Title: Assessing the impact of COVID-19 on the physical activity of Year 6 children and their parents: Identifying scalable actions to mitigate adverse impacts & provide rapid evidence to policy makers (ACTIVE-6)
Funder: Department of Health and Social Care

Abstract: Physical activity is important for the health and well-being of children and adults. Children and adults should do some physical activity which raises the heart rate every day. Many children and adults do not take part in enough physical activity. Levels of physical activity are likely to be lower because of the coronavirus pandemic. This is because changes have been made to all aspects of society that would normally provide physical activity opportunities including school, sport clubs and work. There are now fewer ways in which children and parents can be physically active. _x000D_ _x000D_ Information from national online surveys suggests that physical activity patterns have changed because of the “lockdown” and the phased return to school and work. The impact of these changes has not been the same for everyone. Families who have less access to resources are likely to have been more affected by the changes. However, current information is very limited as surveys do not measure physical activity well and are very difficult for children to complete. The surveys also provide little information on what schools and communities could do to help increase physical activity while minimising spread of the virus. We also do not know how much each different approach costs or how easy / hard it would be to put in place in nationwide. _x000D_ _x000D_ This project will work with schools and families to see how physical activity has changed because of the coronavirus and what can be done to help more children and families to be active. We have worked with children, parents, teachers, local public health teams, and national physical activity leaders to design a study that will help us to answer these questions. We have 7 broad aims. _x000D_ _x000D_ 1) We will use devices called accelerometers (very accurate activity monitors), to see how active Year 6 children and their parents are during 2021. We will do this in up to 50 primary schools in Southwest England. _x000D_ _x000D_ 2) We will compare the physical activity of the new group of children and families to information that we collected from the same schools using the same methods, 3 years ago. This will help us to understand if patterns have changed and if there are differences by gender or where a person lives. _x000D_ _x000D_ 3) We will look at all the things that families, schools and communities are doing and their cost to see what is helping to promote physical activity and what could be shared nationwide. _x000D_ _x000D_ 4) We will conduct interviews with parents and school staff and focus groups with children to understand how their physical activity may have changed and what families, schools, and governments could do to help them to be more active. _x000D_ _x000D_ 5) We will regularly share what we find with schools and governments during the project so that they can quickly use the information to help people to be physically active. _x000D_ _x000D_ 6) We will repeat the process during 2022 to see if things have improved and any further changes that could be made. _x000D_ _x000D_ 7) We will work with children, parents, schools, and the government to share the information from the project to help as many children and their families to be as active as possible.

Lay abstract: Background: Physical activity is important for health and well-being in children and adults. The end of primary school is key for maximising physical activity into secondary school. Covid-19 and lockdown measures have had a profound impact on the whole system which surrounds and impacts on children and parents’ physical activity. The closure of parks, schools, extra-curricular activities, as well as changes to employment, income, and housing security have all affected physical activity. These impacts are unlikely to be uniform with people living with greater inequalities are likely to be more profoundly affected._x000D_ _x000D_ This project will examine the impact of COVID-19 on the physical activity of Year 6 children and their parents and what can be done to minimise adverse impacts of physical activity restrictions while not exacerbating inequalities. We will identify key knowledge so that if there is a second wave of the virus, we are better prepared to keep people active and can make decisions based on evidence of what works. _x000D_ _x000D_ Methods: The proposed study is a repeated cross-sectional quantitative design with linked qualitative study. The comparator will be pre-COVID data. For the quantitative data we will collect data at two time-points Time1 will be between March - December 2020. This will provide data on the acute impacts on physical activity. Time2 will assess the same measures, in the same schools between January and July 2022 to provide information on chronic impacts. _x000D_ _x000D_ The primary outcome (for children and parents) will be accelerometer measured average minutes of moderate to vigorous intensity physical activity per day. We will also use child and parent surveys to assess demographics, and psychosocial variables. We will use a school audit to assess physical activity policies and changes to provision since the virus. We will also examine the implications of COVID-19 on the time and resources that schools allocate to physical activity and family members health-related quality of life. _x000D_ _x000D_ Data will be compared to a survey of 1296 Year 6 children and their parents collected 3 years earlier, in the same schools using the same methods (Time 0). We will conduct focus groups with 48 children and interviews with 30 parents and 18 teachers in a sub-group of schools at Times 1 and 2 to identify how patterns of behaviour and provision have changed in response to the virus and what could be put in place to mitigate impacts. _x000D_ _x000D_ We will use multi-level models to examine differences in physical activity at Time 1, when contrasted with Time0. We will then examine the extent to which the family and school level variables explain differences. The process will be repeated for Time 2. The qualitative data will be analysed to identify identity changes in provision and actions that have been taken to mitigate impacts. We will conduct rapid analyses of the data at 5 time points to provide summaries of how physical activity patterns have changed and mitigation strategies that have some evidence of promise to policy makers. _x000D_ _x000D_ Timelines: This is a 27-month project starting March 2021. _x000D_ _x000D_ Anticipated impact: This study will provide data on the magnitude and type of changes in physical activity that have occurred in response to the pandemic but more importantly we will identify strategies that could be put in place at scale to mitigate adverse impacts.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE