans to help adolescents go through future pandemics with as little damage as possible. Parents and educators should support adolescents against the adverse impacts of events such as the COVID 19 pandemic.

Impact of "Long Covid" on Children: Global and Hong Kong Perspectives

BACKGROUND

The coronavirus disease (COVID-19) pandemic spares no nation or city, and the virus is responsible for the escalating incidence and mortality worldwide.

OBJECTIVE

This article reviews the impact of "Long Covid" on Children.

METHODS

A PubMed search was conducted in December 2021 in Clinical Queries using the key terms "COVID-19" OR "long COVID". The search was restricted to children and adolescent aged < 18 years and English literature.

RESULTS

Many large-scale studies have provided strong scientific evidence as to the detrimental and irreversible sequelae of COVID-19 on the health, psychology, and development of affected children. Many insights into managing this disease can be obtained from comparing the management of influenza. COVID-19 is generally a mild respiratory disease in children. Several syndromes, such as multisystem inflammatory syndrome in children (MIS-C) and COVID toe, are probably not specific to SARS-CoV-2. "Long COVID", or the long-term effects of SARS-CoV-2 infection, or the prolonged isolation and containment strategies on education and psychosocial influences on children associated with the pandemic, are significant.

CONCLUSION

Healthcare providers must be aware of the potential effects of quarantine on children's mental health. More importantly, healthcare providers must appreciate the importance of the decisions and actions made by governments, non-governmental organizations, the community, schools, and parents in reducing the possible effects of this situation. Multifaceted age-specific and developmentally appropriate strategies must be adopted by healthcare authorities to lessen the negative impact of quarantine on the psychological well-being of children.

Assessing the health, social, educational and economic impact of the COVID-19 pandemic on adolescents in low- and middle-income countries: a rapid review of the literature

COVID-19 has caused profound health, social, educational and economic devastation around the world, especially among the lives of adolescents in low- and middle-income countries. This paper looks at a wide array of outcomes impacting adolescents' daily lives including health (mental, physical, sexual and reproductive health, vaccine perceptions and overlap between these topics), social relationships (family and peer), education and socio-economic disparities. Both scientific and grey literature between December 2019 and February 2022 were sought from PubMed, Google Scholar and organisations conducting research among adolescents, and coded. A total of 89 articles were included, 73% of which were peer-reviewed; 37% of the articles were from WHO's Western Pacific region; 62% of the articles were cross-sectional; 75% were quantitative. Three major topics emerged in more than half the articles: mental health (72%), education (61%) and socio-economic ramifications (55%). However, there were regional differences in topics and many of them overlapped. The results indicate that, where there has been research, almost all findings have been linked to worse mental health during the pandemic. Overall, remote education was seen as a negative experience. The ramification of school closures on future aspirations, in particular early school leaving, highlights the importance of prioritising education during future pandemics based on the situation within the country. Gender and other disparities have made marginalised adolescents vulnerable to the economic ramifications of containment measures. Given the risks identified, there is a pressing need to put adolescents at the centre of establishing priorities for their health agenda for post-pandemic recovery.

The Association between exposure to COVID-19, internalizing symptoms, and Dispositional Mindfulness in Adolescents: a longitudinal pre- and during-pandemic study

This study examined the association between contact with COVID-19 and internalizing symptoms in Spanish adolescents, and the moderation and mediation roles of dispositional mindfulness. Adolescents (N = 383; 58% female; Mage = 15.62, SD = 1.32) completed measures of dispositional mindfulness (MAAS-A) and internalizing symptoms (DASS-21), other stressors different from COVID-19, and contact with COVID-19 twice, in October 2019 and 2020. Three profiles emerged according to their contact with COVID-19: (1) little/no contact, (2) knowing someone close (outside home) who was infected, hospitalized, or died, and (3) being or someone at home being infected and/or hospitalized. Compared to little/no contact, both contact profiles predicted dispositional mindfulness and anxiety; and profile 2 predicted stress. Dispositional mindfulness mediated the association between both contact profiles and depression and stress. This study suggests that contact with COVID-19 predicts increased internalizing symptoms in adolescents, which could be partially explained by the decrease in mindfulness levels.

The Impact of the COVID-19 Outbreak on Lifestyle-Related Behavior Among the General Population

INTRODUCTION

Coronavirus has affected more than 200 countries around the world. Due to lockdowns, people have limited outdoor activities and started adopting new and healthy lifestyle behaviors.

METHOD

A cross-sectional study was conducted to explore the impact of COVID-19 on lifestyle-related behavior. Data were collected from different regions of North India using Google Forms (Google, Inc., Mountain View, CA, USA) with the help of a standardized questionnaire. Both descriptive and inferential statistics were used for analysis. The p-value was set at <0.05.

RESULTS

A total of 468 responses were recorded (mean age: 28.51 years). A significant improvement was found in the intake of fruits and vegetables as well as pulses, eggs, or meat during the COVID-19 pandemic. Participation in household chores and screen time in watching mobile or television were significantly increased. The majority (44.4%) of participants had stable weight, and 37.8% gained weight during the COVID-19 pandemic. The anxiety they felt in a day also increased, which was predominantly due to fear of COVID-19. During the COVID-19 pandemic, a significant association was found between physical activity scores and gender, residence, nature of work, and hours of work of study subjects.

CONCLUSION

There is an improvement in healthy eating behavior, quality of sleep, and participation in household chores during the COVID-19 pandemic. Further, domains of lifestyle can be explored to bring a positive style of living for the achievement of healthy lifestyle behavior by the general population.

Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

BACKGROUND

The coronavirus disease (COVID-19) and universal mitigation strategies have fundamentally affected peoples' lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID-19 pandemic.

METHODS

Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2-24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size.

RESULTS

A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher's z = - 0.198, p < 0.001) and positive (Fisher's z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information.

CONCLUSIONS

PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).

Socioeconomic Deprivation and Inequalities in Mental Well-Being during the COVID-19 Pandemic among Adolescents

The COVID-19 pandemic highlighted the existing inequalities in education and mental health. The aim of this study was to examine socioeconomic disadvantages and mental well-being inequalities among Slovenian adolescents in October 2020. The study used nationally representative data from 3052 adolescents aged 14 and 18 (Mage = 14.4 and 18.4). The WHO-5 Well-Being Index (WHO-5) was used to measure mental well-being and risk for depression. Multinomial logistic regression was used to identify differences in the pattern of associations regarding sociodemographic characteristics and experiences during the pandemic with poor well-being and risk for depression. Our study found that adolescents from socially disadvantaged families faced poorer conditions as regards academic performance, had fewer opportunities to socialise with friends online, and were more likely to feel lonely; they reported lower levels of mental well-being and were at a higher risk for depression. The unemployment of both parents and adolescents' perceptions of family wealth were found to be the most important predictors of depression risk. In addition, experiencing deprivation and economic hardship during the pandemic was also identified as a significant predictor. The study concludes that social and economic conditions were critical determinants of adolescents' mental health during the pandemic and that effective intervention is needed to promote their well-being and reduce inequalities.

Association of parent-child interactions with parental psychological distress and resilience during the COVID-19 pandemic

Introduction

The effects of psychological distress/resilience on parent-child engagement (e.g., family dinners, reading) during the COVID-19 pandemic have not been well studied. Among very young children from underrepresented backgrounds enrolled in the ongoing longitudinal Bronx Mother Baby Health Study of healthy term infants, we (1) examined associations between exposures to COVID-19-related events, demographic factors and parental psychological distress and resilience; and (2) correlated these factors with parent-child engagement activities.

Methods

Between June 2020-August 2021, parents of 105 Bronx Mother Baby Health Study participants aged birth-25 months completed questionnaires related to exposures to COVID-19-related events, frequency of positive parent-child engagement activities, food and housing insecurity, and parental psychological distress and resilience. Families were also asked open ended questions about the pandemic's impact.

Results

29.8% and 47.6% of parents reported food and housing insecurity, respectively. Greater exposures to COVID-19-related events were associated with increased parental psychological distress. Positive parent-child interactions were associated with demographic factors and higher levels of maternal education, but not with exposures to COVID-19-related events.

Discussion

This study adds to a growing body of literature on the negative impacts of COVID-19 exposures and psychosocial stressors on families during the pandemic, supporting the need for enhanced mental health resources and social supports for families.

Physical, psychological, and behavioral problems among children and adolescents in countries with different economic statuses during the COVID-19 pandemic: a systematic review and meta-analysis

Introduction

The COVID-19 pandemic has impacted children and adolescents' physical activity (PA), sleeping patterns, and psychological and behavioral health. Yet, little is known about the differences between those in countries with various economic statuses.

Methods

Articles published from database inception through 16 March 2022 were retrieved using CINAHL Complete, Cochrane Library, EMBASE, Medline, PubMed, and PsycINFO. High-quality studies that reported the number of participants with parameters associated with PA, sleeping patterns, and psychological and behavioral problems in young people aged under 18 years during the pandemic were included. We referenced the Canadian 24-Hour Movement Guidelines for PA and sleep duration to provide the event rate for young people who were not compliant with the guidelines. The event rate of young people who had decreased sleep quality and experienced psychological and behavioral problems were also investigated. A subgroup analysis was conducted to identify the differences in those in countries with diverse economic statuses. Funnel plot analysis and Egger's test were also conducted to identify any risk of publication bias.

Result

A total of 66 studies with 1,371,168 participants aged between 0 and 18 years, involving 27 countries, were included. During the pandemic, we identified that 41% (95% CI: 39%, 43%; I²= 96.62) and 43% (95% CI: 34%, 52%; I²= 99.42) of young people did not meet the PA and sleep duration recommendation guidelines. In addition, 31% (95% CI: 28%, 35%; I²= 99.66) of young people had decreased their sleep quality. Yet, no significant difference was found across countries with different economic statuses. However, the event rates of participants with psychological and behavioral problems were 32% (95% CI: 28%, 36%; I²= 99.85) and 19% (95% CI: 14%, 25%; I²= 99.72), respectively. In addition, the rate of psychological problems was more severe in those who live in lower middle-income countries (p < 0.001), while the rate of behavioral problems was more severe in those who live in high-income countries (p = 0.001).

Discussion

During the pandemic, the discouragement of PA, poor sleep quality, and high risk of psychological and behavioral problems are concerning. A large number of young people did not comply with the recommendation guidelines. Timely implementation of recovery plans is critical to address the adverse effects on young people.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=309209, identifier CRD42022309209.

A qualitative study of positive psychological experiences and helpful coping behaviours among young people and older adults in the UK during the COVID-19 pandemic

While much research has focused on challenges that younger and older people have faced during the COVID-19 pandemic, little attention has been given to the capacity for resilience among these groups. We therefore explored positive psychological experiences and coping behaviours that protected mental health and well-being. Participants were 40 young people (aged 13-24) and 28 older adults (aged 70+) living in the UK during the COVID-19 pandemic. Interviews were held between May 2020 and January 2021. We generated six themes using qualitative thematic analysis, including: engagement in self-fulfilling activities, increased sense of social cohesion, personal growth, use of problem-focused strategies to manage pandemic-related stressors, giving and receiving social and community support, and utilising strategies to regulate thoughts and emotions. While all six themes were relevant both to younger and older adults, there were nuances in how each was experienced and enacted. For example, many older adults adjusted their routines given worries about virus vulnerability, while some young people experienced greater personal growth amidst increased awareness of mental health as they navigated the various lockdown restrictions.

The Association between Physical Activity, Self-Compassion, and Mental Well-Being after COVID-19: In the Exercise and Self-Esteem Model Revised with Self-Compassion (EXSEM-SC) Perspective

During the great life-altering challenges brought by Coronavirus 2019, school closures and lack of access to exercise and social interactions may have increased students' negative emotions. The current research acts as a follow-up study to the development of the EXSEM-SC, using the Repeated Measures Panel Analysis Framework (RMPAF) to examine the stability of the model in revealing the relationship between physical activity, self-compassion, and mental well-being among Hong Kong adolescents. It is also aimed at examining the changes in physical activity, self-compassion, and mental well-being among Hong Kong adolescents between, before, and after the peak of COVID-19 using the EXSEM-SC Model. The RMPAF has involved 572 (60% Female, Mage = 13.63, SD =1.31) Hong Kong secondary school students. Furthermore, using the abductive qualitative approach, a total of 25 (Mage = 14.84, SD = 1.40) students were involved in the in-depth interviews to further investigate the relationships within the EXSEM-SC. The quantitative results showed that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs, as well as satisfying model construct consistency. Moreover, it showed no significant differences in the level of physical activity, self-compassion, and mental well-being during and after the peak of COVID-19. The qualitative results demonstrated two new categories within the EXSEM-SC variables, which are personality traits and injuries experiences. With the stability of the EXSEM-SC model among adolescents, it is expected that the physical activity intervention, which is based on the EXSEM-SC model, could also aim at easing Hong Kong adolescent's mental health issues. In addition, in terms of generating a long-term impact among students, the physical activity and self-compassionate intervention should be promoted among schools. However, the quantitative properties of the two new categories in the qualitative outcomes should be involved in future investigation.

Consequences of COVID-19 on adolescents in Arizona: A longitudinal study protocol

Introduction

The long-term impact of COVID-19 is unknown. We developed a 5-year prospective cohort study designed to generate actionable community-informed research about the consequences of COVID-19 on adolescents ages 12-17 years in Arizona.

Methods

The study has two primary outcomes: 1) acute and long-term outcomes of COVID-19 illness and 2) symptoms of depression and anxiety. Data is collected using an online survey with plans to integrate qualitative data collection methods. The survey is administered at baseline, 4, and 8 months in year one, and annually in years two through five. This study is informed by Intersectionality Theory, which considers the diverse identities adolescents have that are self and socially defined and the influence they have collectively and simultaneously. To this end, a sample of variables collected is race/ethnicity, language usage, generational status, co-occurring health conditions, and gender. Additional measures capture experiences in social contexts such as home (parent employment, food, and housing security), school (remote learning, type of school), and society (racism).

Results

Findings are not presented because the manuscript is a protocol designed to describe the procedure instead of report results.

Discussion

The unique contributions of the study is its focus on COVID-19 the illness and COVID-19 the socially experienced pandemic and the impact of both on adolescents.

The Impact of Distance Education during the COVID-19 Pandemic on Physical Activity and Well-Being of Czech and Polish Adolescents

BACKGROUND

The aim of this study was to identify the changes in the structure of weekly physical activity (PA) and well-being among adolescent boys and girls between habitual education (HE) and distance education (DE) during the pandemic in secondary schools.

METHODS

The research was carried out in 12 Czech and 18 Polish schools during 2019 to 2020 academic session for HE and 2020 to 2021 academic session for DE. The research involved 723 girls and 626 boys aged 15 to 18 years. The structure of the weekly PA was assessed using the International Physical Activity Questionnaire-Long Form, while well-being was assessed using the World Health Organization-5 Well-Being Index.

RESULTS

There was a statistically significant decrease of PA among boys in school PA, transportation PA, recreation PA, vigorous PA, moderate PA, walking, and overall weekly PA during the DE resulting from the pandemic. In girls, during DE, a decrease was observed in school PA, vigorous PA, and overall PA. During DE, a high level of well-being was reported by only 34.9% of girls (43.8% during HE) and 50% of boys (65.6% during HE).

CONCLUSIONS

The observed low PA and high incidence of depressive symptoms in adolescents in distance education during pandemic constraints are a challenge for schools to change in supporting physical activity, eliminating similar negative impacts on school life in the future.

Social networking use, mental health, and quality of life of Hong Kong adolescents during the COVID-19 pandemic

Background

During the COVID-19 pandemic, adolescents' use of social networking sites/apps has surged, and their mental health and quality of life have also been significantly affected by the pandemic and its associated social-protection measures. The present study first examined the prevalence of social networking sites/apps use and social networking addiction, the mental health status, and the health-related quality of life among Hong Kong adolescent students. We further investigated the associations of the youths' daily use of social networking sites/apps and their social networking addiction with their mental health and quality of life during the pandemic.

Methods

A total of 1,147 students (age = 15.20 ± 0.53 years) recruited from 12 randomly selected local secondary schools in Hong Kong participated in a questionnaire survey in classroom settings between January and June, 2020, right after the COVID-19 outbreak. The questionnaire includes demographic characteristics and scales that measure social networking sites/apps use and social networking addiction, mental health, and quality of life.

Results

Approximately 46.4% of the participants reported using social networking sites/apps often or very often, and 7.8% met the criteria for social networking addiction using Bergen's Social Media Addiction Scale. The prevalence of mild to extremely severe depression, anxiety, and stress among the adolescents stood at 39.6, 37.5, 48.8%, respectively, and the participants' physical, social, and school functioning were lower than the norms of healthy adolescents before the pandemic. Participants who used social networking sites/apps but for <3 h per day (excluding students who never used social networking sites/apps) showed significantly fewer problems of depression, anxiety, and stress than did those who spent more than 3 h per day on social networking sites/apps. Social networking addiction was found to be consistently associated with poor mental health and health-related quality of life.

Conclusion

This study provides important evidence supporting the potential protective effect of guiding adolescents to use social networking sites/apps appropriately in order to mitigate their negative emotions during contexts such as that of the pandemic; it further points to the need to provide extra support to promote the well-being of young people, especially those in disadvantaged situations (e.g., non-intact family) during and after the pandemic.

Youth physical activity and the COVID-19 pandemic: A systematic review

•

Numerous studies examined youth physical activity (PA) during the COVID-19 pandemic.

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Overall decreases in youth PA were seen during the first 1.5 years of the pandemic.

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There were differences in PA by sub-populations (e.g., age, sex/gender)

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There were also differences in PA by location/type (e.g., outdoor, play)

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Programming and policy should focus on evolving PA promotion for youth.

The purpose of the systematic review was to identify, evaluate, and synthesize evidence from available published literature examining the impact of the coronavirus disease 2019 (COVID-19) pandemic on youth physical activity (PA). A systematic review of the literature was conducted for years 2020–2021. Published articles were searched in eight databases. Inclusion criteria included: availability of full-text, written in English language, and reported quantitative or qualitative results of original or secondary data on PA and COVID-19 related factors among youth (ages 5–17 years). A standard quality assessment tool assessed risk of bias and quality of included articles. The search retrieved 2,899 articles with 51 articles ultimately meeting inclusion criteria. The majority of articles (65 %) investigated change in PA from before to during the pandemic. Most evidence indicated an overall decrease in youth PA levels during the pandemic with differences observed among sub-populations (e.g., age, sex or gender), type, and location. Findings suggest pandemic-related closures hindered PA participation due to a high reliance on school- and sport-based PA. Programmatic strategies (e.g., activity breaks, active curriculum, free online activities/lessons) should include aligning intervention measures and geared towards evolving and ongoing PA promotion based on the latest findings.

What matters for adolescent suicidality: Depressive symptoms or fixed mindsets? Examination of cross-sectional and longitudinal associations between fixed mindsets and suicidal ideation

BACKGROUND

Fixed mindsets or beliefs about the non-malleability of self-attributes are linked to a wide range of negative psychological outcomes. Its association with suicidal ideation (SI) among young people has not been explored.

OBJECTIVES

To examine the association of fixed mindsets of depression, anxiety, and stress and SI; and its mediating role underlying the association between depression and SI.

METHODS

A sample of 1393 adolescents (M_age  = 13.04, SD = 0.85, 640 boys) from 11 middle schools voluntarily participated in a two-wave longitudinal study before and during the COVID-19 pandemic with a 9-month interval.

RESULTS

Both depressive symptoms and fixed mindsets were positively and significantly associated with concurrent and future suicidality, after controlling for demographic and socioeconomic status and previous SI. Participants with stronger fixed mindsets were more likely to have SI than those with only depressive symptoms. Also, fixed mindsets mediated the association between depressive symptoms and SI in both cross-sectional and longitudinal models.

CONCLUSION

The current study provides empirical evidence of the effects of fixed mindsets and SI and the mediating role of fixed mindset between depressive symptoms and SI among young people. Interventions to foster a growth mindset may enhance hope and reduce suicidality among adolescents.

Big Five Traits as Predictors of a Healthy Lifestyle during the COVID-19 Pandemic: Results of a Russian Cross-Sectional Study

The healthy lifestyle of people around the world has changed dramatically during the COVID-19 pandemic. The personality risk factors for these processes from around the world remain understudied. This study aimed to examine the associations of the Big Five traits with a healthy lifestyle during the COVID-19 pandemic. In a cross-sectional study, data from 1215 Russian university students were analyzed. Participants completed the Big Five Inventory-10 and Short Multidimensional Inventory Lifestyle Evaluation. The results showed that personality traits predicted many dimensions of a healthy lifestyle during the COVID-19 pandemic. Diet and nutrition were positively predicted by extraversion, agreeableness, and conscientiousness, and it was negatively predicted by neuroticism. Substance abuse was positively predicted by agreeableness and conscientiousness, and it was negatively predicted by extraversion. Physical activity was positively predicted by extraversion and conscientiousness, and it was negatively predicted by neuroticism. Stress management was positively predicted by extraversion and conscientiousness, and it was negatively predicted by neuroticism. Restorative sleep was positively predicted by extraversion and conscientiousness, and it was negatively predicted by neuroticism. Social support for healthy practices was positively predicted by extraversion, agreeableness, and conscientiousness. Environmental exposures were positively predicted by extraversion, and neuroticism was positively and negatively predicted by conscientiousness. Our findings may be useful for further exploration of personality risk factors for healthy practices in challenging life circumstances.

Students' perceptions, educational challenges and hope during the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic has disrupted the lives of US students both at home and at school. Little is known regarding how adolescents perceive COVID-19 has impacted (both positively and negatively) their academic and social lives and how protective factors, such as hope, may assist with resilience. Importantly, not all pandemic experiences are necessarily negative, and positive perceptions, as well as potential protective factors, are key to understanding the pandemic's role in students' lives.

METHOD

Utilizing quantitative and qualitative approaches, the present study descriptively examined 726 6th through 12th grade (51% female, 53% White) students' perceptions of how COVID-19 related to educational and life disruptions, and positive aspects of their lives, within the United States. Analyses additionally explored the role of pre-pandemic hope in improving feelings of school connectedness during the pandemic.

RESULTS

Results showed that most students felt that switching to online learning had been difficult and their education had suffered at least moderately, with a sizeable proportion of students feeling less academic motivation compared with last year. When asked to share qualitative answers regarding perceived challenges and positive aspects of life, themes were consistent with quantitative perceptions. Students' pre-pandemic hope positively predicted students' feelings of school connectedness.

CONCLUSIONS

Findings paint a complex picture of youth's COVID-19 experiences and have implications for proactive ways to support students as COVID-19 continues to affect daily life and educational structures and practices.

Impact of the first COVID–19 lockdown on the lifestyle of elementary school children

COVID-19 lockdown affects people's daily routine and has an impact on their lifestyle. Recent studies documented associations between body weight changes and children's lifestyle during social isolation. Childhood obesity is associated with a higher risk of COVID-19 severity and mortality. Our aim was to assess the effects of lockdown due to the COVID-19 pandemic on children's sleep, screen time, physical activity, and eating habits. 387 parents of five elementary school students between 16 and 26 June 2020 were interviewed through an online questionnaire. Physical activity level decreased (63.8%), sleep (60.9%) and screen (5.64 ± 3.05 h/day) times and food intake (39.8%) increased. 80.6% of parents reported changes in children's diet: increased consumption of fruits and vegetables (32.4%), breakfast (15.5%), water and sugar-free beverages (17.6%), snacks (40.4%), sugary drinks (9.9%) was observed. Body weight increased in 44.4% of children. The results of the survey conducted under GYERE®-Children's Health Program are in line with the international literature findings: body weight change during the quarantine is significantly associated with food intake, snacking, sugary drinks, and we also found association with fruit and vegetable consumption and lack of breakfast. Effective strategies and electronic health interventions are needed to prevent sedentary lifestyle and obesity during lockdown.

Impacts of COVID-19 Pandemic on Dietary Consumption among Chinese Residents: Evidence from Provincial-Level Panel Data

The COVID-19 pandemic has profoundly affected people’s daily lives, including their dietary behaviors. Using a panel data set of 31 provinces from 2015 to 2020, this study employed two-way fixed effects (FE) models to examine the impacts of the COVID-19 pandemic on dietary consumption among Chinese residents. The results showed that the COVID-19 pandemic positively affected residents’ consumption of grain, eggs, dairy, and white meat (poultry and aquatic products), while it had a negative effect on individuals’ red meat consumption in both urban and rural areas. These results were robust to different measures of the COVID-19 pandemic, including the number of confirmed cases, suspect cases, and dead cases. Comparatively, the changes in food consumption induced by the COVID-19 pandemic were more prominent for Chinese residents who lived in rural areas than urban areas. In addition, compared to their counterparts, the dietary consequences of the pandemic were more pronounced for residents living in the eastern region and regions with a high old-age dependency ratio and low illiteracy rate. Furthermore, the estimation results of the quantile regression model for panel data suggested that the COVID-19 pandemic had relatively larger impacts on the dietary consumption of Chinese residents at lower quantiles of food consumption compared with those at higher quantiles. Overall, the results of this study suggested that Chinese residents had a healthier diet after the outbreak of the COVID-19 pandemic. We discussed possible mechanisms, including health awareness, income, food supply and prices, and other behavioral changes during COVID-19 (e.g., physical activity and cooking). To further improve residents’ dietary behaviors and health, our study proposed relevant measures, such as increasing residents’ dietary knowledge, ensuring employment and income, and strengthening the food supply chain resilience during the pandemic.

Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review

BACKGROUND

Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being.

OBJECTIVE

The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers.

METHODS

We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis.

RESULTS

We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers.

CONCLUSIONS

This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.

Change in BMI and Fitness among Primary School Children in Austria: A 24-Month Follow-Up Study of 303 Children Measured before and during the Ongoing COVID-19 Pandemic

The ongoing COVID-19 pandemic not only impacted the health of school children directly through SARS-CoV-2 infections, but the associated closures of schools and sports facilities also resulted in long-term negative side effects. The aim of this study was to investigate the effects of COVID-19-related mitigation measures on the health and fitness status of primary school children in Austria. A total of 303 primary school children participated in the longitudinal study. Data on height, weight, and fitness were collected before the COVID-19 pandemic (September 2019) and at one-year intervals (September 2020 and September 2021) during the course of the pandemic. In the first year, from September 2019 to September 2020, there were alarming increases in body mass index (BMI) standard deviation scores (SDSs) (from 0.32 to 0.49) and dramatic decreases in both cardiorespiratory endurance (CRE) (from 0.49 to −0.43) and action speed (from −0.31 to −0.64). In the second year (September 2020 to September 2021), the BMI scores stabilized, and improvements in CRE were observed, especially in the subgroup of children who were members of sports clubs. In the future, more initiatives and projects, in addition to sports club activities, should be started and expanded, particularly in schools, to specifically counteract the observed health damage and, thus, have a positive effect on the development of all children, especially those without sports club membership.

Perceived severity of COVID-19, social support, and pandemic-related stress associated with lifestyle changes among undergraduate students in Indonesia

Introduction:

COVID-19 affects lifestyles, including those of undergraduate students who are one of the most vulnerable populations. This study aimed to describe changes in lifestyle-related behaviors and assess the correlation between the perceived risk of COVID-19, social support, perceived stress, and lifestyle changes among undergraduate students during the pandemic.

Design and methods:

A total of 547 students from 32 provinces in Indonesia completed online questionnaires comprising four measures: perceived risk of COVID-19, the Lifestyle-related Behavior Questionnaire, the Multidimensional Scale of Perceived Social Support, and the Pandemic-related Perceived Stress Scale.

Results:

Undergraduate students who lived with their families had healthier lifestyles than students who lived alone ( p = 0.007). Furthermore, The Pearson’s correlation showed a significant correlation between lifestyle changes with perceived severity ( r = 0.107; p < 0.05), social support ( r = 0.237; p < 0.001and pandemic-related stress ( r = −0.304, p < 0.001). Higher perceived severity of COVID-19 and social support were associated with a healthier lifestyle, whereas increased stress correlated with a less healthy lifestyle.

Conclusion:

Psychological factors correlated with lifestyle changes of Indonesian undergraduate students during the pandemic. Therefore, psychological aspects should be more considered by relatives and institutions to ensure healthier lifestyles of students.

Age Difference in Roles of Perceived Social Support and Psychological Capital on Mental Health During COVID-19

Due to the outbreak of the Coronavirus Disease-2019 (COVID-19) pandemic and consequent confinement measures, young people are vulnerable to mental health problems. The current study compared a group of 440 young adolescents (10-12 years) and a group of 330 emerging adults (18-25 years) to investigate the extent to which perceived social support and psychological capital (PsyCap) were differentially associated with mental health problems. Participants were asked to report their current psychosocial adaptation status during the COVID-19 pandemic, and data were collected via online questionnaires during a relatively severe period of COVID-19 in China. Results of the multi-group path analysis indicated that the effect of perceived social support on mental health problems was mediated by PsyCap for young adolescents, but not for emerging adults. These results were discussed with respect to the mechanism of how social support and PsyCap serve as protective mental health factors for youth in the context of the COVID-19 pandemic.

Factors contributing to adolescents' COVID-19-related loneliness, distress, and worries

As the world continues to face uncertainty due to COVID-19, there is concern for adolescent wellbeing as they attempt to cope with changes to their education and social interactions. Considering the trade-offs between physical distancing and virtual education versus in-person instruction may be particularly pertinent to understanding adolescent loneliness and worries surrounding COVID-19 and their academics. Adolescents (N = 1,708; age M = 12.42, SD = 2.40; 53.3% girls and 46.7% boys) from the United States self-reported their perceptions of social support, COVID-19 attitudes, and indicators of wellbeing (i.e., loneliness, COVID-19 stress, academic worry) in an online cross-sectional survey between November 30, 2020 to December 21, 2020. Higher levels of social support and attitudes of lower COVID-19 concern were associated with lower levels of loneliness, COVID-19 stress, and academic worries. Adolescents receiving greater virtual instruction were more worried about their academics compared to those receiving greater in-person instruction. A moderation effect between loneliness and instruction type revealed that the effect of social support was stronger for those receiving greater virtual instruction. Despite the quick and dramatic change to one's education, adolescents were relatively unaffected by the type of instruction they had recently received. Instead, perceived social support and their attitudes toward COVID-19 were more strongly related to their wellbeing.

Effects of the COVID-19 pandemic on pediatric trauma in Southern California

PURPOSE

The COVID-19 pandemic resulted in increased penetrating trauma and decreased length of stay (LOS) amongst the adult trauma population, findings important for resource allocation. Studies regarding the pediatric trauma population are sparse and mostly single-center. This multicenter study examined pediatric trauma patients, hypothesizing increased penetrating trauma and decreased LOS after the 3/19/2020 stay-at-home (SAH) orders.

METHODS

A multicenter retrospective analysis of trauma patients ≤ 17 years old presenting to 11 centers in California was performed. Demographic data, injury characteristics, and outcomes were collected. Patients were divided into three groups based on injury date: 3/19/2019-6/30/2019 (CONTROL), 1/1/2020-3/18/2020 (PRE), 3/19/2020-6/30/2020 (POST). POST was compared to PRE and CONTROL in separate analyses.

RESULTS

1677 patients were identified across all time periods (CONTROL: 631, PRE: 479, POST: 567). POST penetrating trauma rates were not significantly different compared to both PRE (11.3 vs. 9.0%, p = 0.219) and CONTROL (11.3 vs. 8.2%, p = 0.075), respectively. POST had a shorter mean LOS compared to PRE (2.4 vs. 3.3 days, p = 0.002) and CONTROL (2.4 vs. 3.4 days, p = 0.002). POST was also not significantly different than either group regarding intensive care unit (ICU) LOS, ventilator days, and mortality (all p > 0.05).

CONCLUSIONS

This multicenter retrospective study demonstrated no difference in penetrating trauma rates among pediatric patients after SAH orders but did identify a shorter LOS.

The Impact of the Corona Virus Disease 2019 Pandemic on Chinese Middle School Students' Self-Perceived Emotional States: A Wuhan Perspective

This mixed-methods study examined the impact of the COVID-19 pandemic on 1493 Grades 7, 8, and 9 students’ self-perceived emotional states in Wuhan, China when it was locked down for the pandemic on January 23, 2020 and when the lockdown was lifted on April 8, 2020, as well as the changes of their emotional states over the 1-year period after the lockdown was lifted. A five-point Likert scale survey was administered to the participants between March 1 and April 1, 2020 when Wuhan was blocked down; and three focus group interviews were conducted between May 1 and May 31, 2021, 1 year after the lockdown was lifted. The results showed that these students in Wuhan experienced feelings of loss of control and negative emotions when the city was locked down and they were home quarantined; furthermore, there were significant differences for their self-perceived feelings of loss of control and negative emotions across demographic variables of gender, grade level, physical activity, social economic status, and family cohesion; finally, their emotional states changed substantially at different time nodes during this pandemic. Implications for students, parents, and schools are discussed.

Influence of the Pedagogical Model and Experience on the Internal and External Task Load in School Basketball

The methodology used by the teacher in Physical Education sessions conditions the physical fitness of the students, since the design of the tasks determines the physical and physiological demands to which they are exposed. This study aimed to quantify and compare, according to the teaching methodology and students' previous experience, the external (eTL) and internal (iTL) load resulting from the application of three intervention programmes that follow different teaching methodologies to teach school basketball: the Tactical Games Approach (TGA), Direct Instruction (DI) and Service Teacher's Basketball Unit (STBU). The Ratings of Perceived Exertion (RPEs) recorded in the assessments (pre-test/post-test) were also studied. A total of 49 students, aged 11 to 12 and divided into three class groups, from the sixth grade of primary education at a state school in Spain, participated in the study. Teaching-learning programs were randomly assigned to student groups. All the sessions were monitored with inertial devices that made it possible to record physical activity and convert the information into kinematic parameters. The results indicated that during the sessions, the students who followed the TGA method recorded higher values of eTL (player load; DI = 4.92, TGA = 6.95, STBU = 2.99) and iTL (mean heart rate; DI = 142.94, TGA = 157.12, STBU = 143.98). In addition, during the evaluation tests, they presented heart rate levels similar to those obtained by the students in the other programmes. However, they spent more time doing high-intensity activity, working longer in the running (DI = 3.42, TGA = 11.26, STBU = 8.32) and sprinting speed ranges (DI = 0.00, TGA = 0.12, STBU = 0.11), and presenting better physical fitness. During the assessments, students with no prior basketball experience showed higher levels of top speed; experienced students had higher levels of heart rate. The TGA method favours the physical condition and health of primary education students, which is why this method is recommended when planning Physical Education sessions.

The changes of suicidal ideation status among young people in Hong Kong during COVID-19: A longitudinal survey

BACKGROUND

Pandemics affect the physical and mental well-being of all potentially at-risk young people globally. This longitudinal study examines changes of suicidal ideation status among adolescents during COVID-19.

METHOD

A follow-up after nine-months of a school-based survey among 1,491 secondary school students was conducted during COVID-19. Psychological well-being, psychological factors, family support, and COVID-19-related experiences were examined.

RESULTS

The prevalence of suicidal ideation were 24% and 21% among the participants before and during COVID-19, respectively. In particular, 897 (65.0%) remained non-suicidal, 193 (14.0%) recovered from being suicidal, 148 (10.7%) newly reported being suicidal, and 143 (10.4%) remained suicidal. Respondents who remained suicidal were found to have significantly higher depression, anxiety, stress, loneliness, and social anxiety, fixed mind-set, lower meaning of life and self-control; and lower parental support and supervision than the other three groups. Participants with suicidal ideation reported more negative perceptions about COVID-19 than non-suicidal participants. Multinomial logistic regression showed that anxiety, trait anxiety and life satisfactory in baseline were associated with suicidal ideation at follow-up.

LIMITATION

This study was limited by the small number of protective variables being included in the baseline survey to examine the potential reasons for the recovery of suicidal ideation at follow-up.

CONCLUSION

Poor psychological well-being, lower level of family support, and negative impacts of the pandemic were consistently associated with students' presence of suicidal ideation during the pandemic. Further intervention studies are needed to examine effects of mental health consequences of COVID-19 on youth mental health and to promote positive youth well-being.

Physical Activity of Children and Adolescents during the COVID-19 Pandemic-A Scoping Review

To counteract the COVIC-19 pandemic, many governments have introduced social distancing measures. While these restrictions helped contain the virus, it had adverse effects on individuals’ mental and physical health—especially children. The aim of the present study is to review the evidence on the effects of COVID-19 restrictions on children’s physical activity and their determinants. A scoping review was conducted in the databases PubMed, Web of Science, SportDiscus, and BISp-Surf. Inclusion criteria were empirical and peer-reviewed studies, youth samples, investigation of COVID-19 restrictions, and investigating changes and/or determinants of physical activity before and during the COVID-19 pandemic. Risk of bias was assessed using the checklist by Downs and Black. The search resulted in 1672 studies, of which 84 studies were included in the analysis. The results highlighted a decrease in physical activity during the pandemic, ranging between −10.8 min/day and −91 min/day. If an increase was detected, it related to unstructured and outdoor activities. The main determinants of children’s physical activity during the pandemic were age, gender, socioeconomic background, and the outdoor environment. The results imply that governments need to consider the negative effects that restrictive measures have on children’s physical activity and act to ensure high levels of physical activity.

The impacts of coping style and perceived social support on the mental health of undergraduate students during the early phases of the COVID-19 pandemic in China: a multicenter survey

BACKGROUND

An increasing number of undergraduate students in China have been reported to have psychological problems. In response to the COVID-19 pandemic, a series of preventive and control measures were implemented, which undoubtedly worsened their psychological health. Coping style and social support were probably important factors that affected the psychological well-being of undergraduate students during the pandemic. This study aimed to explore the effects of coping style and perceived social support on the psychological well-being of college students and relevant risk factors.

METHODS

This cross-sectional study was performed in February and March of 2020 by distributing an online questionnaire among undergraduate students from seven geographical regions across China. The questionnaire included sociodemographic information; the 21-item Depression, Anxiety and Stress Scale (DASS-21); the Perceived Social Support Scale (PSSS); and the Simplified Coping Style Questionnaire (SCSQ). For the analyses, t-tests, one-way analysis of variance (ANOVA), the Kruskal-Wallis test and multiple linear regression were utilized. The level of significance was set at P < 0.05.

RESULTS

Among 3113 college students, the rates of anxiety, depression and stress symptoms were 13.3, 15.4 and 6.8%, respectively. Increased rates of current smoking and drinking (5.5 and 25.2%, respectively) among undergraduates were identified. The results indicated that the PSSS subscales and SCSQ subscales were significantly associated with DASS-21 scores (P < 0.001). Multiple linear regression analysis showed that active coping style and family support were protective factors while passive coping style could aggravate psychological problems among participants (P < 0.001).

CONCLUSIONS

A remarkable number of college students adopted passive coping strategies to cope with negative feelings, such as smoking and drinking, which were detrimental to their mental health. In contrast, active coping strategies helped improve their psychological well-being. Moreover, family support was particularly important for maintaining their mental health and ameliorating mental health challenges in this major health crisis. Consequently, suitable psychointervention, routine screening for risk behaviors, and provision of further social support are needed for undergraduate students in the COVID-19 pandemic or other emergency public health events.