Daily and average associations of physical activity, social media use, and sleep among adolescent girls during the COVID-19 pandemic.

Adolescents' daily lives have been disrupted during the Coronavirus disease 2019 (COVID-19) pandemic. It remains unclear how changes in adolescents' daily physical and social behaviours affect their sleep. The present study examined the daily and average effects of physical activity and social media use (i.e., video chatting, texting, and social networking sites) on adolescent girls' sleep during the COVID-19 pandemic. Adolescent girls aged 12-17 years (N = 93; 69% White) from a larger longitudinal study completed a 10-day daily diary protocol during state-mandated stay-at-home orders. Girls reported on daily sleep (duration, timing, quality), physical activity, and social media use during COVID-19. Multilevel modelling was used to examine the within- and between-person effects of physical activity and social media on sleep duration, timing, and quality during the 10-day period. Between-person associations indicate that youth with greater social media use (texting, video chatting, and social networking) and less physical activity had later sleep timing across the 10-day study period. Only video chatting was associated with shorter sleep duration. There were no within-person effects of physical activity or social media activities on sleep outcomes. Findings indicate that physical activity and social media use may impact later adolescent sleep timing during the COVID-19 pandemic. It will be critical for research to examine the potential long-term costs of delayed sleep timing, and whether targeting specific youth behaviours associated with sleep and circadian disruption improve mental and physical health during the COVID-19 pandemic and beyond.

Utilization of Asynchronous and Synchronous Teledermatology in a Large Health Care System During the COVID-19 Pandemic.

Background: Teledermatology offers an opportunity to continually deliver care during the coronavirus disease 2019 pandemic. Objective: To provide quantitative data about the use of teledermatology. Methods: Retrospective analysis of teledermatology consultations was performed from March 16 to May 1, 2020. The number/type of encounters, differences in diagnoses, and prescriptions between asynchronous and synchronous teledermatology visits were analyzed. Results: A total of 951 visits (36.2%) were asynchronous whereas 1,672 visits (63.8%) were synchronous. Only 131 (<5%) visits required an acute in-person follow-up. The diagnosis of acne was more frequent with asynchronous visits (p < 0.002, Bonferroni corrected). Antibiotics and nonretinoid acne medications were prescribed more with asynchronous visits, whereas immunomodulators and biologics were more commonly prescribed with synchronous visits (p < 0.02, Bonferroni corrected). Providers at our institution were split on preferred mode (54.2% synchronous, 45.8% asynchronous); however, synchronous visits were preferred for complex medical dermatology patients and return patients (p < 0.05). Limitations: This study is limited by being a single-center study. Conclusions: Asynchronous teledermatology was used more for acne management, whereas synchronous teledermatology was preferable to providers for complex medical dermatology. Postanalysis of the data collected led us to institute a hybridization of our asynchronous and synchronous teledermatology.