Social Determinants of Health and Distance Learning in Italy in the Era of the SARS-CoV-2 Pandemic.

OBJECTIVES: To investigate the experiences by distance learning (DL) method during the first wave of the SARS-CoV-2 pandemic in Italy, and to search for correlations with purported experiences and respective levels of social determinants of health (SDH). STUDY DESIGN AND METHODS: Cross-sectional online survey, investigating various SDH and parents' attitude towards DL, proposed 6 months after the beginning of the pandemic to a sample population of parents with school-aged children throughout Italy. RESULTS: A total of 3791 questionnaires were analyzed. Non-Italian parents complained more frequently of difficulties in providing support to their children in DL due to poor digital skills (p = 0.01), lack of good-quality digital equipment (p = 0.01), problems with the Italian language (p < 0.001), and a lower level of education (p < 0.001). When parents lived apart, greater difficulties in concentration in children using DL (p = 0.05) and a lower parental capacity to support DL (p = 0.002) were reported. Adequate digital structures appeared related to living in owned compared to rented property, higher levels of parental education, and better familial financial situations. CONCLUSIONS: Students from families with financial difficulties and low levels of parental education, or even those living in houses for rent or having separated parents, may be disadvantaged in an educational context since the introduction of DL.

Sleep disorders reveal distress among children and adolescents during the Covid-19 first wave: results of a large web-based Italian survey.

BACKGROUND: Measures to contain the Covid-19 pandemic led to significant lifestyle changes for children and adolescents mainly related to the closure of schools and recreational activities, reduced social interaction, and increased family concerns. METHODS: A cross-sectional online survey of 78 questions investigating social determinants of health, mood changes, symptoms of anxiety, increase in sleep disorders and unusual repetitive movements was offered to parents living in Italy with children ≤18 years; including families of children with disabilities, autism spectrum disorders, chronic diseases, and specific learning disabilities. The survey was conducted on the Qualtrics platform 6 months after the beginning of the pandemic and distributed in hospitals and paediatricians' waiting rooms as well as through social networks. The primary outcomes were the increase in sleep disorders among children and adolescents. Possible risk factors were investigated through multivariable regression. RESULTS: Six thousand two hundred ten volunteer parents responded to the questions concerning mood changes, sleep disorders and unusual repetitive movements, and were included in the present study. The majority were female (91.8%) and Italian (97.0%). 72.7% answered that their children had become more nervous, worried, or sad (80.2% in children with learning disabilities); 77.6% reported feelings of loneliness and 69.3% more difficulties in children falling asleep, 30.2% in staying asleep, and 18.7% an increase in nightmares and/or sleep terrors. Statistical analysis identified socioeconomic status, parent's job loss, food insecurity, family attitude toward the pandemic, and children's mood swing, feelings of loneliness, or missing outdoor activities, as major risk factors for sleep disorders. CONCLUSION: The first Covid-19 lockdown impacted children's and adolescents' health through an increase in sleep disorders. In the following phases of the pandemic, this evidence may be useful to investigate and treat these disorders as well as make decisions about containment health policies concerning this age group.

Parents' Perception of Food Insecurity and of Its Effects on Their Children in Italy Six Months after the COVID-19 Pandemic Outbreak.

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic and subsequent containment measures are causing an increase in food insecurity (FI) worldwide, with direct consequences on children's nutrition. We aimed to investigate the effects of the lockdown imposed in Italy on FI and changes in eating habits and body weight in the pediatric population 6 months after the beginning of the pandemic through a cross-sectional online survey proposed to parents of children <18 and living in Italy. Among 5811 respondents, most of whom were Italian, living in Northern Italy, and with a wealthy household economy, 8.3% reported that their families were at risk of FI before the appearance of SARS-CoV-2 and, alarmingly, this percentage increased to 16.2% after the pandemic began, with households from Southern Italy being more at risk. Moreover, 27.3% of the parents reported that their children were eating more; an increase in "junk food" consumption was also found; 31.8% of the respondents declared an increase in children's weight; weight loss prevailed among adolescents. Since the SARS-CoV-2 pandemic is again requiring restrictions, our findings might serve as a warning to politicians to promote healthy lifestyles and provide assistance to the groups in need.