School Parks as a Community Health Resource: Use of Joint-Use Parks by Children before and during COVID-19 Pandemic

How Societal Forces of Change Are Transforming Youth Physical Activity Promotion in North America

BACKGROUND

Climate change, increasing recognition of institutionalized discrimination, and the COVID-19 pandemic are large-scale, societal events (ie, forces of change) that affect the timing, settings, and modes of youth physical activity. Despite the impact that forces of change have on youth physical activity and physical activity environments, few studies consider how they affect physical activity promotion.

METHODS

The authors use 2 established frameworks, the ecological model of physical activity and the youth physical activity timing, how, and setting framework, to highlight changes in physical activity patterns of youth in North America that have resulted from contemporary forces of change.

RESULTS

North American countries-Canada, Mexico, and the United States-have faced similar but contextually different challenges for promoting physical activity in response to climate change, increasing recognition of institutionalized discrimination, and the COVID-19 pandemic. Innovative applications of implementation science, digital health technologies, and community-based participatory research methodologies may be practical for increasing and sustaining youth physical activity in response to these forces of change.

CONCLUSIONS

Thoughtful synthesis of existing physical activity frameworks can help to guide the design and evaluation of new and existing physical activity initiatives. Researchers, practitioners, and policymakers are encouraged to carefully consider the intended and unintended consequences of actions designed to respond to forces of change.

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.

Natural environments, psychosocial health, and health behaviors in a crisis - A scoping review of the literature in the COVID-19 context

The COVID-19 outbreak led to major restrictions globally, affecting people's psychosocial health and their health behaviors. Thus, the purpose of this scoping review was to summarize the available research regarding nature and health in the COVID-19 context. Keywords relating to natural environments and COVID-19 were combined to conduct a systematic online search in six major databases. Eligibility criteria were a) published since 2020 with data collected in the COVID-19 context b) peer-reviewed, c) original empirical data collected on human participants, d) investigated the association between natural environments and psychosocial health or health behaviors, and e) English, German, or Scandinavian languages. Out of 9126 articles being screened, we identified 188 relevant articles, representing 187 distinct studies. Most research focused on adults in the general population and was predominantly conducted in the USA, Europe, and China. Overall, the findings indicate that nature may mitigate the impact of COVID-19 on psychological health and physical activity. Through a systematic thematic analysis of the extracted data, three primary themes were identified: 1) type of nature assessed, 2) psychosocial health and health behaviors investigated, and 3) heterogeneity in the nature-health relationship. Research gaps in the COVID-19 context were identified regarding I) nature characteristics that promote psychosocial health and health behaviors, II) investigations of digital and virtual nature, III) psychological constructs relating to mental health promotion, IV) health-promoting behaviors other than physical activity, V) underlying mechanisms regarding heterogeneity in the nature-health relationship based on human, nature, and geographic characteristics, and VI) research focusing on vulnerable groups. Overall, natural environments demonstrate considerable potential in buffering the impact of stressful events on a population level on mental health. However, future research is warranted to fill the mentioned research gaps and to examine the long-term effects of nature exposure during COVID-19.

How the COVID-19 pandemic changed patterns of green infrastructure use: A scoping review

The use of green infrastructure (GI) has been established as a way to alleviate stress and the COVID-19 pandemic has placed a new emphasis on the importance of GI as both a coping mechanism and a source of recreation. This scoping review seeks to address whether the COVID-19 pandemic affected the use of GI, specifically the ways in which the pandemic altered visitation patterns and the frequency of the use of GI. This review identifies studies that explore the relationship between the COVID-19 pandemic and GI use and assesses whether the pandemic has altered the use of GI, including whether GI use increased, decreased, or remained the same and examines potential changes in visitation structure as well as other effects studied. This review also discusses how future planning for GI can consider the lessons learned from the pandemic. Key findings suggest that GI use increased, as did visitors' appreciation for GI and its benefits. The use of local GI to one's home also increased in importance. Decreases in visitation were typically a result of COVID-19 lockdown restrictions and fear of viral transmission within GI.

Neighborhood Greenspace and Changes in Pediatric Obesity During COVID-19

INTRODUCTION

Pediatric obesity rates increased during the COVID-19 pandemic. This study examined the associations of neighborhood greenspace with changes in pediatric obesity during the pandemic.

METHODS

Electronic health record data from a large pediatric primary care network were extracted to create a retrospective cohort of patients aged 2-17 years with a visit in each of 2 periods: June 2019-December 2019 (before pandemic) and June 2020-December 2020 (pandemic). Multivariable longitudinal generalized estimating equations Poisson regression estimated the associations of census tract‒level Normalized Difference Vegetation Index with (1) changes in obesity risk during the pandemic and (2) risk of new-onset obesity among children who were not obese prepandemic. Analyses were conducted between November 2021 and May 2022.

RESULTS

Among 81,418 children (mean age: 8.4 years, 18% Black), the percentage of children who were obese increased by 3.2% during the pandemic. Children in Normalized Difference Vegetation Index Quartiles 2-4 had smaller increases in obesity risk during the pandemic than those in Quartile 1 (risk ratio=0.96, 95% CI=0.93, 0.99; Quartile 3 risk ratio=0.95; 95% CI=0.91, 0.98; Quartile 4 risk ratio=0.95, 95% CI=0.92, 0.99). Among the subset who were not obese before the pandemic, children in Normalized Difference Vegetation Index quartiles 3-4 had a lower risk of new-onset obesity during the pandemic (Quartile 3 risk ratio=0.82, 95% CI=0.71, 0.95; Quartile 4 risk ratio=0.73, 95% CI=0.62, 0.85). Higher Normalized Difference Vegetation Index was associated with smaller increases in obesity risk and lower risk of new-onset obesity among children in urban and suburban areas, but results were in the opposite direction for children in rural areas.

CONCLUSIONS

Children living in greener neighborhoods experienced smaller increases in obesity during the pandemic than children in less green neighborhoods, although findings differed by urbanicity.

Climate change and physical activity: ambient temperature and urban trail use in Texas

Individuals in the USA are insufficiently active, increasing their chronic disease risk. Extreme temperatures may reduce physical activity due to thermal discomfort. Cooler climate studies have suggested climate change may have a net positive effect on physical activity, yet research gaps remain for warmer climates and within-day physical activity patterns. We determined the association between ambient temperatures (contemporary and projected) and urban trail use in a humid subtropical climate. At a trail in Austin, TX, five electronic counters recorded hourly pedestrian and cyclist counts in 2019. Weather data were acquired from World Weather Online. Generalized additive models estimated the association between temperature and trail counts. We then combined the estimated exposure-response relation with weather projections from climate models for intermediate (RCP4.5) and high (RCP8.5) emissions scenarios by NASA NEX-GDDP. From summer to autumn to spring to winter, hourly trail counts shifted from bimodal (mid-morning and early-evening peaks) to one mid-day peak. Pedestrians were more likely to use the trail between 7 and 27 °C (45-81°F) with peak use at 17 °C (63°F) and cyclists between 15 and 33 °C (59-91°F) with peak use at 27 °C (81°F) than at temperature extremes. A net decrease in trail use was estimated by 2041-2060 (RCP4.5: pedestrians =  - 4.5%, cyclists =  - 1.1%; RCP8.5: pedestrians =  - 6.6%, cyclists =  - 1.6%) and 2081-2100 (RCP4.5: pedestrians =  - 7.5%, cyclists =  - 1.9%; RCP8.5: pedestrians =  - 16%, cyclists =  - 4.5%). Results suggest climate change may reduce trail use. We recommend interventions for thermal comfort at settings for physical activity.

Potential indirect impacts of the COVID-19 pandemic on children: a narrative review using a community child health lens

▪In this narrative review, we summarise the vast and burgeoning research on the potential and established indirect impacts on children of the COVID-19 pandemic. We used a community child health lens to organise our findings and to consider how Australia might best respond to the needs of children (aged 0-12 years). ▪We synthesised the literature on previous pandemics, epidemics and natural disasters, and the current COVID-19 pandemic. We found clear evidence of adverse impacts of the COVID-19 pandemic on children that either repeated or extended the findings from previous pandemics. ▪We identified 11 impact areas, under three broad categories: child-level factors (poorer mental health, poorer child health and development, poorer academic achievement); family-level factors that affect children (poorer parent mental health, reduced family income and job losses, increased household stress, increased abuse and neglect, poorer maternal and newborn health); and service-level factors that affect children (school closures, reduced access to health care, increased use of technology for learning, connection and health care). ▪There is increasing global concern about the likely disproportionate impact of the current pandemic on children experiencing adversity, widening existing disparities in child health and developmental outcomes. ▪We suggest five potential strategy areas that could begin to address these inequities: addressing financial instability through parent financial supplements; expanding the role of schools to address learning gaps and wellbeing; rethinking health care delivery to address reduced access; focusing on prevention and early intervention for mental health; and using digital solutions to address inequitable service delivery.

Changes in Physical Activity and Sedentary Behavior before and during the COVID-19 Pandemic: A Swedish Population Study

Governments have enforced measures to limit the spread of COVID-19 with varying degrees of success, which could affect people's physical activity (PA) and sedentary behavior. This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between changed PA levels and demographical and behavioral determinants were also investigated. In December 2020, 1035 individuals (18-79 years old) completed a survey about their PA and sedentary behavior before and during the pandemic. Factors influencing their PA were also explored. Fifty-one percent of the sample reported reduced total PA, 18% had no change, and 31% increased their PA. Overall, organized PA decreased the most and sedentary behavior increased. The youngest and oldest age groups reported the greatest reduction in PA, while middle-aged groups reported the most increased PA. Men reported a larger increase in sedentary behavior than women. Mental and physical capability was associated with change in PA. In conclusion, this study indicates that, during the COVID-19 pandemic, the majority of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior, which may have negative health consequences. Interventions are recommended to address both PA and sedentary behavior, specifically to strengthen people's ability to perform PA and focusing on the youngest and oldest age groups.