Pediatric Resident UCSF Benioff Children's Hospital Oakland University of California San Francisco Oakland, California, United States
Background: Closures of schools, recreational programs and playgrounds during the COVID-19 pandemic may adversely impact child health behaviors. There is a paucity of data on how the COVID-19 pandemic has affected child health behaviors in low-income, non-white children with overweight or obesity, a group that is at high risk of excess weight gain and comorbid health conditions.
Objective: To understand the impact of the COVID-19 pandemic on child screen time, physical activity and bedtime, and to assess whether parental stress or anxiety is associated with child screen time and physical activity during the pandemic among children ages 4-12 with overweight or obesity.
Design/Methods: We conducted a cross-sectional study among parents of children ages 4-12 in San Francisco with BMI>85th percentile. We collected data via a survey that addressed child health behaviors prior to and since the start of the pandemic. We measured parents’ stress via the Perceived Stress Scale (PSS) and parents’ anxiety with the Generalized Anxiety Disorder 7 questionnaire (GAD-7). We used multivariate linear regression to assess associations between parents’ scores on the PSS and the GAD-7 with child screen time and physical activity during the pandemic.
Results: 145 parents completed the survey. The majority were publicly insured (90%), Latino (77%), and primarily spoke Spanish at home (70%). Mean daily child screen time was higher during the pandemic compared to before the pandemic (3.8 hours vs 1.6 hours, p<0.001). Mean daily physical activity was lower (1 hour vs 1.8 hours, p<0.001). On average, children’s bedtime had shifted 1.6 hours later during the pandemic and 65% of children had a bedtime later than 10 pm during the pandemic compared to 3% prior to the pandemic (p<0.001). Parental moderate-to-severe anxiety was associated with higher screen time during the pandemic in a multivariate model (β=1.07 CI 0.29-1.85). We found no association between parental stress and either child screen time or physical activity. Conclusion(s): School-aged children with overweight or obesity in San Francisco, CA have increased their screen time, decreased their physical activity and have later bedtimes during the COVID-19 pandemic. These health behavior changes are likely to have negative impacts on cardiometabolic health in this vulnerable population. There is a critical need for policies that support healthy behaviors among children during the COVID-19 pandemic.
Table 1: Child and parent demographic characteristics in a study of child health behaviors during the COVID-19 pandemic among children ages 4-12 in San Francisco, CA. n=145
Table 2: Parent reported child health behaviors including screen time, physical activity, and bedtime prior to and during the COVID-19 pandemic among a predominantly low-income sample of children ages 4-12 in San Francisco, CA. n=145
Table 3: Results of bivariate and multivariate linear regression models examining the association between parental moderate-to-severe anxiety and child hours of daily screen time during the COVID-19 pandemic among children ages 4-12 in San Francisco, CA.
Authors/Institutions: Lauren Lendzion, University of California San Francisco, Oakland, California, United States; John Huang, University of California San Francisco, San Francisco, California, United States; Suzanna Martinez, University of California, San Francisco, San Francisco, California, United States; Amy L. Beck, University of California San Francisco, San Francisco, California, United States