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Meta-Analysis
. 2022 Jun 15;22(1):1201.
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

Affiliations
Meta-Analysis

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

Feifei Li et al. BMC Public Health. .

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 1st Jan 2020 to 28th 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.

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Conflict of interest statement

All the authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart outlining literature search process, inclusion and exclusion of studies
Fig. 2
Fig. 2
Random effect of the difference in preventive behaviors between children/adolescents and adults
Fig. 3
Fig. 3
Random effect of age on preventive behaviors in children and adolescents
Fig. 4
Fig. 4
Random effect of gender on preventive behaviors in children and adolescents
Fig. 5
Fig. 5
Random effect of attitude and perceived severity on preventive behaviors in children and adolescents
Fig. 6
Fig. 6
Random effect of family economic status on preventive behaviors in children and adolescents

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