Abstract
Schools and communities across the United States shifted between virtual and in-person formats and reduced recreational offerings throughout the 2020-2021 school year due to widespread COVID-19 infection. Early cross-sectional studies indicate children’s physical activity (PA) decreased during the pandemic, but variation may be seen according to school format and seasonal changes in behavior. Purpose: The purpose of this study was to longitudinally assess changes in PA and screen time (ST) behaviors throughout one year of the COVID-19 pandemic and according to changes in school format. Methods: Parents of children ages 6-17y were recruited via email and social media. Most participants (57%) lived in the Midwestern region of the United States. The survey included questions about school format, home characteristics, child PA, child ST, child sleep habits, and parental support of PA. Initial data were collected in November 2020 with follow-up surveys in February, May, and August 2021. Children were first classified according to school format in each season then further grouped based on longitudinal changes in school format (i.e., in-person all year vs. remote to in-person, etc.). PA and ST behaviors were compared by season and school format using repeated measures ANOVA. Results: Overall, children achieved 60 minutes of PA on fewer days in winter (2.4 ± 0.3 days; p < 0.001; n = 176) than compared to fall (3.7 ± 0.3 days; n = 175), spring (3.8 ± 0.3 days; n = 141), and summer (3.8 ± 0.3 days; n = 112). Longitudinal analysis (n = 61) showed that PA was consistently highest among students attending school fully in-person and lowest among students attending remotely, though school format differences did not reach statistical significance. Non-school ST did not differ by season or school format but tended to be highest in winter and amongst students attending school remotely. Conclusion: In general, children demonstrated healthier lifestyle behavior patterns when attending school in-person than when attending school remotely. Seasonal variation in activity followed the expected pattern with the lowest PA in winter. These results provide a unique opportunity to evaluate lifestyle behaviors by school format throughout the year and suggest that students exhibit healthier behavior patterns when school occurs in person.
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