Authors: Reeti Douglas, Neha Tripathi, Ashley Allen, Cait Ennis, Jessica Judy, Emily Klink, and Jenelle Mrugalski7
Department of Occupational Therapy, Wingate University, Wingate, NC, USA
Corresponding Author:
Reeti Douglas, OTD, OTR/L
Department of Occupational Therapy
Wingate University
220 N Camden St
Wingate, NC 28174
r.douglas@wingate.edu
704-233-8973
Reeti Douglas OTD, OTR/L is an Assistant Professor of Occupational Therapy at Wingate in Wingate, NC. Her research interests focus on pediatric and youth sports rehabilitation, pediatric and youth athlete mental health, and pediatric and adolescent hand rehabilitation.
Ashley Allen, Cait Ennis, Jessica Judy, Emily Klink, and Jenelle Mrugalski are doctoral students in the Occupational Therapy program at Wingate University. Their research interests include pediatrics, mental health, and sports rehabilitation.
Psychosocial Impact of COVID-19 on Female Youth Cheerleaders
ABSTRACT
Purpose: As a result of the COVID-19 pandemic, national restrictions were implemented limiting social gatherings and disrupting many facets of everyday life including sports. To gain a better understanding of how the COVID-19 pandemic has affected the social and emotional wellbeing of children and adolescents in sports, the present study examined parental perspectives of female youth competitive cheerleaders during the national pandemic.
Methods: A sample of 97 parents of female youth competitive cheerleaders completed an online Qualtrics survey investigating their perspectives on the psychosocial wellbeing of their children during the COVID-19 pandemic.
Results: Descriptive statistics were used for the quantitative analysis to determine general findings from the survey results. Results revealed that all age groups (5-18 years old) reported high levels of frustration (≥63.7%), all hours of training (1-14 hours a week) reported high levels of frustration (≥63.1%), and all levels of cheer (Level 1-6) reported high levels of frustration (≥62.9%). All age groups (≥67.1%), all hours of training (≥60.1), and levels 2-5 of cheer (≥ 57.1) reported high levels of feelings of loneliness during the pandemic. For all age groups, an increased interest in watching television or playing video games was reported as high (≥66.6%). Parents of level 2-6 cheerleaders (≥57.1) and cheerleaders who trained 5-14 hours a week (≥ 57.9) reported high levels of restlessness without participating in cheer activities.
Conclusions: Findings suggest that as a result of the COVID-19 pandemic, female youth competitive cheerleaders experienced high levels of frustration, loneliness, and restlessness and spent more time engaging in sedentary activities rather than participating in active sports-related functions and practices.
Applications in Sports: This study found that the impacts of COVID-19 on the psychosocial wellbeing of youth athletes include increased levels of frustration, loneliness, and restlessness, which can be attributed to decreased participation in sports. The findings of this study provide data to support the importance of addressing psychosocial needs with female youth athletes and addressing the benefits of sports for leisure occupation and social participation. Implications of this study can be applied to healthcare professions and athletic departments to guide future research and programs regarding sports and youth.
Key Words: pediatric athletes, psychosocial wellbeing, mental health, youth sports
INTRODUCTION
COVID-19, a respiratory disease caused by the SARS-CoV-2 virus, was named a global pandemic in March 2020 by the World Health Organization (9). In the United States, there have been over 80 million cases and 980,000 deaths as of April 2022 (4). To prevent the spread of COVID-19, restrictions were implemented nationwide, including social distancing, school closures, cessation of group activities and gatherings, stay at home orders, and mandated curfews. During this time, children were subject to a more sedentary lifestyle, which negatively affected physical, social, and emotional wellbeing (9).
The COVID-19 pandemic has presented many challenges for people of all ages, especially for children and adolescents who engage in competitive sports. According to the U.S. All Star Federation (21), a national competitive cheer and dance organization, there are currently 150,000 All Star athletes competing on a national level. Competitive youth cheerleaders are expected to participate in various competitions and training that traditionally involve routine social and physical contact with peers and coaches. Due to restrictions from COVID-19, competitive athletes have more limited participation in rigorous weekly practices and scheduled competitions. In addition to the physical repercussions of the pandemic, competitive athletes have also experienced a decrease in social interactions with teammates and coaches.
Previous research investigating the impacts of COVID-19 on children and adolescents has indicated psychosocial health to be negatively influenced. Costa et al. (7) explored the impact of COVID-19 on competitive athletes’ social and athletic identities, stress levels, and emotional regulation, and found that the shift in social distancing and quarantine guidelines has negatively impacted children and adolescents’ emotional wellbeing. The American Academy of Orthopaedic Surgeons examined the physical and mental impact on young athletes when their daily sports routine is altered and found that changes in sleep quality during the pandemic were associated with higher levels of anxiety, specifically for female athletes (1). According to a systematic review conducted by Loades et al. (15), one-third of adolescents reported high levels of loneliness during the early stages of COVID-19. Moreover, research has identified various impacts on psychosocial wellbeing that adolescent athletes have developed in the midst of the pandemic, including anxiety and depression. A cross-sectional study of adolescent athletes assessed levels of anxiety, depression, and general quality of life following COVID-19 related sports cancellations. Results of this study outlined a higher prevalence of moderate to severe anxiety as well as a higher occurrence of depression in team sports (16). Available literature indicates that the disruption in social and physical activity that competitive sports usually provide has led to feelings of isolation amongst athletes as well as negatively influenced their psychosocial well-being. Researchers found that increased involvement in sports activities is associated with decreased levels of depression and anxiety (17).
There has been limited research examining the full consequences of COVID-19 on the social and emotional wellbeing of youth athletes. Furthermore, research specifically focusing on youth female athletes was not identified in current literature. The aim of this study is to gain a better understanding of how the COVID-19 pandemic has affected the social and emotional wellbeing of female youth athletes. This research may provide insight into the impacts of the isolation and disruption resulting from COVID-19 in competitive youth sports.
METHODS
Participants
For this initial research study, researchers chose to limit the research to a specific geographic region, gender, and sport. For the purpose of convenience sampling, competitive cheerleading facilities in the Charlotte, North Carolina (NC) area were selected based on their affiliation with the U.S. All Star Federation (21). Researchers identified the inclusion criteria for this study as parents of female youth (5 to 18 years of age) competitive cheerleaders in the Charlotte, NC region. University Research Review Board (RRB) approval was obtained.
Instrumentation
A quantitative, descriptive survey was administered through Qualtrics, an online platform. This method abides by social distancing guidelines introduced as a result of the COVID-19 pandemic, while maintaining the anonymity of participants, and being easily accessible at no cost to participants.
The survey was developed based on the Revised Child Anxiety and Depression Scale found on the Child Outcomes Research Consortium website (5,6). In a recent position paper from The International Consortium for Health Outcome Measurement, the RCADS was proclaimed as one of the best-validated international measures for children and youth depressive symptoms (14). Additionally, according to a recent systematic review and meta-analysis which analyzed 146 individual research studies which had used the RCADS, the RCADS was found to be an excellent reliability outcome measure for cross-cultural use in diverse youth populations (18). The RCADS was selected on the basis of high internal consistency (α Total Score=0.95) and favorable test-retest reliability (rTotal Score=0.93) (10). Individual questions were adapted from this assessment and modified in order to help answer the research question and target the desired population. Questions were adapted in order to be relevant to what was specifically being measured and respective questions included “when not able to participate in cheer activities”. Obsessive compulsive disorder related questions were not used from the RCADS scale, along with specific questions of suicide and death. Questions which inquired about increased sedentary behaviors, such as increased sleep and television use were additionally added into the questionnaire. Additional questions were added to investigate how the children’s activities and hobbies were impacted by the lack of participation in cheer activities. Participants were asked to respond to a total of 26 questions, which collected ordinal data, based on a Likert-type scale. Informed consent was obtained from each participant prior to beginning the survey.
Various data strengthening techniques were used within the current research study. A detailed audit trail was maintained throughout the data collection process, which contributed to the overall reliability of the study. To establish content validity, survey questions addressed a wide array of factors of psychosocial health in youth cheerleaders, such as loneliness, stress, fear, and frustration. Therefore, the survey provided an adequate and well-rounded examination of youth cheerleaders’ psychosocial well-being. In addition, face validity of the study was strengthened by ensuring that survey questions were examined by two expert reviewers prior to distribution of the survey to participating cheer facilities (19).
RESULTS
A total of 97 parents participated in the online survey. As three respondents did not meet inclusion criteria, a total of 94 respondents (n=94) were included in the final analysis of results. All responses were complete, without missing entries or responses. 100% of the participants analyzed were parents of female youth competitive cheerleaders. Table 1 reports the demographics of the participants’ children. The most common reported age group of participant’s children was 11-13 years old, and the most common reported level of cheerleading was Level 2. Prior to the COVID-19 pandemic, children of participants most often engaged in 5-9 hours of cheerleading activities per week (60.6%) followed by 1-4 hours (20.2%), and 10-14 hours (19.1%). The age groups of 17-18 years old had an equal representation of how many hours their child spent engaging in cheer activities per week across all three options of hours (1-4 hours, 5-9 hours, 10-14 hours). The two lowest reported findings for hours of training were ages 14-16, with respondents reporting that 7.4% of this age bracket participated in cheer activities for 1-4 hours, as well as 7.4% reporting 10-14 hours per week. The highest reported finding for hours training was 85.2% of cheerleaders that were between the age of 14-16 years spent 5-9 hours engaging in cheer activities per week. The lowest reported cheer level was level 5, with only n=3, or 3.2% of parents reporting their children belonging to this group. The highest reported level was level two, with n=28, or 29.8% of parents reporting their children belonged to this group.
Table 1: Age distribution of training hours and cheer level
| 5-7 | 8-10 | 11-13 | 14-16 | 17-18 | Total | |
| Hours (per week) | ||||||
| 1-4 hours | 1 (25.0%) | 3 (13.6%) | 11 (31.4%) | 2 (07.4%) | 2 (33.3%) | 19 (20.2%) |
| 5-9 hours | 2 (50.0%) | 16 (72.7%) | 14 (40.0%) | 23 (85.2%) | 2 (33.3%) | 57 (60.6%) |
| 10-14 hours | 1 (25.0%) | 3 (13.6%) | 10 (28.6%) | 2 (07.4%) | 2 (33.3%) | 18 (19.1%) |
| Cheer Level | ||||||
| Level 1 | 3 (75.0%) | 8 (36.4%) | 7 (20.0%) | 1 (03.7%) | 0 (00.0%) | 19 (20.2%) |
| Level 2 | 1 (25.0%) | 13 (59.1%) | 5 (14.3%) | 8 (29.6%) | 1 (16.7%) | 28 (29.8%) |
| Level 3 | 0 (00.0%) | 0 (00.0%) | 14 (40.0%) | 8 (29.6%) | 0 (00.0%) | 22 (23.4%) |
| Level 4 | 0 (00.0%) | 1 (4.5%) | 5 (14.3%) | 4 (14.8%) | 4 (66.7%) | 14 (14.9%) |
| Level 5 | 0 (00.0%) | 0 (00.0%) | 2 (05.7%) | 1 (03.7%) | 0 (00.0%) | 3 (03.2%) |
| Level 6 | 0 (00.0%) | 0 (00.0%) | 2 (05.7%) | 5 (18.5%) | 1 (16.7%) | 8 (08.5%) |
Descriptive statistics were used for the quantitative analysis to determine general findings from the survey results. Prior to analyzing results, all data was clubbed into two categories: 1) high levels, characterized by “often” and “always” responses; 2) low levels, characterized by “sometimes” and “never” responses. Responses to survey questions were categorized by age-groups, level of cheer, and training hours per week. Percentages were given for both low and high responses.
Areas of psychosocial impact that had a significant amount of high responses categorized by age group were frustration and loneliness depicted on Table 2. Results revealed that all age groups (5-18 years old) reported high levels of frustration (≥63.7%), with the highest levels of frustration (88.9%) reported for the 14-16 years old age group. In addition, all age groups reported high levels of feelings of loneliness during the pandemic (≥67.1%). Parents of youth competitive cheerleaders ages 17-18 reported the highest levels of loneliness (83.4%). For all age groups, an increased interest in watching television or playing video games was reported as high (≥66.6%), with competitive cheerleaders ages 14-16 reporting the highest levels (74.5%).
TABLE 2: Survey Questions with High Levels (Categorized by Age Group)
| Q7: My child felt frustrated about not being able to participate in cheer activities | |||||
| 5-7 | 8-10 | 11-13 | 14-16 | 17-18 | |
| Low (Never, Sometimes) | 25.00% | 36.40% | 34.30% | 11.10% | 33.30% |
| High (Often, Always) | 75.00% | 63.70% | 65.70% | 88.90% | 66.60% |
| Q13: My child reported feeling lonely from not seeing friends or teammates | |||||
| 5-7 | 8-10 | 11-13 | 14-16 | 17-18 | |
| Low (Never, Sometimes) | 23.30% | 30.90% | 32.90% | 26.50% | 16.70% |
| High (Often, Always) | 76.60% | 69.10% | 67.10% | 73.50% | 83.40% |
| Q20: My child showed increased interest in watching television or playing video games | |||||
| 5-7 | 8-10 | 11-13 | 14-16 | 17-18 | |
| Low (Never, Sometimes) | 33.30% | 33.30% | 28.50% | 25.50% | 33.40% |
| High (Often, Always) | 67.00% | 66.60% | 71.50% | 74.50% | 66.70% |
Similar to all age groups, all levels of cheer reported high levels of frustration and loneliness depicted on Table 3. Results revealed that all levels of cheer (1-6) reported high levels of frustration (≥62.9%), with the highest levels of frustration (87.5%) reported for the level 6 group. Level 2-5 cheerleaders reported high levels of feelings of loneliness during the pandemic (≥57.1%). Parents of youth competitive cheerleaders Level 5 reported the highest levels of loneliness (66.6%). For level 2-6 cheerleaders, feeling restless without participating in cheer activities was reported as high (≥57.1%), with level 5 cheerleaders reporting the highest levels (100%).
TABLE 3: Survey Questions with High Levels (Categorized by Level of Cheer)
| Q6: My child felt restless without participating in cheer activities | ||||||
| Level 1 | Level 2 | Level 3 | Level 4 | Level 5 | Level 6 | |
| Low (Never, Sometimes) | 63.10% | 39.30% | 40.90% | 42.80% | 0.00% | 37.50% |
| High (Often, Always) | 36.80% | 60.70% | 59.00% | 57.10% | 100.00% | 62.50% |
| Q7: My child felt frustrated about not being able to participate in cheer activities | ||||||
| Level 1 | Level 2 | Level 3 | Level 4 | Level 5 | Level 6 | |
| Low (Never, Sometimes) | 37.10% | 17.90% | 31.80% | 28.50% | 33.30% | 12.50% |
| High (Often, Always) | 62.90% | 82.10% | 68.20% | 71.40% | 66.60% | 87.50% |
| Q13: My child reported feeling lonely from not seeing friends or teammates | ||||||
| Level 1 | Level 2 | Level 3 | Level 4 | Level 5 | Level 6 | |
| Low (Never, Sometimes) | 47.30 % | 35.70 % | 40.90 % | 42.90 % | 33.30 % | 50.0 % |
| High (Often, Always) | 52.70 % | 64.30 % | 59.10 % | 57.10 % | 66.60 % | 50.0 % |
Table 4 depicts high levels of frustration, loneliness, and restlessness in all cheerleaders across all hours of training per week. Results revealed that all hours of training (1-14) reported high levels of frustration (≥63.1%), with the highest levels of frustration (77.8%) reported for 10-14 hours of training per week. Regardless of numbers of hours of training per week, all cheerleaders reported high levels of feelings of loneliness during the pandemic (≥60.1%). Parents of youth competitive cheerleaders who trained 1-4 hours a week reported the highest levels of loneliness (68.5%). For cheerleaders training 5-14 hours a week, feeling restless without participating in cheer activities was reported as high (≥57.9%), with cheerleaders training 10-14 hours a week reporting the highest levels (66.6%).
TABLE 4: Survey Questions with High Levels (Categorized by Training Hours )
| Q6: My child felt restless without participating in cheer activities | |||
| 1-4 | 5-9 | 10-14 | |
| Low (Never, Sometimes) | 57.90% | 42.20% | 33.30% |
| High (Often, Always) | 42.20% | 57.90% | 66.60% |
| Q7: My child felt frustrated about not being able to participate in cheer activities | |||
| 1-4 | 5-9 | 10-14 | |
| Low (Never, Sometimes) | 36.80% | 26.40% | 22.30% |
| High (Often, Always) | 63.10% | 73.70% | 77.80% |
| Q13: My child reported feeling lonely from not seeing friends or teammates | |||
| 1-4 | 5-9 | 10-14 | |
| Low (Never, Sometimes) | 31.60% | 39.90% | 38.90% |
| High (Often, Always) | 68.50% | 60.10% | 61.10% |
Feelings of irritability and annoyance, feelings of worry, and sadness were reported to have a similar occurrence of both high and low responses. For questions that asked about declining levels of interest in cheer activities, sports activities, and hobbies, there were a majority of low level reports, indicating that the level of interest in these activities did not often decline. Low levels of stress were reported for all cheerleaders, with the exception of cheerleaders ages 17-18 years old that had equal reports of both high and low levels and level 5 cheerleaders that had high levels of stress. Survey questions asking about difficulty focusing on tasks, not being able to think clearly, making a fool of themselves when they returned to cheerleading practice, and changes in appetite had a high occurrence of reported low levels across all cheerleaders.
Based on the quantitative data analysis, parents of youth competitive cheerleaders revealed psychosocial and emotional changes in their children, specifically increased levels of frustration and loneliness as a result of the COVID-19 pandemic. The findings also suggest that belonging to a competitive sports practice makes up a large part of these youth athletes’ lives, and that with the cessation of competitions, meets, and practices, youth cheerleaders often felt restless and spent their time engaging in more sedentary activities such as watching television.
CONCLUSIONS
During the COVID-19 pandemic, youth competitive athletes have encountered restricted participation in routine practices, competitions, and social events. Sports play an integral role in the lives of many children and adolescents, as participating in sports helps define one’s personal and athletic identity while facilitating one’s physical and psychosocial development and well-being (12). Findings from this study reveal increased levels of frustration and loneliness in youth female competitive cheerleaders as a result of the COVID-19 pandemic and an increase in restlessness and sedentary activities. These findings suggest potential implications for healthcare professionals and athletic departments in the treatment of children and adolescents experiencing changes in their mental and psychosocial health.
This research study supports previous research about school-aged children enduring a decrease in social participation and leisure occupations, leading to negative consequences regarding their social, emotional, and physical well-being (9,11). Previous literature support goals directed at mental health for competitive youth athletes (22). Sports are considered both a leisure occupation and a form of social participation. There is minimal research focused on sports as a leisure occupation for children and adolescents; however, physical activity and occupation-based interventions are increasingly accepted in supporting mental health, promoting positive behaviors, and improving the social participation of children who are at risk for mental disorders (2,3). Moreover, participation in sports as a leisure occupation has the potential to enhance mental, emotional, and psychosocial health (8). This research study showed decreased participation in sports as leisure occupation negatively impacted psychosocial mental health with increased frustration and loneliness. Children and adolescents perceived they had less support from friends and peers during the pandemic lockdowns, which contributed to their feelings of frustration and loneliness (20). Sports is the primary source for social participation in youth athletes and as seen in this study, without social participation in sports, youth competitive cheerleaders felt more frustrated and lonelier.
Due to the limited research on utilizing sports as a leisure occupation and means to social participation in the population of youth athletes, future research is needed to evaluate the benefits of sports for the psychosocial well-being of children. Future research should also examine youth athletes who play a variety of competitive sports in a variety of regions in order to increase generalizability of findings to larger populations.
APPLICATIONS IN SPORT
This research study revealed psychosocial and emotional changes in female youth competitive cheerleaders, specifically increased levels of frustration, loneliness, and restlessness as a result of the COVID-19 pandemic. The findings of this research study will assist healthcare professionals and athletic departments by providing data to support the importance of addressing psychosocial needs with female youth athletes and addressing the benefits of sports for leisure occupation and social participation. Amid the ongoing COVID-19 crisis, resilience in youth athletes should be nurtured by health programs implemented by healthcare professionals, athletic departments, and families in order to help children to overcome conditions of distress, and prospectively provide them with emotional and psychological support (13).
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