High School Sports During the COVID-19 Pandemic: The Effect of Sport Participation on the Health of Adolescents

  1. Timothy A. McGuine
  2. Kevin M. Biese
  3. Scott J. Hetzel
  4. Alison Schwarz
  5. Stephanie Kliethermes
  6. Claudia L. Reardon
  7. David R. Bell
  8. M. Alison Brooks
  9. Andrew M. Watson

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Abstract

During the fall of 2020, some high schools across the United States allowed their students to participate in interscholastic sports while others cancelled or postponed their sport programs due to concerns regarding COVID-19 transmission. What effect this has had on the physical and mental health of adolescents is unknown.

Objective

To identify the effect of playing a sport during the COVID-19 pandemic on the health of student-athletes.

Design

Cross-sectional study.

Setting

Sample recruited via email.

Patients or Other Participants

A total of 559 Wisconsin high school athletes (age = 15.7 ± 1.2 years, female = 43.6%, male = 56.4%) from 44 high schools completed an online survey in October 2020. A total of 171 (30.6%) athletes played (PLY) a fall sport, while 388 (69.4%) did not play (DNP).

Main Outcome Measure(s)

Demographic data included sex, grade, and sport(s) played. Assessments were the General Anxiety Disorder-7 Item for anxiety, Patient Health Questionnaire-9 Item for depression, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale for physical activity, and the Pediatric Quality of Life Inventory 4.0 for quality of life. Univariable comparisons between the 2 groups were made via t tests or χ2 tests. Means for each continuous outcome measure were compared between groups using analysis-of-variance models that controlled for age, sex, teaching method (virtual, hybrid, or in person), and the percentage of students eligible for free or reduced-price lunch.

Results

The PLY group participants were less likely to report moderate to severe symptoms of anxiety (PLY = 6.6%, DNP = 44.1%, P < .001) and depression (PLY = 18.2%, DNP = 40.4%, P < .001). They also demonstrated higher (better) Pediatric Functional Activity Brief Scale scores (PLY = 23.2 [95% CI = 22.0, 24.5], DNP = 16.4 [95% CI = 15.0, 17.8], P < .001) and higher (better) Pediatric Quality of Life Inventory total scores (PLY = 88.4 [95% CI = 85.9, 90.9], DNP = 79.6 [95% CI = 76.8, 82.4], P < .001).

Conclusions

Adolescents who played a sport during the COVID-19 pandemic described fewer symptoms of anxiety and depression and had better physical activity and quality-of-life scores compared with adolescent athletes who did not play a sport.

Article activity feed

  1. Version published to 10.4085/1062-6050-0121.21
  2. ScreenIT

    SciScore for 10.1101/2021.02.07.21251314: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the University of Wisconsin Health Sciences Institutional Review Board in September 2020.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variable33 Wisconsin high school athletes (male and female, grade: 9–12, age: 13-19) were recruited to participate in the study by completing an anonymous online survey in October 2020.

    Table 2: Resources

    No key resources detected.

    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:
    24,25 A limitation of the prior studies is the difficulty discerning if the health changes reported were primarily due to the restrictions on sport participation or the result of other factors such as sex, age, socioeconomic status or the lack of in-person school attendance. After controlling for grade, sex, school instructional delivery method and the % of students qualifying for free and reduced lunch, our findings demonstrate that athletes who did not play interscholastic sports experienced significantly worse symptoms of anxiety and depression, lower levels of physical activity and worse HRQoL compared to athletes who did not play sports in fall 2020. This suggests that the re-initiation of sport participation may result in significant improvements in mental and physical health for adolescents during the CoVID-19 pandemic. Mental Health: Athletes that played high school sports in the fall of 2020 demonstrated significantly lower symptoms of anxiety and depression than those athletes who did not play a sport. Specifically, athletes in the DNP group were more than 6 times as likely to report moderate to severe symptoms of anxiety and more than twice as likely to report moderate to severe symptoms of depression even after adjusting for age, sex, type of school instruction and % of the students qualifying for free and reduced lunch. This seems to suggest that while PLY athletes continue to demonstrate slightly higher levels of depression and anxiety than historical values, th...

    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

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  3. Version published to 10.1101/2021.02.07.21251314v1 on medRxiv