Action and Reaction of Pre-Primary and Primary School-Age Children to Restrictions during COVID-19 Pandemic in Greece

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.

Adolescents' Out-of-School Physical Activity Levels and Well-Being during the COVID-19 Restrictions in Greece: A Longitudinal Study

The present study aimed to identify the impact of social distancing measures on adolescents' physical activity (PA) levels and well-being during the implementation of COVID-19 restrictive measures. There were 438 participants (207 boys and 231 girls), aged 12 to 15 years old (M = 13.5, SD = 0.55). They completed online questionnaires on well-being and PA in three waves (December 2020, February 2021, and June 2021). Correlation analyses were conducted to examine the relationship between well-being and PA variables in the three measurements. Additionally, separate three-way repeated-measures ANOVAs were conducted to capture possible differences in students' moderate to vigorous physical activity (MVPA) levels, life satisfaction, and subjective vitality among the three measurements due to gender, age, and interaction between gender and age. A significant relation emerged between the MVPA variables and well-being. In all measurements, adolescents' PA levels did not meet the World Health Organization (WHO) recommendations of at least 60 min per day in MVPA. Students' MVPA levels, life satisfaction, and subjective vitality were significantly higher in the third measurement compared to the first and second ones. Moreover, significant differences emerged in life satisfaction and subjective vitality between boys and girls in the first and third measurements, respectively. The COVID-19 restrictions appeared to negatively influence adolescents' PA and well-being. Policymakers aimed at facilitating adolescents' well-being in a similar situation in the future should not adopt measures restricting the participation of adolescents in PA.

Impact of the COVID-19 Pandemic on Nutrition, Sleep, Physical Activity, and Mood Disorders of Polish Children

The harmful consequences of the COVID-19 pandemic on children are its impact on eating habits, physical activity, sleep, and mood disorders. In the future, this may result in a higher prevalence of obesity and diet-related diseases. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on children's eating behavior and lifestyle. The study was conducted using a proprietary questionnaire on dietary and lifestyle habits before and during the pandemic, and the reasons for changes due to the pandemic. The study involved 294 parents of children in grades 1-8 in elementary schools in two regions of Poland. The survey showed that during the pandemic, the percentage of children eating five regular meals daily, including fruits and vegetables, and engaging in daily physical activity decreased. However, the percentage of children spending more than 4 h a day in front of a screen increased (p < 0.05). The main reasons for changes in eating habits and physical activity were less eating out, lack of motivation, obstruction, and lack of access to sports facilities (p < 0.05). The pandemic had a significant impact on reduced levels of physical activity and increased time spent in front of a screen. In summary, among the reasons for changes in children's dietary and lifestyle habits, factors related to the pandemic itself, i.e., social restrictions, restrictions, closure of schools and other facilities, and fear of coronavirus infection, had the greatest impact.

Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: A meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta-analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross-sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit-transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics.

Long-Term Impact of COVID-19 Pandemic in Sleep Quality and Lifestyle in Young Adults

Due to the evolution of COVID-19,restrictive measures were implemented. The quarantine resulted in significant changes in the social, economic, and psychological status of the population; however, its long-term effects have not yet been elucidated, especially in young adults. In the present study, people aged 18-25 years were studied, in relation to their sleeping, smoking, eating, and drinking habits and their physical activity before, during, and after the implementation of quarantine. We included 540 respondents (21.2 ± 2.3 years, 62.8% female). During quarantine, from 23 March to 4 May 2020, we observed an increase in sleep hours by 1.17 ± 1.98 h (p < 0.001), time of sleep arrival by 11.90 ± 30.41 min (p < 0.001), and number of daily meals by 0.66 ± 1.4 (p < 0.001). The subjects who consumed alcoholic beverages never or almost never had an upward change of 27.04%, and the time of daily exercise was reduced by 10.16 ± 48.68 min (p < 0.001). After quarantine, cigarettes per day increased by 1.14 ± 3.62 (p < 0.001) and the awakenings during night time increased by 0.37 ± 1.93 (p < 0.001). Our results suggest that the quarantine brought about significant changes in smoking, sleeping habits, physical activity, dietary habits, and the consumption of alcoholic beverages, some of which continue after its termination.

Mask-Wearing Perception of Preschool Children in Korea during the COVID-19 Pandemic: A Cross-Sectional Study

As the COVID-19 pandemic continues, wearing a mask has become a daily routine in Korea over the last two years. This study aims to investigate the mask-wearing perception of preschoolers (ages 4-6). The questionnaire comprised 17 yes-no closed-ended questions and two open-ended questions, and interviews of the children were conducted from January to February 2022, 15 months after mandatory mask wearing. Results showed that children were aware of the need to wear a mask to protect themselves and others from the coronavirus, and they perceived it as necessary and a good thing. Most children responded that they did not feel uncomfortable wearing a mask at preschool. This perception was thought to be influenced by the caregivers' perceptions of the mask in Korea. The way in which 4-5-year-olds perceived the mask differed from the way 6-year-olds did. Children aged between four and five seemed to perceive the mask as a physical self, while children aged six did not. As children who have experienced COVID-19 are growing up, attention is being focused on how the experience of wearing a mask affects their early childhood development.

Impacts of COVID-19 on primary, secondary and tertiary education: a comprehensive review and recommendations for educational practices

COVID-19 lockdown has caused disruption to education of all levels with far-reaching implications and unveiled the shortfalls of the current education model. Cycles of tightening and relaxation of COVID-19 lockdown confer uncertainty to the continuity of education. This article aims to comprehensively present the impacts of COVID-19 on primary, secondary and tertiary education and propose sound educational practices in the COVID-19 era. Papers related to educational impacts and implications of COVID-19 were selected for this review through a PRISMA model. The review shows that a shift of learning remotely or online has affected educators and learners, especially in relation to learning loss among learners, limitations in instructions, assessment and experiential learning in virtual environment, technology-related constraints, connectivity, learning resources and materials, besides psychosocial well-being. These impacts are exacerbated by inequalities in the distribution of resources as well as inequities attributed to socioeconomic status, gender, ethnicity, learning ability and physical conditions. The recommendations for future educational practices comprise adaptability of curricula to embed independent and online learning options, concurrence of diverse learning modalities for seamless learning transitions and flexibility, flexible staffing and learning model, enhanced support, technological and curricular innovation with simplification and standardization, as well as interactive, responsive and authentic virtual environment. This review contributes significantly to enhance preparedness of education to crisis while ensuring continuity and quality of education in the era of COVID-19 uncertainty.

School Performance among Children and Adolescents during COVID-19 Pandemic: A Systematic Review

As a result of COVID-19 restrictions, conventional ways of schooling were not possible, and in order to continue the educational process new digital resources, such as online learning platforms, were imposed. Although virtual courses provided high-quality educational material, the efficiency in children's and adolescents' academic performance in general is yet to be known. The purpose of this systematic review is to examine whether the academic performance of school-aged students was impacted or not through online learning and modified educational methods during the ongoing COVID-19 pandemic. According to the studies, either students suffered from learning losses comparing to pre-pandemic years or, in some cases, they benefited from online learning, especially in mathematics. Younger students and students with neurodevelopmental disorders or special education needs seemed to suffer more. Parents/caregivers reported that their children's performance deteriorated, while others thought that online learning was beneficial. Teachers also reported that students presented academic gaps and difficulties in mathematics and reading compared to typical years. Consequently, the new ways of schooling imposed by the restrictions have not been fully tested and the impact cannot be described thoroughly. The investment in technological equipment in schools for the majority of students, along with the training of teachers in digital competence, should be a priority.

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.