Health-Related Behaviors Among School-Aged Children and Adolescents During the Spanish Covid-19 Confinement

Abstract

In response to the coronavirus disease 2019 (Covid-19) world pandemic, affected countries such as Spain enacted measures comprising compulsory confinement as well as restrictions regarding free movement. Such measures likely influence children's and adolescents' lifestyles. Our study aimed to investigate the impact that the Covid-19 confinement has on health-related behaviors (HRBs) among Spanish children and adolescents. An online survey was administered to 516 parents to collect data about 860 children and adolescents (49.2% girls) aged between 3 and 16 years in relation to physical activity, screen exposure, sleep time, and fruit and vegetable consumption during the Covid-19 confinement. Respectively, t-paired test and t-test between groups served to check differences between HRBs levels before and during the confinement as well as between strict and relaxed confinement. Significant differences were found for a reduction of weekly minutes of physical activity during the confinement (−102.5, SD 159.6) (p < 0.001), an increase of daily hours of screen exposure (2.9, SD 2.1) (p < 0.001), and a reduction of daily fruit and vegetable consumption (−0.2, SD 1.6) (p < 0.001). Sleep time showed a significant difference between strict and relaxed confinement (−0.3, SD 0.1) (p < 0.05), whereas binomial logistic regression adjusted for covariates (age, sex, education of the parents, siblings, current condition, exposure to Covid-19, and previous health risk behavior) showed significantly lower odds for screen exposure risk behavior with relaxed confinement (OR 0.60, 95%CI 0.40-0.91). The present study suggests that Covid-19 confinement reduced physical activity levels, increased both screen exposure and sleep time, and reduced fruit and vegetable consumption. Therefore, most HRBs worsened among this sample of Spanish children and adolescents. Closure of schools, online education, and the lack of López-Bueno et al. Health-Related Behaviors Among Young policies addressing the conciliation between labor and family life could have played an important role in HRBs worsening among pupils, which might be mitigated with adequate conciliation policies, parental guidance, and community support.

Increased Screen Use on Days With Increased Perceived COVID-19-Related Confinements—A Day Level Ecological Momentary Assessment Study

“…Results showed that participants reported increased screen use during leisure time, mostly social media and television watching, followed by news consumption, other internet usage, and gaming. In line with previous research, screen use increased during COVID-19-related confinements compared with usual every day conditions [e.g., ( 13 – 17 , 19 )]. Potentially, the low prevalence of increased gaming in our study is due to our mostly female sample, as previous research showed excessive gaming being prevalent mostly in male individuals ( 27 ).…”

Physical Activity, Sedentary Behavior, Sleep and Self-Regulation in Spanish Preschoolers during the COVID-19 Lockdown

“…For example, changes in physical activity and sedentary behavior were reported by parents and legal guardians of children living in the U.S. using an online survey [ 2 ]. Among Spanish youth, the lockdown substantially reduced physical activity levels (MD = −102.5 min per week) and increased daily hours of screen time (MD = 2.9 h per day); suggesting that restrictive mobility measures with the closure of schools and high schools had played an important role in these lifestyle behaviors worsening [ 3 ]. With higher time spent at home, it can be expected that screen time could reach higher levels than before the COVID-19 lockdown.…”

“…For example, a recent narrative meta-analysis suggested that the pandemic seems to significantly disturb normal sleep patterns and nightmares for children [ 8 ]. The study mentioned above among Spanish youth reported different results according to age group, showing an increase of sleep time of 0.6 h per day among adolescents (13 to 16 years old) but a reduction of 0.4 h per day in preschoolers (3 to 4 years old) [ 3 ]. Pietrobelli et al also showed an increase of 0.65 h per day of sleep time among obese Italian children [ 1 ].…”

“…It has been shown that U.S. children performed less physical activity and engaged in more sedentary behavior during the early COVID-19 period as compared to before the pandemic [ 2 ]. Another study in Spanish children and adolescents (3 to 16 years old) also reported a reduction in physical activity levels and increased both screen exposure and sleep time [ 3 ]. Specifically, these authors suggested that preschoolers (i.e., 3 to 4 years old) reduced their total physical activity (92 min per day) and increased screen time exposure by 2.2 h per day.…”

Emotional Impact of COVID-19 Lockdown Among the Spanish Population

“…Recent studies have determined a significant reduction in the physical activity levels of adults (Giustino et al, 2020;López-Bueno et al, 2020a), and children and adolescents (López-Bueno et al, 2020c), during the Covid-19 confinement. Moreover, such studies have found that adults who experienced higher reductions of physical activity levels, or who performed lower levels of physical activity during the Covid-19 pandemic, have poor mental health and low levels of well-being (López-Bueno et al, 2020b).…”