549 - Child and adolescent well-being and family functioning during the COVID-19 pandemic in those seeking emergency department care with mental health concerns

Poster Number: 549
Publication Number: 549.1753

Background: The longitudinal impact of pandemic-related stressors on child well-being and family functioning over the course of the pandemic is unknown.

Objective: Primary: To evaluate and compare child well-being and quality of life of their families during the early vs. later phases of the COVID-19 pandemic. Secondary: To identify factors independently associated with child well-being.

Design/Methods: Patients < 18 years presenting to two pediatric EDs in Alberta, Canada for a mental health concern between March 15, 2020 – June 30, 2022, were eligible. Early and late pandemic time-periods were defined: March 15, 2020 – March 14, 2021 (first 12 months following provincial public health restriction implementation) and July 1, 2021 – June 30, 2022 (last 12 months of provincial public health restrictions), respectively. The Stirling Children's Well-being Scale (ages 8.0 – < 13.0 years) and Warwick-Edinburgh Mental Well-being Scale (ages 13.0 – < 18.0 years) evaluated well-being. The Family Quality of Life Scale (FQOL) measured family quality of life. Independent t-tests compared well-being scores and multivariable regression analyses evaluated associations between well-being and demographics, ED visit characteristics, and pandemic time-periods.

Results: 1424 eligible participants (50.4% early pandemic and 49.2% late pandemic) were included. 72.8% (1005/1381) were Caucasian and 53.8% (744/1383) were female. Median age was 13 years (IQR, 11-15 years). The most common discharge diagnosis was anxiety and stress-related disorders (ICD-10-CA F40-48; 36.0%; 487/1353). Child and adolescent well-being did not differ between periods, however, FQOL was lower in the late pandemic period with a mean difference of -2.16 (95%CI: -3.79, -0.53); p=0.01]. One characteristic was positively associated with well-being in children aged 8 to < 13 years (being Asian; β=4.42) while receiving outpatient mental health care (β=-2.00), being admitted or transferred for inpatient care (β=-3.15) or older age (β=-0.59) were negatively associated. For children aged > 13 years, being Asian (β=2.98) or having a personality or behavior disorder (β=5.28) were positively associated with well-being while having autism (β=-3.53) or requiring a mental health team consultation (β=-1.56) were negatively associated.

Conclusion(s): Although we found no difference in child well-being across the course of the pandemic, FQOL was lower during the last year of public health restrictions. We also identified certain patient characteristics associated with child well-being which can inform groups most in need of support.