Child Flourishing, School Engagement, Physical Activity, and Screen Time During the Coronavirus Disease 2019 Pandemic in 2020

OBJECTIVE: To examine changes in flourishing, school engagement, physical activity, and recreational screen time among school-aged children in the United States during the Coronavirus Disease 2019 (COVID-19) pandemic in 2020. METHODS: In this cross-sectional study, data come from the 2018–2020 National Survey of Children's Health for 68,203 children aged 6 to 17 years. Flourishing is always/usually curious to learn, resilient and having self-regulation. School engagement is always/usually completing homework and having interest in doing well in school. Other outcomes are daily 60+ minutes physical activity or number of such days, and daily recreational screen time or 2+ hours/day. Weighted regression models compare 2020 to 2019 and 2019 to 2018 adjusting for child/household covariates and state indicators. RESULTS: Among children age 6 to 17 years in 2020, there was a decline in flourishing (OR = 0.69; 95% CI, 0.63, 0.75), school engagement (OR = 0.71; 95% CI, 0.64, 0.79), physically active days (0.26 days, 95% CI, 35, 0.17), and daily 60+ minutes activity (OR = 0.91; 95% CI, 0.83, 1.00), and increase in daily recreational screen time (0.29 hours; 95% CI, 0.25, 0.34) and 2+ hours/day (OR = 1.65; 95% CI, 1.49–1.83) compared to 2019. These differences were observed across all evaluated demographic and socioeconomics subgroups. There were no significant differences between 2019 and 2018, indicating that the 2020–2019 differences were related to the pandemic rather than a continuation of prepandemic trends. CONCLUSIONS: Children's flourishing, school engagement, and physical activity declined while recreational screen time increased during the COVID-19 pandemic in 2020. Monitoring these outcomes in the long-run is important to assessing needs and promoting children's learning and development.