The natural experiment of COVID-19 related governmental measures of home confinement and social distancing has led to a decrease in physical activity levels of school going adolescents of Punjab, India.
Bron
Verkorte titel
Aandoening
Prevention of non communicable diseases
Ondersteuning
Onderzoeksproduct en/of interventie
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Uitkomstmaten
Primaire uitkomstmaten
Change in proportion of adolescents performing sufficient physical activity as per WHO guidelines after school closures due to COVID-19. The change in physical activity levels will be calculated using self-report measures through questionnaire and objective measures using ActiGraph on a sub-sample.
Achtergrond van het onderzoek
Background
Physical inactivity accounts of 6% of global deaths making it the fourth leading cause of mortality followed by high blood pressure (13%), tobacco use (9%), and high blood glucose (6%). Physical inactivity, during childhood and adolescence is leading to a rise in major health problems of overweight, obesity and obesity-related non-communicable diseases (1). Following the outbreak of novel coronavirus disease (COVID-19) and its declaration as a pandemic in March 2020 by the World Health Organization, school closures has been a ubiquitous approach by governments to prevent community transmission. By June 2020, about 1 billion children and adolescents in 112 countries are affected by school closures (2). With the ongoing COVID-19 situation and associated school closures, the physical activity levels are expected to fall furthermore with a simultaneous increase in sedentary time. Physical inactivity was declared a pandemic in 2012 (3), and current data suggests that it will persist long after we recover from the COVID-19 pandemic (4). Home confinement and social distancing not only reduces regular physical activity in adolescents due to closure of schools and access to sports facilities, playgrounds and parks, but also exacerbates the lifestyle related risk factors of obesity such as unhealthy snacking and increase in sedentary behaviour (5-7). In a study conducted between 27-31 March 2020, South Korean parents have reported an increase in screen time in 81% children and decrease in the use of play or sports facility the physical activity levels in 94% children (8). The current study aims to observe the change in proportion of adolescents performing physical activity as per WHO guidelines due to COVID-19 pandemic and associated school closures. It also aims to provide information about the behaviour of adolescents related to physical activity, and other related lifestyle behaviours such as sedentary and screen time, and dietary behaviours.
With the participation of all stakeholders including adolescents themselves, a study will be designed using the Intervention Mapping approach that may provide recommendations for school-based physical activity interventions and assist in preparedness for the future, especially when physical distancing measures may still have to be in place even after schools reopen.
Objectives of the study:
1. Observe the changes in lifestyle with a focus on physical activity and sedentary behaviour due to COVID-19 of adolescents attending schools in Mohali (SAS Nagar) city, Punjab.
2. Understand the reason for changes in lifestyle behaviour since COVID-19 and what measures may be taken to improve the daily routine of adolescents keeping in mind physical distancing.
3. Design a health promotion intervention to improve physical activity and lifestyle of adolescents in post lockdown times of physical distancing using the Intervention Mapping technique.
Methodology
The study will take place in government and private schools of S.A.S. Nagar (Mohali) district of Punjab state. A baseline survey with 1086 adolescents was carried out in 20 government and private schools of Mohali (SAS Nagar) city of Punjab from September 2018-February 2019 as a part of an ongoing study, and follow-up measurements will be done during and after the natural experiment of school closures are still in place. It is a cohort study designed with an aim to measure the change in proportion of adolescents performing physical activity as per WHO guidelines due to COVID-19 pandemic and associated school closures; and deriving causal inferences between COVID-19 and lifestyle changes in adolescents. The study will also try to understand the reasons for changes that may have occurred as a part of the lockdown and associated school closures with the help of qualitative data.
Two modules of the Global School based Student Health Survey (GSHS) Questionnaire 2006 were used as a subjective measure for the physical activity levels in 1086 school-going adolescents. The physical activity module was modified to meet the objectives of the study. Dietary behaviours module was used as it is. The questionnaire was pre-tested in a similar population by self administration method. It has been translated into vernacular language (Punjabi) and pilot tested. The ActiGraph wGT3X-BT was used to objectively measure the physical activity of adolescents. A sub-group of students (n=233) were given verbal instructions to wear ActiGraphs for 7 days mounted on the right side of the waist in front of the right hip at all times except during sleeping and performing water activities such as bathing, swimming etc. The Actigraphs were distributed to the adolescents after initializing for date and time using the ActiLife6 software. The raw acceleration data will be converted into objective activity with the help of a software ActiLife6. Anthropometric measurements were performed on study participants during baseline and will be repeated in follow-up stage after schools reopen. Body Mass Index (BMI) of adolescents was calculated using individual measures of weight and height and manually applying the formula for calculation. Waist circumference will be measured using the Seca 203 measuring tape.
The study will facilitate to find the gaps in knowledge about physical activity and sedentary behaviours of adolescents especially in the light of the ‘new normal’ of physical distancing thereby trying to put articulate innovative ways of staying physically active.
References
1. Global Recommendations on Physical Activity for Health [press release]. Switzerland: World Health Organization 2010.
2. Global Education Coalition Paris, France: UNESCO; 2020 [Available from: https://en.unesco.org/covid19/educationresponse/globalcoalition.
3. Kohl HW, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, et al. The pandemic of physical inactivity: global action for public health. The Lancet. 2012;380(9838):294-305.
4. Hall G, Laddu DR, Phillips SA, Lavie CJ, Arena R. A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another? Prog Cardiovasc Dis. 2020.
5. Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attina A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18(1):229.
6. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity (Silver Spring). 2020.
7. Ruiz-Roso MB, de Carvalho Padilha P, Matilla-Escalante DC, Brun P, Ulloa N, Acevedo-Correa D, et al. Changes of Physical Activity and Ultra-Processed Food Consumption in Adolescents from Different Countries during Covid-19 Pandemic: An Observational Study. Nutrients. 2020;12(8).
8. Guan H, Okely AD, Aguilar-Farias N, del Pozo Cruz B, Draper CE, El Hamdouchi A, et al. Promoting healthy movement behaviours among children during the COVID-19 pandemic. The Lancet Child & Adolescent Health. 2020.
Doel van het onderzoek
The natural experiment of COVID-19 related governmental measures of home confinement and social distancing has led to a decrease in physical activity levels of school going adolescents of Punjab, India.
Onderzoeksopzet
Follow-up measurements to be completed by 30 April 2021
Onderzoeksproduct en/of interventie
Natural experiment of coronavirus related governmental measures
Publiek
Wetenschappelijk
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
1. Adolescents in the age group of 10-19 years.
2. Adolescents enrolled in urban schools of SAS Nagar.
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
Children who have physical deformity, are mentally retarded, or have acute/prolonged fever.
Opzet
Deelname
Voornemen beschikbaar stellen Individuele Patiënten Data (IPD)
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In overige registers
Register | ID |
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NTR-new | NL8309 |
Ander register | Institute Ethics Committee, PGIMER, Chandigarh : NK/6692/Study/525 |