# The association between learning models and child health behaviours during the COVID-19 pandemic

## TL;DR

This study found that virtual learning during the pandemic increased children's screen time and physical activity but also delayed their sleep onset, with differences based on age and gender.

## Contribution

The study provides new insights into how virtual learning during the pandemic affected children's health behaviors in Canada, including gender and age differences.

## Key findings

- Virtual learning was associated with higher daily screen time, outdoor time, and physical activity.
- Girls had a later sleep onset time compared to boys during virtual learning.
- Children over 6 years had higher outdoor time when learning virtually.

## Abstract

This paper aimed to explore the association between school learning models (virtual vs. in-person) and child health behaviours (daily screen time, physical activity, outdoor time, sleep duration, and sleep onset time) during COVID-19, and whether these associations were modified by child's age, sex, and family income.

A longitudinal cohort study was conducted among children four to 13 years from the TARGet Kids! COVID-19 Study of Children and Families between November 2020 and July 2022. TARGet Kids! is a primary care research network in Ontario, Canada. Data on sociodemographic characteristics, child school learning models and health behaviours were collected from repeated parent-reported questionnaires. Linear mixed effects models were fit adjusting for confounders identified a priori.

A total of 367 children [51 % male; 7.3 (± 2.2) years] with 779 observations on school learning model were included. Compared to in-person learning, virtual learning was associated with higher daily screen time (0.22 h; 95 % CI 0.03, 0.40), higher outdoor time (0.71 h; 95 % CI 0.56, 0.86), higher physical activity (0.64 h; 95 % CI 0.44, 0.85), and a later sleep onset time (0.22 h; 95 % CI 0.15, 0.28). Older children had higher daily outdoor time, girls had a later sleep onset time and children with a family income greater than $150,000 reported higher daily physical activity.

Virtual learning was associated with higher daily screen time, outdoor time and physical activity, and later sleep onset time during the pandemic.

•COVID-19 virtual learning impact on child health behaviours in Canada is unknown.•Virtual learning children had higher daily screen time and later daily sleep onset.•A later sleep onset was most prominent among girls vs. boys.•Virtual learning children had higher physical activity and outdoor time.•Higher daily outdoor time found in children >6 years attending school virtually.

COVID-19 virtual learning impact on child health behaviours in Canada is unknown.

Virtual learning children had higher daily screen time and later daily sleep onset.

A later sleep onset was most prominent among girls vs. boys.

Virtual learning children had higher physical activity and outdoor time.

Higher daily outdoor time found in children >6 years attending school virtually.