JBI Evidence Synthesis

IMPACT OF COVID-19 ON THE LIFESTYLE OF CHILDREN AND

ADOLESCENTS: A LATIN AMERICAN NARRATIVE DESCRIPTIVE REVIEW

AUTHORS

Lucas Tomasi de Santana1, Maria Rita Marques de Oliveira2, Adriana Aparecida de Oliveira
Barbosa2, Najla de Oliveira Cardozo2.

1. São Paulo State University, International School of Pharmaceutical Sciences, Araraquara,

Brazil.

2. São Paulo State University, School of Medicine, Botucatu, Brazil.

Abstract

Objective: Investigate and compile the impacts of the COVID-19 pandemic on the lifestyle of
children and adolescents of Latin America.

Introduction: Healthy lifestyle behaviors (HLS) have been consistently associated with
reduced all-cause mortality and increased life expectancy and well-being. In addition, the
COVID-19 pandemic has brought a public health crisis spanning economics, politics and
spheres that have shown the complexity of health promotion and maintaining a healthy
lifestyle. Thus, it is of paramount importance to investigate vulnerable populations, such as
children and adolescents, and low- and middle-income countries, such as those in Latin
America, that have been affected by the COVID-19 pandemic to mitigate health-promoting
and disease-prevention strategies and actions.

Inclusion criteria: Inclusion criteria: The formulation of the research question followed the
PCC structure (problem, concept and context): impacts of the COVID-19 pandemic (Problem
- P); Child and adolescent lifestyle (Concept - C); Latin American countries (Context - C).What
are the impacts of the COVID-19 pandemic on the lifestyle of Latin American children and
adolescents? The inclusion criteria will be: Studies on the impacts of the covid-19 pandemic
on the lifestyle of children and adolescents; (b) Studies that present analysis of results; (c)
Studies that were carried out in Latin America. Studies that do not present results that can be
interpreted as scientific evidence, such as opinion articles, publicity articles, news articles and
other documents, will be excluded. For the theoretical framework of lifestyle behaviors, the
focus was on nutrition, physical activity, social relationships, mental health, screen time and
sleep quality, smoking and alcoholism. Healthy Lifestyles (SF) are hegemonically interpreted

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as a set of individual behaviors capable of promoting health, understood as health, understood

as an eminently biological phenomenon.

Methods: This is a narrative descriptive review of the scientific literature, a working project
that synthesizes information and presents results critically. It will be prepared in accordance
with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
2020 statement. The study protocol will be registered with the Open Science Facility (OSF).
The electronic bibliographic databases chosen were LILACS, Scielo, Pubmed and Scopus,
which will be used without restrictions on language and year of publication. At the end, an
open search will be made in Google Scholar and in the reference lists of the selected articles.
The search strategy used was the word form composed in COVID-19 pandemic and lifestyle
of children and teenagers combined with the Latin American countries group or according to
the syntax of the databases with the use of filters. For the selection of studies and exclusion of
duplicates, the online tool (Rayyan QCRI®) will be used and will be performed by two
independent and blinded reviewers. Data will be extracted according to a form by two
independent reviewers. In the selection and extraction stages, there will be a third reviewer for
discussion of results and consensus.

Results (ONLY for reviews): It is expected that the investigation of the scientific evidence
from Latin America will allow us to compile conclusions on the impacts and lifestyle changes
of the child and adolescent population during the COVID-19 pandemic.

Conclusions (for reviews ONLY): The identification and compilation of the impacts of
COVID-19 on the lifestyle of Latin American children and adolescents can support the
mitigation of disease-preventive and health-promoting strategies and actions. The childhood
and adolescence phase is important for changes that can last into adulthood and therefore it is
of paramount importance to know the challenges and perspectives where there is a structural
economic crisis and public health problems are growing.

Introduction

In 2019, the COVID-19 pandemic emerged in China as a respiratory viral disease that
soon spread worldwide [1]. The first country in Latin America hit by the SARS-CoV2 virus was
Brazil on February 26, 2020 [2]. With the rapid spread of the virus, some emergency protective
measures were implemented, including social distancing [3], as the closure of stores and schools,
people's lifestyles have been greatly limited due to social isolation [1].

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Many practices carried out in public places were prohibited due to social isolation,
resulting in a decrease in the practice of physical exercises and an increase in sedentary
behavior among Brazilian adolescents [4]. With the closure of schools, remote teaching was
adopted, which contributed to the increase in the screen of smartphones, tablets and notebooks
in children and adolescents [5]. Another consequence of this distancing is the increase in poverty
and hunger, compromising the guarantee of food and nutritional security. In Brazil, the
National School Feeding Program was adopted to alleviate the consequences of hunger for
[6].
thousands of children and adolescents Due to social distancing measures was the delivery
of food at home due to [7]. Which caused an increase in the purchase and consumption of ready-
to-eat foods and fast-food chains. Thus, many Argentines, Colombians [8] and Ecuadorians
prioritized this type of purchase during the pandemic [9].

The change in the shopping profile brought the habit of stocking food and empty
shelves in supermarkets with panic shopping [10], observed among Brazilians who started to
stock products with a long shelf life [11]. Amid the impasses in food production and distribution,
Brazilian logistics were affected and resulted in a large increase in food prices [12], also affecting
food waste [13]. This may also be related to the increased consumption of industrialized sweets
and desserts in children [14] and alcohol consumption among adolescents [4]

According to the World Health Organization (WHO), alcoholism is the dependence of

[1]
the individual and is considered the inability to control alcohol consumption , however,
studies show that Brazilian adolescents have reduced their consumption of alcoholic beverages
during the pandemic [4].

Smoking is the act of consuming cigarettes or other products containing tobacco and is
[1]
the leading cause of preventable death in the world . In Mexico, there has been an increase
in tobacco and e-cigarette use among teenagers compared to pre-pandemic times [15], along with
stress and emotional changes [16]. In adolescents and children, there was a prevalence of fear of
losing family members or even of becoming ill, to the point of triggering constant negative
thoughts [17], which is related to the increase in the consumption of psychotropic substances, as
well as the change in the quality of sleep of children and adolescents [16].

In the face of so many changes, the COVID-19 pandemic presents an opportunity to

[18]
reflect on its challenges in the lifestyle of the Latin American population . A preliminary
search was performed in MEDLINE, Cochrane Database of Systematic Reviews, OSF,
PROSPERO and JBI Evidence Synthesis and no systematic review or scoping review was

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identified on the topic. With the aim of investigating and compiling the impacts of the COVID-
19 pandemic on the lifestyle of Latin American children and adolescents.

Review question

The formulation of the research question followed the PCC structure (problem, concept, and
context): impacts of the COVID-19 pandemic (Problem - P); Juvenile children lifestyle
(Concept - C); Latin America (Context - C). What are the impacts of the COVID-19 pandemic
on the lifestyle of children and adolescents in Latin America?

Keywords

Quality of life, Change of behavior, Coronavirus Disease, Children, Adolescents.

Eligibility criteria
Problem
Impacts of the COVID-19 which is an infectious disease caused by the coronavirus SARS-
CoV-2, Obtained its first registration on November 17, 2019, near Wuhan, China, and in 2020
contaminating the whole world [1] In an attempt to reduce the transmission of SARS-CoV-2
among people around the world, emergency measures were taken, such as social distancing [3].
Concept
Lifestyle, understood mainly as a set of individual behaviors capable of favoring health,
understood as a phenomenon of high biological degree [19] many habits such as lack of physical
exercise, inadequate diet, smoking, sleep and excessive consumption of beverages alcoholics,
screen time can directly influence, modify, encourage or inhibit the lifestyle of children and
adolescents and how they lead[1].
Context
Latin America has approximately 659,744,000 inhabitants [1] and is made up of 20 countries,
as follows: Argentine, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, El
Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru,
Dominican Republic, Uruguay and Venezuela. These countries are divided according to their
location, which can be central America and the Caribbean or South America. 80% of the Latin
American population lives in large cities such as São Paulo, Buenos Aires, Mexico City and
Rio de Janeiro. Cities that suffered a lot with the arrival of the COVID-19 pandemic. The
countries of Latin America and the Caribbean have been hard hit by the pandemic mainly due
to a lack of preparation of their health systems and due to the fragmented social security system
[30]
.
Types of Sources

This narrative descriptive review of the scientific literature will consider both
experimental and quasi-experimental studies, including randomized controlled trials, non-
randomized controlled trials, before and after studies, and interrupted time series studies. In
addition, analytical observational studies, including prospective and retrospective cohort
studies, case-control studies, and cross-sectional analytical studies will be considered for

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inclusion. This review will also consider descriptive observational study designs, including
case series, individual case reports, and cross-sectional descriptive studies for inclusion.
Qualitative studies that focus on qualitative data, including, but not limited to, designs such as
phenomenology, grounded theory, ethnography, qualitative description, and action research
will also be considered. In addition, systematic, scoping, and literature reviews that meet the
inclusion criteria will also be considered, provided they present pertinent results.

Animal or laboratory studies, texts, letters, news articles, conference abstracts, reviews,
and opinion articles will not be considered for inclusion in this descriptive review of the
scientific literature due to the absence of relevant analysis of results.

Methods

The proposed narrative descriptive review of the scientific literature will be conducted
according to the JBI methodology and PRISMA criteria for descriptive review of the scientific
literature.

Search strategy
Lifestyle OR Quality of Life (QOL) OR Health Behaviour
AND

Latin America OR Brazil OR Argentina OR Venezuela OR Uruguay OR Chile OR Colombia

OR Bolivia OR Costa Rica OR Ecuador OR Cuba OR El Salvador OR Guatemala OR Haiti
OR Honduras OR Mexico OR Dominican Republic OR Peru OR Paraguay OR Panama OR
Nicaragua

AND

Pandemic OR Covid-19 OR SARS-CoV2 OR Coronavirus OR Social Isolation

AND
Children OR Adolescent OR School OR Kids OR Toddler OR Teen OR Student
Study/Source of Evidence selection

Following the search, all identified citations will be collated and uploaded into Rayyan and
duplicates removed. Following a pilot test, titles and abstracts will then be screened by two or
more independent reviewers for assessment against the inclusion criteria for the review.
Potentially relevant sources will be retrieved in full and their citation details imported into the
JBI System. The full text of selected citations will be assessed in detail against the inclusion
criteria by two or more independent reviewers. Reasons for exclusion of sources of evidence
at full text that do not meet the inclusion criteria will be recorded and reported in the scoping
review. Any disagreements that arise between the reviewers at each stage of the selection

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process will be resolved through discussion, or with an additional reviewer/s, the kappa
coefficient between the authors will be calculated. The results of the search and the study
inclusion process will be reported in full in the final descriptive review and presented in a
Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping
review (PRISMA-ScR) flow diagram.

Data Extraction

Data will be extracted from papers included in the review using a data extraction form created
by the authors. A standard form will be used by two reviewers independently, with the items:
authors, year of publication, country, objectives, type of study, methodology and instrument,
study focus, population coverage, main results of conclusions.

The form data extraction tool will be modified and revised as necessary during the process of
extracting data from each included evidence source. Modifications will be detailed in the
review. Any disagreements that arise between the reviewers will be resolved through
discussion, or with an additional reviewer/s. If appropriate, authors of papers will be contacted
to request missing or additional data, where required.

Data Analysis and Presentation

They will be organized in tables according to their general characteristics, main results and
conclusions of the studies. These tables will be organized along the flow of information in the
text and will describe how the results relate to the review objectives and question.

Acknowledgements

Acknowledgment to the São Paulo State University, International School of Pharmaceutical

Sciences, Araraquara, Brazil And School of Medicine Botucatu.

Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível
Superior – Brasil (CAPES) – Finance Code 001.

Conflicts of interest

There is no conflict of interest in this project.

References

[1] History of the COVID-19 pandemic - PAHO/WHO | Organização Pan-Americana da

Saúde available at: https://www.paho.org/pt/covid19/historico-da-pandemia-covid-19.
Accessed on April 13, 2022.

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[2] The Coronavirus in Latin America – ASCOA | Americas Society Council of the
Americans available at: https://www.as-coa.org/articles/coronavirus-latin-america. Accessed on
April 15, 2022.

[3] AQUINO, E. M. L; SILVEIRA, I. H; PESCARINI, J.M; AQUINO, R; SOUZA-FILHO,

J. A. DE; ROCHA, A. DOS S; et al. Social distancing measures to control the COVID-19
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[4] MALTA, D, C; GOMES, C, S; BARROS, M, B, A; LIMA, M, G; SILVA, A, G;

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[7] BOTELHO, L. V; CARDOSO, L. DE O; CANELLA, D. S. COVID-19 and the digital

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of the pandemic. Perspectiva: Ciência e Saúde, Osório, v. 5, no. 2, p. 36-50, 2020.
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28, no. 00, p. 1-14, 2021.
[13] DE ARO, F; PEREIRA, B. V; BERNARDO, D. N. D. A. Eating behavior in times of
Covid-19 pandemic. BJDV, Curitiba, v. 7, no. 6, p. 59736-59748, 2021.
[14] FAVONI, S, P, G; OSHIIWA, M; OLIVEIRA, A, S; OLIVEIRA, M, V, S, B;
GIANNONI, J, A; FAVONI, C; et al. Impacts of COVID-19 on Family income and its

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influence on the food consumption pattern of children enrolled in basic education in the city
of Pederneiras-SP. Research, Society and Development, v. 11, n.13. 2022.
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JEREZ-MAYORGA, D; CAAMAÑO-NAVARRETE, F; DELGADO-FLOODY, P. Positive
and Negative Changes in Food Habits, Physical Activity Patterns, and Weight Status during
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[15] BARRERA-NÚÑEZ, D; OLMEDO, N, L; ARCINIEGA, L, Z; GUTIERREZ, I, B,
SHIGEMATSU, L, M, R. Salud pública de México. vol. 65, suplemento, 2023.

[16] MILIAUSKAS, C, R; FAUS, D, P. Saúde mental de adolescentes em tempos de Covid-

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[17] MANGUEIRA, L, F, B; NEGREIROS, R, A, M; DINIZ, M, F, F, M; SOUSA, J, K.

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Appendices
Appendix I: Search strategy

#1 Lifestyle OR Quality of Life OR

Lifestyle Factors
#2 Pandemic OR Covid-19 OR SARS-
CoV2 OR Coronavirus OR Social
Isolation

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#3 Latin America OR Brazil OR

Argentina OR Venezuela OR
Uruguay OR Chile OR Colombia OR
Bolivia OR Costa Rica OR Ecuador
OR Cuba OR El Salvador OR
Guatemala OR Haiti OR Honduras
OR Mexico OR Dominican Republic
OR Peru OR Paraguay OR Panama
OR Nicaragua
#4 2020 to 2023
#5 Children OR Adolescent OR
School OR Kids OR Toddler OR Teen
OR Student

#1 AND #2 AND #3 AND #4 AND #5

Appendix II: Data extraction instrument

Principais
Abrangência
Autor Ano País Objetivo Tipo de Estudo Metodologia Instrumentos/Ferramentas Resultados
populacional
para conclusão

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