Exploring changes in children’s well-being due to COVID-19 restrictions: the Italian EpaS-ISS study
Authors: Giustini Marco , Luzi Ilaria , Spinelli Angela , Andreozzi Silvia , Bucciarelli Mauro , Buoncristiano Marta , Nardone Paola , Ciardullo Silvia ,   on behalf of the EPaS-ISS Group, Ciardullo Silvia , Nardone Paola , Buoncristiano Marta , Spinelli Angela , Giustin Marco , Andreozzi Silvia , Bucciarelli Mauro , Giusti Angela , Cattaneo Chiara , Luzi Ilaria , Gentile Amalia Egle , Zambri Francesca , Palermo Vittorio , Nolfi Annachiara Di , Tambascia Gabriella , Colleluori Claudia , Di Giacomo Manuela , Ranalli Ercole , Mininni Mariangela , Cernuzio Antonella , Lucia Francesco , Mignuoli Anna Domenica , Mortati Filomena , Mazzarella Gianfranco , Angelini Paola , Broccoli Serena , Fridel Marina , Pani Paola , Carletti Claudia , Concina Federica , Ronfani Luca , Biscaglia Lilia , Cairella Giulia , Pancallo Maria Teresa , Pozzo Laura , Sticchi Camilla , Varlese Federica , Celata Corrado , Leoni Olivia , Crottogini Lucia , Lobascio Claudia , Gelmi Giusi , Pirrone Lucia , Chinelli Simona , Filipponi Giorgio , Ravaglia Elsa , Colletta Stefano , Belli Luca , Dichiara Martina , Rosetti Benedetta , Lisi Marialuisa , Patrizzietti Carla , Matacchione Stefania , Paolitto Ermanno , Caputo Marcello , Pasquale Pietro , Stingi Giacomo Domenico , Pacella Pina , Ferro Maria Paola , Miceli Patrizia , Lazzeri Giacomo , Simi Rita , Bietta Carla , Cristofori Marco , Fioretti Giada , Michieletto Federica , Orlando Marta , Ramigni Mauro , Weiss Sabine , Fatehmoghadam Pirous , Mocellin Chiara , Zuccali Maria Grazia 
Published: September 2023

Abstract
Background
While existing research has explored changes in health behaviours among adults and adolescents due to the COVID-19 outbreak, the impact of quarantine on young children’s well-being is still less clear. Moreover, most of the published studies were carried out on small and non-representative samples. The aim of the EpaS-ISS study was to describe the impact of the COVID-19 pandemic on the habits and behaviours of a representative sample of school children aged mainly 8–9 years and their families living in Italy, exploring the changes in children’s well-being during the COVID-19 pandemic compared to the immediately preceding time period.

Methods
Data were collected using a web questionnaire. The target population was parents of children attending third-grade primary schools and living in Italy. A cluster sample design was adopted. A Well-Being Score (WBS) was calculated by summing the scores from 10 items concerning the children’s well-being. Associations between WBS and socio-demographic variables and other variables were analysed.

Results
A total of 4863 families participated. The children’s WBS decreased during COVID-19 (median value from 31 to 25; p = 0.000). The most statistically significant variables related to a worsening children’s WBS were: time of school closure, female gender, living in a house with only a small and unliveable outdoor area, high parents’ educational level and worsening financial situation.

Conclusions
According to parents ' perception, changes in daily routine during COVID-19 negatively affected children’s well-being. This study has identified some personal and contextual variables associated with the worsening of children’s WBS, which should be considered in case of similar events.