Standing up for health - improving mental wellbeing during COVID-19 isolation by reducing sedentary behaviour

Development of an Online Mind-Body Physical Activity Intervention for Young Adults during COVID-19: A Pilot Study

The purpose of this study was to examine the association between the implementation of an online mind-body physical activity (MBPA) intervention and physical activity (PA), stress, and well-being in young adults during COVID-19. The participants were a sample of college students (N = 21; 81% female). The MBPA intervention was organized in four online modules that were administered asynchronously for 8 weeks with three separate 10 min sessions per week. The intervention components consisted of traditional deep breathing, diaphragm mindful breathing, yoga poses, and walking meditation. Objective PA behaviors were assessed using wrist-worn ActiGraph accelerometers, and stress and well-being data were collected using validated self-report instruments. A 2 (sex) × 3 (time) doubly multivariate analysis of variance test with a univariate follow-up showed that the % of wear time in light (LPA) and moderate-to-vigorous physical activity (MVPA) was significantly higher at the end of the intervention compared to baseline (LPA mean difference = 11.3%, p = 0.003, d = 0.70; MVPA mean difference = 2.9%, p < 0.001, d = 0.56). No significant differences were observed for perceived stress and well-being, and there was no moderating effect of sex. The MBPA intervention showed promise, as it was associated with higher PA in young adults during COVID-19. No improvements were observed for stress and well-being. These results warrant further testing of the intervention's effectiveness using larger samples.

A 'health message' on sustainable physical and mental health for the prolonged COVID-19 and other pandemics

The world has been living with another pandemic physical inactivity (PI) and sedentary behavior (SB) and of other nature for years. As social measures to prevent the spread of COVID-19 have been strengthened, the physical activity (PA) barrier has been hit and the PI/SB pandemic has been exacerbated, and in the current situation, triggered by its prolonged period, it is emerging as a problem to be considered in order to combat the PI/SB pandemic through PA and to maintain continuous physical and mental health. This review aims to summarize existing and recent studies on the effects of PA/SB on physical and mental health in preparation for the context of prolonged COVID-19 and provides an easy and fun way to motivate, access PA, and PA recommendations for maintaining physical and mental health. We performed search strategies on PubMed, Medline, Scopus, and Google Scholar databases, and used a literature review of the current available literature on the COVID-19 and the effects of PI, SB, and PA on physical and mental health. The clinical relevance of this review shows that integrating PA into daily life and reducing prolonged sitting time is an important strategy for continuing a healthy life physically and mentally. As a result, for those who have not yet incorporated exercise as part of their daily routine, fun and easy access to PA suggests that in the long run, may be an opportunity to implement newer habits. In addition, in an emergency such as the COVID-19 quarantine period or other pandemics, it is essential for one to maintain health through PA at home, and underscore the 'health message' of the current review that reducing SB, progressively increasing PA, and doing more PA regularly in the current context prolonged COVID-19 can bring significant benefits to long-term habits and physical and mental health.

Current Status and Correlation of Physical Activity and Tendency to Problematic Mobile Phone Use in College Students

OBJECTIVE

To explore the effect of problematic mobile phone use on college students' physical activity and their relationships.

METHODS

A cross-sectional study was conducted among 3980 college students from three universities in Jiangsu province by random cluster sampling. The International Physical Activity Questionnaire Short (IPAQ-SF) measured college students' physical activity. The Mobile Phone Addiction Tendency Scale for College Students (MPATS) measured problematic mobile phone use tendencies. College students' physical activity was measured by the International Physical Activity Questionnaire Short (IPAQ-SF), and the Mobile Phone Addiction Tendency Scale measured their mobile phone addiction tendency for College Students (MPATS).

RESULTS

(1) The proportions of the low-, medium-, and high-intensity physical activity were 83.5%, 10.7%, and 5.8%, respectively, with gender differences; The score of problematic mobile phone use tendency was 38.725 ± 15.139. (2) There were significant differences in problematic mobile phone use tendency among college students with different physical activity intensity (F = 11.839, p < 0.001, η2 = 0.007). (3) The level of physical activity was significantly correlated with the tendency of problematic mobile phone use (r = -0.173, p < 0.001). (4) Physical activity of college students could significantly predict the tendency of problematic mobile phone use (F (3,3605) = 11.296, p < 0.001).

CONCLUSIONS

The physical activity of college students was mainly moderate to low intensity, while the tendency of problematic mobile phone use was high. College students' physical activity level was one of the important constraints of problematic mobile phone use tendency.

Impact of mental health, job insecurity, and COVID-19 symptoms on protective behavior changes among White, Black, and other minorities in the US

INTRODUCTION

Job insecurity such as loss of jobs or reduced wages has become a serious social problem in the US since COVID-19 started. Combined with psychological distress and experience of COVID-19 symptoms, the changes of people's protective behaviors vary across states in the US.

METHODS

This research investigated racial differences in the COVID-19 related factors among White, Black, and other minorities in the US, and examined how mental health mediated the impact of job insecurity on protective behaviors, and how the COVID-19 symptoms moderated the mediation effect of mental health. The 731 valid responses in a cross-sectional survey from May 23 to 27, 2020, in the US were analyzed with independent sample t-tests, Pearson's chi-square tests, and path analysis.

RESULTS

The findings showed that there were significant differences in job insecurity and Nonpharmaceutical Interventions (NPIs) practice among White, Black, and other minorities. Job insecurity was significantly negatively associated with NPIs practice and was significantly positively associated with mental health. Mental health significantly partially mediated the effect of job insecurity on NPIs practice, in that job insecurity is a better predictor of NPIs practice for individuals with worse mental health than that for individuals with better mental health. Experience of COVID-19 symptoms moderates the mediation effect of mental health on the relationship between job insecurity and NPIs practice, in that mental health is a better predictor of NPIs practice for individuals with a higher experience of COVID-19 symptoms than for individuals with a lower experience of COVID-19 symptoms.

DISCUSSION

The findings in this study shed lights on psychological and behavioral studies of people's behavior changes during a pandemic. The study indicates the importance of treating mental health to promote protective behaviors during a pandemic, as well as advocating for employees by identifying the needs for those whose jobs were negatively impacted the most.

Epidemiological Study of Physical Activity, Negative Moods, and Their Correlations among College Students

OBJECTIVE

Negative moods in college students have caused frequent extreme behaviors. This study analyzed the current status and correlation between physical activity and negative moods in college students.

METHODS

A cross-sectional study design was used in the present research. Data on college students' physical activity and negative moods were collected using the Sports Questionnaire Star software. The questionnaires were administered to college students in five colleges and universities in Henan and Jiangsu Provinces, China, and a total of 3711 correctly completed questionnaires were returned. Data on sociological and demographic information, the International Physical Activity Questionnaire Short Form (IPAQ-SF), and the Depression Anxiety and Stress Scale (DASS) were collected. The research was conducted in December 2021.

RESULTS

The low-intensity physical activity rate among college students was 55.56%, while depression, anxiety, and stress symptoms were detected in 35.14%, 65.29%, and 10.99%of the college students, respectively. Depression (K = 35.58, p < 0.001) and anxiety (K = 15.56, p < 0.001) rates were significantly different among the different physical activity intensity groups. The proportion of students who perform high-intensity physical activities was lower than those who perform low- and moderate-intensity physical activities.

CONCLUSION

Low physical activity and high anxiety are evident among college students, and prolonged moderate-to-low-intensity physical activity (including static behavior) induces depression and anxiety. In the future, further studies can be conducted on improving the physical activity intensity of college students, improving the mental health monitoring and intervention systems of college students, and exploring the dose-effect relationship between physical activity and negative moods.

Risk Perception towards COVID-19: A Systematic Review and Qualitative Synthesis

Several studies have attempted to identify how people's risk perceptions differ in regard to containing COVID-19 infections. The aim of the present review was to illustrate how risk awareness towards COVID-19 predicts people's preventive behaviors and to understand which features are associated with it. For the review, 77 articles found in six different databases (ProQuest, PsycInfo, PubMed, Science Direct, SCOPUS, and Web of Science) were considered, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was followed, and data synthesis was conducted using a mixed-methods approach. The results indicate that a high-risk perception towards COVID-19 predicts, in general, compliance with preventive behaviors and social distancing measures. Additionally, risk awareness was found to be associated with four other key themes: demographic factors, individual factors, geographical factors, and timing. Therefore, gaining a greater understanding of individual and cultural differences as well as how people behave could be the basis of an effective strategy for raising public risk awareness and for countering COVID-19.

The effect of triglycerides in the associations between physical activity, sedentary behavior and depression: An interaction and mediation analysis

BACKGROUND

Previous studies reported that there were associations between physical activity (PA), sedentary behavior (SB), triglycerides (TG) and depression. However, it is unclear whether there is an interaction and/or mediation effect of TG in the associations between PA, SB and depression. This study was to explore the effects of TG in the associations between PA, SB and depression, respectively.

METHODS

Our study included 7,728 adults (aged ≥20 years) participating in the 2009-2018 National Health and Nutrition Examination Survey (NHANES), which was a nationally representative survey. With higher TG as a mediator, a four-way decomposition method was used to decompose the total effects of insufficient PA and prolonged SB on depression, respectively.

RESULTS

There were statistically significant associations between moderate-to-vigorous recreational activity (MVRA), SB, TG and depression (all P < 0.05), respectively. With higher TG as a mediator, there were interaction and mediation effects in the association between SB and depression, and the excess relative risk (95% CI) of reference interaction effect (INT_ref) and the total mediation effect were 0.15(0.01,0.29) and 0.03(0.00,0.06), respectively. While insufficient MVRA attributed a proportion of 80.42% for the controlled direct effect (CDE) and 6.28% for total mediation effect. In addition, similar findings were observed in those with hypertension, overweight/obesity, dyslipidemia, and metabolic syndromes.

LIMITATION

This was a cross-sectional study, and the ability to make causal inference was limited.

CONCLUSION

The controlled direct effect of MVRA, the mediation of TG, and the interaction between SB and TG played the vital roles in increasing the risk of depression.

Sleep as a Priority: 24-Hour Movement Guidelines and Mental Health of Chinese College Students during the COVID-19 Pandemic

Research on the combined role of 24-hour movement behaviors (sleep, sedentary behavior [SB], and physical activity) in adult mental health, though important, is in its infancy. In the context of Canadian 24-hour movement guidelines integrating quantitative recommendations for sleep, SB, and moderate-to-vigorous physical activity (MVPA), this study aimed to examine the associations between meeting guidelines and mental health among college students. The study used a cross-sectional sample of 1846 Chinese college students surveyed online in August 2020. Through network analysis and multivariate analysis of covariance, the individual and combined associations between meeting 24-hour movement guidelines and the levels of depression and anxiety after adjusting sociodemographic factors were analyzed. Results indicated that meeting the sleep guideline had stronger associations with depression and anxiety than meeting the SB or MVPA guideline. Specifically, compared to meeting no guidelines, meeting the sleep guideline (alone or in combination with other guidelines) was associated with significantly lower levels of depression and anxiety; meeting both SB and MVPA guidelines was also associated with a significantly lower level of depression. Hence, meeting more guidelines, especially adhering to a healthy sleep routine, may play an important role in promoting the mental health of young adults.

Will Nothing Be the Same Again?: Changes in Lifestyle during COVID-19 Pandemic and Consequences on Mental Health

Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in physical and other meaningful activities of daily living, leisure, social activity, and education. In children, collateral effects of the pandemic include inadequate nutrition with a risk of both overweight and underweight, addiction to screens, lack of schooling, and psychosocial difficulties. Older adults are frequently unable to adapt to lockdown measures and suffer from depression and cognitive complaints. Recent studies focusing on changes in lifestyle during the Covid-19 pandemic and consequences on mental health have been identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All the available literature has been retrospectively reviewed. The results of the present narrative review suggest that mental distress caused by social isolation seems to be linked not only to personality characteristics but also to several lifestyle components (sleep disruption, altered eating habits, reduced physical activity). This review aims to explore major changes in the lifestyle and quality of life and the impact of these changes on mental health, and to inform clinicians and policymakers about elements that may reduce the negative psychological effects of the quarantine period imposed during this worldwide crisis. There is an urgent need for tailored preventive, diagnostic, and therapeutic mental health interventions for the general population and for higher risk groups.

Association between Self-Restraint Behavior, Stigma and Depressive Tendency in Office Workers during the COVID-19 Pandemic in Japan—Self-Restraint Behavior and Depression during the COVID-19

Background: The COVID-19 pandemic has forced people to change their lifestyles, especially with respect to restrictions on going out. Forced quarantine (i.e., lockdown) and self-restraint behavior (SRB), including self-quarantine, are suggested to induce potential negative impacts on public mental health. SRB seems to be related to governmental policies, each individual’s social background and mental condition; however, no empirical studies have been conducted. Methods: 1053 participants (mainly office workers) from epidemic areas and non-epidemic areas in Japan voluntarily conducted an online survey in June 2020. We assessed COVID-19-related aspects such as the degree of SRB, motivation for SRB, stigma, anxiety and depressive feelings due to COVID-19 by original questionnaires) and general mental health status (social anxiety by MINI-SPIN, depressive tendency by PHQ-9, depression-related personality traits by TACS-22 and resilience by TRS). Results: Regional comparison showed significant differences in SRB and social anxiety. People in epidemic areas tend to refrain from going out. Conversely, people in non-epidemic areas tend to shun the public eye. Regardless of epidemic status, proactive SRB was associated with higher motivation for SRB, higher social anxiety, higher depressive tendency, stronger COVID-19-related psychological factors and lower resilience. Moreover, people with proactive SRB in non-epidemic areas had the highest depressive tendency. Discussion: The present cross-sectional survey among office workers in Japan showed that people with proactive SRB have stronger COVID-19-related anxiety and depressive feelings, regardless of where they live. Our key finding is that people with proactive SRB in non-epidemic areas have the highest depressive tendency. Based on the present finding, we herein propose the following hypothesis: Higher levels of depressive tendency may enhance proactive SRB, which may be partly associated with higher levels of stigma, anxiety and depressive feelings related to COVID-19. Limitations: The general tendencies to avoid danger and stigma were not evaluated. Conclusions: Depressive tendency is suggested to be associated with proactive SRB against COVID-19. Intervention for depressive tendency in non-clinical settings (e.g., workplaces) may help citizens understand the infectious situation appropriately and to behave effectively during the pandemic. Further investigations should be conducted to clarify the present findings.

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

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.

Digital Clinics and Mobile Technology Implementation for Mental Health Care

PURPOSE OF REVIEW

Interest in digital mental health, especially smartphone apps, has expanded in light of limited access to mental health services and the need for remote care during COVID-19. Digital clinics, in which apps are blended into routine care, offer a potential solution to common implementation challenges including low user engagement and lack of clinical integration of apps.

RECENT FINDINGS

While the number of mental health apps available in commercial marketplaces continues to rise, there are few examples of successful implementation of these apps into care settings. We review one example of a digital clinic created within an academic medical center and another within the Department of Veterans Affairs. We then discuss how implementation science can inform new efforts to effectively integrate mental health technologies across diverse use cases. Integrating mental health apps into care settings is feasible but requires careful attention to multiple domains that will influence implementation success, including characteristics of the innovation (e.g., utility and complexity of the app), the recipients of the technology (e.g., patients and clinicians), and context (e.g., healthcare system buy-in, reimbursement, and regulatory policies). Examples of effective facilitation strategies that can be utilized to improve implementation efforts include co-production of technology involving all end users, specialized trainings for staff and patients, creation of new team members to aid in app usage (e.g., digital navigators), and re-design of clinical workflows.

Future perspectives of robot psychiatry: can communication robots assist psychiatric evaluation in the COVID-19 pandemic era?

PURPOSE OF REVIEW

Direct face-to-face interview between a psychiatrist and a patient is crucial in psychiatric evaluation, however, such traditional interviews are becoming difficult to conduct because of the infection risk in the COVID-19 era. As telepsychiatry, video interviews using internet are suggested to be useful to evaluate and assist individuals with mental disorders. However, some patients especially with social phobia, depression, and autism spectrum disorder (ASD) hesitate to use even such face-to-face-like tools. Communication robots have been proposed as future assistant tools for such patients. Herein, we summarize recent advancements in robot psychiatry, and propose the benefits of communication robots in psychiatric evaluation.

RECENT FINDINGS

Recent studies have suggested that communication robots are effective in assisting people with ASD. As a pilot trial, we herein conducted semi-structured interviews to evaluate depression and hikikomori, a form of pathological social withdrawal, using a communication robot and a psychiatrist, respectively. There was almost identical evaluation between the two. Interestingly, a person with hikikomori answered that the robot was easier to disclose.

SUMMARY

Robots can reduce the burden of human resources and the infection risk in the COVID-19 era. Robot interview is expected to be implemented for future evaluation system in psychiatry.