Assessing the impact of COVID-19 on the physical activity of 10-11-year-old children and their parents:Active-6 a mixed-methods study

Background: Physical activity is essential for long-term health, yet data from before the COVID-19 pandemic showed only 41% of 10-11-year-olds met the UK government’s physical activity recommendations. Children’s physical activity was limited during the national COVID-19 lockdowns. It is important to measure children’s physical activity in the recovery period to assess the short- and medium-term impact of the lockdowns. Objectives: To use mixed-methods to assess the impact of the COVID-19 pandemic on moderate-to-vigorous physical activity (MVPA) of Year 6 children in the short-term (2021) and medium-term (2022) recovery periods by comparing these to data sampled from the same schools in 2017/18. Methods: Quantitative and qualitative data were collected in two waves: Wave 1 (May-December 2021) when lockdowns had finished but some COVID-19 mitigation policies were still in place and Wave 2 (January-July 2022) when most restrictions had been removed. These were compared with baseline data from similar Year 6 children and parents/carers in the same schools collected between March 2017-June 2018 (Wave 0).Results: In Wave 1, average child accelerometer-measured weekday MVPA was 7-8 minutes lower than pre-pandemic while sedentary time was higher by almost 30 minutes. Child MVPA had recovered to pre-pandemic levels in Wave 2, although sedentary time remained elevated. Across our studies, we found a new normal for child physical activity, characterised as more dependent on structured activities such as active clubs. Physical activity inequalities appear to be widening among girls and low socioeconomic position families, as they face unique barriers to participating in the new normal.Limitations: Our sample includes more households with higher educational qualifications and predominantly female parents. Undertaking this research in schools while COVID-19 disruptions were ongoing created challenges to data collection which may have limited schools’ and families’ participation.Conclusions: COVID-19 lockdowns negatively impacted child physical activity. It took almost a year of no restrictions for this to recover, and sedentary time remains high. Despite this recovery, 59% of children do not meet activity guidelines. There is a new normal to child physical activity that relies on structured activities, and some children and families may face challenges to taking part in the new normal. Strategies are needed to increase child physical activity for all. Future work: Develop new ways to work in partnership with schools to design bespoke physical activity programs that can be delivered at the school site.Develop new ways to help girls and children from lower income households to be physically active.Find the most effective means of maximising existing school resources such as extended school provision (after-school clubs) and physical resources (equipment) to promote physical activity outside of curriculum time.Study registration: The University of Bristol agreed to act as the sponsor for this study. The project was listed on the research registry (project 6646).Funding details: This project was funded by the National Institute for Health Research (NIHR) Public Health programme and will be published in Public Health Research. See the NIHR Journals Library website for further project information.<br/

Quality of life, capability wellbeing, financial strain and physical activity in the short and medium term COVID 19 post-lockdown phases in the UK:a repeated cross-sectional study

BackgroundThe COVID-19 lockdowns had negative effects on children’s and adults’ mental and physical health. There is, however, a paucity of research that explores differences in health-related quality of life (HRQL) and wellbeing over time after the COVID-19 lockdowns had been lifted. Furlough during lockdowns, increases in unemployment, and the emerging cost-of-living crisis all put pressure on family finances, which could have a detrimental effect on HRQL and wellbeing. This study explored how HRQL, capability wellbeing and family financial strain changed after the lockdowns, the relationship between these outcomes, and whether physical activity had any mediating effect on differences in HRQL and capability wellbeing. MethodsCross-sectional data were collected in May-December 2021 (Wave 1) and January-July 2022 (Wave 2). Children (aged 10-11) and their parent/carer were recruited from 23 and 27 schools in each wave respectively, and completed validated questionnaires measuring HRQL (adults - EQ-5D-5L, children - CHU9D), capability wellbeing (adults – ICECAP-A) and family financial strain (adults – Family Financial Strain Scale FESS). Children also completed questions on capability wellbeing. Weekday minutes of moderate-to-vigorous physical activity (MVPA) was measured using accelerometers. Mixed effects regression models, adjusted for gender, age group (adults only), IMD and highest household education, were used to explore differences in HRQL and capability wellbeing between waves. In addition, the moderating effect of financial strain, and the mediating effect of MVPA on HRQL and capability wellbeing were explored. ResultsActive-6 recruited 393 parent-child pairs in Wave 1 and 436 in Wave 2. There were no differences in HRQL (EQ-5D, CHU9D) and capability wellbeing (ICECAP-A) scores between waves, but financial strain was worse in Wave 2 compared to Wave 1 (FESS score difference 1.14 adjusted 95% CI 0.15 : 2.12). Increased financial strain was associated with lower (worse) EQ-5D-5L, CHU9D, and ICECAP-A scores. There was no evidence of a mediating effect of MVPA. Limitations and future workPre-COVID-19 data on HRQL was not collected, so analysis was limited to post-lockdown only. Participating parents were predominantly female and participation was lower among lower socio-economic groups, limiting our ability to explore inequalities. Intervention planning to increase physical activity and health and wellbeing during the COVID-19 recovery should consider the financial strain families are experiencing and the negative implications of financial strain on HRQL. ConclusionsThere were no differences in HRQL and capability wellbeing in children and adults after lockdowns lifted in 2021 and a year later in 2022. The results indicate increasing financial strain, which could reflect the UK’s ‘cost of living crisis’. Study registration The project was listed on the Research Registry (project 6646).Funding statementThis project was funded by the National Institute for Health and Care Research (NIHR) PHR programme and will be published in PHR Journal; Vol. XX, No. XX. See the NIHR Journals Library website for further project information.<br/