Health-related quality of life and adherence to lifestyle recommendations in schoolchildren during the COVID-19 pandemic: results from the longitudinal cohort study Ciao Corona

Abstract

Objectives: Both lifestyle and health-related quality of life (HRQOL) were compromised during the COVID-19 pandemic. Our aim was to investigate changes in adherence to physical activity and screen time recommendations of children and adolescents throughout the pandemic, and their association with HRQOL over time. Methods: Longitudinal data in 1769 primary (grades 1-6) and secondary (7-9) school children ages 6-17 years was taken from the Ciao Corona study, a school-based prospective cohort study in Zurich, Switzerland, with 5 online questionnaires between June 2020 and July 2022. HRQOL was assessed using the KINDL questionnaire. Meeting physical activity and screen time recommendations was defined according to criteria of the world health organization. Results: Adherence to physical activity recommendations dropped in 2020, but had returned to approximately pre-pandemic levels by 2022. Fewer children met screen time recommendations in 2020 and 2021 than pre-pandemic. HRQOL reduced approximately 3 points between 2020 and 2022, and was on average 9.7 points higher (95% CI 3.0 - 16.3) in March 2021 in children who met both recommendations. Conclusions: Adherence to WHO guidelines on physical activity and screen time during the pandemic had a consistent association with HRQOL despite longitudinal changes in behavior.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study is part of Corona Immunitas research network, coordinated by the Swiss School of Public Health (SSPH+), and funded by fundraising of SSPH+ that includes funds of the Swiss Federal Office of Public Health and private funders (ethical guidelines for funding stated by SSPH+ will be respected), by funds of the Cantons of Switzerland (Vaud, Zurich, and Basel) and by institutional funds of the Universities. Additional funding, specific to this study, was available from the University of Zurich Foundation.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ciao Corona was approved by the ethical committee of the canton of Zurich (2020-01336) (ClinicalTrials.gov identifier: NCT04448717). All participants provided written informed consent before being enrolled in the study.

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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Data Availability

Upon study completion in 2023, de-identified and potentially aggregated participant data, together with required data dictionaries, will be available on reasonable request by email to the corresponding author. The purpose and methods of data analysis will be evaluated by the study team first to ensure that it complies with the ethics approval.

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