Physical activity, mental health and well-being of adults during initial COVID-19 containment strategies: A multi-country cross-sectional analysis

Dynamic cross-lagged effects between healthy lifestyles and multimorbidity among middle-aged and older adults in China

BACKGROUND

While healthy lifestyles mitigate the risk of multimorbidity (≥ 2 chronic diseases), their temporal dynamics in aging populations, particularly in low- and middle-income countries undergoing rapid demographic structure transition, remain understudied.

METHODS

Using longitudinal data (2014-2020) from 6,852 Chinese adults (aged ≥ 45 years) in the China Family Panel Studies, we used the subgroup analysis to investigate high risk groups in the chronic diseases status, employed alluvial diagrams to visualize diseases status transition and random intercept cross-lagged panel model to quantify the lagged effect between healthy lifestyles (sleep, physical exercise, smoking, drinking) and chronic diseases status (without diseases, single, multimorbidity).

RESULTS

Compared to male, urban and middle-aged individuals, female, rural and older adults demonstrated more severe chronic diseases status (P < 0.05). The proportion of people with multimorbidity increased over time, from 9.2% in 2014 to 29.1% in 2020. A total of 37.8% of participants experienced diseases status transition, and more than half of whom progressed to multimorbidity. Disease trajectories disproportionately progressed toward multimorbidity. The direction and size of the cross-lagged effects are dynamic. Healthier lifestyles predicted reduced disease severity from 2014 to 2018 (β1=-0.106, P1 < 0.001; β2=-0.111, P2 < 0.001), but this protective effect reversed post-2018, with multimorbidity predicting lower probability of choosing healthy lifestyles (β3=-0.160, P3 < 0.001).

CONCLUSIONS

Our study demonstrates dynamic cross-lagged effect exists between healthy lifestyles and chronic diseases status in middle-aged and older Chinese. Disease trajectories and lifestyle-disease interplay reveal critical time-sensitive windows for intervention. Early-stage lifestyle promotion could delay progression, whereas later-stage disease management requires system-level strategies addressing urban-rural healthcare disparities and self-efficacy barriers. These findings directly inform China's Healthy Aging 2030 priorities.

Telehealth coaching in older adults, behavior change, and impacts of the COVID-19 pandemic: analyses from The Brain Health Champion Study

Introduction

When COVID-19 containment strategies were imposed in March 2020, we became interested in how these restrictions might interfere with brain-healthy behaviors of older adults who were either actively participating in or who had recently completed our telehealth behavior change intervention. Telehealth interventions have emerged as important tools for supporting brain health behaviors remotely, particularly among older adults. The objective of the current study was to assess how older adults with and without cognitive impairment were affected by COVID-19 restrictions and whether they were affected differently based on their active participation or recent completion of our Brain Health Champion (BHC) study and their cognitive status.

Methods

BHC study 1.0 and 2.0 participants and their study partners were emailed in April and May of 2020 a link to five electronic surveys to collect qualitative and quantitative data on various health factors, including self-reports of pre-pandemic and current brain health behaviors (e.g., physical activity, Mediterranean diet adherence, social engagement, and cognitive stimulation), anxiety, sleep, and depression. The fifth survey was distributed to collect study feedback.

Results

Ten out of 11 participants from Study 2.0 and 15 out of 30 participants from Study 1.0 completed the surveys. Results demonstrated that early pandemic restrictions negatively impacted all participants in physical activity (p < .01) and social interactions (p < .001), with no impact on cognitive activities (p = .479) and dietary intake (p = .814). A significant difference was found between Study 1.0 and 2.0 participants (p < .001) in self-reported changes in level of cognitive activity. Study 1.0 participants indicated a decrease in cognitive activities since the start of COVID-19 restrictions, whereas those in Study 2.0 reported an increase in cognitive activities.

Discussion

Our findings suggest that pandemic restrictions significantly impacted activities typically done outside the home (social and physical activity), while those feasibly achieved at home were less affected (Mediterranean diet adherence and cognitive activity). Additionally, the intervention augmented by digital health components likely exerted some protective effects against the impact of COVID-19 containment strategies. Digitally-facilitated research and clinical telehealth programs are well-positioned to offer some protection to vulnerable individuals from disruptive events that could impede adoption or maintenance of healthy lifestyle changes.

Impact of COVID-19 on the prevalence of dyslipidemia in Ecuador: A cross-sectional study between 2017 and 2022

OBJECTIVE

To determine changes in the prevalence of dyslipidemias during the pre-COVID-19 and COVID-19 years in three regions of Ecuador.

DESIGN

Cross-sectional study. SITE: Quito, Guayaquil, and El Coca.

PARTICIPANTS

Adults with cholesterol, HDL, LDL, and triglyceride levels at primary care centers from January 2017 to December 2022.

INTERVENTIONS

Not applicable.

MAIN MEASUREMENTS

Data were obtained from five BIODIMED primary care centers. Cholesterol, HDL, LDL, and triglyceride levels were classified according to the ATP III guidelines. Dyslipidemia was considered present when one or more parameters exceeded specific thresholds. Sociodemographic variables and the year of examination were included as independent variables.

RESULTS

The study analyzed 110,521 participants' laboratory results, where 65.3% were males and an average age of 38±12 years. The study spanned the Andean (72.4%), Coast (15.4%), and Amazonic region (12.3%). Pre-pandemic exams constituted 60.9% of the sample. The prevalence of dyslipidemia increased gradually from 43.1% in 2017 to 64.1% in 2022. Cholesterol levels, HDL, and LDL exhibited changes during the pandemic, with an increased risk of hypercholesterolemia, low HDL, and high LDL.

CONCLUSIONS

During the COVID-19 pandemic, a notable increase in the prevalence of dyslipidemias, including hypercholesterolemia, high triglycerides, and high LDL, was determined across three regions in Ecuador.

How Are We Preparing Australian and Aotearoa New Zealand Teachers to Be Health Promotors? Examining Physical Activity, Sleep and Sun Safety in Initial Teacher Education

ISSUE ADDRESSED

While physical activity, sleep and sun safety (PASS) have been identified as important modifiable health behaviours and schools and teachers have been identified as vital for health promotion and primary prevention; little is known about how initial teacher education programs across Australia and New Zealand (NZ) are preparing future teachers to deliver PASS-related curriculum. This study investigated teacher educators' insights on their programs and their graduate's preparedness to plan and teach PASS education.

METHODS

Teacher educators (n = 98) from Australia and NZ completed a 30-item electronic survey. Quantitative tests were used to explore differences in the data.

RESULTS

Consistently, time spent on physical activity far outweighed sun safety and sleep with many programs having little or no sleep or sun safety content. Of concern, many indicated they did not agree, or know if their graduates were confident to plan and teach physical activity (28%), sun safety (42%) or sleep (75%) lessons, nor were they aware of the related guidelines, health benefits and risks.

CONCLUSIONS

Findings reveal significant variance in what is being offered in Australian and NZ initial teacher education programs. Findings highlight potential gaps in graduate's knowledge of various health behaviours and confidence to plan and teach related content and their preparedness for health promotion. SO WHAT?: Findings highlight a need to include more targeted health promotion education in initial teacher education in Australia and NZ to enable teachers to deliver consistent health promotion messages when they enter school settings to properly support young people's health needs.

Mental health and exercise during the COVID-19 pandemic: A Twitter sentiment analysis

Beyond its immediate health consequences, the COVID-19 pandemic led to an exacerbation in the mental health of the global population. Regular exercise and its lack thereof are also known to affect mental health. Tweets and their content analysis can provide information about aspects of users' lives including their health habits and mental health. The purpose of this study was to examine individuals' exercise habits and mental health during the pandemic by means of sentiment and correlational analyses. These results indicate that, while exercise and mental health tweets were more COVID-focused in the first 12 months of the pandemic, exercise tweets became more exercise-focused, and mental health tweets became more mental-health-focused eventually during the pandemic. Efforts to increase exercise participation in individuals may prove beneficial. Further research needs to examine the effects of exercise on mental health in the aftermath of COVID-19.

Longer-Term Mental Health Consequences of COVID-19 Infection: Moderation by Race and Socioeconomic Status

OBJECTIVE

While evidence suggests that the mental health symptoms of COVID-19 can persist for several months following infection, little is known about the longer-term mental health effects and whether certain sociodemographic groups may be particularly impacted. This cross-sectional study aimed to characterize the longer-term mental health consequences of COVID-19 infection and examine whether such consequences are more pronounced in Black people and people with lower socioeconomic status.

METHODS

277 Black and White adults (age ≥ 30 years) with a history of COVID-19 (tested positive ≥ 6 months prior to participation) or no history of COVID-19 infection completed a 45-minute online questionnaire battery.

RESULTS

People with a history of COVID-19 had greater depressive (d = 0.24), anxiety (d = 0.34), post-traumatic stress disorder (PTSD) (d = 0.32), and insomnia (d = 0.31) symptoms than those without a history of COVID-19. These differences remained for anxiety, PTSD, and insomnia symptoms after adjusting for age, sex, race, education, income, employment status, body mass index, and smoking status. No differences were detected for perceived stress and general psychopathology. People with a history of COVID-19 had more than double the odds of clinically significant symptoms of anxiety (OR = 2.22) and PTSD (OR = 2.40). Education, but not race, income, or employment status, moderated relationships of interest such that COVID-19 status was more strongly and positively associated with all the mental health outcomes for those with fewer years of education.

CONCLUSION

The mental health consequences of COVID-19 may be significant, widespread, and persistent for at least 6 months post-infection and may increase as years of education decreases.

The Iceberg Model of Change: A taxonomy differentiating approaches to change

Change is a ubiquitous phenomenon, but different scientific communities conceptualize change differently, which hampers conceptual clarity. This conceptual paper, which is based on a review of the literature on change, addresses this problem by developing the 'Iceberg Model of Change'. This framework distinguishes three approaches to change: objectification, distinction, and unfolding. The objectification approach treats processes of change as things with symbolic properties, which can be used to steer societal and political discourse, reveal thematic relationships across studies, and emphasize the significance of work. This approach also tends to consider change as a variable (dependent or independent) that can be used to understand antecedents and consequences. The distinction approach conceptualizes change as a series of discrete states of an entity or system at multiple points in time or as phases, enabling comparison of those states. The unfolding approach considers how change processes develop, including the complex, interrelated mechanisms underpinning change. Here, line graphs, visualizations of interaction mechanisms, and trajectories are used to capture change. This framework contributes to research, a) by enabling a comprehensive consideration of change phenomena, b) by promoting interdisciplinary collaboration when project partners differ in their assumptions about change, and c) by emphasizing the need for methodological reflexivity.

SARS-CoV-2 Infection and the Risk of New Chronic Conditions: Insights from a Longitudinal Population-Based Study

BACKGROUND

The post-acute impact of SARS-CoV-2 infections on chronic conditions remains poorly understood, particularly in general populations.

OBJECTIVES

Our primary aim was to assess the association between SARS-CoV-2 infections and new diagnoses of chronic conditions. Our two secondary aims were to explore geographic variations in this association and to assess the association between SARS-CoV-2 infections and the exacerbation of pre-existing conditions.

METHODS

This longitudinal study used data from 8086 participants of the Specchio-COVID-19 cohort in the canton of Geneva, Switzerland (2021-2023). Mixed-effects logistic regressions and geographically weighted regressions adjusted for sociodemographic, socioeconomic, and healthcare access covariates were used to analyze self-reported SARS-CoV-2 infections, new diagnoses of chronic conditions, and the exacerbation of pre-existing ones.

RESULTS

Participants reporting a SARS-CoV-2 infection were more likely to be diagnosed with a new chronic condition compared to those who did not report an infection (adjusted odds ratio [aOR] = 2.15, 95% CI 1.43-3.23, adjusted p-value = 0.002). Notable geographic variations were identified in the association between SARS-CoV-2 infections and new diagnoses. While a positive association was initially observed between SARS-CoV-2 infections and exacerbation of pre-existing chronic conditions, this association did not remain significant after adjusting p-values for multiple comparisons.

CONCLUSIONS

These findings contribute to understanding COVID-19's post-acute impact on chronic conditions, highlighting the need for targeted health management approaches and calling for tailored public health strategies to address the pandemic's long-term effects.

Relating mental health, health-related quality of life and well-being in the aftermath of the COVID-19 pandemic: A cross-sectional comparison in 14 European countries in early 2023

OBJECTIVES

To understand country-level differences in the population's health and well-being in Europe in the aftermath of the COVID-19 pandemic, while also investigating the internal relationships among health and well-being outcomes.

STUDY DESIGN

Cross-sectional study.

METHODS

We collected representative panel-based samples of 1000 adult respondents per country across 14 Western European countries in early 2023. The survey used standardised instruments to assess health and well-being, including EQ-5D-5L, GHQ-12, PHQ-9, general satisfaction, the Brief Resilience Scale and the ULS-6 (Loneliness) Scale. Summary statistics of the aggregate scores for each country were calculated and ranked. Multidimensional unfolding was used to visualize the rank relationships across countries and the indices, whereby a closer distance between a country and an index indicated a higher/better rank. Additionally, two key objective country-level indices (GDP growth rate and excess mortality rates) were integrated into the analysis.

RESULTS

Austria was found to report better status on most of the indices, while Sweden and the UK ranked consistently worse than the other countries. The loneliness, EQ-VAS and satisfaction scores were plotted further from the mental well-being scores and EQ-5D utility scores. Countries that did well in controlling excess mortality and maintaining economic growth tended to exhibit lower performance in self-reported well-being.

CONCLUSION

This study presents the variability in health and well-being across 14 West-European countries. Discrepancies between countries in self-reported outcomes reveal the complex interrelationship among different aspects of well-being. The study also highlights the complexities and challenges in optimising policies to maximize the overall well-being of society.

Exploring Physical Activity Among Mexican American Immigrants in New York City Before and During the COVID-19 Pandemic: A Two-Wave Panel, Mixed-Method Analysis

The COVID-19 pandemic was associated with decreases in moderate-to-vigorous physical activity and increases in sedentary time for children and adults, and there is some evidence that Latino populations were particularly affected. This article leverages a two-wave panel, mixed-method social network dataset collected before and during the pandemic with Mexican American immigrants living in New York City to examine social networks and other factors associated with physical activity and explore participants' perceptions about how the pandemic affected their physical activity. Participants (n = 49) completed in-person, egocentric social network interviews between January and June 2019 and virtual follow-up egocentric social network interviews between May and November 2021. Qualitative data collection with a subsample (n = 25) occurred between October and December 2022. Social network quantitative analyses found that age and female sex were negatively associated with participants' baseline physical activity level, but the proportion of alters (important persons identified by the participant) with whom the participant did physical activity at baseline was positively associated. Baseline physical activity level was inversely related to the change in physical activity, and the change in the proportion of alters who were close to the participant was negatively associated with physical activity change at follow-up. Qualitative results supported the quantitative findings, providing rich narratives regarding the importance of social support for physical activity during the pandemic. Social networks among Mexican American immigrants in New York City provided motivation and support for physical activity but became harder to sustain during a pandemic. The findings can inform strategies to create environments that are conducive to physical activity while also protecting public health.

Assessing the psychometric properties of the World Health Organization -five well-being index (WHO-5) in Filipino samples amid the COVID-19 pandemic

BACKGROUND

The WHO-5 well-being index is a brief rating scale extensively used to evaluate well-being symptoms. Despite the increasing number of studies validating this instrument across different samples from different countries, its psychometric properties remain unexplored in the Philippine context. Bridging this gap, the present study assessed the psychometric properties of the WHO-5 in Filipinos amid the pandemic.

METHODS

In study one, exploratory structural equation modeling (ESEM) was conducted using a sample of Filipinos (N = 2,521) from the general population and a unidimensional model of well-being was extracted. In study two, confirmatory factor analysis (CFA) was employed to examine the one-factor model in 1,289 Filipino government workers. In study three, nomological validity was examined by performing a mediation analysis using 407 Filipino left-behind emerging adult children with dysfunctionality as mediator, pandemic-related adversities as independent variable, and well-being as the dependent variable.

RESULTS

The results of ESEM and CFA provided support for the WHO-5 one-factor model. Moreover, the negative relationship of well-being to anxiety, depression, and distress lend evidence to the scale's criterion validity. The results of the mediation analysis performed in study three implied that those who experienced pandemic-related adversities tended to have greater dysfunctionality, and in turn, had lower levels of well-being.

CONCLUSIONS

Overall, the findings suggest that the WHO-5 well-being index is a psychometrically sound tool for measuring Filipinos' well-being.

The Eternal Present: A Photovoice Study of the Experience of Geriatrics Residents During the COVID-19 Pandemic

During the COVID-19 pandemic, medical residents had the task of being the frontline of the response, being exposed to high risk of infection, increased clinical duty, and long and irregular working hours in highly restricted environments, increasing their levels of stress. We sought to expose the experiences of a group of geriatrics residents during this period of change in their professional and personal lives through the photovoice methodology. Thirteen participants were recruited and had 2 weeks to take photographs. The photographs were discussed in group meetings; the content of the conversations was transcribed and analyzed using interpretive description. Sixteen themes were identified. They were divided into personal life (11 themes) and life as a resident (5 themes). Adaptation was the main theme that came into discussion. The photographs and themes show how life changed for the participants, having a feeling of isolation, especially from their families, and highlighting their experiences as a team and community. While the pandemic, particularly at its beginning, was a period of uncertainty and a heavy load of work, it also provided learning and experience to this group of young physicians, which should not hide the fact that mental health concerns and burnout were a common situation. An online gallery was created which is publicly accessible.

Analysis of the associations between moderate-to-vigorous physical activity and screen time on psychological symptoms among university students: a cross-sectional survey based on six geographic regions in China

BACKGROUND

Declining physical activity and increasing screen time (ST) among Chinese adolescents have become major concerns shared by scholars, while mental health issues are also on the rise. Previous studies have confirmed the association between physical activity and screen time and psychological symptoms, but it is unclear how their psychological symptoms, especially for Chinese university students who have a high proportion of psychological symptoms, and no research evidence has been found.

METHODS

This study investigated physical activity, screen time, and psychological symptoms in 11,173 university students aged 19-22 years in six regions of China. A binary logistic regression analysis was used to analyze the association between moderate-to-vigorous physical activity (MVPA) and screen time and psychological symptoms. And the generalize linear model (GLM) analysis was used to further analyze the association between MVPA and screen time and psychological symptoms.

RESULTS

The detection rate of psychological symptoms among Chinese university students was 16.3%, with a higher percentage of female students (17.5%) than male students (14.7%). The proportion of male students (8.2%) with MVPA > 60 min/d was higher than that of female students (2.3%), and the proportion of male students (33.8%) and female students (34.5%) with screen time > 2 h/d was basically the same. The generalize linear model (GLM) analysis showed that university students with MVPA < 30 min/d and screen time > 2 h/d (OR = 1.59, 95% CI: 1.10-2.31) had the highest risk of psychological symptoms (OR = 1.59, 95% CI: 1.10-2.31) compared to university students with MVPA > 60 min/d and screen time < 1 h/d as the reference group. The risk of psychological symptoms was the highest among those with MVPA < 30 min/d and screen time > 2 h/d (OR = 1.59,95% CI: 1.10-2.31). In addition, university students with MVPA > 60 min/d and a screen time of 1-2 h/d (OR = 0.09, 95% CI: 0.03-0.25) had the lowest risk of psychological symptoms (P < 0.001). The same trend was observed for both male and female students.

CONCLUSION

Chinese university students have a certain proportion of psychological symptom problems, and there is a significant between MVPA and screen time and psychological symptoms, and the same trend exists for both male and female students. Chinese university students should perform MVPA for not less than 60 min a day, and at the same time control the duration of screen time, and screen time should be controlled between 1 and 2 h a day, which has a better promotion effect on psychological health.

Physical activity and mental health trends in Korean adolescents: Analyzing the impact of the COVID-19 pandemic from 2018 to 2022

Objective

Mental health significantly affects the physical and emotional development of adolescents. The aim of the current study was to examine how physical activity (PA) and mental health among Korean adolescents changed before and after the start of the COVID-19 pandemic.

Methods

We used comparative cross-sectional methods, gathering information from the Korea Disease Control and Prevention Agency databases and conducting Chi-square testing and correlation analysis for evaluation.

Results

The findings indicate that before and during the pandemic, participation in both moderate- and high-intensity PA, as well as strength training, mitigated stress, depression, and suicidal ideation. Furthermore, the findings confirm the beneficial effects of various physical activities on mental well-being.

Conclusions

These insights emphasize the vital role of regular PA in improving mental health among adolescents, particularly during a health crisis such as the pandemic.

Cardiovascular and cardiorespiratory effects of high-intensity interval training in body fat responders and non-responders

This study aimed to investigate cardiovascular and cardiorespiratory adaptations to exercise intervention among participants who showed higher (responders-RSBFP) and lower (non-responders-NRSBFP) levels of body fat percentage (BFP) responsiveness. Adolescents (42.5% males) participated in a ten-week school-based high-intensity interval training (HIIT), followed by a comparison of BFP, blood pressure (BP), and cardiorespiratory fitness (CRF). RSBFP age of 16.15 ± 0.36 years, body height 170.82 ± 8.16 cm, weight 61.23 ± 12.80 kg, and BMI 20.86 ± 3.29 kg/m2. Meanwhile, NRSBFP age of 16.04 ± 0.36 years, body height 168.17 ± 8.64 cm, weight 57.94 ± 8.62 kg, and BMI 20.47 ± 2.24 kg/m2. HIIT intervention impacted BFP, with a higher decrease in the RSBFP than the NRSBFP (ΔBFPRs = - 2.30 ± 3.51(10.34%) vs. ΔBFPNRs = 1.51 ± 1.54(6.96%) p < 0.001). The primary comparison showed a statistically significant interaction effect in relation to CRF (F(1,71) = 14.12; p < 0.001). Detailed comparisons showed large and significant CRF changes in RSBFP (7.52%; d = 0.86; p < 0.001) but not in NRSBFP (2.01%; d = 0.11; p = 0.576). In addition, RSBFP and NRSBFP benefited equally in SBP (5.49%, d = 0.75; p < 0.001; 4.95%, d = 0.74; p < 0.001, respectively). These findings highlight that exercise benefits on body fat may be mainly related to gains in CRF. Due to substantial intra-individual variability in adaptation, there is a need for personalized intervention tailored for those with different reaction thresholds in body mass components.

Heart Rate Responses of Post-Menopausal Women to Zumba Gold® Classes

This study aimed to describe the heart rate (HR) responses of post-menopausal women during Zumba Gold® classes and to investigate the effects of body fat on HR responses. Twenty-three post-menopausal women (68.8 ± 7.2 years old; 160.0 ± 5.2 cm; 66.9 ± 11.1 kg, 36.0 ± 9.9% body fat) participated. Baseline testing assessed participants' anthropometric and fitness characteristics. Then, HR measurements were taken during four of their regular Zumba Gold® classes, and average HR (HRmean), as well as time spent in different HR intensity categories, was calculated. Linear regressions and t-tests were performed to analyse the data. The average HR during Zumba Gold® classes was 70.2% of maximum HR. Women with lower body fat achieved a significantly higher HRmean and spent less time at light to very light intensity and more time at moderate intensity compared to those with higher body fat. Body fat percentage and age were identified as determinants of time spent at moderate intensity. These findings suggest that Zumba Gold® can be an effective exercise option for post-menopausal women aiming to meet the recommended daily exercise guidelines. Understanding the HR responses during Zumba Gold® classes can aid in the development of safe and effective exercise prescriptions for this population.

Comparison of Depressive Symptoms between International and Domestic Students in a Japanese University: Pre- and Post-COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic led to significant lifestyle changes and uncertainties, triggering a secondary wave of mental health issues in society. University students are especially susceptible to mental disorders. International students are considered more vulnerable due to limited emotional and financial support from their families and difficulties accessing community support. Hence, we conducted a longitudinal analysis to compare depressive symptoms among international students before and during the pandemic.

METHODS

Data from depression screenings conducted at the University of Tsukuba in 2019 and 2020 were utilized. We included all students enrolled in 2019 who underwent health check-ups in both 2019 and 2020. Participants completed the Patient Health Questionnaire-9 (PHQ-9), enabling a comparison of item scores between domestic and international students. Psychopathological network analysis was employed to examine relationships among the items.

RESULTS

Prior to the pandemic, international students generally exhibited relatively good mental health compared with domestic students. During the 2020 pandemic, no significant difference was observed, but international students tended to demonstrate better mental health. However, network analysis revealed intergroup variations in the relationships among PHQ-9 items, with concentration problems and suicidal thoughts being more prominent among international students.

CONCLUSION

This study's findings suggest that young people studying abroad experience mental health crises similar to their domestic counterparts. Nevertheless, the patterns of these crises may differ between the two groups.

Physical activity and mental health in individuals with multimorbidity during COVID-19: an explanatory sequential mixed-method study

OBJECTIVE

To understand the physical activity and mental health of individuals living with long-term conditions during the COVID-19 pandemic.

DESIGN

A sequential explanatory mixed-methods study with two phases: phase 1: quantitative survey and phase 2: qualitative follow-up interviews.

SETTING

For the quantitative phase, an online survey was launched in March 2021, using Microsoft Forms. For the qualitative phase, in-depth semistructured interviews were conducted via online.

PARTICIPANTS

368 adults over 18 years old living in the UK with at least one long-term condition completed the survey. Interviews were conducted in a subsample of participants from the previous quantitative phase, with 26 people. Data were analysed using thematic analysis.

RESULTS

Responses from the survey showed that people with one long-term condition were significantly more physically active and spent less time sitting, than those with two or more conditions, presenting with significantly higher well-being (p<0.0001), and lower levels of anxiety (p<0.01), and depression (p<0.0001). Interviews found that people developed a range of strategies to cope with the impact of changeability and the consequences of their long-term condition on their physical activity.

CONCLUSIONS

The number of long-term conditions influenced physical activity and how people coped with their condition during COVID-19. Findings will inform policy developments in preparation for future pandemics to support and remain people to remain physically active and mental health.

Impact of COVID-19 lockdown on physical activity behavior among students in Somalia

Background

Due to the worldwide reach of the COVID-19 pandemic, authorities across the globe deemed it essential to enforce exceptional containment measures. Maintaining physical activity (PA) during this time was only feasible through engaging in activities at home. Therefore, this study focused on elucidating the levels of PA and well-being among Somali students in the aftermath of the lockdown measures implemented by governments at the onset of the COVID-19 pandemic.

Methods

This study was conducted in Somalia among undergraduate students studying at Somali International University. A total of 1266 students were included in the present study. An online survey was utilized to measure participant PA behavior. The assessment of PA was conducted in the aftermath of the COVID-19 pandemic, utilizing the Godin Leisure questionnaire. The study showed that 85.8% of the study participants (n = 1086) were between the ages of 17 and 22. More than half of the participants (58.7%, n = 743) were female and had no other employment (57.3%, n = 743).

Results

Jogging was the most frequently reported PA (57.3%, n = 726), and PA level was on average 59.7 minutes per day (SD = 25.9). Also, most of the study participants were in their last year (82.1%). In the regression analysis, age, gender, academic year, and work status were significant predictors of being physically active after the COVID-19 pandemic.

Conclusion

Factors affecting PA after the COVID-19 pandemic include age, gender, academic year, and work status. Males, younger individuals, and those who engage in outdoor exercise are more likely to be physically active. Once the COVID-19 restrictions were relaxed, undergraduate students in Somalia were physically active. A high level of PA appears to be advantageous for public health. Universities in Somalia should uphold school policies that promote an active lifestyle among students, aiming to maintain or enhance the existing level of PA.

The relationship between change in routine and student mental wellbeing during a nationwide lockdown

OBJECTIVE

During March 2020, the UK entered a national lockdown, causing a sudden change in undergraduate students' routines. This study uses this event to investigate the impact routine change had on students' mental wellbeing; in particular looking at depression, anxiety, sleep disturbance, and eating behaviors.

METHOD

Participants reported their daily routine timings (waking, breakfast, lunch, evening meal and bedtime) and activities (e.g. exercise amount, time with friends, time studying, etc) on a typical Monday, Wednesday and Saturday during term time and lockdown. Additionally they completed the PROMIS measures of anxiety, depression, and sleep disturbance, and the Eating Pathology Symptom Inventory.

RESULTS

Lockdown saw small but significant shifts in routine timing (on average 1.5 h) However, there was no clear overall pattern of relationships between mental wellbeing and routine structure or magnitude of routine change. There was some evidence of changes in amount of exercise relating to reported anxiety.

DISCUSSION

These findings are consistent with the current literature reporting lockdown effects on behavior. Routine timings shifted, but this change was small and largely did not affect the mental wellbeing reported by undergraduate students. The change in amount of exercise posed by lockdown did appear to be an important factor in wellbeing, and more research should focus on the wellbeing implications of closing places for exercise.

Factors Affecting Well-Being in Korean Young Adults Facing Material Deprivation: Testing the Reserve Capacity Model

Based on the reserve capacity model, the current study aims to explore the effect of material deprivation on well-being in Korean young adults using path analysis to investigate the mediating effects of loneliness, relationship satisfaction, perceived social support, and depression. Data from 2,041 young adults in the 2021 Youth Socio-Economic Reality Survey were included in a secondary analysis. According to the constructed path model, material deprivation, relationship satisfaction, perceived social support, and depression had significant direct effects on well-being. The indirect effect of material deprivation on well-being was statistically significant and sequentially mediated by loneliness, relationship satisfaction, and depression. Findings suggest the multidimensional effects of material deprivation on the mental health and well-being of Korean young adults through loneliness and relationship satisfaction-representing intrapersonal and interpersonal reserves, respectively. Policy support and multidimensional practical programs are needed to help materially deprived young adults build and maintain relationships and avoid feelings of loneliness and social isolation. [Journal of Psychosocial Nursing and Mental Health Services, 62(3), 29-38.].

The physiologic benefits of optimizing cardiorespiratory fitness and physical activity - From the cell to systems level in a post-pandemic world

Cardiovascular (CV) disease (CVD) is a leading cause of premature death and hospitalization which places a significant strain on health services and economies around the World. Evidence from decades of empirical and observational research demonstrates clear associations between physical activity (PA) and cardiorespiratory fitness (CRF) which can offset the risk of mortality and increase life expectancy and the quality of life in patients. Whilst well documented, the narrative of increased CRF remained pertinent during the coronavirus disease 2019 (COVID-19) pandemic, where individuals with lower levels of CRF had more than double the risk of dying from COVID-19 compared to those with a moderate or high CRF. The need to better understand the mechanisms associated with COVID-19 and those that continue to be affected with persistent symptoms following infection (Long COVID), and CV health is key if we are to be able to effectively target the use of CRF and PA to improve the lives of those suffering its afflictions. Whilst there is a long way to go to optimise PA and CRF for improved health at a population level, particularly in a post-pandemic world, increasing the understanding using a cellular-to-systems approach, we hope to provide further insight into the benefits of engaging in PA.

The role of social network structure and function in moderate and severe social and emotional loneliness: The Dutch SaNAE study in older adults

Background

Loneliness is a serious public health problem. This became even more visible during the COVID-19 pandemic. Yet, the key social network aspects contributing to loneliness remain unknown. Here, we evaluated social network structure and function and associations with (moderate/severe) social and emotional loneliness in older adults.

Methods

This cross-sectional study includes online questionnaire data (SaNAE cohort, August-November 2020), in independently living Dutch adults aged 40 years and older. For the separate outcomes of social and emotional loneliness, associations with structural social network aspects (e.g., network diversity - having various types of relationships, and density - network members who know each other), and functional social network aspects (informational, emotional, and practical social support) were assessed and risk estimates were adjusted for age, educational level, level or urbanization, comorbidities, and network size. Multivariable logistic regression analyses were stratified by sex.

Results

Of 3396 participants (55 % men; mean age 65 years), 18 % were socially lonely which was associated with a less diverse and less dense network, living alone, feeling less connected to friends, not having a club membership, and fewer emotional supporters (men only) or informational supporters (women only). 28 % were emotionally lonely, which was associated with being socially lonely, and more exclusively online (versus in-person) contacts (men only), and fewer emotional supporters (women only).

Conclusion

Network structure and function beyond the mere number of contacts is key in loneliness. Public health strategies to prevent loneliness in older adults should be sex-tailored and promote network diversity and density, club membership, informational and emotional support, and in-person contact.

Trends in obesity, leisure-time physical activity, and sedentary behavior in Korean adults: Korea national health and nutritional examinations survey from 2014 to 2021

OBJECTIVES

This study aimed to investigate trends in obesity by dividing it based on body mass index (BMI) and waist circumference indicators, sedentary behavior, and leisure-time physical activity (LTPA) in Korean adults from 2014 to 2021. This study also aimed to determine the adherence rate of people with obesity to physical activity.

METHODS

Data from the Korea National Health and Nutritional Examination Survey (KNHANES) from 2014 to 2021 were used. A total of 42,676 participants 19 years or older were included in the final analysis. Sociodemographic characteristics, anthropometric measurements, and physical activity levels were recorded. Physical activity levels were assessed using the Global Physical Activity Questionnaire, a self-reported questionnaire. Multivariable logistic regression analysis adjusted for covariates was used to investigate the prevalence of obesity and sitting time or adherence to meeting the physical activity guidelines for each survey year.

RESULTS

This study included 42,676 adults. The weighted prevalence of obesity in all ages significantly increased from 30.8% (29.1%-32.5%) in 2014 to 34.5% (32.9%-36.2%) in 2017 and 37.3% (35.5%-39.1%) in 2021 (p for trend < 0.004). The weighted adherence rate to LTPA ranged from 25.5% (95% confidence interval [CI], 23.7%-27.2%) in 2014 to 20.5% (95% CI, 18.7%-22.2%) in 2021(p for trend < 0.001). The weighted prevalence of sitting time for 8 h/day or more significantly increased from 46.7% (44.4%-49.0%) in 2014 to 56.2% (54.4%-58.0%) in 2017 and 63% (60.7%-65.3%) in 2021 (p for trend < 0.001). According to this study, the LTPA level among women with obesity was significantly low.

CONCLUSION

From 2014 to 2021, obesity and sedentary behavior significantly increased and adherence to LTPA decreased among Korean adults. Given these concerning trends, comprehensive interventions are needed at the national level to encourage healthy lifestyle behaviors.

Social Media Behaviors and Lifestyle Changes in Young Adults (Ages 18-28 years) During the COVID-19 Pandemic: Analysis From an International Cross-Sectional Study

BACKGROUND

Screen time (ST), mainly social media (SM), has increased during the coronavirus 2019 (COVID-19) pandemic, impacting mental and physical health. This study aims to analyze SM use in young adults ages 18 to 28 years and lifestyle changes during COVID-19 to provide a baseline on pandemic habits in the younger population.

METHODS

An international cross-sectional observational study was conducted from September 2020 to January 2021. Participants responded about their SM behavior, and activities they noticed they did less and more during COVID-19. A total of 183 responses were analyzed.

RESULTS

The top reason respondents increased SM was for entertainment. Many respondents increased ST, physical activity (PA), and sleeping habits during COVID-19, while many decreased socialization, PA, and going outdoors. PA had mixed results among participants, indicating some increased PA and some decreased. Evidence suggests that timing of quarantining during the pandemic significantly influenced variables, like ST (P = .004) and socialization (P = .037).

DISCUSSION AND CONCLUSION

Respondents generally noticed increased SM use for various reasons, including socialization, potentially explaining why respondents feel they socialize less. ST use increased; some people reported increased PA while others reported a decrease. Altogether, this provides vital context on young adults' SM and lifestyle habits, highlighting potential areas for further research.

Moderation effects of health behaviors on stress and suicidal ideation in adolescents: a cross-sectional survey during COVID-19

This cross-sectional online survey study investigated whether certain health behaviors moderated the relationship between perceived stress and suicidal ideation in Austrian adolescents during the COVID-19 pandemic. A total of 1505 14-20-year-old (median age = 16) high school students (77.9% female) filled out an online survey from September to November 2021. Perceived stress was measured with the PSS10, suicidal ideation with item 9 of the PHQ-9. The following health behaviors were assessed: Physical activity (days/week), phone use (hours/day), problematic drinking behavior (CAGE). All three health behaviors significantly moderated the relationship between perceived stress and suicidal ideation (all p < .05), but effects were small. The moderation analyses revealed that higher physical activity and less time spent on the phone were associated with less suicidal ideation at higher stress levels. Showing signs of problematic drinking behavior was associated with higher suicidal ideation at higher stress levels. In conclusion, these results suggest that some health behaviors may be able to act as a buffer between perceived stress and suicidal ideation. However, more research is needed to confirm these potentially buffering effects.

Fresh or frozen grafts for allogeneic stem cell transplantation: conceptual considerations and a survey on the practice during the COVID-19 pandemic from the EBMT Infectious Diseases Working Party (IDWP) and Cellular Therapy & Immunobiology Working Party (CTIWP)

The COVID-19 pandemic has had a significant impact on medical practices, including the delivery of allogeneic hematopoietic cell transplantation (HCT). In response, transplant centers have made changes to their procedures, including an increased use of cryopreservation for allogeneic haematopoietic progenitor cell (HPC) grafts. The use of cryopreserved grafts for allogeneic HCT has been reviewed and analysed in terms of potential benefits and drawbacks based on existing data on impact on cell subsets, hematological recovery, and clinical outcomes of approximately 2000 patients from different studies. A survey of European Society for Blood and Marrow Transplantation centers was also conducted to assess changes in practice during the pandemic and any unnecessary burdens on HPC donors. Before the pandemic, only 7.4% of transplant centers were routinely cryopreserving HPC products, but this percentage increased to 90% during the pandemic. The results of this review and survey suggest that cryopreservation of HPC grafts is a viable option for allogeneic HCT in certain situations, but further research is needed to determine long-term effects and ethical discussions are required to balance the needs of donors and patients when using frozen allografts.

Effects of COVID-19 Lockdown on Heart Failure Patients: A Quasi-Experimental Study

INTRODUCTION

The COVID-19 lockdown has been associated with reduced levels of physical activity, quality of life, and sleep quality, but limited evidence exists for its impact on heart failure patients. This study examined the influence of the COVID-19 lockdown on these aspects in heart failure patients, with specific comparisons by age and sex.

METHODS

A quasi-experimental cross-sectional study of patients with heart failure was conducted. The assessment involved two time points: during the COVID-19 lockdown (March to June 2020) and post-lockdown (July to October 2020). A total of 107 HF patients participated, with assessments of overall PA (using the International Physical Activity Questionnaire), QoL (employing the Cantril Ladder of Life), and sleep quality (utilizing the Minimal Insomnia Symptom Scale) conducted during and after the COVID-19 lockdown.

RESULTS

HF patients reported lower levels of total PA (p = 0.001) and walking PA (p < 0.0001) during lockdown than after lockdown, whilst no differences were observed in QoL nor sleep quality. In addition, both younger and older patients reported lower walking PA and total PA during lockdown than after lockdown, while older patients reported lower QoL during lockdown than after lockdown. Moreover, both men and women reported lower walking PA and total PA during lockdown than after lockdown, whilst women reported lower QoL.

CONCLUSIONS

HF patients need improved PA programs during lockdowns, as these programs can elevate PA levels and enhance QoL, especially when faced with the risk of decompensation during health crises.

The impact of COVID-19 lockdowns on the body mass index of people living with obesity: A UK retrospective cohort study using the UK Clinical Practice Research Datalink

BACKGROUND

Restrictions implemented by governments during the coronavirus disease 2019 (COVID-19) pandemic affected people's eating habits and physical activity. We investigated the effect of COVID-19 lockdowns and restrictions on body mass index (BMI) and weight in a UK population, according to BMI class, sex, age and ethnicity.

METHODS

This retrospective observational cohort study used the Clinical Practice Research Datalink AURUM database. Baseline spanned from 22 March 2017-22 March 2020, and the follow-up lockdown period was from 23 March 2020 (start of the lockdown in the UK) to 13 March 2021. The descriptive analysis included individuals with ≥ 1 valid BMI/weight measurements during both the baseline and follow-up periods, while the model-based analysis comprised individuals with ≥ 1 valid measurement(s) during baseline. Results were stratified by baseline BMI category, sex, age and ethnicity.

RESULTS

In the descriptive analysis (n = 273,529), most individuals did not change BMI category post-lockdown (66.4-83.3%). A greater proportion of women (12.6%) than men (9.5%) moved up BMI categories post-lockdown. Compared with older groups, a higher proportion of individuals < 45 years old increased post-lockdown BMI category. The model-based analysis (n = 938,150) revealed consistent trends, where changes in body weight and BMI trajectories pre- and post-lockdown were observed for women and for individuals < 45 years.

CONCLUSION

During COVID-19 restrictions, women and young individuals were more likely than other groups to increase BMI category and weight post-lockdown.

Long COVID and psychological distress in young adults: Potential protective effect of a prior mental health diagnosis

BACKGROUND

Although young adulthood is a period characterized by marked psychological vulnerability, young adults are typically considered to be in good physical health and are therefore understudied with respect to the effects of COVID-19 infection and long COVID. The present study examined associations between post-acute sequelae of COVID-19 (PASC) and serious psychological distress during young adulthood, and tested whether prior mental health diagnosis moderated this association.

METHODS

Participants were 44,652 young adults who completed the Spring 2022 administration of the American College Health Association-National College Health Assessment III (ACHA-NCHA). Blockwise logistic regressions tested the odds of meeting the clinical threshold for serious psychological distress.

RESULTS

PASC was associated with 53 % increased likelihood of meeting the clinical threshold for serious psychological distress. Among young adults with a prior mental health diagnosis, PASC predicted 36 % increased odds of serious psychological distress; among those without a diagnosis, PASC predicted 81 % increased odds.

LIMITATIONS

PASC was assessed using a single self-report item rather than a clinical diagnosis of specific symptomatology. The analyses were cross-sectional and relied on concurrent reports of PASC and psychological distress which precluded us from making claims regarding directionality of the associations. The outcome of generalized psychological distress limited us from generating targeted treatment recommendations.

CONCLUSIONS

PASC may confer elevated psychological distress among young adults. The association of PASC to serious psychological distress was stronger in young adults without a mental health diagnosis than those with a diagnosis. Prior experience with mental illness may mitigate the psychological burden of long-term symptomatology.

Accessibility and applicability of physical activity guidelines and recommendations for adults living with long term conditions during COVID-19

To review the applicability and accessibility of physical activity guidelines for adults living with long-term conditions whilst shielding during the COVID-19. A narrative review with systematic methodology was conducted between 2015 and 2021, with two stages: 1) Search of electronic databases PubMed/Medline, Web of Science, PsycInfo, and Cinahl; 2) search of long-term condition organisations. Sixty-five articles were identified, where nine included specific guidelines during the COVID-19, 28 specific guidelines to individuals living with long-term conditions and 7 identified the utilization of online resources. Twenty-one long-term condition organizations websites were reviewed where all of them included a section regarding physical activity guidelines and seven referred to online and offline accessible resources during COVID-19. Accessibility and applicability were variable across academic databases and long-term conditions organisation websites. Findings could inform long-term condition policy and guidelines development to better and more relevant support people living with long-term conditions to be physically active.

A Comparison of the Impact of COVID-19-Related Restrictions on Physical Activity Among Public Employees

OBJECTIVES

This article compares the impact of COVID-19-related restrictions on the level of physical activity, performed by public servants, in April and November 2020.

METHODS

The survey examined the amount (in minutes per week) and the energy expenditure (in metabolic equivalent of task in minutes per week [METmin/week]) of physical activity for both before and during contact restrictions in April and November 2020, respectively.

RESULTS

Especially for sports activity difference was determined by the medians before (April/November: median [Mdn] = 180.0 min/wk) and during (April: Mdn = 130 minutes, November: Mdn = 60 min/wk) restrictions ( P < 0.05).Also for energy consumption (METmin/wk), the medians before and during the contact restrictions declined for both periods.

CONCLUSIONS

Measures against the coronavirus have led to a reduction in activity levels among public employees, regardless of their work environment. The decrease in participation in sport activities seemed to be even more noticeable within the second restriction period.

Change of human flourishing during the COVID-19 pandemic in Japan: Results from population-based U-CORONA study

Longitudinal change in flourishing during the pandemic of COVID-19 would provide new insight to reveal determinants of well-being. We aimed to describe changes in flourishing during the COVID-19 pandemic in Japan and to examine the association of sex, age, education, and income with changes in flourishing. Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study conducted in October 2020 and November 2021 was used (n = 419 in 2020 and n = 478 in 2021, and n = 327 for both waves). Flourishing was assessed using a 12-item multidimensional flourishing scale including six domains. Change of flourishing was categorized into decreased, unchanged, and increased. Multinomial logistic regression was applied to longitudinal data to estimate the relative risk ratio of increase and decrease in flourishing scores. Cross-sectional analysis showed that the mean score of flourishing was approximately seven in both waves, with no sex differences, but older adults had higher scores than young-aged adults. We found that men were twice as likely to lose their flourishing scores as women and lower levels of education were associated with 2-3 times declining flourishing scores than higher levels of education. Age and income were not significantly associated with the change of flourishing. During the COVID-19 pandemic, flourishing declined, and men and lower-educated people were more vulnerable. In prolonged difficult situations, support for men and less educated people may contribute to the prevention of declining well-being in Japan.

The COVID-19 pandemic and mental health in Kazakhstan

The COVID-19 pandemic had significant impacts on mental health. We examined factors associated with symptoms of depression and anxiety during the COVID-19 pandemic in Kazakhstan. We surveyed 991 adults in Kazakhstan in July 2021 using multistage stratified sampling. Depression and anxiety were measured with the Patient Health Questionnaire-4. We conducted logistic regression to assess associations between depression and anxiety and sociobehavioral factors. Overall, 12.01% reported depressive symptoms and 8.38% anxiety. Higher likelihood of depression was associated with being female (AOR: 1.64; 95% CI [1.05, 2.55]), having experience with COVID-19 in the social environment (AOR: 1.85; 95% CI [1.1-3.14]), experiencing food insecurity (AOR: 1.80; 95% CI [1.11-2.89]), increased family conflict (AOR: 2.43; 95% CI [1.32-4.48]) and impaired healthcare access (AOR: 2.41; 95% CI [1.32-4.41]). Higher likelihood of anxiety was associated with being female (AOR: 3.43; 95% CI [1.91-6.15]), increased family conflict (AOR: 2.22; 95% CI [1.11-4.44]) and impaired healthcare access (AOR: 2.63; 95% CI [1.36-5.12]). Multiple factors were associated with mental health in Kazakhstan during the COVID-19 pandemic. Further research is needed to determine the extent to which these factors and their associated mental health outcomes may persist.

Global impacts of COVID-19 on lifestyles and health and preparation preferences: An international survey of 30 countries

BACKGROUND

The health area being greatest impacted by coronavirus disease 2019 (COVID-19) and residents' perspective to better prepare for future pandemic remain unknown. We aimed to assess and make cross-country and cross-region comparisons of the global impacts of COVID-19 and preparation preferences of pandemic.

METHODS

We recruited adults in 30 countries covering all World Health Organization (WHO) regions from July 2020 to August 2021. 5 Likert-point scales were used to measure their perceived change in 32 aspects due to COVID-19 (-2 = substantially reduced to 2 = substantially increased) and perceived importance of 13 preparations (1 = not important to 5 = extremely important). Samples were stratified by age and gender in the corresponding countries. Multidimensional preference analysis displays disparities between 30 countries, WHO regions, economic development levels, and COVID-19 severity levels.

RESULTS

16 512 adults participated, with 10 351 females. Among 32 aspects of impact, the most affected were having a meal at home (mean (m) = 0.84, standard error (SE) = 0.01), cooking at home (m = 0.78, SE = 0.01), social activities (m = -0.68, SE = 0.01), duration of screen time (m = 0.67, SE = 0.01), and duration of sitting (m = 0.59, SE = 0.01). Alcohol (m = -0.36, SE = 0.01) and tobacco (m = -0.38, SE = 0.01) consumption declined moderately. Among 13 preparations, respondents rated medicine delivery (m = 3.50, SE = 0.01), getting prescribed medicine in a hospital visit / follow-up in a community pharmacy (m = 3.37, SE = 0.01), and online shopping (m = 3.33, SE = 0.02) as the most important. The multidimensional preference analysis showed the European Region, Region of the Americas, Western Pacific Region and countries with a high-income level or medium to high COVID-19 severity were more adversely impacted on sitting and screen time duration and social activities, whereas other regions and countries experienced more cooking and eating at home. Countries with a high-income level or medium to high COVID-19 severity reported higher perceived mental burden and emotional distress. Except for low- and lower-middle-income countries, medicine delivery was always prioritised.

CONCLUSIONS

Global increasing sitting and screen time and limiting social activities deserve as much attention as mental health. Besides, the pandemic has ushered in a notable enhancement in lifestyle of home cooking and eating, while simultaneously reducing the consumption of tobacco and alcohol. A health care system and technological infrastructure that facilitate medicine delivery, medicine prescription, and online shopping are priorities for coping with future pandemics.

Physical activity and mental health experiences of people living with long term conditions during COVID-19 pandemic: A qualitative study

INTRODUCTION

Regular physical activity is a strategy that is effective in the physical management of long term conditions. The COVID-19 pandemic, led to disruption of physical activity routines for many people with long term conditions. It is important, to understand the experiences of people with long term conditions regarding physical activity during COVID-19 to enable future identification of strategies to mitigate the impact of restrictions on health.

OBJECTIVE

To explore perceptions and experiences of people with long term conditions of the impact of the UK Government physical distancing restrictions on their physical activity participation during the COVID-19 pandemic.

METHODS

A qualitative study, with in depth videoconference semi-structured interviews were conducted between January and April 2022, with 26 adults living with at least one long term condition in the UK. Data were managed in analytical matrices within Excel and data analysis was conducted using thematic analysis.

RESULTS

Two main themes were developed, explaining how participants managed their physical activity during COVID19 lockdowns, and based on those experiences, what they considered should be in place should another lockdown occur:1) COVID-19 and physical activity: Losses, opportunities and adapting to new formats; and 2) Micro, meso, and macro contexts: creating the right conditions for physical activity support in future pandemics.

CONCLUSIONS

This study provides information on how people with long term conditions managed their condition during the COVID-19 pandemic and generates new understanding of how physical activity routines changed. These findings will be used to inform stakeholder engagement meetings with individuals with long term conditions and local, regional, and national policy makers, to co-produce recommendations that will help people living with long term conditions remain active during and after COVID-19 and other pandemics.

Associations of the perceived benefits and harms of COVID-19 with confidence in coping with the pandemic and mental health symptoms: a population-based survey in Hong Kong

Introduction

Both perceived benefits and harms of COVID-19 have been reported, but whether they affect confidence in coping with the pandemic and mental health remains uncertain.

Objective

To examine the association of perceived benefits and harms of COVID-19 with confidence in coping with the pandemic and mental health symptoms.

Methods

A population-based survey was conducted on 7,535 Hong Kong adults from 22 February to 23 March 2021, when the 4^th wave of COVID-19 was under control. Information on sociodemographic characteristics, perceived benefits (10 options) and harms (12 options) of COVID-19, confidence in coping with the pandemic (range 0-10), loneliness (range 0-4), anxiety (General Anxiety Disorders-2, range 0-6) and depression (Patient Health Questionnaire-2, range 0-6) was collected. Latent profile analysis was used to identify the combined patterns of perceived benefits and harms of COVID-19. The associations of combined patterns with confidence in coping with COVID-19, loneliness, anxiety, and depression were examined using linear regression (β coefficient) adjusting for sociodemographic characteristics.

Results

The combined patterns of perceived benefits and harms were classified into benefit (n = 4,338, 59.3%), harm (n = 995, 14.0%), and ambivalent (n = 2,202, 26.7%) groups. Compared with the ambivalent group, the benefit group had a significantly higher level of confidence (adjusted β 0.46, 95% CI 0.33 to 0.58), and lower levels of loneliness (-0.35, -0.40 to-0.29), anxiety (-0.67, 0.76 to-0.59), and depression (-0.65, -0.73 to-0.57). The harm group had a significantly lower level of confidence (-0.35, -0.53 to-0.16), and higher levels of loneliness (0.38, 0.30 to 0.45), anxiety (0.84, 0.73 to 0.96), and depression (0.95, 0.84 to 1.07).

Conclusion

Perceived greater benefit from COVID-19 was associated with better mental health and stronger confidence in coping with the pandemic.

Change in health, wellbeing and physical activity levels during the COVID-19 pandemic: a longitudinal cohort of parkrun participants in the United Kingdom

Lockdown restrictions imposed across the UK in response to the coronavirus disease 2019 (COVID-19) pandemic had a profound impact on many people's health and wellbeing. People were encouraged to be active, but population surveys suggest some groups found this easier than others. We explored the changes in health, wellbeing and physical activity levels among a sample in the UK who experienced the sudden loss of a weekly community-based physical activity opportunity, parkrun. A sample of UK parkrun participants responded to two surveys: pre-COVID-19 in January/February 2019 and during the COVID-19 pandemic in September 2020. Outcomes were happiness, life satisfaction, connections with others, physical health, mental health and physical activity. The sample was stratified by gender, age, deprivation status, physical activity and number of parkruns completed. Demographics were reported using descriptive statistics; distributions between sub-groups were compared using Chi-square tests while differences in outcomes were determined using the Mann-Whitney U test. Open text responses were also analysed. Happiness, life satisfaction, connections with others, physical health and mental health of 450 parkrun participants were negatively impacted for all sub-groups, although the impact was not experienced equally. Physical activity fell by 6% while happiness and life satisfaction fell by 12%. People experienced the worst negative impact on their connections with others. The COVID-19 pandemic negatively impacted the wellbeing of a greater proportion of females, younger adults, inactive people, those from higher deprivation areas, and those who had completed fewer parkruns. There is evidence that the wellbeing of those who were more active, and those more involved in a community-based physical activity initiative pre-pandemic, was less negatively affected during the COVID-19 lockdown.

Measuring information overload and message fatigue toward COVID-19 prevention messages in USA and China

COVID-19 prevention messages are a crucial component of disease mitigation strategies and the primary driver of health decision-making during the global pandemic. However, the constant and repetitive nature of COVID-19 messaging may cause unintended consequences. Among the commonly observed phenomena are information overload and message fatigue, which might be experienced differently depending on cultural background. Using measurement invariance testing, this study compared how individuals from two countries-USA (n = 493) and China (n = 571)-experienced information overload and message fatigue toward COVID-19 prevention messages. Findings revealed that people in China showed significantly lower level of information overload and message fatigue than those in the USA. This study explores the extent of the unintended persuasive effects that people have experienced during the COVID-19 pandemic in different societies, a comparison which has never been studied before, even outside of the context of COVID-19. The study also provides much-needed practical insights to develop public health initiatives that improve COVID-19 prevention communication, which can further reduce these unintended effects in both countries, and has implications for other countries as well.

Impact of COVID-19 Restriction on Weight, Physical Activity, Diet and Psychological Distress on People with PCOS

BACKGROUND

People with polycystic ovary syndrome (PCOS) have higher weight gain and psychological distress compared to those without PCOS. While COVID-19 restrictions led to population level adverse changes in lifestyle, weight gain and psychological distress, their impact on people with PCOS is unclear. The aim of this study was to investigate the impact the 2020 COVID-19 restrictions had on weight, physical activity, diet and psychological distress for Australians with PCOS.

METHODS

Australian reproductive-aged women participated in an online survey with assessment of weight, physical activity, diet and psychological distress. Multivariable logistic and linear regression were used to examine associations between PCOS and residential location with health outcomes.

RESULTS

On adjusted analysis, those with PCOS gained more weight (2.9%; 95% CI; 0.027-3.020; p = 0.046), were less likely to meet physical activity recommendations (OR 0.50; 95% CI; 0.32-0.79; p = 0.003) and had higher sugar-sweetened beverage intake (OR 1.74; 95% CI 1.10-2.75; p = 0.019) but no differences in psychological distress compared to women without PCOS.

CONCLUSIONS

People with PCOS were more adversely affected by COVID-19 restrictions, which may worsen their clinical features and disease burden. Additional health care support may be necessary to assist people with PCOS to meet dietary and physical activity recommendations.

Lifestyle Changes during the SARS-CoV-2 Pandemic as Predictors of BMI Changes among Men and Women in Poland

BACKGROUND

Social isolation during the SARS-CoV-2 pandemic affected people's body weight, therefore, this study was designed to evaluate the association between lifestyle elements and the change in BMI during lockdown.

METHODS

This retrospective observational study involved 290 questionnaires completed by adult participants divided into three groups according to BMI change during isolation. The structured questionnaire included a general description of the study objective and collected data regarding sociodemographics, anthropometrics, physical activity, sedentary behaviour, sleep duration, and food intake pre- and during COVID-19 lockdown.

RESULTS

A decrease or increase in BMI was found in 23.6% and 47.8% of women and 18.5% and 42.6% of men, respectively. Among those who lost weight, 46.5% of women and 40% of men followed a diet of their own choice, 30.2% of women and 25% of men changed their product mix and reduced their intake, 40% of men stopped eating outside the home. An increase in BMI was associated with increased food intake (32.2% of women and 28.3% of men), increased sleep duration on weekdays (49.2% of women and 43.5% of men) and, in more than 50% of subjects, decreased physical activity. In women, increased BMI was associated with the highest frequency of snacking (p = 0.0003), the highest intake of sweets (p = 0.0021), and in men with the highest intake of alcohol (p = 0.0017).

CONCLUSIONS

The observed changes in BMI during social isolation were the result of lifestyle modifications including dietary behaviour and differed by gender.

Psychological well-being of young adults during COVID-19 pandemic: Lesson learned and future research agenda

Psychological and mental well-being has become a topic of concern worldwide after the hit of the COVID-19 pandemic. It has triggered enormous global health care vulnerabilities and resulted in full and partial lockdowns to prevent the new case. This research study provides a comprehensive overview of the published international scientific studies on the effect of COVID-19 on the psychological well-being of young adults. This study aims to review the top-cited authors, documents, journals, productive countries, the most used keywords, and trending themes in this area. Articles related to psychological well-being during the COVID-19 pandemic from January 2020 to December 2022 were extracted from the Scopus database with specified keywords. In total, 482 documents were retrieved as original articles and bibliometric analysis, thematic analysis and content analysis are performed and analyzed. The results show that the United States has contributed the largest publications followed by the United Kingdom and Italy. Through the cluster analysis, it is found that many articles have been published and considered the psychological and mental impact of COVID-19. Young adults from both developed and developing countries are majorly affected by the COVID-19 pandemic. The pandemic prioritizes the importance of global psychological well-being and health care. This study focused on different aspects, such as stress, resilience, and the mental health of young adults. The research findings of this study put forth the urgent need to provide preventive policies and intervention procedures to address the psychological health of young adults and proposed a conceptual framework.

Increased Depression and the Worsening of Depressive Symptoms Associated with Physical Inactivity during the COVID-19 Pandemic: A Two-Phase Cross-Sectional Study

The COVID-19 pandemic has increased the incidence of depression and other mental disorders in the general population, influenced by various individual and contextual factors. Physical activity (PA) interventions offer a promising approach to mitigating the negative mental health effects of the pandemic. This study aims to analyze the association between PA and depressive symptoms. A total of 785 individuals aged 37.4 ± 13.2 years (72.5% female) were evaluated at two different time points: the first between 2018 and 2019, and the second during the COVID-19 pandemic in 2020. Depressive symptoms, demographic, and socioeconomic data were assessed using the Beck Depression Inventory to estimate depressive symptoms. Frequency analysis and binary and multinomial regression were employed for data analysis. The prevalence of mild depressive symptoms increased from 23.1% before the pandemic to 35.1% during the pandemic. Our findings reveal that practicing PA before the pandemic was a protective factor (OR: 0.19; 95% CI: 0.13, 0.30; p < 0.001) against mild depressive symptoms. Additionally, individuals who continued to practice PA during the pandemic had a lower chance of presenting mild (OR: 0.21; 95% CI: 0.15, 0.30) and moderate/severe (OR: 0.15; 95% CI: 0.08, 0.27) symptoms. Furthermore, our study shows that PA, which was already a protective factor before the pandemic, remained protective during the pandemic, even for those with the highest levels of depression.

Is the meaning of subjective well-being similar in Latin American countries? A cross-cultural measurement invariance study of the WHO-5 well-being index during the COVID-19 pandemic

BACKGROUND

There is an urgent need to assess changes in well-being on a multinational scale during the COVID-19 pandemic, thus culturally valid scales must be available.

METHODS

With this in mind, this study examined the invariance of the WHO well-being index (WHO-5) among a sample of 5183 people from 12 Latin Americans countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, and Uruguay).

RESULTS

The results of the present study indicate that the WHO-5 is strictly invariant across samples from different Latin American countries. Furthermore, the results of the IRT analysis indicate that all items of the WHO-5 were highly discriminative and that the difficulty required to respond to each of the five items is ascending. Additionally, the results indicated the presence of moderate and small size differences in subjective well-being among most countries.

CONCLUSION

The WHO-5 is useful for assessing subjective well-being in 12 Latin American countries during the COVID-19 pandemic, since the differences between scores can be attributed to differences in well-being and not in other characteristics of the scale.

An exploration of happiness, anxiety symptoms, and depressive symptoms among older adults during the coronavirus pandemic

The COVID-19 pandemic has affected millions of people worldwide. Because of the challenges associated with the pandemic, universal levels of happiness have likely depleted. We know little about how those with prior existing mental health concerns have responded to the pandemic. Using cross-sectional (study 1; N = 1,366) and longitudinal (study 2; N = 262) data, we utilized a stress and resilience perspective to explore mental health symptoms and happiness among older adults before and after the declaration of the pandemic. Results for both studies indicated higher levels of depression and anxiety symptoms predicted lower levels of happiness; however, for those who indicated higher levels of mental health symptoms, post-pandemic declaration happiness levels were higher than pre-pandemic happiness levels. Findings suggest that resilience may be learned throughout a lifetime, and that experiences from prior stressors may show benefits in responding to future ones, even among vulnerable populations.

The Effect of Physical Activity and Sedentary Behavior on Mental Health During the COVID-19 Pandemic Among the Adult Population in the Rural Area of Perambalur: A Cross-Sectional Study

Background The global COVID-19 pandemic has been incredibly destructive, especially for mental health. The lockdown measures required people to stay in their homes. This lifestyle caused them to become sedentary, which could have an impact on both their physical and mental well-being. We used the International Physical Activity Questionnaire (IPAQ) and the General Health Questionnaire-12 (GHQ-12) to measure the physical activity (PA) and mental health of adults in Perambalur, India, during the COVID-19 pandemic. Materials and methods The researchers conducted a cross-sectional investigation among people ages 15-60 years old from September 2021 to February 2022. In this study, we included 400 individuals through the method of convenient sampling. We conducted a population-based survey in which a semi-structured questionnaire was used to gather information on the age, gender, weight, height, physical activity (International Physical Activity Questionnaire {IPAQ}), and mental health (General Health Questionnaire-12 {GHQ-12}) of the participants. We conducted an analysis of the data using the Statistical Package for Social Sciences (SPSS) software version 20 (IBM SPSS Statistics, Armonk, NY). Results Most of the participants (65.8%) were female, and 69.5% belonged to the age group of 20-24 years; their mean age was 23 years. Physical activity was scored using the IPAQ, and we divided the participants into three categories: 37%, insufficient; 58%, sufficient; and 5%, high activity. The GHQ-12 assessment revealed that around half of the participants (47.8%) had psychological distress. In a bivariate analysis, those in the 15-19 and 24-29 age groups reported more distress than those in the other age groups (p = 0.006). Those who engaged in sufficient physical activity (54.7%) reported more distress than those who engaged in high (25%) or insufficient activity (p = 0.002). Conclusion Nearly half of the participants experienced psychological distress during the COVID-19 pandemic. Those who were engaging in sufficient physical activity experienced higher levels of distress than those with high and insufficient activities.

The medium-term perceived impact of work from home on life and work domains of knowledge workers during COVID-19 pandemic: A survey at the National Research Council of Italy

Objective

The study aimed to investigate perceptions and determinants of the overall impact on life and work domains among a community of knowledge workers after 18 months of forced work from home due to the pandemic.

Methods

A cross-sectional study with a retrospective assessment was conducted early in 2022 at the National Research Council of Italy. Five single-item questions explored the perceived impact on life domain while a 7-item scale the impact on the work domain. Bivariate analyses and multivariate regressions were used to evaluate the associations between impacts and some key factors defined by 29 ad hoc closed questions.

Results

More than 95% of the 748 respondents reported a perceived change in at least one item of the life domain. For each of these items, although a large group of subjects has reported that working from home had no impact (from 27 to 55%), in the rest of the sample the positive evaluation (from 30 to 60%) clearly prevailed over the negative one. Overall, most of the subjects (64%) rated the impact on the work experience positively. Relationship with colleagues and participation in the work context were the items where the greatest number of negative rates was concentrated (27 and 25%, respectively). On the other hand, positive perceptions prevailed over both negative perceptions and lack of impact perceptions on the subjects of organizational flexibility and quality of work. The frequency of work-room sharing, home-work commute time and changes in sedentary lifestyle, have been identified as common explanatory factors of perceived impacts on both domains.

Conclusion

Overall, respondents reported positive rather than negative perceived impacts of forced work from home in both their lives and work. The obtained results suggest that policies to promote the physical and mental health of employees, strengthen inclusion and maintain a sense of community are necessary to improve workers' health and prevent the effects of perceived isolation on research activities.

From backyards to the backcountry: Exploring outdoor recreation coping strategies and experiences during the 2020 COVID-19 pandemic in New Zealand

This paper explores the impacts that the New Zealand government's lockdown measures to contain the COVID-19 virus during 2020 had on the activity and experiences of outdoor recreationists in New Zealand. Concepts related to coping strategies such as rationalisation, displacement and substitution, have been used frequently to explain the behavioural changes and processes involved in outdoor recreation when disruptions arise such as crowding and recreational conflict. However, such concepts have rarely been applied to rapid on-set disruptors such as pandemics. This paper adopts coping strategy theory to help document the strategies adopted by outdoor recreationists in response to the national lockdown in 2020. Based on a qualitative analysis of twenty interviews with outdoor recreationists in New Zealand, various coping mechanisms such as temporal, activity, and spatial displacement are identified. These include increased appreciation for outdoor settings, discovery of local activities and microadventures, and increased walking activity across the restricted, reaction and reset periods. Outdoor recreation coping strategies may contribute to increased resilience to disruptive and rapid on-set events and enhance understanding of how recreationists respond and adapt to disruption. This research presents a unique insight of coping strategies adopted in response to the national lockdown that may have implications for participation and management of outdoor recreation in New Zealand in the coming years. This paper also offers a new perspective on the behaviourist tradition in the field of outdoor recreation which may be fruitful for future research examining rapid on-set disruptions and crises.

COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States

IMPORTANCE

The adverse effects of COVID-19 containment policies disrupting child mental health and sleep have been debated. However, few current estimates correct biases of these potential effects.

OBJECTIVES

To determine whether financial and school disruptions related to COVID-19 containment policies and unemployment rates were separately associated with perceived stress, sadness, positive affect, COVID-19-related worry, and sleep.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study was based on the Adolescent Brain Cognitive Development Study COVID-19 Rapid Response Release and used data collected 5 times between May and December 2020. Indexes of state-level COVID-19 policies (restrictive, supportive) and county-level unemployment rates were used to plausibly address confounding biases through 2-stage limited information maximum likelihood instrumental variables analyses. Data from 6030 US children aged 10 to 13 years were included. Data analysis was conducted from May 2021 to January 2023.

EXPOSURES

Policy-induced financial disruptions (lost wages or work due to COVID-19 economic impact); policy-induced school disruptions (switches to online or partial in-person schooling).

MAIN OUTCOMES AND MEASURES

Perceived stress scale, National Institutes of Health (NIH)-Toolbox sadness, NIH-Toolbox positive affect, COVID-19-related worry, and sleep (latency, inertia, duration).

RESULTS

In this study, 6030 children were included in the mental health sample (weighted median [IQR] age, 13 [12-13] years; 2947 [48.9%] females, 273 [4.5%] Asian children, 461 [7.6%] Black children, 1167 [19.4%] Hispanic children, 3783 [62.7%] White children, 347 [5.7%] children of other or multiracial ethnicity). After imputing missing data, experiencing financial disruption was associated with a 205.2% [95% CI, 52.9%-509.0%] increase in stress, a 112.1% [95% CI, 22.2%-268.1%] increase in sadness, 32.9% [95% CI, 3.5%-53.4%] decrease in positive affect, and a 73.9 [95% CI, 13.2-134.7] percentage-point increase in moderate-to-extreme COVID-19-related worry. There was no association between school disruption and mental health. Neither school disruption nor financial disruption were associated with sleep.

CONCLUSIONS AND RELEVANCE

To our knowledge, this study presents the first bias-corrected estimates linking COVID-19 policy-related financial disruptions with child mental health outcomes. School disruptions did not affect indices of children's mental health. These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available.