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- Title
School Closures During Social Lockdown and Mental Health, Health Behaviors, and Well-being Among Children and Adolescents During the First COVID-19 Wave: A Systematic Review.
- Authors
Viner, Russell; Russell, Simon; Saulle, Rosella; Croker, Helen; Stansfield, Claire; Packer, Jessica; Nicholls, Dasha; Goddings, Anne-Lise; Bonell, Chris; Hudson, Lee; Hope, Steven; Ward, Joseph; Schwalbe, Nina; Morgan, Antony; Minozzi, Silvia
- Abstract
This systematic review assesses published reports on the associations of COVID-19 school closures during broader social lockdown measures and mental health, health behaviors, and well-being among children and adolescents. Key Points: Question: Is there an association between school closure during broader social lockdown measures during the COVID-19 pandemic and mental health symptoms, health behaviors, and well-being of children and adolescents, aged 0 to 19 years? Findings: In this systematic review of 36 studies from 11 countries, school closures and social lockdown during the first COVID-19 wave were associated with adverse mental health symptoms (such as distress and anxiety) and health behaviors (such as higher screen time and lower physical activity) among children and adolescents. The effects of school closures could not be assessed separately from broader social lockdown measures. Meaning: The potential epidemiologic benefits of school closures during broader social lockdown measures for controlling infectious diseases should be balanced with the potential for adverse mental health symptoms and health behaviors among children and adolescents. Importance: School closures as part of broader social lockdown measures during the COVID-19 pandemic may be associated with the health and well-being of children and adolescents. Objective: To review published reports on the association of school closures during broader social lockdown with mental health, health behaviors, and well-being in children and adolescents aged 0 to 19 years, excluding associations with transmission of infection. Evidence Review: Eleven databases were searched from inception to September 2020, and machine learning was applied for screening articles. A total of 16 817 records were screened, 151 were reviewed in full text, and 36 studies were included. Quality assessment was tailored to study type. A narrative synthesis of results was undertaken because data did not allow meta-analysis. Findings: A total of 36 studies from 11 countries were identified, involving a total of 79 781 children and adolescents and 18 028 parents, which occurred during the first wave of the COVID-19 pandemic (February to July 2020). All evaluated school closure as part of broader social lockdown during the first COVID-19 wave, and the duration of school closure ranged from 1 week to 3 months. Of those, 9 (25%) were longitudinal pre-post studies, 5 (14%) were cohort, 21 (58%) were cross-sectional, and 1 (3%) was a modeling study. Thirteen studies (36%) were high quality, 17 (47%) were medium quality, and 6 (17%) were low quality. Twenty-three studies (64%) were published, 8 (22%) were online reports, and 5 (14%) were preprints. Twenty-five studies (69%) concerning mental health identified associations across emotional, behavioral, and restlessness/inattention problems; 18% to 60% of children and adolescents scored above risk thresholds for distress, particularly anxiety and depressive symptoms, and 2 studies reported no significant association with suicide. Three studies reported that child protection referrals were lower than expected number of referrals originating in schools. Three studies suggested higher screen time usage, 2 studies reported greater social media use, and 6 studies reported lower physical activity. Studies on sleep (10 studies) and diet (5 studies) provided inconclusive evidence on harms. Conclusions and Relevance: In this narrative synthesis of reports from the first wave of the COVID-19 pandemic, studies of short-term school closures as part of social lockdown measures reported adverse mental health symptoms and health behaviors among children and adolescents. Associations between school closure and health outcomes and behaviors could not be separated from broader lockdown measures.
- Subjects
UNITED Kingdom; WELL-being; ONLINE information services; PSYCHOLOGY information storage &; retrieval systems; SYSTEMATIC reviews; MENTAL health; SCHOOLS; HEALTH behavior; STAY-at-home orders; MEDLINE; COVID-19 pandemic; CHILDREN; ADOLESCENCE
- Publication
JAMA Pediatrics, 2022, Vol 176, Issue 4, p400
- ISSN
2168-6203
- Publication type
Article
- DOI
10.1001/jamapediatrics.2021.5840