School's Out, Rules Out: Changes in parent rules and routines over summer from the What's UP (Undermining Prevention)...

Children engage in less healthful behaviors during the summer compared to the school year, when they are exposed to a highly structured school environment. It is unclear whether changes in children's health behaviors may also be explained by parents relaxing rules/routines in summer (e.g., related to sleep, screens, diet). If so, this represents potentially modifiable drivers of children meeting health behavior guidelines. The purpose of this study was to determine if parents have different rules/routines in summer compared to the school year.

This study used data from the What's UP with Summer three-year, longitudinal observational cohort study (2021-2023) that followed elementary-aged children from 17 elementary schools in the southeastern United States. Parents of 1,084 children (age range 5-14 years, 48% girls) completed surveys during school (April/May) and summer (July) each year, yielding six total timepoints. Survey items assessed parental rules related to dietary behaviors (6 questions), screen-use (weekdays and weekends, 3 questions each), and sleep (weekdays and weekends, 3 questions each). Lower scores reflected fewer rules/routines that supported these health behaviors. Mixed-effects models examined changes in parenting rules from school year to summer controlling for socioeconomic status (poverty-income ratio, parent education), child age and sex.

Compared to the school year, parent rules in summer decreased for weekday screen-use (b= -0.31, 95% CI -0.34, -0.28), weekend screen-use (b= -0.09, 95% CI -0.13, -0.06), weekday sleep (b= -0.81, 95% CI -0.84, -0.78), and weekend sleep (b = -0.21, 95%CI -0.24, -0.17). There was no significant change in diet-related rules (b= -0.01, 95% CI -0.02, 0.00). Age had a significant interaction effect for screen and sleep rules/routines, while povertyincome ratio and child sex did not.

Parents reported fewer rules for screen use and sleep during summer compared to the school year, and overall rules/routines declined as children grew older. The gap between summer and school sleep rules also widened with age. These findings suggest that the structure of school year routines help support parents in maintaining rules and routines that shape children's health behaviors.