Parent decision-making regarding youth sport participation during the COVID-19 pandemic.

PURPOSE: To describe youth sport participation behaviors during the COVID-19 pandemic as reported by parents of youth sport athletes, to examine the association of family demographics with the likelihood of children resuming sports, and to qualitatively report the factors influencing parental decision-making regarding youth sport participation during the COVID-19 pandemic. METHODS: A national sample of parents of youth athletes from across the United States (n=236, age: 39.2±8.1 years, 57.2% female) were recruited to complete an online questionnaire by Qualtrics Online Samples (Qualtrics, Provo, UT) using a combination of actively managed, double-opt-in market research panels. The questionnaire focused on changes in child sport participation and family finances as a result of COVID-19 and included both close-ended and open-ended questions. RESULTS: Most parents (63.1%) reported the time their children spent participating in organized youth sports had decreased because of the COVID-19 pandemic. Three-quarters of parents (75.5%) reported that it was likely that their children would fully resume participating in organized youth sports within the next year. Parents whose financial situation was worsened by COVID-19 were less likely to report that their children would resume sports in the upcoming year. Three domains related to parental decision-making emerged from the open-ended responses: safety, fear, and normalcy. CONCLUSIONS: Understanding the factors influencing changes in youth sport participation during the pandemic can allow systems to implement strategies for safe participation in youth sport and physical activity among children. Encouraging participation in outdoor sports with appropriate safety precautions such as masking, social distancing, and hygiene may reduce fear of participation among parents.

COVID-19 Outbreaks Associated With Youth Club Sports: Maricopa County, Arizona, September-November 2020.

The Maricopa County Department of Public Health in Arizona investigated three COVID-19 outbreaks associated with club sports, two in tournaments and one in a hockey league. During September through November 2020, 195 team-associated and 69 secondary household contact cases were identified among 2093 athletes, coaches, and staff members; the team attack rate ranged from 6% to 72%. Outbreaks occurred during high community transmission periods in Maricopa County. Identification of contacts and characterization of prevention strategies were challenging because of limited cooperation from athletes, families, and staff. (Am J Public Health. 2022;112(2):216-219. https://doi.org/10.2105/AJPH.2021.306579).

Timeout? The Epidemiology of Pediatric Sports Injuries During the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic resulted in closure of schools and playgrounds while requiring social distancing, changes that likely affected youth sports participation. The purpose of this study was to identify changes in the epidemiology of pediatric sports injuries during the COVID-19 pandemic. METHODS: This retrospective cohort study included patients between the ages of 4 and 18 years who presented to orthopaedic clinics within a single children's hospital network with an acute injury sustained during athletic activity between March 20, 2020, and June 3, 2020 (the strictest period of state-level shelter-in-place orders). These patients were compared with those within the same dates in 2018 and 2019. Chi square and Mann-Whitney U tests were used, as appropriate. RESULTS: Significantly less sports injuries were seen during the pandemic (n = 257) compared with the same dates in 2018 (n = 483) and 2019 (n = 444) despite more providers available in 2020 (P < 0.001). During the pandemic, patients with sports injuries were younger (median age 11 versus 13 years, P < 0.001) and had less delay in presentation (median 5 versus 11 days, P < 0.001). A higher proportion were White (66.9% versus 47.7%, P < 0.001), privately insured (63.4% versus 48.3%, P < 0.001), and seen at a nonurban location (63.4% versus 50.2%, P < 0.001). Most sports injuries during the pandemic were fractures (83.7%). Although 71.4% of all injuries in the prepandemic period occurred in the context of formal sports, only 15.2% were sustained in a formal athletic context in 2020 (P < 0.001). The frequency of surgical treatment was higher during the pandemic (14.8% versus 7.8%, P = 0.001), mainly because most of these injuries were fractures requiring surgical intervention. CONCLUSIONS: Fewer sports injuries were seen in the outpatient setting during the COVID-19 pandemic, and most of these injuries were fractures and occurred outside of organized sports settings. Patients were more likely to be White, privately insured, and seen at a nonurban location.

Growth, Somatic Maturation, and Their Impact on Physical Health and Sports Performance: An Editorial.

Over time, complex interactions and a nonlinear progression among a wide range of variables contribute to the improvement of physical health and of the elite level achievement in youth sport practitioners [...].

Promoting an Emergency Action Plan for Sudden Cardiac Arrest in Youth Sports During a Pandemic.

INTRODUCTION: Pandemic-related restrictions increased the risk of delayed emergency response of bystanders to sudden cardiac arrest among youth athletes. Education and SCA emergency preparedness, implemented by nurse leaders and adapted to environmental changes, can greatly reduce the risks associated with an SCA episode. METHOD: A nurse-led, quality improvement pilot project was implemented in a recreational youth soccer league. The project included the implementation of an emergency action plan (EAP; with or without the pandemic and social-distancing restrictions) for bystanders responding to SCA. RESULTS: Participants showed significant improvement in knowledge and perceptions of SCA and emergency response (p < .001). Willingness to initiate cardiopulmonary resuscitation (CPR) improved (p = .127), and fear to engage in EAP decreased (p = .119) following an educational intervention on SCA. DISCUSSION: Nurse-led SCA education and implementation of youth league EAP successfully demonstrated safety in SCA preparedness and best practice recommendations for youth sports from the Interassociation Task Force.

COVID-19 and Youth Sports: What Are the Risks of Getting Back on the Field Too Quickly?

The widespread shutdown in response to the coronavirus disease 2019 (COVID-19) pandemic, although varied across state and county levels, has undoubtedly impacted everyone to some degree. Within the pediatric population, the closure of schools and organized youth athletic programs has resulted in a unique situation that has made athletes physically deconditioned and at risk for injury. As sports and competition gradually restart, there are considerable risks to the skeletally immature athlete. The anatomic and physiologic changes that occur to bone and cartilage during growth make the young athlete particularly susceptible to both acute and overuse injuries. In the context of the pandemic, deconditioning, obesity, lack of variety, and the resultant mental health burden pose unique challenges in ensuring that young athletes safely return to the field. This review aims to identify risk factors for sport-related injuries and to outline strategies for minimizing these injuries as pediatric patients return-to-play after COVID-19. [Pediatr Ann. 2021;50(11):e465-e469.].

Lessons Learned from COVID-19: The Youth Sports World Going Forward.

The coronavirus disease 2019 pandemic profoundly impacted athletes and organizations of all ages and calibers. As optimism grows and restrictions lift, the mindset of youth sports shifts to prospection. Using the lessons learned during the cancelled, postponed, or modified 2020-2021 season, stakeholders should envision a different playing field moving forward. The void of youth sports highlighted the many values it brings to athletes physically, mentally, and socially. The regionality of sport during the pandemic highlighted resource and funding disparities among communities. Consideration must be given to the overall health of the student-athlete and how to return to competition and spectatorship safely and responsibly. The pandemic required youth sport to collaborate with public health with the hope of creating a semblance of normalcy in upcoming seasons. [Pediatr Ann. 2021;50(11):e470-e473.].

Current Recommendations on Returning to Youth Sports After COVID-19 Infection.

Children represent a small fraction of total cumulative cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The potential health consequences related to infection for children are not inconsequential. For example, some may develop multisystem inflammatory syndrome in children, which is commonly associated with cardiovascular involvement. Nevertheless, the short- and long-term effects of SARS-CoV-2 infection remain unknown. In particular, the impact on physical health and how it affects one's ability to return to physical activity are continuously evolving. As more youth sports organizations are lifting restrictions, the volume of youth athletes will increase and the demand for providing medical clearance will grow. This article aims to provide a review of return to physical activity guidelines for young athletes post-SARS-CoV-2 infection based on expert consensus statements and professional organization recommendations. [Pediatr Ann. 2021;50(11):e461-e464.].

Viral Diseases and Youth Sports: How to Handle Common Infections that Sideline Athletes.

The coronavirus disease 2019 (COVID-19) pandemic has brought to forefront the large morbidity, mortality, and complications that viral illnesses can cause. For athletes, viral illnesses can be disruptive toward their participation in youth sports. This article outlines the details of how the most common viral illnesses affect the youth athlete and youth sports, including COVID-19, non-COVID-19 upper respiratory infections, influenza, Epstein-Barr virus, varicella, herpes, and other dermatologic infections. In this article, we review current available guidelines and recommendations on how to handle these infections in athletes during sports as well as return-to-play recommendations. [Pediatr Ann. 2021;50(11):e454-e460.].

The COVID-19 Pandemic Upended Youth Sports.

The American Academy of Pediatrics estimates that approximately 35 to 45 million young people age 6 to 18 years participate in some type of athletics every year. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic interrupted youth sports and left many children unable to train in-person with teammates and coaches. Given the large impact sports and physical activity have on the lives of children and adolescents, the effect that coronavirus disease 2019 restrictions have had on the psychological and physical well-being of young athletes is significant. The youth sports community has worked hard to find creative ways to safely bring children and adolescents back to the fields and courts with rules and regulations in place. Youth practices and competitions are potential spreader events for SARS-CoV-2, especially given the challenge of identifying young athletes and other participants with asymptomatic active viral infection. With the implementation of rapid result testing programs and the US Food and Drug Administration approval of a highly effective vaccine in adolescents and, most recently, in younger children, youth sports are once again becoming a place for young athletes to train, socialize, and learn invaluable lessons in teamwork and leadership. [Pediatr Ann. 2021;50(11):e450-e453.].

COVID-19 Planning in United States Adolescent Sports: A Survey of 1880 Organizations Representing More Than 500 000 Youth Athletes.

CONTEXT: High schools and youth sport organizations that restarted participation in the fall of 2020 during the COVID-19 pandemic relied on information sources to develop risk-mitigation procedures. OBJECTIVE: To compare the risk-mitigation procedures and information sources used by high school athletic departments and youth sport organizations. DESIGN: Cross-sectional study. SETTING: Surveys of high school and youth sport organization programs from across the United States. PATIENTS OR OTHER PARTICIPANTS: A total of 1296 high schools and 584 youth sport organizations, representing 519 241 adolescent athletes, responded to the surveys. MAIN OUTCOME MEASURE(S): Surveys regarding restarting sport, COVID-19 cases, risk-reduction procedures, and the information sources used to develop risk-reduction plans in the fall of 2020 were distributed to high school athletic directors and youth sport directors throughout the United States. The proportions of high schools and youth sport organizations using different risk-reduction procedures and information sources were compared using the χ2 test. RESULTS: High schools used more risk-reduction procedures than did youth sport organizations (high schools = 7.1 ± 2.1 versus youth sport organizations = 6.3 ± 2.4; P < .001) and were more likely than youth sport organizations to use symptom monitoring (high schools = 93% versus youth sport organizations = 85%, χ2 = 26.3; P < .001), temperature checks on site (66% versus 49%, χ2 = 53.4; P < .001), face masks for athletes during play (37% versus 23%, χ2 = 38.1; P < .001) and when off the field (81% versus 71%, χ2 = 26.1; P < .001), social distancing for staff (81% versus 68%, χ2 = 43.3; P < .001) and athletes off the field (83% versus 68%, χ2 = 57.6; P < .001), and increased facility disinfection (92% versus 70%, χ2 = 165.0; P < .001). Youth sport organizations relied more on information from sport national governing bodies than did high schools (youth sport organizations = 52% versus high schools = 10%, χ2 = 411.0; P < .001), whereas high schools were more likely to use information from sources such as the National Athletic Trainers' Association (high schools = 20% versus youth sport organizations = 6%, χ2 = 55.20; P < .001) and the National Federation of State High School Associations (high schools = 72% versus youth sport organizations = 15%, χ2 = 553.00; P < .001) for determining risk-reduction strategies. CONCLUSIONS: High schools and youth sport organizations reported using a broad range of risk-reduction procedures, but the average number was higher among high schools than youth sport organizations. Use of information from the Centers for Disease Control and Prevention and local health authorities was high overall, but use of information from professional health care organizations was low. Professional health care organizations should consider using additional measures to improve information uptake among stakeholders in youth sports.

Youth ice hockey COVID-19 protocols and prevention of sport-related transmission.

OBJECTIVES: This observational study evaluated the impact of return-to-play protocols to prevent transmission of SARS-CoV-2 in a youth ice hockey programme in Virginia Beach, Virginia. METHODS: Following an outbreak of SARS-CoV-2 in November 2020, a COVID-19 Response Team evaluated the epidemiological data to identify transmission dynamics and develop enhanced protocols to prevent transmission. During the subsequent 18-week study period, incident cases were investigated to identify the likely transmission source; testing, quarantine and isolation recommendations were provided to families in accordance with Centers for Disease Control and Prevention guidelines. RESULTS: Simple but stringent protocols were implemented among 148 youth ice hockey players ages 6-18. Players were required to arrive at the rink in full gear; locker rooms were closed, building entry was limited to one parent per player, and masks were required at all times except for players on the ice. Following implementation of the enhanced protocols, more than 500 practices and games were completed with at least 15 858 athlete-hours of exposure and no within-programme COVID-19 transmission was detected despite high community incidence and sporadic household exposures. CONCLUSION: This study suggests indoor youth sports can operate safely with appropriate protocols in place, even within communities of high COVID-19 transmission, even when athletes are not yet vaccinated or wearing masks during play. Transmission appears to be more likely in congested indoor areas involving adults than on the ice during play. Protocols should be developed in collaboration with programme participants. Strong collaboration in the interest of youth sports can motivate adoption of protocols which prevent within-team transmission.

COVID-19 in US Youth Soccer Athletes During Summer 2020.

CONTEXT: As sports are reinitiated around the United States, the incidence of COVID-19 among youth soccer athletes remains unknown. OBJECTIVE: To determine the incidence of COVID-19 among youth soccer athletes and the risk-mitigation practices used by youth soccer organizations. DESIGN: Cohort study. SETTING: Survey distributed to Elite Clubs National League member clubs. PATIENTS OR OTHER PARTICIPANTS: Youth soccer club directors throughout the United States. MAIN OUTCOME MEASURE(S): Surveys were completed in late August 2020 regarding the club's current phase of return to soccer (individual only, group noncontact, group contact), date of reinitiation, number of players, cases of COVID-19, and risk-reduction procedures being implemented. Case and incidence rates were compared with national pediatric data and county data from the prior 10 weeks. A negative binomial regression model was developed to predict club COVID-19 cases using the local incidence rate and phase of return as covariates and the log of club player-days as an offset. RESULTS: A total of 124 respondents had reinitiated soccer, representing 91 007 players with a median duration of 73 days (interquartile range = 53-83 days) since restarting. Of the 119 clubs that had progressed to group activities, 218 cases of COVID-19 were reported among 85 861 players. Youth soccer players had a lower case rate and incidence rate than children in the United States (254 versus 477 cases per 100 000; incidence rate ratio = 0.511, 95% CI = 0.40, 0.57; P < .001) and the general population in the counties where data were available (268 versus 864 cases per 100 000; incidence rate ratio = 0.202, 95% CI = 0.19, 0.21; P < .001). After adjusting for the local COVID-19 incidence, we found no relationship between the club COVID-19 incidence and the phase of return (noncontact: b = 0.35 ± 0.67, P = .61; contact: b = 0.18 ± 0.67, P = .79). Soccer clubs reported using a median of 8 (interquartile range = 6-10) risk-reduction procedures. CONCLUSIONS: The incidence of COVID-19 among youth soccer athletes was relatively low when compared with the background incidence among children in the United States during the summer of 2020. No relationship was identified between the club COVID-19 incidence and the phase of return to soccer.

Understanding the impact of COVID-19 on youth sport in Australia and consequences for future participation and retention.

BACKGROUND: COVID-19 continues to represent the single biggest challenge to contemporary community sport globally. Compliance with social distancing policies, strict return-to-play protocols, and COVID-19 specific training has, perhaps, forever changed the way that children and young people engage in organised sport. Within this context, and while many children and families seek to re-engage with community sport, we (researchers and sport practitioners) have an obligation to ask questions about how the pandemic has impacted youth sport, understand the short- and long-term consequences, and explore what (if any) opportunities can be seized to assist and improve future participation and retention. The aim of this paper was to present an in-depth exploration of the impact of COVID-19 on youth sport in South Australia. METHODS: Within an interpretive descriptive methodology, this qualitative investigation draws on rich, individual interview and focus group data with 39 youth (ages 15-18), parents, coaches, and sport administrators. A reflexive thematic analysis was undertaken, leading to the development of four substantive themes. RESULTS: We conceptualised the '4 Rs' to advance theoretical understandings about the pandemic's impact on youth sport, including the themes 'recognising struggle', 'reconnection', 're-engaging after restrictions, and 'reimagining sport'. The themes captured insights about a decline in mental wellbeing and physical activity, an increase in family connectedness, the challenge for sports to attract volunteers and participants back into sport, and the opportunities to reset values and philosophies underpinning the provision of youth sport. CONCLUSION: The findings provide valuable insight into the youth sport setting as a result of the global pandemic and suggest that families, sporting clubs and sporting organisations require additional resources and tools (for example, support for parents to facilitate their children's training at home during lockdown) to aid recovery efforts and to ensure the survival and prosperity of youth sport into the future.

The effect of COVID-19 quarantine on physical and social parameters of physical education providers and youth sport coaches.

The potential ramifications of the COVID-19 pandemic global shut down on physical education providers and youth sport coaches may be particularly severe due to substantial cutbacks on many of their normal activities. This population faces unique challenges in engaging in "virtual learning" given the physical nature of their job, potentially leading to sedentary lifestyle, weight gain, and the development of depressive mood disorders. This commentary aims to explore options to mitigate worsening of stress, depression, physical inactivity, and social disconnection in youth sport coaches following the guidelines of the American College of Sports Medicine (ACSM) and to call attention to this vulnerable demographic which has been substantially impacted by the COVID-19 pandemic.

Mental Health, Physical Activity, and Quality of Life of US Adolescent Athletes During COVID-19-Related School Closures and Sport Cancellations: A Study of 13 000 Athletes.

CONTEXT: In the spring of 2020, US schools closed to in-person teaching and sports were cancelled to control the transmission of coronavirus disease 2019 (COVID-19). It is critical to understand the mental and physical health of adolescent athletes during this time. OBJECTIVE: To describe the health of athletes during COVID-19-related school closures and sport cancellations. DESIGN: Cross-sectional study. SETTING: A national sample recruited via social media. PATIENTS OR OTHER PARTICIPANTS: A total of 13 002 US adolescent athletes (age = 16.3 ± 1.2 years, females = 52.9%, males = 47.0%) completed an anonymous online survey. MAIN OUTCOME MEASURE(S): Demographic information collected was sex, grade, sport(s) played, and zip code. Assessments used were the General Anxiety Disorder 7-Item for anxiety, Patient Health Questionnaire 9-Item for depression, the Pediatric Functional Activity Brief Scale for physical activity, and the Pediatric Quality of Life Inventory 4.0 for quality of life. Mental health, physical activity, and health-related quality-of-life variables were compared among sex, grade, sport(s) played, and poverty level using means and 95% confidence intervals (CIs) from the survey-weighted analysis of variance. RESULTS: Females reported a higher prevalence of moderate to severe anxiety symptoms (females = 43.7% versus males = 28.2%). The Pediatric Functional Activity Brief Scale score was highest (best) for grade 9 (mean = 14.5, 95% CI = 14.0, 15.0) and lowest for grade 11 (mean = 10.9, 95% CI = 10.5, 11.3). The prevalence of depression symptoms was highest in team sport (74.1%) and lowest in individual sport (64.9%) participants. The total Pediatric Quality of Life Inventory score was lowest (worst) for athletes from counties with the highest poverty levels (high: mean = 74.5, 95% CI = 73.7, 75.3; middle: mean = 78.9, 95% CI = 78.0, 79.8; and low: mean = 78.3, 95% CI = 77.4, 79.1). CONCLUSIONS: The health of US adolescents during the COVID-19-related school closures and sport cancellations varied to differing degrees depending on sex, grade level, type of sport participation, and level of poverty. Health policy experts should consider these findings in the future when creating and implementing policies to improve the health of adolescents in the United States.