Abstract
OBJECTIVE: To understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on parental perceptions of health behaviors and food insecurity among children with overweight and obesity living in San Francisco and to assess the relationship between food insecurity and dietary intake during the pandemic. METHODS: Parents of children ages 4 to 12 in San Francisco with body mass index ≥85th percentile measured at a clinic visit at a Federally Qualified Health Center or academic practice from January 1st to March 15th, 2020 were eligible to participate. Parents completed a survey reporting on child health behaviors and household food insecurity prior to and since the start of the pandemic. Survey items were abstracted from validated surveys with adaptations. Regression models evaluated associations between food insecurity and dietary intake variables. RESULTS: Most participants (n = 145) were publicly insured (90%), Latino (77%), and spoke Spanish at home (70%). Parents perceived that child mean daily nonacademic screen time was higher during the pandemic compared to before (3.8 hours vs 1.6 hours). Mean daily physical activity was reported to be lower compared to prior to the pandemic (1 hour vs 1.8 hours). On average, reported bedtime shifted 1.6 hours later. Food insecurity increased significantly but was not associated with intake of fruits, vegetables, sugar-sweetened beverages, or foods with added sugar during the pandemic. CONCLUSIONS: Parents of children with overweight or obesity in San Francisco perceive increased child screen time, decreased physical activity and later bedtimes during the COVID-19 pandemic. Findings suggest a need for policies that support healthy lifestyle behaviors among low-income children during the pandemic.