The association between learning models and child health behaviours during the COVID-19 pandemic.

Objective: This paper aimed to explore the association between school learning models (virtual vs. in-person) and child health behaviours (daily screen time, physical activity, outdoor time, sleep duration, and sleep onset time) during COVID-19, and whether these associations were modified by child's age, sex, and family income.

Methods: A longitudinal cohort study was conducted among children four to 13 years from the TARGet Kids! COVID-19 Study of Children and Families between November 2020 and July 2022. TARGet Kids! is a primary care research network in Ontario, Canada. Data on sociodemographic characteristics, child school learning models and health behaviours were collected from repeated parent-reported questionnaires. Linear mixed effects models were fit adjusting for confounders identified

Results: A total of 367 children [51 % male; 7.3 (± 2.2) years] with 779 observations on school learning model were included. Compared to in-person learning, virtual learning was associated with higher daily screen time (0.22 h; 95 % CI 0.03, 0.40), higher outdoor time (0.71 h; 95 % CI 0.56, 0.86), higher physical activity (0.64 h; 95 % CI 0.44, 0.85), and a later sleep onset time (0.22 h; 95 % CI 0.15, 0.28). Older children had higher daily outdoor time, girls had a later sleep onset time and children with a family income greater than $150,000 reported higher daily physical activity.

Conclusions: Virtual learning was associated with higher daily screen time, outdoor time and physical activity, and later sleep onset time during the pandemic.