Changes in physical activity and sedentary time among children with asthma during the COVID-19 pandemic and influencing factors

Abstract

Objective

Regular physical activity is essential for asthma control in children, but it remains understudied within the context of COVID-19. Physical activity and sedentary time levels before and during the COVID-19 pandemic among children with asthma were documented and differences by characteristics were explored.

Methods

This was a cross-sectional self-administered online survey study of 5- to 17-year-old children with asthma from the United States between December 2020 and April 2021.

Results

This study included 68 children with asthma. Although only 4.6% of the children were fully inactive before the pandemic, this number increased to 24.6% during the survey period (p < 0.001). Children spent significantly less time outdoors and more time in front of screens during the pandemic versus before (p < 0.001). The variety of activities in which children with asthma engaged in during the pandemic was lower than what they used to do prior to the COVID-19 crisis. Boys, Hispanic children, those of low-income households, and those not attending school in-person were significantly associated with less participation in physical activity during the pandemic. Ethnicity remained significantly associated after adjusting for multiple comparisons.

Conclusions

During the COVID-19 pandemic, children with asthma were less active and spent more time in front of screens and less time outdoors. Subgroup analyses revealed individual, parental, and organizational characteristics being associated with differential participation in physical activity, highlighting disparities in opportunities for children with asthma of different circumstances to remain active and healthy during the pandemic. Additional, more robust longitudinal studies are needed to confirm these results.

Keywords:

• disparities
• epidemiology
• outdoor time
• pediatrics
• quality of life
• screen time
• survey

Acknowledgements

We would like to thank all the survey participants. We thank Dr. Maya Jerath, Dr. Andrea Coverstone, and Dr. Ayse Budan Caliskan (all at Washington University School of Medicine in St. Louis) for their noteworthy suggestions on the study design and assistance with recruitment.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

Dr. Leyao Wang is supported by the National Institutes of Health (5R21AI139649-02 to L.W.). This project was supported in part by funds from the Public Health Cubed (PH3) seed funding (17040 to L.W., D.S., and L.L.) in the Institute for Public Health at Washington University in St. Louis.