Physical activity and screen time: prospective associations with child emotional and behavioral well-being during the COVID pandemic.

Background: Physical activity (PA) and screen time (ST) were examined longitudinally over 66 months to evaluate their association with child emotional and behavioral health during the early months of the COVID pandemic.

Methods: Data are from 288 racially/ethnically diverse low-income children ages 2-4 years enrolled in the NET- Works studies (2012-2020). Baseline, 12-, 24-, 36- and 66-month measures of PA and ST were collected before the onset of the COVID pandemic. During the pandemic shutdown, parents completed a measure of their child's emotional and behavioral health (Strengths and Difficulties Questionnaire, SDQ). Longitudinal associations were examined between children's previous five-year PA and ST patterns and emotional and behavioral problems during the COVID shutdown.

Results: Children whose objectively measured PA met recommendations at all five visits during the previous 66 months had poorer emotional and behavioral health, compared to less consistently active children (SDQ Emotions 0.91 points higher, 95% CI = 0.22, 1.6, p = 0.046; SDQ Conduct 1.1 points higher, 95% CI = 0.45, 1.8; p = 0.007). Child ST was not significantly associated with emotional or behavioral health.

Conclusion: Future longitudinal research should examine the effects of changes in children's habitual PA on children's emotional and behavioral well-being.

Impact: To prevent declines in psychological and behavioral well-being among children who are currently regularly physically active, it is important to support their continued engagement in PA during periods when external barriers to PA are high. Increases in physical activity among children who are currently more sedentary may help limit the negative effects of stressors on children's emotional and behavioral well-being, but further research is needed.