Insights into parents' perceived worry before and during the COVID-19 pandemic in Australia: inequality and heterogeneity of influences.

BACKGROUND: Excessive worry is an invisible disruptive force that has adverse health outcomes and may advance to other forms of disorder, such as anxiety or depression. Addressing worry and its influences is challenging yet crucial for informing public health policy. METHODS: We examined parents' worries, influences, and variability before and during COVID-19 pandemic and across geography. Parents (n = 340) and their primary school-aged children from five Australian states completed an anonymous online survey in mid-2020. After literature review, we conceptualised the influences and performed a series of regression analyses. RESULTS: Worry levels and the variables contributing to parents' worry varied before to during the pandemic. The proportion of parents who were "very worried all the time" increased by 14.6% in the early days of the pandemic. During the pandemic, ethnic background modified parents' worry and parents' history of daily distress symptoms was a significant contributor (p < 0.05). Excessive exposure to news remained significant both before and during the pandemic. The primary predictor of parents' worry before COVID-19 was perceived neighbourhood safety, while the main predictor during COVID-19 was financial risk due to income change. Some variable such as neighbourhood safety and financial risk varied in their contribution to worry across geographical regions. The proportion of worried children was higher among distraught parents. CONCLUSION: Parents' worry during the health pandemic was not triggered by the health risks factors but by the financial risk due to income change. The study depicts inequality in the impact of COVID-19 by ethnic background. Different policies and reported virus case numbers across states may have modified the behaviour of variables contributing to the geography of parents' worry. Exposure to stressors before the COVID-19 pandemic may have helped parents develop coping strategies during stressful events. Parents are encouraged to limit their exposure to stressful news. We advocate for parents-specific tailored policies and emphasise the need for access to appropriate mental health resources for those in need. Advancing research in geographical modelling for mental health may aid in devising much-needed location-targeted interventions and prioritising resources in future events.

Children's outdoor active mobility behaviour and neighbourhood safety: a systematic review in measurement methods and future research directions.

BACKGROUND: Numerous studies have examined the association between safety and primary school-aged children's forms of active mobility. However, variations in studies' measurement methods and the elements addressed have contributed to inconsistencies in research outcomes, which may be forming a barrier to advancing researchers' knowledge about this field. To assess where current research stands, we have synthesised the methodological measures in studies that examined the effects of neighbourhood safety exposure (perceived and measured) on children's outdoor active mobility behaviour and used this analysis to propose future research directions. METHOD: A systematic search of the literature in six electronic databases was conducted using pre-defined eligibility criteria and was concluded in July 2020. Two reviewers screened the literature abstracts to determine the studies' inclusion, and two reviewers independently conducted a methodological quality assessment to rate the included studies. RESULTS: Twenty-five peer-reviewed studies met the inclusion criteria. Active mobility behaviour and health characteristics were measured objectively in 12 out of the 25 studies and were reported in another 13 studies. Twenty-one studies overlooked spatiotemporal dimensions in their analyses and outputs. Delineations of children's neighbourhoods varied within 10 studies' objective measures, and the 15 studies that opted for subjective measures. Safety perceptions obtained in 22 studies were mostly static and primarily collected via parents, and dissimilarities in actual safety measurement methods were present in 6 studies. The identified schematic constraints in studies' measurement methods assisted in outlining a three-dimensional relationship between 'what' (determinants), 'where' (spatial) and 'when' (time) within a methodological conceptual framework. CONCLUSIONS: The absence of standardised measurement methods among relevant studies may have led to the current diversity in findings regarding active mobility, spatial (locality) and temporal (time) characteristics, the neighbourhood, and the representation of safety. Ignorance of the existing gaps and heterogeneity in measures may impact the reliability of evidence and poses a limitation when synthesising findings, which could result in serious biases for policymakers. Given the increasing interest in children's health studies, we suggested alternatives in the design and method of measures that may guide future evidence-based research for policymakers who aim to improve children's active mobility and safety.

Is there a correlation between children's outdoor active mobility behaviour and neighbourhood safety? A systematic review of the evidence.

OBJECTIVE: To identify, summarise and evaluate evidence on the correlation between perceived and actual neighbourhood safety (personal and road danger) and diverse forms of outdoor active mobility behaviour (ie, active play, exercise, and travel) among primary-school-aged children. DESIGN: A systematic review of evidence from observational studies exploring children's active mobility behaviour and safety. DATA SOURCES: Six electronic databases were searched: Google Scholar, PubMed, Scopus, Science Direct, ProQuest and Web of Science from study inception until July 2020. DATA EXTRACTION AND SYNTHESIS: Study selection and quality assessment were conducted independently by two reviewers. We expanded on a quality assessment tool and adopted a vote-counting technique to determine strength of evidence. The outcomes were categorised by individual, family and neighbourhood levels. RESULTS: A total of 29 studies were included, with a majority of cross-sectional design. Higher parental perceived personal safety correlated with increased children's active mobility behaviour, but most commonly in active travel (eg, independent walking or cycling to a local destination). Increased concerns regarding road danger correlated with a decrease in each type of children's active behaviour; active travel, play and exercise. However, these correlations were influenced by child's sex/gender, age, car ownership, neighbourhood types, across time, and proximity to destination. Limited or inconclusive evidence was found on correlate of children's outdoor active mobility behaviour to 'stranger danger', children's perceived personal safety, race/ethnicity, socioeconomic status or measured safety. CONCLUSION: Children are restricted by perception of safety. Encouraging children's active travel may require future strategies to address characteristics relevant to types of the neighbourhood that promote a high sense of personal safety. Children and parents may embrace other types of active mobility behaviour if road danger is mitigated. Sex/gender and age-specific interventions and redesign of public places could lead to child-friendly cities. Future studies may benefit from adopting validated measurement methods and fill existing research gaps.