"Everything kind of revolves around technology": a qualitative exploration of families' screen use experiences, and intervention suggestions.

BACKGROUND: Managing children's screen time is challenging for most families. Interventions have had limited success in reducing screen time, potentially due to a lack of understanding of the experiences, needs and recommendations of families. This study aimed to 1) understand the screen time experiences of families, particularly during COVID-19 lockdowns; and 2) explore parent and child suggestions for the design, components, and content of a screen time management program. METHODS: Parents and children from 30 families living in Victoria, Australia completed a semi-structured interview (63 interviews) via Zoom in October-November 2021. Parents were maged 40.8 (± 8.9) years and predominantly female (90%). Children were maged 11.4 (± 2.4) years and 47% female. The interviews were audio recorded, transcribed verbatim and analysed using inductive thematic analysis combined with a summative content analysis approach. RESULTS: Three themes under Aim 1 emerged. Theme 1) 'Screen time management experiences and practices', including rules and strategies, challenges, and the impact of COVID-19 lockdowns. Theme 2) 'Impact of screens on family interaction and communication' including conflicts within the family, reduced face-to-face interactions, and negative impact on child's behaviour and wellbeing. Theme 3) 'Benefits of increased screen time due to COVID-19 lockdowns' including continuation of social interactions, extracurricular activities, improved technology skills and using screens as a 'babysitter'. Findings from Aim 2 suggest that families want a screen time management program delivered online to parents and children, which includes static and interactive content that incorporates health information, alternative activities, cyber-safety information, tips for goal setting and rewards, screen monitoring tools, links to reputable information, and parent social connections. Reminders via text message or through the online platform would help maintain engagement in the program. CONCLUSIONS: Families are experiencing challenges in managing the complex balance between the increased need for screens and the impact it has on the family. These findings provide valuable parent and child insights to assist in developing screen time management programs that are created with an understanding of the needs and challenges of families.

Socioecological correlates associated with muscle-strengthening exercise at home during COVID-19 among adolescents: The our life at home study.

This study examined adolescent muscle-strengthening exercise (MSE) participation at home and associated socioecological correlates during Australia's initial COVID-19 lockdown restrictions. Adolescents (N = 731, Mage = 16.3, SD = 1.2 years, 73% female) self-reported their MSE participation in February 2020 (pre-lockdown; at a gym or at home) and April/May (during lockdown; at home only as gyms were closed). They also reported a range of potential individual, family, and home environment correlates. Remoteness and area-level socioeconomic disadvantage were also considered. Logistic regression models examined potential correlates of participation in any MSE and MSE engagement ≥3 times/week during April/May. Fewer adolescents participated in MSE during April/May (48%) than February (54%), however, the proportions that engaged in MSE ≥3 times/week were the same (30%). Prioritising being active every day (OR = 2.43, 95% CI = 1.52, 3.90), being active with sibling/s ≥ 5 days/week (OR = 2.24, 95% CI = 1.00, 5.00) and access to weights at home (OR = 2.98, 95% CI = 1.94, 4.57) were associated with higher odds of any MSE participation at home during April/May. These variables were also positively associated with MSE participation at home ≥3 times/week. Understanding how to support adolescents to prioritise being active, engage in MSE with siblings, and provide equipment may assist adolescents to engage in home-based MSE.

Physical activity and active recreation before and during COVID-19: The Our Life at Home study.

OBJECTIVES: To examine the effects of COVID-19 related 'lockdown restrictions' on Australian's (5-75 years) physical activity recommendation achievement and active recreation participation. DESIGN: Cross-sectional online survey with self and proxy-report items (where the participant was a parent). METHODS: Adults (n = 1360) and adolescents (n = 1292) reported the frequency they performed 30- or 60-min of moderate-to-vigorous physical activity (MVPA), muscle-strengthening exercises, and participation in 11 active recreation behaviours in February 2020 (pre-COVID-19) and in April/May (during lockdown restrictions). Parents also proxy-reported activity for their child (n = 147, 5-12 years). Mixed effects logistic regressions or a logistic regression (with robust sandwich estimation for variance) assessed recall differences pre- and during lockdown, and interaction by sex. RESULTS: Compared to February, in April/May children were less likely to meet MVPA recommendations (OR = 0.27, 95%CI = 0.12-0.64); adolescents males, but not females, were less likely to meet MVPA (OR = 0.71, 95%CI 0.43, 1.17) and both recommendations (OR = 0.12, 95%CI = 0.02, 0.79); and adults were more likely to meet MVPA (OR = 1.26, 95%CI = 1.01, 1.57) but less likely to meet muscle-strengthening exercise recommendations (OR = 0.76, 9%CI = 0.65, 0.89). Across age groups more participants reported walking, muscle strengthening exercises at home, and yoga/Pilates/stretching at home, and fewer performed informal sport practice and play, and recreational activities. CONCLUSIONS: Lockdown restrictions had different effects on physical activity and active recreation among age groups and by sex. Physical activity promotion strategies that target children and adolescents, at home physical activity options, active neighbourhoods, and (re)engagement in informal sport and recreational activities post-COVID-19 are critical for (re)engaging Australians in health-enhancing behaviours.

Changes in Families' Leisure, Educational/Work and Social Screen Time Behaviours before and during COVID-19 in Australia: Findings from the Our Life at Home Study.

This study aimed to understand differences in leisure, educational/work and social screen time behaviours experienced by parents and children due to COVID-19 lockdown restrictions, which may inform behaviour change strategies and policy in the transition to a COVID-normal life. Participants in the "Our Life at Home" study (n = 218 parents from Australia, 43.4 ± 6.8 years, 88% female) completed a cross-sectional online survey in April/May 2020. Parents recalled their own and their child (8.7 ± 2.0 years, 42% female) or adolescents (15.0 ± 1.5 years, 50% female) participation in nine screen time behaviours in the past month (during lockdown) and retrospectively for February 2020 (pre-lockdown), providing data on 436 individuals. Screen time behaviours included leisure (computer/laptop and tablet/smartphone for leisure, TV/videos/DVDs and game consoles); education/work (computer/laptop and tablet/smartphone for work/education); and social screen time (computer/tablet/smartphone for social communication with friends, family and work (parents only)). Wilcoxon signed-rank tests and effect sizes (r) compared the time spent in each behaviour pre-lockdown and during lockdown. Large differences were observed in social (parents: r = 0.41-0.57; children: r = 0.55-0.65; adolescents: r = 0.28-0.43) and education (children: r = 0.50-0.65 and adolescents: r = 0.25-0.37) behaviours. There were small or no differences in leisure time screen use. COVID-19 lockdown restrictions have impacted parent's and children's screen time, and future research and policy should consider strategies to support families to manage screen time.

The Use of Digital Platforms for Adults' and Adolescents' Physical Activity During the COVID-19 Pandemic (Our Life at Home): Survey Study.

BACKGROUND: Government responses to managing the COVID-19 pandemic may have impacted the way individuals were able to engage in physical activity. Digital platforms are a promising way to support physical activity levels and may have provided an alternative for people to maintain their activity while at home. OBJECTIVE: This study aimed to examine associations between the use of digital platforms and adherence to the physical activity guidelines among Australian adults and adolescents during the COVID-19 stay-at-home restrictions in April and May 2020. METHODS: A national online survey was distributed in May 2020. Participants included 1188 adults (mean age 37.4 years, SD 15.1; 980/1188, 82.5% female) and 963 adolescents (mean age 16.2 years, SD 1.2; 685/963, 71.1% female). Participants reported demographic characteristics, use of digital platforms for physical activity over the previous month, and adherence to moderate- to vigorous-intensity physical activity (MVPA) and muscle-strengthening exercise (MSE) guidelines. Multilevel logistic regression models examined differences in guideline adherence between those who used digital platforms (ie, users) to support their physical activity compared to those who did not (ie, nonusers). RESULTS: Digital platforms include streaming services for exercise (eg, YouTube, Instagram, and Facebook); subscriber fitness programs, via an app or online (eg, Centr and MyFitnessPal); facilitated online live or recorded classes, via platforms such as Zoom (eg, dance, sport training, and fitness class); sport- or activity-specific apps designed by sporting organizations for participants to keep up their skills (eg, TeamBuildr); active electronic games (eg, Xbox Kinect); and/or online or digital training or racing platforms (eg, Zwift, FullGaz, and Rouvy). Overall, 39.5% (469/1188) of adults and 26.5% (255/963) of adolescents reported using digital platforms for physical activity. Among adults, MVPA (odds ratio [OR] 2.0, 95% CI 1.5-2.7), MSE (OR 3.3, 95% CI 2.5-4.5), and combined (OR 2.7, 95% CI 2.0-3.8) guideline adherence were higher among digital platform users relative to nonusers. Adolescents' MVPA (OR 2.4, 95% CI 1.3-4.3), MSE (OR 3.1, 95% CI 2.1-4.4), and combined (OR 4.3, 95% CI 2.1-9.0) guideline adherence were also higher among users of digital platforms relative to nonusers. CONCLUSIONS: Digital platform users were more likely than nonusers to meet MVPA and MSE guidelines during the COVID-19 stay-at-home restrictions in April and May 2020. Digital platforms may play a critical role in helping to support physical activity engagement when access to facilities or opportunities for physical activity outside the home are restricted.