COVID-19 and Healthy Habits in Missouri Families

Background: The COVID-19 pandemic and subsequent social distancing measures have undermined several healthy habits that families had or were establishing prior to the start of the pandemic. This study looks at those changes through online survey to Missouri families to evaluate how COVID-19 has impacted healthy lifestyle habits in Missouri families, along with degree of social distancing and any associations in changes in employment, food scarcity issues, and health concerns.

Methods: An online survey (through RedCap) was conducted during spring to summer 2020 evaluate changes during the time of initial lock down and social distancing, for families living in Missouri with children ages 2-18 years. The survey was advertised on social media and in local clinics to gather participants' responses.

Results: A total of 298 responses were received from the survey. 58% of respondents noted a change in employment (35% stated now working from home, 18% noted decrease in work hours, and 5% noted they had been laid off or lost job completely). While there were no overall statistically significant changes in healthy habits during the initial lock down period in spring-summer 2020 noted, a subset analysis noted that when comparing those with a change in employment to those without a change in employment, Missouri families did note several statistically significant changes in their healthy habits. Those with a change in employment were more likely to note a decrease in their child(ren)'s physical activity, report an increase in screen time (p=0.044), are more likely to report noticing family members eating between meals or snacking more (p = 0.004), and are also more likely to report worrying about their child(ren)'s nutrition (p = 0.049), and are more likely to note changes in their child(ren)'s sleep patterns (p = 0.021) during the pandemic. These groups were not significantly different in their self-reported income, the degree to which they socially distanced, their grocery store frequency, food scarcity, or how much they were eating out.

Conclusion: Our study of Missouri families and healthy-habit maintenance during the initial months of the COVID-19 pandemic revealed that overall healthy habits were maintained during the initial months of COVID-19. However, a subset analysis comparing those who reported a change in employment vs. those who did not report a change in employment revealed that those who experienced a change in employment were more likely to report changes in healthy habits such as amount of screen time and physical activity, snacking between meals, changes in sleep, and overall concern for their child(ren)'s nutrition. This study highlights that major life events may affect healthy habit changes and families' abilities to change healthy habits during these events and can help pediatricians understand the impact of major life changes for families on healthy habit development and maintenance.