The impact of sitting time and physical activity on mental health during COVID-19 lockdown

Abstract Objective The primary aim of this study was to investigate the association between physical activity (PA) and sitting time on adults’ mental health (i.e., depression, anxiety and wellbeing) and the influence of mediators and confounders. Methods An online survey was disseminated in the UK between May and June 2020. A total of 284 participants (33.5 ± 12.4 years) self-reported their PA, sitting time and mental health through validated questionnaires. Results Multiple stepwise regression analysis revealed that being of younger age, female, on a lower income, with one or more comorbid health conditions, with a previous diagnosis of mood disorder and increased sitting time independently correlated with higher depression scores (F (13,219) = 12.31, p < 0.001), and explained 42% of the variance. Similar results were found for wellbeing where socio-demographic, health outcomes and sitting time influenced the subjective wellbeing (F (14,218) = 5.77, p < 0.001, 27% variance), although only socio-demographic and health outcomes contributed to the variation in anxiety score (F (13,219) = 7.84, p < 0.001, 32% variance). PA did not explain variation when sitting time was taken into account in any of the models. Combined analysis revealed that participants with lower sedentary time (< 8 h) and with both low or moderate and high PA presented a significantly lower depression score [low PA: (B = −2.7, 95% CI −4.88, −0.52); moderate and high PA (B = −2.7, −4.88, −0.52)]. Conclusion Sitting time was strongly associated with adverse mental health during COVID-19 lockdown and should be considered in future public health recommendations.

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How is the COVID-19 lockdown impacting the mental health of parents of school-age children in the UK? A cross-sectional online survey

BMJ Open ◽

10.1136/bmjopen-2020-043397 ◽

2021 ◽

Vol 11 (5) ◽

pp. e043397

Author(s):

Austen El-Osta ◽

Aos Alaa ◽

Iman Webber ◽

Eva Riboli Sasco ◽

Emmanouil Bagkeris ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Social Isolation ◽

Online Survey ◽

Female Gender ◽

School Age Children ◽

School Age ◽

Cross Sectional ◽

The Uk ◽

The Impact

ObjectiveInvestigate the impact of the COVID-19 lockdown on feelings of loneliness and social isolation in parents of school-age children.DesignCross-sectional online survey of parents of primary and secondary school-age children.SettingCommunity setting.Participants1214 parents of school-age children in the UK.MethodsAn online survey explored the impact of lockdown on the mental health of parents with school-age children, and in particular about feelings of social isolation and loneliness. Associations between the UCLA Three-Item Loneliness Scale (UCLATILS), the Direct Measure of Loneliness (DMOL) and the characteristics of the study participants were assessed using ordinal logistic regression models.Main outcome measuresSelf-reported measures of social isolation and loneliness using UCLATILS and DMOL.ResultsHalf of respondents felt they lacked companionship, 45% had feelings of being left out, 58% felt isolated and 46% felt lonely during the first 100 days of lockdown. The factors that were associated with higher levels of loneliness on UCLATILS were female gender, parenting a child with special needs, lack of a dedicated space for distance learning, disruption of sleep patterns and low levels of physical activity during the lockdown. Factors associated with a higher DMOL were female gender, single parenting, parenting a child with special needs, unemployment, low physical activity, lack of a dedicated study space and disruption of sleep patterns during the lockdown.ConclusionsThe COVID-19 lockdown has increased feelings of social isolation and loneliness among parents of school-age children. The sustained adoption of two modifiable health-seeking lifestyle behaviours (increased levels of physical activity and the maintenance of good sleep hygiene practices) wmay help reduce feelings of social isolation and loneliness during lockdown.

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Income-related health inequality among Chinese adults during the COVID-19 pandemic: evidence based on an online survey

International Journal for Equity in Health ◽

10.1186/s12939-021-01448-9 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Peng Nie ◽

Lanlin Ding ◽

Zhuo Chen ◽

Shiyong Liu ◽

Qi Zhang ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Health Outcomes ◽

Family Member ◽

Health Inequalities ◽

Online Survey ◽

Mainland China ◽

Decomposition Analysis ◽

National Sample ◽

Vulnerable Groups

AbstractBackgroundPartial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic.MethodsThe 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for this analysis. Concentration Index (CI) and Corrected CI (CCI) were used to measure income-related inequalities in mental health and self-reported health (SRH), respectively. Wagstaff-type decomposition analysis was used to identify contributors to health inequalities.ResultsMost participants reported their health status as “very good” (39.0%) or “excellent” (42.3%). CCI of SRH and mental health were − 0.09 (p < 0.01) and 0.04 (p < 0.01), respectively, indicating pro-poor inequality in ill SRH and pro-rich inequality in ill mental health. Income was the leading contributor to inequalities in SRH and mental health, accounting for 62.7% (p < 0.01) and 39.0% (p < 0.05) of income-related inequalities, respectively. The COVID-19 related variables, including self-reported family-member COVID-19 infection, job loss, experiences of food and medication shortage, engagement in physical activity, and five different-level pandemic regions of residence, explained substantial inequalities in ill SRH and ill mental health, accounting for 29.7% (p < 0.01) and 20.6% (p < 0.01), respectively. Self-reported family member COVID-19 infection, experiencing food and medication shortage, and engagement in physical activity explain 9.4% (p < 0.01), 2.6% (the summed contributions of experiencing food shortage (0.9%) and medication shortage (1.7%),p < 0.01), and 17.6% (p < 0.01) inequality in SRH, respectively (8.9% (p < 0.01), 24.1% (p < 0.01), and 15.1% (p < 0.01) for mental health).ConclusionsPer capita household income last year, experiences of food and medication shortage, self-reported family member COVID-19 infection, and physical activity are important contributors to health inequalities, especially mental health in China during the COVID-19 pandemic. Intervention programs should be implemented to support vulnerable groups.

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Attitudes About COVID-19 and Health: A Mixed-Methods Smartphone-App and Online Survey Study (Preprint)

10.2196/preprints.29963 ◽

2021 ◽

Author(s):

Anna M. Hood ◽

Hanne Stotesbury ◽

Jennifer Murphy ◽

Melanie Kölbel ◽

April Slee ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Data Collection ◽

Physical Health ◽

Online Survey ◽

Smartphone App ◽

The Uk ◽

The Impact ◽

Monthly Survey

BACKGROUND Behavioral mitigation strategies to slow the spread of COVID-19 have resulted in sweeping lifestyle changes, with short and long-term psychological, well-being, and quality of life implications. The Attitudes About COVID-19 and Health (ATTACH) study focuses on understanding attitudes and beliefs whilst considering the impact on mental and physical health and the influence of broader demographic and geographic factors on attitudes, beliefs, and mental health burden. OBJECTIVE In this assessment of our first wave of data collection, we provide baseline cohort descriptives of ATTACH study participants in the United Kingdom (UK), United States of America (USA), and Mexico. Additionally, we assess responses to daily poll questions related to COVID-19 and conduct a cross-sectional analysis of baseline assessments collected in the UK between June 26 and October 31, 2020. METHODS The ATTACH study uses smartphone-app technology and online survey data collection. Participants completed poll questions twice daily related to COVID-19 and a monthly survey assessing mental health, social isolation, physical health, and quality of life. Poll question responses were graphed using 95% Clopper-Pearson (exact) tests with 95% confidence intervals. Pearson correlations, hierarchical linear regression analyses, and generalized linear models assessed relationships, predictors of self-reported outcomes, and group differences, respectively. RESULTS By October 31, 2020, 1405, 80, and 90 participants had consented to participate in the UK, USA, and Mexico, respectively. Descriptive data for the UK daily poll questions indicated that participants were generally following social distancing measures, but worry and negative impacts on families increased as the pandemic progressed. Although participants generally reported feeling that the reasons for current measures had been made clear, there was low trust that the government was doing everything in its power to meet public needs. In the UK, 1282 participants also completed a monthly survey (95% white, 72% female, 21% key or essential workers). Nineteen percent of UK participants reported a pre-existing mental health disorder, 31% reported a pre-existing chronic medical illness, and 35% were over 65. Fifty-seven percent of participants reported being more sedentary since the pandemic began, and 41% reported reduced access to medical care. Those with poorer mental health outcomes lived in more deprived neighborhoods, in larger households (ps < .05), had more pre-existing mental health disorders and medical conditions, and were younger than 65 years (all ps < .001). CONCLUSIONS Communities who have been exposed to additional harm during the COVID-19 pandemic were experiencing worse mental outcomes. Factors including having a medical condition, or living in a deprived neighborhood or larger household were associated with heightened risk. Future longitudinal studies should investigate the link between COVID-19 exposure, mental health, and sociodemographic and residential characteristics.

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Psychological distress and resilience in a sample of Adolescents and Young Adults with cancer during the COVID-19 pandemic

10.1101/2021.03.29.21254529 ◽

2021 ◽

Author(s):

Clare Jacobson ◽

Rebecca Mulholland ◽

Nicola Miller ◽

Laura Baker ◽

Daniel Glazer ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Cancer Treatment ◽

Online Survey ◽

Protective Factor ◽

Care Delivery ◽

Self Report ◽

Patient Health ◽

The Uk ◽

The Impact

AbstractBACKGROUNDAdolescents and young people (AYA) with cancer are at greater risk of psychological distress which can impact treatment. COVID-19 has resulted in changes to cancer care delivery and AYA have been disproportionately affected by economic and educational effects of COVID-19, potentially impacting on mental health. Understanding the impact of COVID-19 on AYA with cancer is important to inform care.METHODSOnline survey of 16-24 year olds receiving cancer treatment at 8 cancer centres in the UK in December 2020. We measured: self-perceived increased anxiety since COVID-19, impact of COVID-19 on treatment, life and relationships and used the 8-item Patient Health Questionnaire(PHQ-8), 7-item Generalised Anxiety Disorder Scale(GAD) and the 2-item Connor-Davidson Resilience Scale(CD-RISC).RESULTS112 AYA participated (17.8% of total eligible). 62.8% were female, 67.3% were 21-24 years. 83% were white. 59.8% had previously experienced mental health difficulties. 67.9% received cancer treatment during the pandemic and 33.9% were diagnosed during the pandemic. 78.6% reported COVID-19 having a significant impact on their life, 55.4% on their key relationship and 39.3% on their treatment. 79% reported experiencing some degree of increased anxiety since COVID-19.43.4% had moderate-severe PHQ-8 scores and 37.1% for GADS-7. Self-report of impact on life was associated with greater anxiety during COVID-19 and moderate-severe PHQ-8 score (OR 3.64, 95% CI 2.52 to 19.40, p <0.01; OR 5.23, 95%CI 1.65 to 16.56, p < 0.01). Impact on relationships was associated with greater anxiety and moderate-severe GADS-7and PHQ-8 score (OR 2.89, 95% CI 1.11 to 7.54, p = 0,03; OR 3.54, 95% CI 2.32 to 15.17, p<0.01; OR 2.42, 95% CI 1.11 to 5.25, p =0.03). Greater CD-RISC score was associated with lower risk of anxiety and mod-severe GADS-7and PHQ-8 scores (OR 0.58, 95%CI 0.41 to 0.81, p <0.01; OR 0.55 95% CI 0.4 to 0.72, p <0.01; OR 0.52, 95% CI 0.38 to 0.69, p <0.01)CONCLUSIONSWe found high levels of psychological distress in AYA with cancer, which is important knowledge for clinical teams working with this age group. Perceived impact of COVID-19 on relationships and life was predictive of poorer mental health, with resilience a potential protective factor.

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Motivation to Improve Mental Wellbeing via Community Physical Activity Initiatives and the Associated Impacts—A Cross-Sectional Survey of UK parkrun Participants

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413072 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13072

Author(s):

Allison Dunne ◽

Steve Haake ◽

Helen Quirk ◽

Alice Bullas

Keyword(s):

Mental Health ◽

Physical Activity ◽

Physical Health ◽

Online Survey ◽

Local Community ◽

Health Conditions ◽

Mental Wellbeing ◽

Health Improvement ◽

Mental Health Conditions ◽

The Impact

Participation in regular physical activity is a well-established strategy to support good mental wellbeing in adults with, and without, mental health conditions. The physical activity initiative parkrun is a free, weekly, timed, running and walking event which is attended by people from the local community of all abilities. The purpose of this study was to investigate the mental wellbeing of UK parkrun participants along with their motives for taking part and the impact of participation. Mental health conditions were self-reported in 2.5% of 60,000 respondents to an online survey of parkrunners, with the most prevalent being depression and anxiety. Those with mental health conditions were more motivated than those without to first participate in parkrun to manage their health conditions and improve their mental health. Those with mental health conditions were equally motivated to improve their physical health when compared to those without, and reported similar levels of improvement. Mental wellbeing scores for those with mental health conditions were close to the normal range, suggesting that engagement in parkrun may have had a role in limiting the effect of their illness. Community initiatives could replicate parkrun’s model, and use the potential for both mental and physical health improvement, as well as health condition management, as a motivation for participation.

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Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from The COVID-19 Psychological Wellbeing Study

10.31234/osf.io/j2pce ◽

2020 ◽

Cited By ~ 1

Author(s):

Jenny Groarke ◽

Emma Berry ◽

Lisa Graham-Wisener ◽

Phoebe McKenna-Plumley ◽

Emily McGlinchey ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Emotion Regulation ◽

Health Outcomes ◽

Mental Health Outcomes ◽

Psychological Wellbeing ◽

Public Health Issue ◽

Cross Sectional ◽

The Uk ◽

The Impact

Objectives: Loneliness is a significant public health issue. The COVID-19 pandemic has resulted in lockdown measures limiting social contact. The UK public are worried about the impact of these measures on mental health outcomes. Understanding the prevalence and predictors of loneliness at this time is a priority issue for research. Design: The study employed a cross-sectional online survey design. Method: Baseline data collected between March 23rd and April 24th 2020 from UK adults in the COVID-19 Psychological Wellbeing Study were analysed (N = 1963, 18-87 years, M = 37.11, SD = 12.86, 70% female). Logistic regression analysis was used to look at the influence of sociodemographic, social, health and COVID-19 specific factors on loneliness. Results: The prevalence of loneliness was 27% (530/1963). Risk factors for loneliness were younger age group (OR: 4.67 – 5.31), being separated or divorced (OR: 2.29), meeting clinical criteria for major depression (OR: 1.74), greater emotion regulation difficulties (OR: 1.04), and poor quality sleep due to the COVID-19 crisis (OR: 1.30). Higher levels of social support (OR: 0.92), being married/co-habiting (OR: 0.35) and living with a great number of adults (OR: 0.87) were protective factors. Conclusions: Rates of loneliness during the initial phase of lockdown were high. Risk factors were not specific to the COVID-19 crisis. Findings suggest that supportive interventions to reduce loneliness should prioritise younger people and those with mental health symptoms. Improving emotion regulation and sleep quality may be optimal initial targets to reduce the impact of COVID-19 regulations on mental health outcomes.

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Wellbeing during the COVID-19 pandemic in the UK: a secondary data analysis

10.31235/osf.io/pv4qs ◽

2021 ◽

Author(s):

Jen Murphy ◽

Mark Elliot

Keyword(s):

Mental Health ◽

Online Survey ◽

National Level ◽

Secondary Data ◽

Well Being ◽

Ordinary Least Squares ◽

Least Squares Regression ◽

The Uk ◽

Survey Responses ◽

The Impact

Introduction: In March 2020 in response to the COVID pandemic the UK government declared a national lockdown where citizens were required to stay at home. The impact of this lockdown on levels of well-being has been a source of concern for citizens and mental health professionals.Objectives: We investigated the trajectory of well-being over the course of the ?first wave and sought to determine whether the change in well-being is distributed equally across the population. Speci?fically we investigated pre-existing medical conditions, social isolation, ?financial stress and deprivation as a predictor for well-being and whether there were community level characteristics which protect against poorer well-being.Methods: Using online survey responses from the COVID19 modules of Understanding society, we linked 8,379 English cases across ?five waves of data collection to location based deprivation statistics. We used ordinary least squares regression to estimate the association between deprivation, pre-existing conditions and socio-demographic factors and the change in well-being scores over time, as measured by the GHQ-12 questionnaire.Results: A decline in well-being was observed at the beginning of the fi?rst lock down period at the beginning of March 2020. This was matched with a corresponding recovery between April and July as restrictions were gradually lifted. There was no association between the decline and deprivation, nor between deprivation and recovery. The strongest predictor of well-being during the lockdown, was the baseline score, with the counterintuitive finding that for those will pre-existing poor well-being, the impact of pandemic restrictions on mental health were minimal, but for those who had previously felt well, the restrictions and the impact of the pandemic on well-being were much greater.Conclusion: These data show no evidence of a social gradient in well-being related to the pandemic. In fact, wellbeing was shown to be highly elastic in this period indicating a national level of resilience which cut across the usually observed health inequalities.

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The Impact of Community Size, Community Climate, and Victimization on the Physical and Mental Health of SGM Youth

Youth & Society ◽

10.1177/0044118x19856141 ◽

2019 ◽

Vol 52 (3) ◽

pp. 427-448

Author(s):

Megan S. Paceley ◽

Jessica N. Fish ◽

Margaret M. C. Thomas ◽

Jacob Goffnett

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Physical Health ◽

Online Survey ◽

Community Context ◽

Physical And Mental Health ◽

Community Size ◽

Health Community ◽

The Impact ◽

Community Climate

Sexual and gender minority (SGM) youth experience high rates of victimization leading to health disparities. Community size and community climate are associated with health outcomes among SGM youth; however, we lack studies that include them as covariates alongside victimization to understand their collective impact on health. This study utilized minority stress theory to understand how community context shapes experiences of victimization and health among SGM youth. SGM youth in one Midwestern U.S. state completed an online survey ( n = 201) with measures of physical health, mental health, community context, and victimization. Data were analyzed via multiple regression using a path analysis framework. Results indicate that perceived climate was associated with mental, but not physical, health; Community size was unrelated to health outcomes. Victimization mediated the association between community climate and mental health. Findings are discussed in light of current literature and implications for research and practice are shared.

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Evidence of Impact of Outdoor Swimming on Health using an Online Survey (Preprint)

10.2196/preprints.25589 ◽

2020 ◽

Author(s):

Heather Massey ◽

Paul Gorczynski ◽

C Mark Harper ◽

Lisa Sansom ◽

Kieren McEwan ◽

...

Keyword(s):

Mental Health ◽

Online Survey ◽

Poor Mental Health ◽

Medical Conditions ◽

Starting Point ◽

Injury Category ◽

Current Sample ◽

The Uk ◽

Evidence Of Impact ◽

The Impact

BACKGROUND Outdoor swimming has grown in popularity in many countries including the UK. Many anecdotal accounts indicate an improvement in medical conditions which are considered a consequence of outdoor swimming. OBJECTIVE This study aimed to better understand outdoor swimmers’ perceptions of their health and the extent to which participation impacted upon their existing, self-reported symptoms. METHODS A survey was deployed investigating outdoor swimming behaviours and reports of any diagnosed medical conditions, if any. Medical conditions were coded into categories and descriptive statistics generated regarding the outdoor swimmers’ behaviours and about the effect outdoor swimming had on their medical symptoms, if any. The medical categories were clustered in to five larger categories based on their prevalence in the current sample: mental health, musculoskeletal & injury, neurological, cardiovascular & blood disease, ‘Other’ which consists of all conditions not categorised in the four previous groups. RESULTS In total, 722 outdoor swimmers responded, of which 498 (69%) were female. The probability of outdoor swimming having ‘some impact’ on health across all medical categories was 3.57 times higher compared to no impact (B=1.28,95% CI [0.63, 1.91], P<.001), 44.32 times higher for the mental health category (B=3.79, 95% CI [2.28, 5.30], P<.001), 5.25 times higher for Musculoskeletal & injury category (B = 1.66, 95% CI [0.52, 2.79], P=.004) and 4.02 times higher for ‘Other’ category (B = 1.39, 95% CI [0.27, 2.51], P=.015). Overall, outdoor swimming was associated with perceived reductions in symptoms of poor mental health (2(2)=25.099, P<0.001), musculoskeletal and injury (2 (2)=8.242, P=.038), cardiovascular and blood (2(2)=14.685, P=.006) and ‘other’ conditions (2(2)= 18.213, P<.001). CONCLUSIONS Physical activity taken in the form of outdoor swimming is perceived to have positive impacts on health and is associated with perceived symptom reductions in mental health, musculoskeletal, cardiovascular and respiratory conditions. This study cannot provide causal relationships, or provide mechanistic insight. It does, however, provide a starting point for more targeted prospective intervention research into individual conditions or categories of condition to establish the impact in those who choose to start outdoor swimming.

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The Impact of the COVID-19 Pandemic on US College Students’ Physical Activity and Mental Health

Journal of Physical Activity and Health ◽

10.1123/jpah.2020-0325 ◽

2021 ◽

Vol 18 (3) ◽

pp. 272-278 ◽

Cited By ~ 1

Author(s):

Oliver W.A. Wilson ◽

Kelsey E. Holland ◽

Lucas D. Elliott ◽

Michele Duffey ◽

Melissa Bopp

Keyword(s):

Mental Health ◽

Physical Activity ◽

College Students ◽

Depressive Symptoms ◽

Perceived Stress ◽

Online Survey ◽

Well Being ◽

Significant Decline ◽

Spring Semester ◽

The Impact

Background: Investigating the impact of the COVID-19 pandemic on both physical activity (PA) and mental health is important to demonstrate the need for interventions. This study examined the apparent impact of the pandemic on college students’ PA, perceived stress, and depressive symptoms. Methods: From 2015 through 2020, data were collected at the beginning and end of the spring semester at a large Northeastern US university via an online survey assessing student demographics, PA, perceived stress, and depressive symptoms. Mixed ANOVA examined differences in PA and mental health changes over the spring semester between “normal” and COVID-19 circumstances. Two-way ANOVA examined the interaction between circumstance and changes in PA in relation to changes in mental health. Results: Participants (n = 1019) were predominately women and non-Hispanic white. There was a significant decline in PA and an increase in perceived stress under COVID-19, but not normal, circumstances and a significant increase in depressive symptoms under COVID-19, but not normal, circumstances among women. Conclusions: A significant decline in PA and mental health among college students occurred under COVID-19 circumstances, and PA did not appear to protect against deterioration in mental health. Proactive and innovative policies, programs, and practices to promote student health and well-being must be explored immediately.

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