Regional differences in movement behaviours of children and youth during the second wave of the COVID-19 pandemic in Canada: follow-up from a national study.

OBJECTIVES: Public health restrictions varied by region during the COVID-19 pandemic and reduced opportunities for children to be physically active. The purpose of this study was to assess regional differences in movement behaviours of Canadian children and youth during the second wave of the COVID-19 pandemic. METHODS: A national sample of Canadian parents (n=1568; 58% women) of children and youth (5-17 years of age) completed an online survey. Participants were classified based on region of residence (British Columbia, Prairies, Ontario, Quebec, or Atlantic Canada). Differences in movement and play behaviours (physical activity, outdoor play, sleep, screen time) between children and youth living in different regions were examined. RESULTS: Compared to children and youth in Quebec (the region with the highest COVID-19 prevalence), children and youth in the Prairies (F(1,1563)=9.0, p=0.01) and Atlantic Canada (F(1,1563)=17.1, p<0.001) participated in more moderate-to-vigorous physical activity (MVPA). Compared to Quebec, living in Atlantic Canada increased the odds of meeting the MVPA guideline (odds ratio (OR)=2.1, p=0.02), living in Ontario decreased the odds of meeting the sleep guideline (OR=0.6, p=0.01), and living in Ontario (OR=0.7, p=0.04) or Atlantic Canada (OR=0.6, p=0.049) decreased the odds of meeting the screen time guideline. Children and youth in Atlantic Canada demonstrated smaller declines in outdoor play than their counterparts in Quebec. CONCLUSION: Movement and play behaviours varied between regions of Canada where the highest COVID-19 prevalence corresponded to lower odds of meeting the physical activity guidelines. Low compliance with 24-hour movement guidelines suggests that regional pandemic recovery plans need to prioritize opportunities for healthy movement.

RéSUMé: OBJECTIFS: Les restrictions sanitaires ont varié d'une région à l'autre durant la pandémie de COVID-19, et elles ont réduit les possibilités pour les enfants d'être actifs. Notre étude visait à évaluer les différences régionales dans les comportements liés au mouvement des enfants et des jeunes canadiens au cours de la deuxième vague de la pandémie. MéTHODE: Un échantillon national de parents canadiens (n = 1 568; 58 % de femmes) d'enfants et de jeunes (5­17 ans) ont répondu à un sondage en ligne. Les participants ont été classés selon leur région de résidence (Colombie-Britannique, Prairies, Ontario, Québec ou Canada atlantique). Les différences dans les comportements liés au mouvement et au jeu (activité physique, jeu à l'extérieur, sommeil, temps d'écran) entre les enfants et les jeunes de différentes régions ont été examinées. RéSULTATS: Comparativement aux enfants et aux jeunes du Québec (la région qui présentait la plus forte prévalence de COVID-19), les enfants et les jeunes des Prairies (F(1,1563) = 9,0, p = 0,01) et du Canada atlantique (F(1,1563) = 17,1, p < 0,001) ont fait plus d'activité physique modérée à vigoureuse (APMV). Comparativement au Québec, le fait de vivre au Canada atlantique a accru la probabilité de respecter les lignes directrices sur l'APMV (rapport de cotes (RC) = 2,1, p = 0,02), le fait de vivre en Ontario a réduit la probabilité de respecter les lignes directrices sur le sommeil (RC = 0,6, p = 0,01), et le fait de vivre en Ontario (RC = 0,7, p = 0,04) ou au Canada atlantique (RC = 0,6, p = 0,049) a réduit la probabilité de respecter les lignes directrices sur le temps d'écran. Les enfants et les jeunes du Canada atlantique ont présenté des baisses moins importantes du jeu à l'extérieur que les enfants et les jeunes du Québec. CONCLUSION: Les comportements liés au mouvement et au jeu ont varié d'une région à l'autre du Canada; là où la prévalence de la COVID-19 était la plus élevée, la probabilité de respecter les lignes directrices sur l'activité physique était la plus faible. La faible conformité aux lignes directrices sur le mouvement sur une période de 24 heures donne à penser que les plans de rétablissement régionaux après la pandémie devront accorder la priorité aux possibilités de mouvement sain.

The Impact of an After-School Physical Activity Program on Children's Physical Activity and Well-Being during the COVID-19 Pandemic: A Mixed-Methods Evaluation Study.

INTRODUCTION: This study evaluated the impact of the Build Our Kids' Success (BOKS) after-school program on children's physical activity (PA) and well-being during the COVID-19 pandemic. METHODS: Program leaders, children, and their parents were recruited from after-school programs in Nova Scotia, Canada, that delivered BOKS programming in Fall 2020. After participating, Grade 4-6 children (n = 14) completed the Physical Literacy Assessment for Youth Self (PLAYself), Physical Activity Questionnaire for Older Children (PAQ-C), the Physical Activity Enjoyment Scale (PACES), and 5 National Institutes of Health (NIH) Patient-Reported Outcomes Measures Information System (PROMIS) scales. Children (n = 7), parents (n = 5), and program leaders (n = 3) completed interviews, which were analyzed for themes inductively. RESULTS: The average PAQ-C score was 2.70 ± 0.48, PLAYself was 68.23 ± 13.12, and PACES was 4.22 ± 0.59 (mean ± SD). NIH PROMIS scores were below standard means (cognitive function, family relationships) or within normal limits (peer relationships, positive affect, and life satisfaction). A thematic analysis of interviews revealed that children's PA levels were impacted by the pandemic and that BOKS positively impacted children's physical well-being and integrated well with school-based activities. CONCLUSIONS: Participation in BOKS provided an overall positive experience and may have mitigated COVID-19-related declines in PA in well-being. The results of this evaluation can inform future physically-active after-school programming.

Barriers to and strategies to address COVID-19 testing hesitancy: a rapid scoping review.

BACKGROUND: Testing is a foundational component of any COVID-19 management strategy; however, emerging evidence suggests that barriers and hesitancy to COVID-19 testing may affect uptake or participation and often these are multiple and intersecting factors that may vary across population groups. To this end, Health Canada's COVID-19 Testing and Screening Expert Advisory Panel commissioned this rapid review in January 2021 to explore the available evidence in this area. The aim of this rapid review was to identify barriers to COVID-19 testing and strategies used to mitigate these barriers. METHODS: Searches (completed January 8, 2021) were conducted in MEDLINE, Scopus, medRxiv/bioRxiv, Cochrane and online grey literature sources to identify publications that described barriers and strategies related to COVID-19 testing. RESULTS: From 1294 academic and 97 grey literature search results, 31 academic and 31 grey literature sources were included. Data were extracted from the relevant papers. The most cited barriers were cost of testing; low health literacy; low trust in the healthcare system; availability and accessibility of testing sites; and stigma and consequences of testing positive. Strategies to mitigate barriers to COVID-19 testing included: free testing; promoting awareness of importance to testing; presenting various testing options and types of testing centres (i.e., drive-thru, walk-up, home testing); providing transportation to testing centres; and offering support for self-isolation (e.g., salary support or housing). CONCLUSION: Various barriers to COVID-19 testing and strategies for mitigating these barriers were identified. Further research to test the efficacy of these strategies is needed to better support testing for COVID-19 by addressing testing hesitancy as part of the broader COVID-19 public health response.

The Effect of an After-School Physical Activity Program on Children's Cognitive, Social, and Emotional Health during the COVID-19 Pandemic in Nova Scotia.

Children's physical activity participation declined during the COVID-19 pandemic, and these negative changes could lead to longer-term impacts on children's cognitive, social, and emotional health. PURPOSE: To determine parent/caregivers' perceptions of their children's cognitive function, peer and family relationships, life satisfaction, physical activity, sleep, positive affect, and global health, before and after participating in the Build Our Kids' Success (BOKS) programming at after-school programs in Fall 2020. METHODS: Parents of children participating in the BOKS programming at after-school programs in Nova Scotia, Canada, were recruited. At baseline, 159 parents completed the National Institutes of Health (NIH) Patient-Reported Outcomes Measures Information System (PROMIS) parent-proxy questionnaire, and 75 parents completed the measures at follow-up. Independent t-tests were used to determine if there were differences between baseline and follow-up Parent Proxy Questionnaire data. RESULTS: All NIH PROMIS outcome variables at baseline and follow-up were within normal limits (Adjusted T-Scores: 46.67 ± 7.15 to 50.04 ± 7.13). There were no significant differences in life satisfaction (t(188) = -1.05, p = 0.30), family relationships (t(189) = 0.31, p = 0.76), cognitive function (t(199) = -1.16, p = 0.25), peer relationships (t(192) = -1.86, p = 0.06), positive affect (t(195) = 0.25, p = 0.81), global health (t(216) = -0.43, p = 0.67), physical activity (t(202) = 0.787, p = 0.732), sleep disturbance (t(193) = 1.72, p = 0.087), or psychological stress (t(196) = 1.896, p = 0.059), from baseline to follow-up. CONCLUSIONS: Parent-proxy questionnaires suggested that the BOKS programming had a protective effect on children's health behaviours and cognitive, social, and emotional health as values remained within normal limits and were not impacted by the public health restrictions during the second wave of the COVID-19 pandemic in Nova Scotia.

The Effects of the COVID-19 Pandemic on Health and Well-Being of Children and Youth in Nova Scotia: Youth and Parent Perspectives.

Objectives: The COVID-19 pandemic led to school closures, cancellations of major events, and loss of in-person social interactions for children and youth. These restrictions undoubtedly impacted the lives of children and youth. This study describes the well-being of children and youth in Nova Scotia during the COVID-19 pandemic and their thoughts and feelings about the return to school, from the perspectives of both youth and parents. Methods: A province-wide survey was conducted in August 2020 with parents of school-age children and youth and youth to measure youth well-being since the pandemic began. Results: Parents of children and youth in grades pre-primary to 12 (n = 699; 53% girls) and youth in grades 3-12 (n = 279; 69% girls) completed the online survey. Perceptions of parents about children's emotions during the pandemic were: bored, safe, lonely, happy, and anxious. Youth reported feeling bored, relaxed, depressed, safe, and worried. Sixty-three percent of youth and 72% of parents reported that they/their child felt they were missing important life events. Parents reported that being with parents, being physically active and being with friends made their child feel positive. Youth reported that being with friends, pets and watching TV made them feel good during this time. Seventy-six percent of parents and 62% of youth reported they/their child were getting more screen time than before the pandemic. With schools closed, participants most frequently shared that they missed friends and social interactions, in-person learning, and extra-curricular activities. Youth and parents expressed worries about COVID-19 outbreaks and related restrictions when schools re-opened to in-person learning. Conclusion: The well-being of children and youth in Nova Scotia was greatly impacted by the COVID-19 pandemic and related school closures in 2020. It is essential that pandemic recovery plans prioritize the health and well-being of children and youth.

Fare well to Nova Scotia? Public health investments remain chronically underfunded.

Inspired by Fiset-Laniel et al.'s (2020) article entitled "Public health investments: neglect or wilful omission? Historical trends in Quebec and implications for Canada", we assessed public health investments since the establishment of the Nova Scotia provincial health authority in 2015. We analyzed Nova Scotia Department of Health and Wellness budgets from 2015-2016 to 2019-2020 and observed that less than 1% of funding was budgeted for public health annually, an amount well below the recommendation that 5-6% of healthcare funding be spent on public health. Healthcare spending has increased annually since 2015-2016, but proportions of funding to different programs and services have remained static. Specifically, we did not observe a change in investment in public health over time, suggesting that while the government does not necessarily spend too much or too little on healthcare, it spends far too little on public health. This chronic under-funding is problematic given the high rates of non-communicable diseases in Nova Scotia and health inequities experienced within the population. The 2020 COVID-19 pandemic has highlighted the importance of public health work, and the need for a pandemic recovery plan that prioritizes investment in all areas of public health in Nova Scotia.

RéSUMé: Inspirés par l'article de Fiset-Laniel et coll. (2020) intitulé « Public health investments: neglect or wilful omission? Historical trends in Quebec and implications for Canada ¼, nous avons évalué les investissements en santé publique depuis la fondation de l'autorité sanitaire provinciale de la Nouvelle-Écosse en 2015. Nous avons analysé les budgets du ministère de la Santé et du Mieux-Être de la Nouvelle-Écosse de 2015−2016 à 2019−2020 et nous avons observé que moins de 1 % du financement était prévu pour la santé publique annuellement, un montant bien inférieur à la recommandation que 5−6 % du financement pour les soins de santé soit dépensé sur la santé publique. Les dépenses de santé ont augmenté annuellement depuis 2015−2016, mais les proportions du financement consacrés à différents programmes et services ont demeuré statiques. Spécifiquement, nous n'avons pas observé de changement dans l'investissement en santé publique au fil du temps, indiquant que tandis que le gouvernement ne dépense pas nécessairement trop ou trop peu sur les soins de santé, il dépense bien trop peu sur la santé publique. Ce sous-financement chronique est problématique étant donné les hauts taux de maladies non transmissibles en Nouvelle-Écosse et les inégalités en matière de santé qui existent au sein de la population. La pandémie de la COVID-19 de 2020 a souligné l'importance du travail lié à la santé publique, ainsi que la nécessité d'un plan de rétablissement suite à une pandémie qui priorise l'investissement dans tous les domaines de santé publique en Nouvelle-Écosse.