Caregivers' Reports of the Complex Impacts of the Pandemic on Family Food and Physical Activity Behaviors by Race, Ethnicity, Urbanicity, and Income

Background: The COVID-19 pandemic affected health and well-being worldwide, but little is known about how the pandemic specifically impacted families with young children. Evidence suggests a relationship between well-being and health behaviors (diet, physical activity) and that preexisting health disparities were exacerbated during the pandemic. Purpose: This project sought caregiver perspectives on pandemic impacts, overall and by race, ethnicity, urbanicity, and household income. Methods: Caregivers of 4- to 11-year-olds were randomly selected to complete a mixed-mode survey in the winter of 2021-22 to evaluate ongoing community health education and programming. Qualitative content analysis of open-ended survey responses was conducted. Data were analyzed blind to demographic characteristics; later, differences by population were explored. Results: Survey analysis (n = 1,429, response rate 27%) identified positive and negative impacts of the pandemic on youth diet and physical activity. Caregivers, unprompted, provided responses about the interconnected impacts on mental and physical health and health behaviors. Pandemic stress was described, including reduced energy, social isolation, and "fear of spread." Significant differences by key characteristics were found. Discussion: These findings reflect patterns that could underlie growing disparities. Translation to Health Education Practice: This work provides context for designing interventions that equitably promote healthy behaviors for young families. Translation to Health Education Practice