Abstract
ObjectiveThe primary objective was to determine the association between public health preventive measures and children’s outdoor time, sleep duration, and screen time during COVID-19.MethodsA cohort study using repeated measures of exposures and outcomes was conducted in healthy children (0 to 10 years) through The Applied Research Group for Kids (TARGet Kids!) COVID-19 Study of Children and Families in Toronto, Canada, between April 14 and July 15, 2020. Parents were asked to complete questionnaires about adherence to public health measures and children’s health behaviours. The primary exposure was the average number of days that children practiced public health preventive measures per week. The three outcomes were children’s outdoor time, total screen time, and sleep duration during COVID-19. Linear mixed-effects models were fitted using repeated measures of primary exposure and outcomes.ResultsThis study included 554 observations from 265 children. The mean age of participants was 5.5 years, 47.5% were female and 71.6% had mothers of European ethnicity. Public health preventive measures were associated with shorter outdoor time (−17.2; 95% CI −22.07, −12.40; p < 0.001) and longer total screen time (11.3; 95% CI 3.88, 18.79; p = 0.003) during COVID-19. The association with outdoor time was stronger in younger children (<5 years), and the associations with total screen time were stronger in females and in older children (≥5 years).ConclusionPublic health preventive measures during COVID-19 were associated with a negative impact on the health behaviours of Canadian children living in a large metropolitan area.
Highlights
Healthy movement behaviours are known to improve the physical and psychosocial health of children and youth (Tremblay et al 2016; Lasselin et al 2016; World Health Organization 2019)
We further explored the relationship between public health measures, screen time, and calendar date (Online Resource 4) and found that both the adherence to public health measures and total screen time decreased over time throughout our analysis and speculate that this may be due to change in weather or quarantine fatigue (Zhao et al 2020)
When developing COVID-19 public health guidelines, public health officials should take into account the negative impact of the guidelines on children’s health, since adhering to these public health measures has had a negative impact on children’s outdoor time and screen time
Summary
Healthy movement behaviours are known to improve the physical and psychosocial health of children and youth (Tremblay et al 2016; Lasselin et al 2016; World Health Organization 2019). Canada imposed public health measures that included restrictions requiring physical distancing, social distancing in the form of limited community gatherings and interactions, and limited playground and park use (Government of Canada 2020). Size of social gatherings outside of household was limited to 5 people (Detsky and Bogoch 2020; Nielsen 2021). In June 2020, cities in Ontario gradually entered Stage 2 of the province’s recovery plan, allowing for the reopening of outdoor recreational facilities for team sports (with limits on physical distancing) and the size of social gatherings was increased to 10 people (Nielsen 2020). While implemented to reduce the spread of COVID-19 infection, such measures may have presented additional barriers to maintaining healthy behaviours
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