Health Behavior Changes during the COVID-19 Pandemic: A Longitudinal Analysis among Children

Int J Environ Res Public Health. 2022 Jul 28;19(15):9220. doi: 10.3390/ijerph19159220.


This longitudinal study compared children’s health behaviors before the COVID-19 pandemic versus during the pandemic. This analysis examined the association between individual-level characteristics and health behavior change. Four prospective cohort studies in the Environmental influences on Child Health Outcomes (ECHO) Program contributed data. Children aged 4−12 years and their caregivers were recruited in California, Colorado, North Dakota, and New Hampshire. Dietary intake, physical activity, screen time, and sleep duration were assessed with questionnaires pre-pandemic and during the pandemic. The final sample included 347 children: 47% female and 62% non-Hispanic White. Compared with pre-pandemic, weekday screen time duration was higher during the pandemic (3.0 vs. 4.5 h, p < 0.001). Unadjusted increases in screen time duration differed by race and ethnicity: 1.3 h/day for non-Hispanic White children, 2.3 h/day for Hispanic children, and 5.3 h/day for non-Hispanic Black children. Overall, no changes occurred in sugar-sweetened beverage (SSB) intake (p = 0.26), discretionary food intake (p = 0.93), and physical activity (p = 0.15). Sleep duration increased by 30 min among children who did not meet sleep recommendations pre-pandemic. Child sex and maternal education level were not associated with health behavior change. The pandemic may have exacerbated disparities in some health behaviors. Families may need support to re-establish healthy routines.

Keywords: COVID-19; diet; disparities; longitudinal; physical activity; screen time; sleep.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • COVID-19* / epidemiology
  • Child
  • Female
  • Health Behavior
  • Humans
  • Longitudinal Studies
  • Male
  • Pandemics*
  • Prospective Studies