The purpose of this study was to assess the immediate changes in physical activity, play, sedentary behaviours, leisure screen time, and sleep in school-aged children and youth across Canada during the initial period of the COVID-19 crisis. We found that children and youth were less active, played outside less, were more sedentary, engaged in more recreational screen-based activities, and slept more during the initial COVID-19 virus outbreak compared with before the restrictions. We observed commonly found gender and age group related differences [22]. In general, girls were less active than boys and youth (12–17 years) were less active than children (5–11 years). Girls engaged in more social media use and slept more than boys. The largest reported change in behaviours related to leisure screen-based activities, where children and youth were watching upwards of 6.5 h per day. On average, younger children experienced less change from their pre-COVID-19 movement behaviours compared with older children. These findings are the first to confirm speculations that pandemic-related restrictions are unfavourably related to movement behaviours of children and youth [13, 23]. This observation has triangulated support from quantitative (descriptive and correlational) and qualitative (contextual) evidence.
The prevalence of children and youth meeting the Canadian 24-Hour Movement Behaviour Guidelines [3] was much lower in this sample (2.6%, Table 2) compared to other national samples collected before the COVID-19 outbreak. For example, based on similar data collection methods, Rhodes et al. (2019) reported 12.7% of Canadian 5–17 year-olds met the guideline [5]. Using more robust measures, including accelerometer-measured physical activity, Carson et al. (2017) reported 17.1% Canadian children and youth (5–17 years) met the overall guidelines [1]. An international sample of 9–11 year-old children from 12 countries reported an average of 7.2% (Canada 14.0%) meeting the guidelines in 2016 before the COVID-19 virus outbreak [24]. These comparisons suggest a dramatic reduction in the proportion of Canadian children and youth meeting these guidelines during the COVID-19 outbreak.
The reported reduction in outdoor play may contribute to or even exacerbate the decline reported in physical activity. Correlations between moderate-to-vigorous (r = 0.34; p < 0.01) and light physical activity (r = 0.28; p < 0.01) and changes in outdoor time supports this point. Spending time outdoors is associated with greater physical activity, less sedentary time, improved sleep, and a number of other benefits (e.g., mental health, immune function) [6, 7]. Active play indoors does not seem to replace active play outdoors resulting in a net decline in reported play-based activity. To prevent the unintended unhealthy behaviour consequences of COVID-19 restrictions and ‘stay home’ advice, health promotion messaging needs to be balanced with disease prevention messaging [25]. With attentive and responsible spatial and temporal distancing a healthy marriage of “stay home” and “get outside and play” is achievable.
We identified several factors that helped to support physical activity, outdoor play, and sleep, and reduce time spent in screen-based and other sedentary behaviours. This highlights that the impact of the pandemic has not been uniform for all Canadian children and youth. Living in a detached house, being a younger parent, and owning a dog were all favourably associated with healthy movement behaviours. Children living in a house versus an apartment may have easier access to front or back yards for outdoor play and physical activity [26]. The largest associations were noted with parental encouragement for and engagement in healthy movement behaviours. Similar to previous research [5, 19, 27], we found that parent support was a key correlate of children and youth movement behaviours. The most significant relationship was parental co-participation [27]. Although parents and their children are undoubtedly experiencing higher stress during the COVID-19 outbreak [28], promoting physical activity and outdoor play by targeting co-participation, while respecting public health restrictions, may be one strategy to enhance health behaviours of children and youth [28, 29]. The associations observed with parental age are consistent with typical age-related declines in physical activity [29]. Finally, families who had a dog had higher physical activity and outdoor time. A recent systematic review also showed that dog-related interventions increased physical activity [30].
There are emerging calls bringing attention to the likely impact of the global pandemic on the movement behaviours of adults, children and youth [31, 32]. Our findings describe some of the ways Canadian parents are adapting to this challenge. In the open-ended questions, respondents of this survey identified several creative ways that they were using their leisure-time to develop or renew new family hobbies. Families are reconnecting through leisure, though primarily sedentary leisure activities. Carving out time for family leisure and starting new hobbies and activities may be helpful strategies to reduce the mental health challenges (e.g., depression, anxiety) that are being exacerbated by lockdown conditions [33, 34]. Where possible, families should consider substituting sedentary leisure for more active leisure pursuits. A recent review of reviews demonstrated that increased physical activity was associated with decreased depressive symptoms in children and youth [35] and suggested that physical activity should be included in interventions to reduce the public health burden of mental illness. Many children and their families may characterize the COVID-19 virus outbreak and lockdown as traumatic [36]. Adopting healthy movement behaviours may help to mitigate the negative effects on children and youth of this pandemic [13].
Acknowledging the challenges in meeting movement behaviour guidelines and based on the advice of parents surveyed in this study, we recommend that:
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Parents continue to be creative in their home-based leisure activities and support and encourage their children to play and be active in innovative and safe ways. Suggestions include co-participation in activities, trying new leisure hobbies, using online health and/or physical activity apps, and getting outdoors as much as possible (while following public health requirements). It is recommended that children and youth aim to accumulate 60 min per day of moderate-to-vigorous physical activity and play outdoors regularly [3, 4, 6, 7].
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Parents continue to set routines for their children, including supervised time for screens, regular sleep and wake times, and time for quality family time. Limit leisure screen time to 2 h per day and swap screen time for play time wherever possible [3, 4].
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Public health officials support parents by implementing safe physical distancing measures that provide extra space for everyone to walk, cycle, wheel, and scoot. This could include temporary reallocation of roadway space and keeping expansive green spaces open.
Strengths, limitations, and future directions
Given that the evidence on the effect of the COVID-19 virus outbreak on children’s health-related behaviours is scarce, this study has many of strengths. First, the sample was a nationally representative cohort of over 1500 parents of school-aged children and youth. Second, we assessed parental-related factors to determine associations between parental behaviours (e.g., co-play) and child and youth behaviours. Our study was limited by its cross-sectional design although given our aim this approach was appropriate. The parent-report nature of the study and the possibility of social desirability and/or recall bias may affect our findings. While we were able to assess associations between parent work status and child movement and play behaviours, we did not have data to indicate whether or not parents were working from home or had lost their job as a result of the pandemic. Further, sampled parents represented the geographic, cultural, and socioeconomic make up of Canada, however it should be noted that parents received a small financial incentive for participation in each survey (up to $3.00). Results may not generalize to other countries. Future studies should evaluate the longer-term consequences of the COVID-19 virus outbreak and recovery on the movement behaviours of children and youth. To develop targeted health promotion strategies [25], it would be useful to identify province-specific or geographic differences influencing health behaviours of children and youth.