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LitCovid-PubTator

Id Subject Object Predicate Lexical cue tao:has_database_id
20 20-44 Disease denotes coronavirus disease 2019 MESH:C000657245
21 46-54 Disease denotes COVID-19 MESH:C000657245
22 230-238 Disease denotes infected MESH:D007239
23 259-265 Disease denotes deaths MESH:D003643
24 393-399 Disease denotes deaths MESH:D003643
25 427-433 Disease denotes deaths MESH:D003643
35 902-910 Species denotes children Tax:9606
36 1046-1054 Species denotes children Tax:9606
37 1616-1624 Species denotes children Tax:9606
38 1774-1782 Species denotes children Tax:9606
39 1990-1998 Species denotes children Tax:9606
40 607-615 Disease denotes COVID-19 MESH:C000657245
41 1541-1548 Disease denotes fitness MESH:D012640
42 1740-1748 Disease denotes COVID-19 MESH:C000657245
43 1956-1964 Disease denotes COVID-19 MESH:C000657245
47 2120-2128 Species denotes children Tax:9606
48 2093-2101 Disease denotes COVID-19 MESH:C000657245
49 2429-2437 Disease denotes COVID-19 MESH:C000657245
55 2764-2772 Species denotes children Tax:9606
56 3000-3012 Species denotes participants Tax:9606
57 3261-3266 Species denotes child Tax:9606
58 3292-3297 Species denotes child Tax:9606
59 3337-3345 Disease denotes COVID-19 MESH:C000657245
61 3716-3724 Disease denotes COVID-19 MESH:C000657245
66 3945-3950 Species denotes child Tax:9606
67 4277-4282 Species denotes child Tax:9606
68 4374-4382 Species denotes children Tax:9606
69 4434-4439 Species denotes child Tax:9606
75 4763-4771 Species denotes children Tax:9606
76 4919-4924 Species denotes child Tax:9606
77 5925-5928 Chemical denotes TPA
78 4981-4989 Disease denotes COVID-19 MESH:C000657245
79 5561-5569 Disease denotes COVID-19 MESH:C000657245
89 6089-6101 Species denotes participants Tax:9606
90 6273-6285 Species denotes participants Tax:9606
91 7368-7379 Species denotes participant Tax:9606
92 7908-7913 Species denotes child Tax:9606
93 6499-6507 Disease denotes COVID-19 MESH:C000657245
94 7140-7148 Disease denotes COVID-19 MESH:C000657245
95 7196-7204 Disease denotes COVID-19 MESH:C000657245
96 7577-7585 Disease denotes COVID-19 MESH:C000657245
97 7852-7860 Disease denotes COVID-19 MESH:C000657245
112 8371-8383 Species denotes participants Tax:9606
113 8446-8458 Species denotes participants Tax:9606
114 8654-8666 Species denotes participants Tax:9606
115 8687-8699 Species denotes Participants Tax:9606
116 9298-9306 Species denotes children Tax:9606
117 9355-9360 Species denotes women Tax:9606
118 9370-9378 Species denotes Children Tax:9606
119 9476-9488 Species denotes participants Tax:9606
120 9597-9609 Species denotes participants Tax:9606
121 9795-9799 Species denotes boys Tax:9606
122 9804-9809 Species denotes girls Tax:9606
123 9896-9902 Species denotes people Tax:9606
124 9932-9940 Species denotes children Tax:9606
125 8554-8562 Disease denotes COVID-19 MESH:C000657245
129 10557-10565 Species denotes children Tax:9606
130 10116-10124 Disease denotes COVID-19 MESH:C000657245
131 10541-10549 Disease denotes COVID-19 MESH:C000657245
145 10967-10975 Species denotes children Tax:9606
146 11098-11106 Species denotes Children Tax:9606
147 11398-11406 Species denotes Children Tax:9606
148 11477-11485 Species denotes Children Tax:9606
149 11714-11720 Species denotes people Tax:9606
150 11805-11811 Species denotes people Tax:9606
151 11853-11861 Species denotes Children Tax:9606
152 11879-11885 Species denotes people Tax:9606
153 11950-11958 Species denotes children Tax:9606
154 12013-12021 Species denotes Children Tax:9606
155 12262-12270 Species denotes Children Tax:9606
156 12365-12373 Species denotes Children Tax:9606
157 10942-10950 Disease denotes COVID-19 MESH:C000657245
161 12684-12692 Species denotes children Tax:9606
162 12647-12655 Disease denotes COVID-19 MESH:C000657245
163 12929-12937 Disease denotes COVID-19 MESH:C000657245
169 13292-13300 Species denotes children Tax:9606
170 13485-13493 Species denotes children Tax:9606
171 13672-13680 Species denotes children Tax:9606
172 13975-13983 Species denotes children Tax:9606
173 14600-14606 Species denotes people Tax:9606
175 15627-15635 Species denotes children Tax:9606
183 15946-15954 Species denotes children Tax:9606
184 16128-16136 Species denotes children Tax:9606
185 16220-16228 Species denotes children Tax:9606
186 16424-16429 Species denotes child Tax:9606
187 17376-17382 Species denotes people Tax:9606
188 17387-17395 Species denotes children Tax:9606
189 16733-16741 Disease denotes COVID-19 MESH:C000657245
192 17688-17696 Species denotes children Tax:9606
193 18000-18008 Species denotes children Tax:9606
199 19198-19206 Species denotes children Tax:9606
200 19492-19500 Species denotes children Tax:9606
201 20220-20229 Chemical denotes vitamin D MESH:D014807
202 19177-19185 Disease denotes COVID-19 MESH:C000657245
203 20230-20251 Disease denotes deficiency and myopia MESH:D009216
205 20858-20866 Disease denotes COVID-19 MESH:C000657245
214 22082-22090 Species denotes children Tax:9606
215 22365-22373 Species denotes children Tax:9606
216 23020-23026 Species denotes people Tax:9606
217 21936-21944 Disease denotes COVID-19 MESH:C000657245
218 22026-22034 Disease denotes COVID-19 MESH:C000657245
219 22333-22341 Disease denotes COVID-19 MESH:C000657245
220 22688-22696 Disease denotes COVID-19 MESH:C000657245
221 23361-23372 Disease denotes impairments MESH:D060825
229 23637-23649 Species denotes participants Tax:9606
230 23791-23803 Species denotes participants Tax:9606
231 23841-23849 Species denotes children Tax:9606
232 24362-24368 Species denotes people Tax:9606
233 24582-24588 Species denotes people Tax:9606
234 23905-23916 Disease denotes impairments MESH:D060825
235 25371-25379 Disease denotes COVID-19 MESH:C000657245
243 25681-25689 Species denotes children Tax:9606
244 25924-25929 Species denotes child Tax:9606
245 26314-26322 Species denotes children Tax:9606
246 26409-26417 Species denotes children Tax:9606
247 26475-26478 Chemical denotes TPA
248 25615-25623 Disease denotes COVID-19 MESH:C000657245
249 25791-25799 Disease denotes COVID-19 MESH:C000657245

LitCovid-PD-HP

Id Subject Object Predicate Lexical cue hp_id
T1 20220-20240 Phenotype denotes vitamin D deficiency http://purl.obolibrary.org/obo/HP_0100512
T2 20245-20251 Phenotype denotes myopia http://purl.obolibrary.org/obo/HP_0000545
T3 20354-20370 Phenotype denotes behavior changes http://purl.obolibrary.org/obo/HP_0000708

LitCovid-sentences

Id Subject Object Predicate Lexical cue
T12 0-2 Sentence denotes 1.
T13 3-15 Sentence denotes Introduction
T14 16-121 Sentence denotes The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on everyday life worldwide.
T15 122-306 Sentence denotes Since the declaration of the global pandemic and the first national cases, Chile has had a total of 462,991 infected and suffered 12,741 deaths (from March through September 2020) [1].
T16 307-478 Sentence denotes During the pandemic, Chile has been in the top 10 countries with the highest ratio of deaths per 100 k population (67.9 deaths/100 k inhabitants by 30 September 2020) [2].
T17 479-616 Sentence denotes In response to this pandemic, the Chilean government implemented several approaches to reduce the health and economic impact of COVID-19.
T18 617-732 Sentence denotes On 16 March 2020, all schools were closed, and, in the same week, workplaces implemented work-from-home strategies.
T19 733-844 Sentence denotes On 17 March, all national parks were closed, and on 26 March some districts enforced lockdowns and curfews [3].
T20 845-1012 Sentence denotes These restrictions likely had a negative impact on young children’s movement behaviors, (physical activity, sedentary behavior—including screen time, and sleep) [4,5].
T21 1013-1312 Sentence denotes Global guidelines recommend that children aged 1 to 5 should accumulate at least 180 min of physical activity, engage in no more than 1 h sedentary screen time (none for 1-year-olds), and have between 11–14 h (1- to 2-year-olds) and 10 to 13 h (3- to 5-year-olds) good-quality sleep per night [6,7].
T22 1313-1600 Sentence denotes Complying with these movement behavior guidelines, in one or more of several possible combinations of these recommendations (e.g., physical activity and sleeping) has been favorably associated with motor development, cognition, fitness, emotional regulation, adiposity, among others [6].
T23 1601-1710 Sentence denotes Limiting young children’s ability to meet these recommendations may have long-term health consequences [4,8].
T24 1711-1898 Sentence denotes Studies conducted during the COVID-19 pandemic have shown that children and adolescents have decreased physical activity, increased screen time, and slightly increased sleep duration [5].
T25 1899-2054 Sentence denotes However, there is a lack of data regarding the impact of COVID-19 on movement behaviors in children under 5 years of age and from Latin-American countries.
T26 2055-2260 Sentence denotes Understanding the association between COVID-19 factors and young children’s movement behaviors is important in guiding decision-making among policymakers, and in educating parents and health professionals.
T27 2261-2367 Sentence denotes This information would be relevant not only during the pandemic but also when returning to a “new normal”.
T28 2368-2559 Sentence denotes The purpose of this study was to examine the early impact of COVID-19 restrictions implemented in Chile on levels of physical activity, screen time, and sleep among toddlers and preschoolers.
T29 2560-2701 Sentence denotes In particular, we aimed to explore the sociodemographic factors associated with changes in these movement behaviors in this population group.
T30 2703-2705 Sentence denotes 2.
T31 2706-2727 Sentence denotes Materials and Methods
T32 2728-2868 Sentence denotes Main caregivers of 1- to 5-year-old children living in Chile were invited to participate in an online survey from 30 March to 27 April 2020.
T33 2869-2989 Sentence denotes The study was promoted through social media (Facebook, Twitter, and Instagram) and emails from educational institutions.
T34 2990-3159 Sentence denotes Potential participants accessed a personalized link to read more detailed information about the study and gave their online informed consent to participate in the study.
T35 3160-3355 Sentence denotes The inclusion criteria were: (1) living in Chile, (2) being the main caregiver of a 1- to 5-year-old child, and (3) living with the child most of the time before and during the COVID-19 pandemic.
T36 3356-3457 Sentence denotes The study was approved by the Scientific Ethics Committee at Universidad de La Frontera, Chile (ORD.:
T37 3458-3468 Sentence denotes 009-2020).
T38 3469-3590 Sentence denotes Data were collected and managed using REDCap (Research Electronic Data Capture) [9] hosted at Universidad de La Frontera.
T39 3591-3725 Sentence denotes Data collection started two weeks after the government enforced educational centers to close in Chile (16 March 2020) due to COVID-19.
T40 3726-3837 Sentence denotes At the end of the data collection, the education centers were still closed at a national level (27 April 2020).
T41 3839-3843 Sentence denotes 2.1.
T42 3844-3870 Sentence denotes Sociodemographic Variables
T43 3871-3978 Sentence denotes The online survey included questions about the caregiver, family, and the child participating in the study.
T44 3979-4249 Sentence denotes The sociodemographic and home characteristics section of the survey included questions about educational level, family income, occupational situation, dwelling type and size, space to play at home, inhabitants per home, area of residence (urban/rural), city, and region.
T45 4250-4399 Sentence denotes If there was more than one child at home between 1 to 5 years of age, the caregiver was asked to answer for only one of the children (freely chosen).
T46 4400-4548 Sentence denotes Also, caregivers were asked about child sex, age, disability (yes/no and type), and enrolment in an early childhood education center (ECEC; yes/no).
T47 4549-4679 Sentence denotes Caregivers were also asked if they were in lockdown at home at the moment of the survey, and the number of days spent in lockdown.
T48 4681-4685 Sentence denotes 2.2.
T49 4686-4704 Sentence denotes Movement Behaviors
T50 4705-4840 Sentence denotes A proxy-report from the main caregiver was used to assess children’s movement behaviors (physical activity, screen time, and sleeping).
T51 4841-4999 Sentence denotes Caregivers were asked to provide the time (in hours and minutes) spent by the child on each of the movement behaviors before and during the COVID-19 pandemic.
T52 5000-5097 Sentence denotes Sleep quality was assessed with a Likert scale (1 to 7; a higher score indicated better quality).
T53 5098-5231 Sentence denotes The survey was piloted in a small sample before the official launch to optimize readability, length, and pertinence of the questions.
T54 5232-5315 Sentence denotes The questions regarding movement behaviors are included as a Supplementary File S1.
T55 5316-5579 Sentence denotes The questions included in the study were based on those included in the International Study of Movement Behaviors in the Early Years (SUNRISE, www.sunrise-study.com) [10,11], but adaptations were made to capture the potential changes during the COVID-19 pandemic.
T56 5580-6056 Sentence denotes Unpublished data from pilot studies in several countries assessed the concurrent validity of the questions for measuring time spent in total physical activity (TPA) and moderate-to-vigorous physical activity (MVPA) compared with ActiGraph GT3x accelerometers (ActiGraph, Pensacola, FL, USA) have shown significant but low correlations with both TPA (r = 0.14; p = 0.003) and MVPA (r = 0.16; p = 0.002), which is comparable with other proxy-report tools in this age group [12].
T57 6058-6062 Sentence denotes 2.3.
T58 6063-6083 Sentence denotes Statistical Analysis
T59 6084-6168 Sentence denotes Only participants with complete data for all sections were included in the analysis.
T60 6169-6349 Sentence denotes Mean (standard deviation, SD), median (interquartile range, IQR), and proportions were used to describe participants on key characteristics and outcomes based on data distribution.
T61 6350-6508 Sentence denotes Comparisons between sociodemographic characteristics were performed using parametric and non-parametric tests to compare behaviors before and during COVID-19.
T62 6509-6578 Sentence denotes Multicollinearity was assessed with variable inflation factors (VIF).
T63 6579-6900 Sentence denotes We used multiple linear regressions with a residualized change score approach [13,14] to investigate the sociodemographic predictors (independent variables) of changes in physical activity, recreational screen time, sleep duration, and sleep quality (dependent variables) during the early stages of the pandemic in Chile.
T64 6901-7085 Sentence denotes This approach provides robust estimates by eliminating auto-correlated errors and regression towards the mean, which often makes it preferable to the simple change score approach [13].
T65 7086-7263 Sentence denotes First, we regressed the standardized score during the COVID-19 pandemic on the standardized scores before the COVID-19 pandemic for each of the behaviors assessed in this study.
T66 7264-7471 Sentence denotes The residualized change score (i.e., trend) for each behavior was then estimated as the average of each participant’s residual score (i.e., the difference between the estimated value and the observed value).
T67 7472-7628 Sentence denotes A positive residualized change score indicates an increase in the specific behavior from the time before COVID-19 and a negative score indicates a decrease.
T68 7629-7861 Sentence denotes For each residualized change score, we explored the predictive role of a series of sociodemographic factors a priori thought to have influenced changes in the behaviors herein assessed after ECEC and school closures due to COVID-19.
T69 7862-7963 Sentence denotes We adjusted all models for age and sex of the child, family income, presence of lockdown, and region.
T70 7964-8052 Sentence denotes Data preparation and validation was conducted with Stata 15.0 (College Station, TX, USA:
T71 8053-8178 Sentence denotes StataCorp LLC), while analyses were conducted in R (version 3.5.2) (R Foundation for Statistical Computing, Vienna, Austria).
T72 8179-8243 Sentence denotes The level of significance was set at usual p < 0.05, two-tailed.
T73 8245-8247 Sentence denotes 3.
T74 8248-8255 Sentence denotes Results
T75 8256-8363 Sentence denotes In total, 5505 individuals accessed the survey and 5266 accepted participation and signed the consent form.
T76 8364-8421 Sentence denotes We had participants from each of the 16 regions in Chile.
T77 8422-8618 Sentence denotes A total of 2109 (40.0%) participants were excluded from the analysis because they provided incomplete data (726 in demographics and COVID-19 related questions and 1383 for the movement behaviors).
T78 8619-8686 Sentence denotes The final sample consisted of 3157 participants with complete data.
T79 8687-8909 Sentence denotes Participants that provided complete data were more likely to be older (31.4 [6.06] vs. 30.3 [6.26], p < 0.001) and more educated (52.4% vs. 40.2% with university studies or more, p < 0.001) than those with incomplete data.
T80 8910-9281 Sentence denotes The caregivers’ characteristics from those with complete data were comparable with those observed for the respective age group in the last National Census in terms of dwelling (81.6% vs. 79.7% living in a house) and living area (11.4% vs. 13.5% living in a rural area), but the current sample was more educated (65.7% vs. 39.7% with more than 12 years of education) [15].
T81 9282-9328 Sentence denotes The mean age of children was 3.1 (1.38) years.
T82 9329-9369 Sentence denotes Most main caregivers were women (96.6%).
T83 9370-9470 Sentence denotes Children enrolled in ECEC or schools were 28.1% of 1- to 2-year-olds and 71.9% of 3- to 5-year-olds.
T84 9471-9513 Sentence denotes Most participants lived in houses (81.6%).
T85 9514-9574 Sentence denotes About 9 out of 10 caregivers reported space to play at home.
T86 9575-9735 Sentence denotes A large proportion of participants resided in urban areas (88.6%), and 76.3% s were under lockdown at the moment of the survey (mean duration 23.5 days [7.26]).
T87 9736-9985 Sentence denotes Most sociodemographic characteristics were similar between boys and girls, except for the sex of the main caregiver (95.4% vs. 97.8%, p < 0.001), the number of people (4.2 vs. 4.1, p = 0.013) and children (1.6 vs. 1.7, p = 0.004) per home (Table 1).
T88 9987-9991 Sentence denotes 3.1.
T89 9992-10041 Sentence denotes Movement Behaviors before and during the Pandemic
T90 10042-10149 Sentence denotes Table 2 shows the changes in movement behaviors from before to during the COVID-19 pandemic by sex and age.
T91 10150-10452 Sentence denotes Across all ages, mean time spent in physical activity decreased (−0.75 [CI 95% −0.81, −0.70] h/day), recreational screen time and sleep duration increased (1.4 [CI 95% 1.34, 1.45] h/day and 0.09 [CI 95% 0.04, 0.15] h/night, respectively) and sleep quality declined (−0.75 [CI 95% −0.81, −0.69] points).
T92 10453-10550 Sentence denotes No differences by sex were observed for any of the movement behaviors before and during COVID-19.
T93 10551-10708 Sentence denotes Older children were consistently less physically active, spent more time in screens, slept less, and had better sleep quality before and during the pandemic.
T94 10709-10802 Sentence denotes More details according to other sociodemographic factors are shown in Supplementary Table S1.
T95 10804-10808 Sentence denotes 3.2.
T96 10809-10851 Sentence denotes Predictors of Change in Movement Behaviors
T97 10852-10960 Sentence denotes Table 3 shows the sociodemographic predictors of changes in movement behaviors due to the COVID-19 pandemic.
T98 10961-11097 Sentence denotes Older children had greater reductions in physical activity and sleep duration, while they had more marked increase in their screen time.
T99 11098-11197 Sentence denotes Children whose main caregiver was a man had smaller decline in physical activity and sleep quality.
T100 11198-11397 Sentence denotes Those with caregivers aged ≥35–<45 years had greater reduction in physical activity and increase in screen time, while those with caregivers aged 45 and older had greater reduction in sleep duration.
T101 11398-11476 Sentence denotes Children whose family had higher income had smaller decrease in sleep quality.
T102 11477-11662 Sentence denotes Children whose main caregiver was more educated and those previously enrolled in an ECEC had greater reductions in their physical activity levels, and a greater increase in screen time.
T103 11663-11852 Sentence denotes Toddlers and preschoolers living with five or more people had less marked decline in their physical activity, while those living with four or people had less marked increase in screen time.
T104 11853-11926 Sentence denotes Children living with four people had greater reduction in sleep duration.
T105 11927-12012 Sentence denotes Those living with more children had a less marked decline in their physical activity.
T106 12013-12157 Sentence denotes Children who lived in apartment had greater reductions in physical activity and sleep quality, while they had a greater increase in screen time.
T107 12158-12261 Sentence denotes Those living in a home different to a house or apartment had less marked increase in their screen time.
T108 12262-12364 Sentence denotes Children who lived in homes with more square meters per person had a smaller decline in sleep quality.
T109 12365-12564 Sentence denotes Children who had a space to play at home and those living in rural areas had smaller decline in physical activity and sleep quality, and less marked increase in screen time compared with their peers.
T110 12566-12568 Sentence denotes 4.
T111 12569-12579 Sentence denotes Discussion
T112 12580-12711 Sentence denotes To our knowledge, this is the first study examining the effects of COVID-19 on movement behaviors among children aged 1 to 5 years.
T113 12712-12844 Sentence denotes We found that all movement behaviors changed across all ages, reflecting important secondary detrimental effects from this pandemic.
T114 12845-13126 Sentence denotes The most common sociodemographic predictors of movement behaviors change during the COVID-19 pandemic were age, main caregiver’s sex, age, and education, family income, previous enrolment in an ECEC, dwelling type, available space to play, and type of residence area (urban/rural).
T115 13127-13266 Sentence denotes This is also the first known study in Chile that examined all three components of the 24-h movement behaviors in toddlers and preschoolers.
T116 13267-13419 Sentence denotes A novel finding was that children from poorer families were more physically active than those in more affluent or educated families during the pandemic.
T117 13420-13518 Sentence denotes This finding is different from that commonly observed in Chilean children and adolescents [16,17].
T118 13519-13774 Sentence denotes It is plausible that those caregivers were less likely to work from home under lockdown and kept more “normal” routines with their families, while those children may have had more freedom to play indoors and less demand to stay quiet during working hours.
T119 13775-13917 Sentence denotes Also, having space to play at home was consistently related to healthier levels in all movement behaviors both before and during the pandemic.
T120 13918-14137 Sentence denotes This finding reinforces the need for ensuring spaces for children at home and surrounding areas to play as this is likely to promote these behaviors not only during the pandemic but also in the return to a “new normal”.
T121 14138-14549 Sentence denotes In Chile, specific content was developed for promoting physical activity through social media and national TV (since the 27 April 2020) as a response to the pandemic [18,19], and an expert committee on physical activity was installed by the Ministries of Sports, Health, and Education to inform, adapt and add physical activity content into the curriculum of the classes delivered remotely in this context [20].
T122 14550-14819 Sentence denotes Nevertheless, the lockdown measures did not allow people to participate in physical activity outdoors and most public parks were still closed during the period included in our study [3], with few councils prioritizing pedestrian zones to favor physical distancing [21].
T123 14820-15082 Sentence denotes These opposing strategies where on one hand physical activity is promoted indoors while at the same time it is severely restricted outdoors need to be periodically revised and aligned with the latest evidence, so health impairing over-restrictions are prevented.
T124 15083-15224 Sentence denotes Preschoolers were the most affected by the restrictions during the pandemic, particularly for physical activity and recreational screen time.
T125 15225-15354 Sentence denotes This may be explained by preschoolers needing more space to play and having greater access to screen-based devices than toddlers.
T126 15355-15490 Sentence denotes The reduction in physical activity and the increase in screen time have particularly affected those with previous enrolment in an ECEC.
T127 15491-15765 Sentence denotes Schools would be in a better position to respond with specific actions to prevent physical inactivity during this period than ECECs, as children and adolescents are more likely to be connected to participate in their virtual school activities than toddlers and preschoolers.
T128 15766-15875 Sentence denotes Therefore, governments, policymakers, and professionals should devote particular attention to this age group.
T129 15876-16071 Sentence denotes Our results suggest that more educated parents tend to restrict their children’s physical activity more, while at the same time may provide more opportunities to engage in screen-based behaviors.
T130 16072-16256 Sentence denotes This is an interesting finding as, before the pandemic, children with more educated caregivers tended to engage less with screen-based devices than children with less-educated parents.
T131 16257-16454 Sentence denotes This may be partially explained as more educated caregivers may have to work from home, and this, in turn, may require the caregiver to use screens to entertain their child while working from home.
T132 16455-16660 Sentence denotes This may be even more complicated in families living in apartments, one of the strongest predictors of declines in physical activity and increases of screen time observed in this study during the pandemic.
T133 16661-16710 Sentence denotes This finding has implications for urban planning.
T134 16711-17032 Sentence denotes As the full impact of COVID-19 is uncertain and other pandemics may occur, upgrading substandard areas that are currently plenty of small social apartments with insufficient recreational public spaces should be considered, together with stronger regulation, as part of a plan to build healthier and more resilient cities.
T135 17033-17296 Sentence denotes Undoubtedly, families and caregivers play a key role in facilitating movement behaviors of toddlers and preschoolers, but some political actions such as allowing specific time for those residing in apartments to go outside with their family may boost the process.
T136 17297-17650 Sentence denotes Some caregivers and family characteristics (caregiver’s sex and age, number of people and children per home) were also associated with changes in movement behaviors during the pandemic, so strategies should consider messages and actions for the entire family group, particularly small families and those whose main caregivers are aged 35 and older [22].
T137 17651-17774 Sentence denotes Overall, sleep quality worsened, but children with higher family income and less crowded homes showed less marked declines.
T138 17775-17912 Sentence denotes This aspect may reflect other social issues that are not captured in this study that are related to the economic situation in Chile [23].
T139 17913-18129 Sentence denotes The decrease in sleep quality has also been described in a study conducted in Italy in children aged 3 to 6 during the early stages of the pandemic; however, after two weeks of follow-up, this decline plateaued [24].
T140 18130-18371 Sentence denotes Some key messages to promote healthy sleep duration and quality, such as creating a bedtime routine and avoiding screens before sleep should be regularly disseminated and reinforced; and particularly tailored to low-income families [4,6,25].
T141 18372-18497 Sentence denotes Having space to play at home was the most consistent factor in the home environment predicting changes in movement behaviors.
T142 18498-18653 Sentence denotes A novel finding from our study is that the play space was not only important for physical activity and screen time but also had an impact on sleep quality.
T143 18654-18845 Sentence denotes This is particularly important as this association reinforce the call from the World Health Organization for focusing on the interaction of all three behaviors as they benefit each other [6].
T144 18846-19016 Sentence denotes Therefore, strategies originally thought for promoting active playing at home or surroundings may impact sleep, and this, in turn, may benefit the whole home environment.
T145 19017-19140 Sentence denotes Another relevant factor that resulted in healthier changes in physical activity and screen time was living in a rural area.
T146 19141-19312 Sentence denotes Recent studies conducted during the COVID-19 pandemic in children and adolescents have also reported that rurality is an important correlate of movement behaviors [26,27].
T147 19313-19487 Sentence denotes A study conducted in Croatia reported that the decrease in physical activity was more evident in adolescents living in urban areas than it was in those from rural areas [26].
T148 19488-19642 Sentence denotes For children living in Canada, factors such as living in an apartment and the proximity to major roads were barriers to engage in outdoor activities [27].
T149 19643-19780 Sentence denotes Also, adolescents spent more time outdoor if they lived in a low-density area and had access to parks in high-density neighborhoods [28].
T150 19781-19916 Sentence denotes We acknowledge that one of the primary measures taken by countries to control the pandemic was the imposition of mobility restrictions.
T151 19917-20088 Sentence denotes However, decision-makers should seek options to facilitate outdoor recreational activities for the population while preserving safety and physical distancing instructions.
T152 20089-20256 Sentence denotes Outdoor time is not only relevant for all movement behaviors but also the lack of it may impact other areas such as mental health, vitamin D deficiency and myopia [4].
T153 20257-20544 Sentence denotes In our study, the region of residence and lockdown situation were not predictors of the movement behavior changes suggesting that regardless of location and containment measures, movement behaviors, in both toddlers and preschoolers, were similarly affected during the pandemic in Chile.
T154 20545-20645 Sentence denotes The provision of safe spaces for physical activity is critical when physical distancing is required.
T155 20646-20892 Sentence denotes As parks may be limited in space, availability and accessibility, programs such as open streets (e.g., Ciclovía) or play streets can be adapted and implemented while maintaining the physical distancing and other COVID-19-safe measures [29,30,31].
T156 20893-21088 Sentence denotes Thus, councils could provide additional safe spaces by closing lanes to cars, implementing complete streets schemes, and transforming them into spaces for physical activity, play, and recreation.
T157 21089-21290 Sentence denotes Colombia has been highly innovative during the pandemic as they modified their current programs, usually delivered in parks or closed areas to face the needs of the population during the pandemic [32].
T158 21291-21454 Sentence denotes For example, in Bogotá, one of the first measures taken during the pandemic was the closure of lanes to private cars and the instalment of daily open streets [33].
T159 21455-21637 Sentence denotes Also, professionals from the Ministry of Sports Colombia have delivered their physical activity programs in the neighborhoods while maintaining an appropriate physical distance [32].
T160 21638-21904 Sentence denotes These low-cost initiatives have been positively received by the general public and policymakers [34,35], so once adapted to local needs they could be implemented in other contexts and countries, including Chile, and could help to alleviate the inactivity crisis [3].
T161 21905-22007 Sentence denotes The detrimental effects of the COVID-19 pandemic in toddlers and preschoolers are still uncertain [8].
T162 22008-22258 Sentence denotes If sustained, the COVID-19 lockdown measures may have a serious impact on children, with a greater effect on those from a more deprived background, increasing the gap in other developmental outcomes such as motor development, cognition, and literacy.
T163 22259-22353 Sentence denotes Actions to prevent the adverse effects of the restriction measures due to COVID-19 are needed.
T164 22354-22547 Sentence denotes As younger children are mostly dependent on adults, we should embrace this challenge and offer the best possible opportunities to promote a comprehensive development in the current context [8].
T165 22548-22741 Sentence denotes Messages and strategies should be respectful and appropriate for the families as many are suffering not only from the direct effects of the COVID-19 but also from economic and social hardships.
T166 22742-22898 Sentence denotes These challenges are novel and highly demanding for governments and can only be successfully addressed if coordinated actions across sectors are undertaken.
T167 22899-23073 Sentence denotes Cross-country collaborative efforts are needed to understand further how the pandemic is affecting movement behaviors of people from other ages, locations, and social groups.
T168 23074-23143 Sentence denotes This may guide the allocation of resources where it is more critical.
T169 23144-23408 Sentence denotes This study adds evidence that allows more balanced decision-making processes where not only the need to impose mobility restrictions to prevent contagion is taken into consideration but so is the need to avoid health impairments derived from extended confinements.
T170 23409-23559 Sentence denotes Government departments are encouraged to develop and update their protocols in awareness of the multiple health impacts derived from the confinements.
T171 23561-23586 Sentence denotes Strengths and Limitations
T172 23587-23683 Sentence denotes Strengths of this study include a large sample of participants from each of the Chilean regions.
T173 23684-23945 Sentence denotes As recruitment was conducted online, voluntary response bias may have affected the sample composition with participants being more concerned regarding their children’s health and having therefore higher chances to notice impairments in their movement behaviors.
T174 23946-24191 Sentence denotes Besides this limitation, the respondents’ characteristics were comparable from those observed in the last National Census for the respective age group in terms of dwelling type and living area, but the sample in our study was more educated [15].
T175 24192-24326 Sentence denotes Although our instrument was piloted before it was officially launched, we had a large percentage of incomplete questionnaires (40.0%).
T176 24327-24475 Sentence denotes This could be explained since some people may be more reluctant to provide personal information through online platforms than in face-to-face modes.
T177 24476-24598 Sentence denotes Some of the factors associated with the movement behaviors showed small predictive power (e.g., number of people at home).
T178 24599-24684 Sentence denotes This may be explained as there are some other factors explaining these relationships.
T179 24685-24862 Sentence denotes We recognize that movement behaviors are complex and depend on several dynamic factors that our questions were unable to capture, particularly during early stages of a pandemic.
T180 24863-25078 Sentence denotes However, we measured these factors using the best assessment option possible under the very restricted circumstances imposed at the very early stages of the pandemic, when the data collection was conducted in Chile.
T181 25079-25206 Sentence denotes We acknowledge that self-report measures used in this study may have biased the results (e.g., social desirability and recall).
T182 25207-25446 Sentence denotes The use of accelerometers was not possible as physical distancing was mandated at the national level, including for those studies that were not strictly related to COVID-19 in clinical settings during the early stages of the pandemic [36].
T183 25447-25594 Sentence denotes Considering this, we collected data only for four weeks to minimize the risk of recall bias regarding the retrospective nature of some assessments.
T184 25596-25598 Sentence denotes 5.
T185 25599-25610 Sentence denotes Conclusions
T186 25611-25702 Sentence denotes The COVID-19 lockdown measures have shown to have a serious impact on children’s behaviors.
T187 25703-25847 Sentence denotes This study has shown that all movement behaviors changed during the early stages of the COVID-19 pandemic in toddlers and preschoolers in Chile.
T188 25848-26117 Sentence denotes The most common sociodemographic factors associated with these changes were child’s age, main caregiver’s age, sex, and education, family income, main caregiver’s education, previous enrolment in an ECEC, dwelling type, space to play at home and type of residence area.
T189 26118-26294 Sentence denotes Toddlers and preschoolers with space to play at home and living in rural areas had less marked impacts on physical activity, screen time, and sleep quality due to the pandemic.
T190 26295-26506 Sentence denotes In contrast, older children, those whose caregivers were aged ≥35–<45 years and had higher educational level, and children living in apartments had greater changes, decreasing the TPA and increasing screen time.
T191 26507-26808 Sentence denotes Together, the information provided in this study may help professionals and decision-makers to balance more precisely the health risks and benefits of confinements, inform future strategies and focus resources to reduce the potential adverse effects of the pandemic, immediately, and in the long-term.