Mental Health and Health-Related Quality of Life of Children and Youth during the First Year of the COVID-19 Pandemic: Results from a Cross-Sectional Survey in Saskatchewan, Canada

Abstract

For children and youth, the COVID-19 pandemic surfaced at a critical time in their development. Children have experienced extended disruptions to routines including in-person schooling, physical activities, and social interactions—things that bring meaning and structure to their daily lives. We estimated the prevalence of anxiety and depression symptoms of children and youth and their experiences of health-related quality of life (HRQoL), during the first year of the pandemic, and identified factors related to these outcomes. Further, we examined these effects among ethnocultural minority families. We conducted an online survey (March–July 2021) with 510 children and youth aged 8–18 years and their parents/caregivers. The sample was representative of the targeted population. We modelled the relationship between anxiety, depression (measured using the Revised Child Anxiety and Depression Scale), HRQoL (measured using KIDSCREEN-10), and sociodemographic, behavioural, and COVID-19-contributing factors using binary logistic regression. A priori-selected moderating effects of sociodemographic characteristics and self-identified ethnocultural minority groups on the outcomes were tested. The point-in-time prevalence of medium-to-high anxiety symptoms and depression symptoms was 10.19% and 9.26%, respectively. Almost half (49.15%) reported low-to-moderate HRQoL. Children reporting medium-to-high anxiety symptoms, depression symptoms, and low-to-moderate HRQoL were more likely to be aged 8–11 years, 16–18 years, ethnocultural minority participants, living in rural/urban areas, having good/fair MH before COVID-19, experiencing household conflicts, having less physical activity, and having ≥3 h of recreational screen time. Those who had more people living at home and ≥8 h of sleep reported low anxiety and depression symptoms. Ethnocultural minority 16–18-year-olds were more likely to report low-to-moderate HRQoL, compared to 12–15-year-olds. Additionally, 8–11-year-olds, 16–18-year-olds with immigrant parents, and 16–18-year-olds with Canadian-born parents were more likely to report low–moderate HRQoL, compared to 12–15-year-olds. Children and youth MH and HRQoL were impacted during the pandemic. Adverse MH outcomes were evident among ethnocultural minority families. Our results reveal the need to prioritize children’s MH and to build equity-driven, targeted interventions.

See us, hear us! children, adolescents and families in Saskatchewan coping with mental health during the COVID-19 pandemic

“…As part of a sequential study design, we conducted, first, a quantitative online survey from March to July 2021 that helped us understand the prevalence of mental health outcomes in children in Saskatchewan. In the study, See Us, Hear Us (SUHU) quantitative survey consisting of 510 child-parent dyads, we found that 38% of children and youth ages 8–18 reported that their overall mental health worsened, 22% reported having ups and downs, 4% recorded having experienced better mental health and 36% reported no real change to their mental health in the first year of the pandemic, 2020–2021 school year (Muhajarine et al, 2022 ).…”

“…The interview participants were drawn from the pool of respondents in the preceding Muhajarine et al’s quantitative study ( 2022 ) who had expressed interest in participating in follow-up interviews. These participants were contacted via email to coordinate and select a suitable time and date for the interview.…”

“…We (VP and ID) applied an iterative process of reading and rereading transcripts to familiarize ourselves with the data. We coded data using pre-defined codes based on findings from our larger study (Muhajarine et al, 2022 ) (e.g., quantitatively, increased screen time affected mental health, therefore, we used this code to understand qualitatively how screen time habits were impacting mental health) and used inductive coding to derive new patterns from the interview data. We then organized similar codes into preliminary themes.…”

“…Subsequently, as the pandemic progressed, multiple research studies highlighted that children, as a demographic group, faced significant challenges such as low mood, social isolation, worry, anxiety, depression, and stress (Jiao et al, 2020 ; Meherali et al, 2021 ; O’Sullivan et al, 2021 ). Other studies emphasized that children with pre-existing/poorer mental health conditions and developmental disorders were at higher risk for poor mental health resulting from the pandemic restrictions (Cost et al, 2022 ; Muhajarine et al, 2023 ; O’Sullivan et al, 2021 ). The pandemic had additional effects, notably on parents of school-aged children, who experienced higher stress (Adams et al, 2021 ; Gadermann et al, 2021 ).…”