Changes in Physical Activity during the COVID-19 Pandemic-An Analysis of Differences Based on Mitigation Policies and Incidence Values in the Federal States of Germany

Changes in physical activity among Canadian adults more than 6 months into the COVID-19 pandemic: a secondary analysis of the INTERACT cohort study

OBJECTIVE

To estimate the effect of (a) the COVID-19 pandemic and (b) COVID-19 restriction stringency on daily minutes of device-measured moderate-to-vigorous physical activity (MVPA).

DESIGN

Physical activity data were collected from the INTerventions, Equity, Research and Action in Cities Team (INTERACT) cohorts in Montreal, Saskatoon and Vancouver before (May 2018 to February 2019, 'phase 1') and during the pandemic (October 2020 to February 2021, 'phase 2'). We estimated the effect of the two exposures by comparing daily MVPA measured (a) before vs during the pandemic (phase 1 vs phase 2) and (b) at different levels of COVID-19 restriction stringency during phase 2. Separate mixed effects negative binomial regression models were used to estimate the association between each exposure and daily MVPA, with and without controlling for confounders. Analyses were conducted on person-days with at least 600 min of wear time. Effect modification by gender, age, income, employment status, education, children in the home and city was assessed via stratification.

SETTING

Montreal (Quebec), Saskatoon (Saskatchewan) and Vancouver (British Columbia), Canada.

MAIN OUTCOME MEASURE

Daily minutes of MVPA, as measured using SenseDoc, a research-grade accelerometer device.

RESULTS

Daily minutes of MVPA were 21% lower in phase 2 (October 2020 to February 2021) compared with phase 1 (May 2018 to February 2019), controlling for gender, age, employment status, household income, education, city, weather and wear time (rate ratio=0.79, 95% CI 0.69, 0.92). This did not appear to be driven by changes in the sample or timing of data collection between phases. The results suggested effect modification by employment, household income and education. Restriction stringency was not associated with daily MVPA between October 2020 and February 2021 (adjusted rate ratio=0.99, 95% CI 0.96, 1.03).

CONCLUSIONS

Between October 2020 and February 2021, daily minutes of MVPA were significantly lower than 2 years prior, but were not associated with daily COVID-19 restriction stringency.

Family predictors of physical activity change during the COVID-19 lockdown in preschool children in Germany

The COVID-19 pandemic is associated with crucial changes in children's daily life including their physical activity (PA) and screen time (ST). Among preschool children, the family represents an important factor for sufficient PA levels by being the gatekeeper for PA. Thus, the aim of this study was to investigate the influence of the family environment, specifically SES, parental support, and having siblings on COVID-19-related changes of PA and ST behavior in 317 (170 boys, 147 girls) German preschool children using longitudinal data. Our results indicate a decline in total amount of sports-related PA, an increase in outdoor play, as well as an increase in leisure ST in preschool children. The changes in total amount of PA differed between children with different levels of parental support as well as in dependence on having siblings. Furthermore, levels of outdoor play and ST in preschool children were influenced by environmental factors like having access to their own garden. We conclude that the family environment (parental support as well as physical environment) is highly relevant for PA and ST levels in preschool children. To provide every child with PA opportunities during potential future lockdowns, restriction policies should be adapted and parents need sophisticated information about the importance of their support and thus the PA levels of their children.

Change in sports activity and walking and cycling for transport since the COVID-19 pandemic - Results of the GEDA 2021 study

Background

Physical activity is a significant health promotion behaviour. COVID-19 pandemic mitigation measures, such as reducing social contact, closing sports facilities and working from home offices, may make it more difficult to engage in regular physical activity.

Methods

The data collected between July and October 2021 from the nationally representative study German Health Update (GEDA 2021) were used. The activity behaviour is described by the change in the amount of sports activity as well as the amount of physical active transport (walking/cycling) since the beginning of the COVID-19 pandemic. The sample comprises 2,985 participants aged 18 and older.

Results

A quarter of the population reduced their sports activity compared to before the COVID-19 pandemic, while 12% increased their sports activity and 38% reported no change. In terms of physical active transport, it shows that 15% reduced the amount, 17% increased it and 55% maintained it. Compared to younger adults, older adults were more likely to maintain their activity behaviour rather than reduce or increase it.

Conclusion

Even before the pandemic, physical inactivity was common among the population. The high proportion of adults who reduced their sports activity during the pandemic underlines the need for effective measures to promote physical activity.

Is there a dose-response relationship? Investigating the functional form between COVID-19 incidence rates and life satisfaction in a multilevel framework

While there is plenty of research linking the effects of the global COVID-19 pandemic to a drastic reduction of life satisfaction in the population, there is little information on the functional form of this relationship. Until now, one could suspect that this association is linear and a higher number of COVID-19 infections in a region leads to a continuous decline of satisfaction. However, there are reasons to assume that this interrelation is indeed more complex and deserves further attention. To resolve this question, high-quality panel data of the first wave of COVID-19 from Germany are analysed in a fixed-effect multilevel framework. With information from more than 6,000 respondents (after imputation) nested in 339 federal districts, we estimate linear models with higher-order terms up to the fifth degree of median COVID-19 incidence rates and random intercepts for districts to describe the functional form. The results indicate that even regions with very low incidences are affected and a linear decline of satisfaction is only apparent for rather low incidence levels, quickly reaching a plateau, which is then quite constant, even for higher incidence levels. These findings indicate that at least in rich and industrialized countries like Germany, assuming a strictly linear relation between incidences and change of satisfaction is not appropriate.

Exercise frequency during the COVID-19 pandemic: A longitudinal probability survey of the US population

Regular physical activity is important for general health and reduces the risk for COVID-19 infections and for severe outcomes among infected people. However, measures to mitigate COVID-19 likely decrease population physical activity. This study aimed to examine 1) changes in exercise frequency in a representative sample of US adults during the pandemic (04/01/2020-07/21/2021), and 2) how sociodemographic characteristics, pre-COVID health-related behaviors and outcomes, and state-level stringency of COVID-19 containment measures predict exercise frequency. Self-reported exercise frequency and its individual-level predictors were determined based on 151,155 observations from 6,540 adult participants (aged ≥ 18 years) in all US states from the Understanding America Study. State-level stringency of COVID-19 control measures was examined from the Oxford COVID-19 Government Response Tracker. Exercise frequency varied significantly over 28 survey waves across 475 days of follow-up (F 1,473 = 185.5, p < 0.001, η2 = 0.28, 95% CI = 0.23-1.00), where exercise frequency decreased between April 2020 and January 2021, and then increased from January 2021 to July 2021. Those who were younger, living alone, non-White, had no college degree, lower household income, low pre-pandemic physical activity levels, obesity, diabetes, kidney disease and hypertension had lower exercise frequency. State-level stringency of COVID-19 control measures was inversely associated with exercise frequency (B = 0.002, SE = 0.001, p < 0.01) between April and December 2020 when the overall stringency level was relatively high; but the association was non-significant (B = 0.001, SE = 0.001, p > 0.05) between January and July 2021, during which the stringency index sharply declined to a low level. This longitudinal probability survey of the US population revealed significant fluctuations in exercise during COVID-19. Low exercise levels are concerning and deserve public health attention. Health inequalities from physical inactivity are likely to exacerbate because of COVID-19. Physical activity promotion in safe environments is urgently warranted, especially in at-risk population subgroups.