Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries

Background: The 2020 COVID-19 pandemic has placed unprecedented restrictions on children’s ability to participate in adequate movement behaviours. This international longitudinal study compared young children’s physical activity, sedentary behaviour and sleep behaviours before and during the COVID-19 pandemic. Methods: : Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in physical activity, sedentary behaviour (screen-time) and sleep and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). PA, sedentary screen time (SST) and sleep were assessed via parent questionnaire. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Results: : 948 parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (AdjOR=2.0, 95%CI 1.0 to 3.8) and SST (2.2, CI 1.2 to 3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO recommendations (AdjOR 3.3, CI 1.1 to 9.8) than those who were not. Children of caregivers with higher compared to lower stress were less likely to meet all three guidelines (0.5, CI 0.3 to 0.9). Conclusion: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting caregivers’ mental health are important prevention strategies.