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Science M, Caldeira-Kulbakas M, Parekh RS, Maguire BR, Carroll S, Anthony SJ, Bitnun A, Bourns LE, Campbell DM, Cohen E, Dodds A, Dubey V, Friedman JN, Greenwood JL, Hopkins JP, Imgrund R, Korczak DJ, Looi T, Louca E, Mertz D, Nashid J, Panzera G, Schneiderman JE, Schwartz KL, Streitenberger L, Vuppal S, Walsh CM, Jüni P, Matava CT, Allen U, Alvares AD, Birken CS, Brown A, Carbone VL, Christie A, Cividino ME, Cohen-Silver JH, Cohn RD, Crosbie J, da Costa BR, Dharmaraj B, Freeman SJ, Gaebe K, Hajjaj O, Huang L, Khan S, Lee E, Logeman C, Manteghi S, Moore C, Morris SK, Orkin J, Pelger SD, Pickel L, Salman S, Shouldice A, Solomon R, Thampi N, Thorpe K, Wasiak A, Xie J. Effect of Wearing a Face Mask on Hand-to-Face Contact by Children in a Simulated School Environment: The Back-to-School COVID-19 Simulation Randomized Clinical Trial. JAMA Pediatr 2022; 176:1169-1175. [PMID: 36279142 PMCID: PMC9593317 DOI: 10.1001/jamapediatrics.2022.3833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
IMPORTANCE Wearing a face mask in school can reduce SARS-CoV-2 transmission but it may also lead to increased hand-to-face contact, which in turn could increase infection risk through self-inoculation. OBJECTIVE To evaluate the effect of wearing a face mask on hand-to-face contact by children while at school. DESIGN, SETTING, AND PARTICIPANTS This prospective randomized clinical trial randomized students from junior kindergarten to grade 12 at 2 schools in Toronto, Ontario, Canada, during August 2020 in a 1:1 ratio to either a mask or control class during a 2-day school simulation. Classes were video recorded from 4 angles to accurately capture outcomes. INTERVENTIONS Participants in the mask arm were instructed to bring their own mask and wear it at all times. Students assigned to control classes were not required to mask at any time (grade 4 and lower) or in the classroom where physical distancing could be maintained (grade 5 and up). MAIN OUTCOMES AND MEASURES The primary outcome was the number of hand-to-face contacts per student per hour on day 2 of the simulation. Secondary outcomes included hand-to-mucosa contacts and hand-to-nonmucosa contacts. A mixed Poisson regression model was used to derive rate ratios (RRs), adjusted for age and sex with a random intercept for class with bootstrapped 95% CIs. RESULTS A total of 174 students underwent randomization and 171 students (mask group, 50.6% male; control group, 52.4% male) attended school on day 2. The rate of hand-to-face contacts did not differ significantly between the mask and the control groups (88.2 vs 88.7 events per student per hour; RR, 1.00; 95% CI, 0.78-1.28; P = >.99). When compared with the control group, the rate of hand-to-mucosa contacts was significantly lower in the mask group (RR, 0.12; 95% CI, 0.07-0.21), while the rate of hand-to-nonmucosa contacts was higher (RR, 1.40; 95% CI, 1.08-1.82). CONCLUSIONS AND RELEVANCE In this clinical trial of simulated school attendance, hand-to-face contacts did not differ among students required to wear face masks vs students not required to wear face masks; however, hand-to-mucosa contracts were lower in the face mask group. This suggests that mask wearing is unlikely to increase infection risk through self-inoculation. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04531254.
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Affiliation(s)
- Michelle Science
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada,Public Health Ontario, Toronto, Ontario, Canada,Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Monica Caldeira-Kulbakas
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rulan S. Parekh
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Division of Nephrology, Department of Pediatrics and Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bryan R. Maguire
- Biostatistics Design and Analysis Unit, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stacie Carroll
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario, Canada,Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario, Canada
| | - Samantha J. Anthony
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Ari Bitnun
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada,Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Douglas M. Campbell
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Neonatal Intensive Care Unit, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada,Allan Waters Family Simulation Program, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada,Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Eyal Cohen
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Complex Care Program, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada,Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada,Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
| | - Alison Dodds
- SimKids Simulation Program, The Learning Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vinita Dubey
- Communicable Disease Control, Toronto Public Health, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jeremy N. Friedman
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jodi L. Greenwood
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario, Canada,Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario, Canada
| | - Jessica P. Hopkins
- Public Health Ontario, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ryan Imgrund
- Biostatistics, Southlake Regional Health Centre, Newmarket, Ontario, Canada
| | - Daphne J. Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Looi
- Department of Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada,The Wilfred and Joyce Posluns Centre for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Emily Louca
- SimKids Simulation Program, The Learning Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Dominik Mertz
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada,Department of Infection Prevention and Control, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - John Nashid
- Corporate Strategy, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Giovanna Panzera
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario, Canada,Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario, Canada
| | - Jane E. Schneiderman
- Division of Respiratory Medicine, Clinical Research Services, The Hospital for Sick Children, Toronto, Ontario, Canada,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Kevin L. Schwartz
- Public Health Ontario, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Division of Infectious Diseases, Department of Medicine, Unity Health Toronto, Toronto, Ontario, Canada
| | - Laurie Streitenberger
- Infection Prevention & Control (IPAC) Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sunayna Vuppal
- SimKids Simulation Program, The Learning Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Catharine M. Walsh
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada,SimKids Simulation Program, The Learning Institute, The Hospital for Sick Children, Toronto, Ontario, Canada,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Jüni
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada,Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Clyde T. Matava
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada,Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Upton Allen
- for the Back-to-School COVID-19 School Study Group
| | | | | | - Ahuva Brown
- for the Back-to-School COVID-19 School Study Group
| | | | | | | | | | | | | | | | | | | | | | - Omar Hajjaj
- for the Back-to-School COVID-19 School Study Group
| | - Lennox Huang
- for the Back-to-School COVID-19 School Study Group
| | - Sarah Khan
- for the Back-to-School COVID-19 School Study Group
| | - Eon Lee
- for the Back-to-School COVID-19 School Study Group
| | | | | | - Clara Moore
- for the Back-to-School COVID-19 School Study Group
| | | | - Julia Orkin
- for the Back-to-School COVID-19 School Study Group
| | | | | | - Soha Salman
- for the Back-to-School COVID-19 School Study Group
| | | | | | - Nisha Thampi
- for the Back-to-School COVID-19 School Study Group
| | - Kevin Thorpe
- for the Back-to-School COVID-19 School Study Group
| | - Anna Wasiak
- for the Back-to-School COVID-19 School Study Group
| | - Jiayin Xie
- for the Back-to-School COVID-19 School Study Group
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Coelho SG, Segovia A, Anthony SJ, Lin J, Pol S, Crosbie J, Science M, Matava CT, Parekh RS, Caldeira-Kulbakas M, Carroll S, Greenwood JL, Panzera G, Imgrund R, Osokin K, Korczak DJ. Le retour en classe et le port du masque pendant la pandémie de COVID-19 : le point de vue des élèves d’après une étude de simulation scolaire. Paediatr Child Health 2022; 27:S95-S102. [PMID: 36092299 PMCID: PMC9455641 DOI: 10.1093/pch/pxac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/22/2022] [Indexed: 11/14/2022] Open
Abstract
Objectifs La présente étude s’est penchée sur le point de vue des enfants relativement au retour en classe après le confinement imposé par la pandémie, sur le port du masque en classe et sur la santé mentale des enfants et des parents pendant la pandémie. Méthodologie La présente étude transversale a fait partie d’un exercice de simulation scolaire de deux jours au cours duquel les élèves ont été répartis au hasard entre diverses recommandations sur le port du masque. Au moyen d’analyses régression multiple, les chercheurs ont analysé le compte rendu des parents sur la santé mentale et, après la simulation, celui des élèves sur l’anxiété liée à la COVID-19 et le port du masque. Les élèves plus âgés ont participé à des groupes de travail semi-structurés pour compléter les données du questionnaire. Résultats Sur les 190 élèves de la présente étude, 31 % ne dépassaient pas la quatrième année et 95 % avaient hâte de rentrer en classe. La plus grande anxiété des parents ou des proches (β= 0,67; p <0,001) et leur niveau de scolarité plus bas (β=1,86; p <0,002) étaient prédicteurs d’une plus grande anxiété des enfants à l’égard de la COVID-19. Les élèves plus âgés étaient plus susceptibles de trouver le port du masque nuisible aux interactions avec leurs camarades que les plus jeunes (χ2[1]=31,16; p <0,001) et pour leur capacité à comprendre l’enseignant (χ2[1]=13,97; p <0,001). Les élèves du groupe sans masque étaient plus susceptibles de craindre de contracter la COVID-19 à l’école (χ2[1]=10,07; p <0,05) que ceux du groupe qui le portaient, et d’anticiper éprouver de la difficulté à le porter (χ2[1]=18,95; p <0,001). Conclusions Chez les enfants anxieux à cause de la COVID-19, l’anxiété des parents et l’information sur la COVID-19 pourraient être des cibles d’intervention. De futures recherches devraient porter sur les effets de la mise en œuvre prolongée de mesures sanitaires d’atténuation des risques sur la réussite scolaire et la santé mentale des enfants.
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Affiliation(s)
- Sophie G Coelho
- Département de psychiatrie, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Alicia Segovia
- Département de psychiatrie, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Samantha J Anthony
- Sciences évaluatives de la santé de l’enfant, The Hospital for Sick Children, Toronto (Ontario)Canada
- Faculté de travail social Factor-Inwentash, Université de Toronto, Toronto (Ontario)Canada
- Département de travail social, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Jia Lin
- Sciences évaluatives de la santé de l’enfant, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Sarah Pol
- Sciences évaluatives de la santé de l’enfant, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Jennifer Crosbie
- Département de psychiatrie, faculté de médecine, Université de Toronto, Toronto (Ontario)Canada
- Neurosciences et santé mentale, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Michelle Science
- Département de pédiatrie, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Clyde T Matava
- Département d’anesthésie et de médecine de la douleur, The Hospital for Sick Children, Toronto (Ontario)Canada
- Département d’anesthésiologie et de médecine de la douleur, faculté de médecine, Université de Toronto, Toronto (Ontario)Canada
| | - Rulan S Parekh
- Département de pédiatrie, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Monica Caldeira-Kulbakas
- Département d’anesthésie et de médecine de la douleur, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Stacie Carroll
- Programme d’éducation et de partenariats communautaires, conseil scolaire du district de Toronto, Toronto (Ontario)Canada
- Soins centrés sur l’enfant et sur la famille, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Jodi L Greenwood
- Programme d’éducation et de partenariats communautaires, conseil scolaire du district de Toronto, Toronto (Ontario)Canada
- Soins centrés sur l’enfant et sur la famille, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Giovanna Panzera
- Programme d’éducation et de partenariats communautaires, conseil scolaire du district de Toronto, Toronto (Ontario)Canada
- Soins centrés sur l’enfant et sur la famille, The Hospital for Sick Children, Toronto (Ontario)Canada
| | - Ryan Imgrund
- Southlake Regional Health Centre, Newmarket (Ontario)Canada
- Conseil scolaire du district catholique de York, Toronto (Ontario)Canada
| | | | - Daphne J Korczak
- Département de psychiatrie, The Hospital for Sick Children, Toronto (Ontario)Canada
- Département de psychiatrie, faculté de médecine, Université de Toronto, Toronto (Ontario)Canada
- Neurosciences et santé mentale, The Hospital for Sick Children, Toronto (Ontario)Canada
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3
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Coelho SG, Segovia A, Anthony SJ, Lin J, Pol S, Crosbie J, Science M, Matava CT, Parekh RS, Caldeira-Kulbakas M, Carroll S, Greenwood JL, Panzera G, Imgrund R, Osokin K, Korczak DJ. Return to school and mask-wearing in class during the COVID-19 pandemic: Student perspectives from a school simulation study. Paediatr Child Health 2022; 27:S15-S21. [PMID: 35620563 PMCID: PMC9126272 DOI: 10.1093/pch/pxab102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives This study examined children’s perspectives about returning to in-person school following lockdown due to the pandemic and about mask-wearing in class, as well as the mental health of children and parents during the pandemic. Methods This cross-sectional study was part of a 2-day school simulation exercise that randomized students to different masking recommendations. Parent-report of mental health and post-simulation child-report of COVID-19-related anxiety and mask-wearing were analyzed using descriptive and multiple regression analyses. Semi-structured focus groups were conducted with older students to supplement questionnaire data. Results Of 190 students in this study, 31% were in grade 4 or lower 95% looked forward to returning to in-person school. Greater child anxiety about COVID-19 was predicted by increased parent/caregiver anxiety (β=0.67; P<0.001), and lower parental educational attainment (β=1.86; P<0.002). Older students were more likely than younger students to report that mask-wearing interfered with their abilities to interact with peers (χ2(1)=31.16; P<0.001) and understand the teacher (χ2(1)=13.97; P<0.001). Students in the group that did not require masks were more likely than students in the masking group to report worries about contracting COVID-19 at school (χ2(1)=10.07; P<0.05), and anticipated difficulty wearing a mask (χ2(1)=18.95; P<0.001). Conclusions For children anxious about COVID-19, parental anxiety and education about COVID-19 may be targets for intervention. Future research should examine the impact of prolonged implementation of public health mitigation strategies in school on academic achievement and children’s mental health.
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Affiliation(s)
- Sophie G Coelho
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alicia Segovia
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Samantha J Anthony
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.,Department of Social Work, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jia Lin
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sarah Pol
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michelle Science
- Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Clyde T Matava
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rulan S Parekh
- Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Monica Caldeira-Kulbakas
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stacie Carroll
- Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario, Canada.,Child and Family Centered Care, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jodi L Greenwood
- Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario, Canada.,Child and Family Centered Care, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Giovanna Panzera
- Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario, Canada.,Child and Family Centered Care, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ryan Imgrund
- Southlake Regional Health Centre, Newmarket, Ontario, Canada.,York Catholic District School Board, Toronto, Ontario, Canada
| | | | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
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Lin J, Pol SJ, Korczak DJ, Coelho S, Segovia A, Matava CT, Parekh RS, Science M, Caldeira-Kulbakas M, Crosbie J, Carroll S, Greenwood JL, Panzera G, Imgrund R, Anthony SJ. Impact of COVID-19 Public Health Protocols on Teachers Instructing Children and Adolescents During an In-Person Simulation. J Can Acad Child Adolesc Psychiatry 2022; 31:52-63. [PMID: 35614958 PMCID: PMC9084371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/09/2021] [Indexed: 06/15/2023]
Abstract
Objective As a result of the COVID-19 pandemic, public health agencies and school boards across Canada enacted new protocols, including face masks, physical distancing and enhanced hygiene, to support the safe reopening of in-person school. This study explored the experiences and perceptions of teachers instructing children and adolescents in person during a two-day school simulation. Method This study was part of a large school simulation exercise conducted in Toronto, Ontario. Kindergarten to grade 12 teachers taught in classrooms with either masked students, or students who were un-masked or only masked when physical distancing was not possible. A qualitative descriptive phenomenology approach was utilized, and data were collected via virtual focus groups. Qualitative data analysis involved multiple rounds of inductive coding to generate themes. Results The sample included 14 teachers (92.9% female; 85.7% White), with a median of 9.5 years teaching experience. Three primary themes emerged: 1) learning to navigate public health measures, 2) needing to adapt teaching strategies and 3) striving to manage conflicting priorities. The majority of teachers reported that mask-wearing and physical distancing impacted their classroom teaching, communication and connection with students. Conclusions As schools transition to in-person instruction, teachers will be required to play dual roles in education and public health, with implications on safety, teaching and professional identity. Public health agencies and school boards are encouraged to engage teachers in ongoing conversations regarding in-person school planning and operations. Furthermore, evidence-based interventions, including increased teaching development programs, are recommended to support teachers during the COVID-19 pandemic.
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Affiliation(s)
- Jia Lin
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario
| | - Sarah J Pol
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario
| | - Daphne J Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Sophie Coelho
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
| | - Alicia Segovia
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
| | - Clyde T Matava
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Rulan S Parekh
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
| | - Michelle Science
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
| | | | - Jennifer Crosbie
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario
- Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario
| | - Stacie Carroll
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario
- Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario
| | - Jodi L Greenwood
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario
- Toronto District School Board, Toronto, Ontario
| | - Giovanna Panzera
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario
- Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario
| | - Ryan Imgrund
- York Catholic District School Board, Aurora, Ontario
| | - Samantha J Anthony
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario
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