Trends in and relations between children’s health-related behaviors pre-, mid- and post-Covid

BACKGROUND: Covid-19 has had a major negative impact on children's engagement in health-related behaviors. This study examines trends in children's screen time, outdoor play and sports club membership in pre- (2016-19), mid- (2020-21) and post- (2021-22) Covid years. Also, predicting factors (gender, age and active commuting) of these health-related behaviors are examined. METHODS: Data were collected via yearly self-report questionnaires among pupils in Grades 3-6 (mean age 10.14 ± 1.25 years; total n over the five cohorts = 6351, 50.8% girls). Multilevel path models were constructed in Mplus to examine whether children's screen time, outdoor play and sports club membership differed between pre-, mid- and post-Covid years; and which factors predicted engagement in these health-related behaviors (using data of all cohorts). RESULTS: During and after Covid-19, children's screen time was higher, while they engaged less in outdoor play and were less often member of a sports club than before. Although these negative trends peaked during Covid-19, they slowly seem to be returning to pre-Covid levels in recent year. Younger children, girls and active commuters had less minutes screen time per day and played outdoors more days per week; boys and active commuters were more often sports club member. CONCLUSIONS: Although in the first year post-Covid children seem to be engaging more in health-related behaviors than during Covid-19, we still found lower levels of engagement than in the years before Covid-19, underlining the importance of early intervention to ensure an appropriate amount of engagement in health-related behaviors for all children.