A systematic review and meta-analysis on the preventive behaviors in response to the COVID-19 pandemic among children and adolescents

Feifei Li; Wei Liang; Ryan E Rhodes; Yanping Duan; Xiang Wang; Borui Shang; Yide Yang; Jiao Jiao; Min Yang; Rashmi Supriya; Julien S Baker; Longyan Yi

doi:10.1186/s12889-022-13585-z

A systematic review and meta-analysis on the preventive behaviors in response to the COVID-19 pandemic among children and adolescents

BMC Public Health. 2022 Jun 15;22(1):1201. doi: 10.1186/s12889-022-13585-z.

Authors

Feifei Li^#^{1

2}, Wei Liang^#^{1

2}, Ryan E Rhodes³, Yanping Duan^{1

2}, Xiang Wang⁴, Borui Shang⁵, Yide Yang⁶, Jiao Jiao⁷, Min Yang², Rashmi Supriya^{1

2}, Julien S Baker^{1

2}, Longyan Yi⁸

Affiliations

¹ Center for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
² Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
³ School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada.
⁴ Department of Curriculum and Instruction, the Education University of Hong Kong, Ting Kok, Hong Kong, China.
⁵ Department of Social Sciences, Hebei Sport University, Shijiazhuang, China.
⁶ Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China.
⁷ Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
⁸ China Institute of Sport and Health Science, Beijing Sport University, Beijing, China. 2136@bsu.edu.cn.

^# Contributed equally.

Abstract

Purpose: The purpose of this review was to synthesize the empirical evidence of relevant studies related to preventive behaviors in response to the COVID-19 pandemic among children and adolescents. Further to this, we aimed to identify the demographic, psychological, and social and environmental correlates of such behaviors.

Methods: Following PRISMA guidelines, eligible literature was identified by searching seven databases (PsycINFO, PubMed, MEDLINE, EMBASE, Cochrane Library, PROSPERO registry platform, and ClinicalTrials.gov website) and reference list of included studies and relevant review papers from 1^st Jan 2020 to 28^th Feb 2021. The standardized mean difference and correlation coefficients r were extracted to estimate the effect sizes. Analyses were conducted using R software.

Results: Of the 35,271 original papers, 23 eligible studies were included in the qualitative synthesis and all these studies were of moderate-to-high quality, of which 17 studies were further included into the quantitative analysis. Children and adolescents (6-20 yrs.) showed a poorer practice of COVID-19 preventive behaviors compared to younger adults (21-59 yrs.) with a small-to-medium effect size (SMD = -.25, 95%CI = -.41 to -.09). For the demographic correlates, children and adolescents' COVID-19 preventive practice was found to be significantly associated with gender (r = .14, 95%CI = .10 to .18), while not with age (r = -.02, 95%CI = -.14 to .10). Narratively, knowledge was found to be consistently and significantly correlated. For the psychological correlates, small-to-medium overall effects were identified for the association with attitudes (r = .26, 95%CI = .21 to .31) and perceived severity (r = .16, 95%CI = .01 to .30). For the family and social correlates, a non-significant association was identified between family economic status and COVID-19 preventive behaviors (r = .004, 95%CI = -.12 to .12).

Conclusions: Interventions and relevant policies of promoting children and adolescent's preventive measures should be a priority. Further, empirical studies identifying the demographic, psychological, and family and social correlates of children and adolescents' preventive behaviors are needed.

Keywords: COVID-19; Children and adolescents; Demographics; Preventive behaviors; Psychosocial factors; Review and meta-analysis; Social and environmental factors.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adolescent Behavior*
Adult
COVID-19* / epidemiology
COVID-19* / prevention & control
Child
Humans
Pandemics / prevention & control