Impact of COVID-19 restrictions on preschool children’s eating, activity and sleep behaviours: a qualitative study

  1. Joanne Clarke
  2. Ruth Kipping
  3. Stephanie Chambers
  4. Kate Willis
  5. Hilary Taylor
  6. Rachel Brophy
  7. Kimberly Hannam
  8. Sharon Anne Simpson
  9. Rebecca Langford

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Abstract

In spring 2020, the first COVID-19 national lockdown placed unprecedented restrictions on the behaviour and movements of the UK population. Citizens were ordered to ‘stay at home’, only allowed to leave their houses to buy essential supplies, attend medical appointments or exercise once a day. We explored how lockdown and its subsequent easing changed young children’s everyday activities, eating and sleep habits to gain insight into the impact for health and well-being.

Design

In-depth qualitative interviews; data analysed using thematic analysis.

Setting

South West and West Midlands of England.

Participants

Twenty parents (16 mothers; 4 fathers) of preschool-age children (3–5 years) due to start school in September 2020. Forty per cent of the sample were from Black, Asian or minority ethnic backgrounds and half lived in the most deprived areas.

Results

Children’s activity, screen time, eating and sleep routines had been disrupted. Parents reported children ate more snacks, but families also spent more time preparing meals and eating together. Most parents reported a reduction in their children’s physical activity and an increase in screen time, which some linked to difficulties in getting their child to sleep. Parents sometimes expressed guilt about changes in activity, screen time and snacking over lockdown. Most felt these changes would be temporary, though others worried about re-establishing healthy routines.

Conclusions

Parents reported that lockdown negatively impacted on preschool children’s eating, activity and sleep routines. While some positive changes were identified, many participants described lack of routines, habits and boundaries which may have been detrimental for child health and development. Guidance and support for families during COVID-19 restrictions could be valuable to help maintain healthy activity, eating, screen time and sleeping routines to protect child health and ensure unhealthy habits are not adopted.

Article activity feed

  1. Version published to 10.1136/bmjopen-2021-051497
  2. ScreenIT

    SciScore for 10.1101/2020.12.01.20241612: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Sampled parents were emailed the participant information sheet (PIS) and consent form.
    IRB: Ethical considerations: Ethical approval was granted by University of Bristol Faculty of Health Sciences Research Ethics Committee (ref: 106002).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data were analysed thematically [18] using NVivo version 12 software (QSR International) to aid data management and analysis.
    NVivo
    suggested: (NVivo, RRID:SCR_014802)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: In-depth interviews enabled us to gain novel insights into the experiences of parents and pre-school children during lockdown and restrictions, although we acknowledge the limitation of investigating pre-school children’s experiences by asking their parents, rather than involving pre-school children directly. A strength of the study was in the ethnic and socioeconomic diversity of the sample from two regions of England, although this was a relatively educated sample (65% educated to degree level). In addition, we recognise that parents volunteering for interview may have had more interest in the topic or may have had different experiences to those that did not volunteer. Rigour was achieved by detailed data analysis and analytical decisions being shared with all team members to achieve credibility.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.12.01.20241612v1 on medRxiv