Association of Web-Based Physical Education With Mental Health of College Students in Wuhan During the COVID-19 Outbreak: Cross-Sectional Survey Study

Aerobic exercise during adolescence and anxiety disorders in adulthood: A cohort study using Add Health

INTRODUCTION

The prevalence of anxiety disorders, and mental chronic diseases, has increased over the last decade among adolescents. Since aerobic exercise reduces the risk of chronic diseases and stress symptoms, we aimed to examine the association between aerobic exercise in adolescence and anxiety disorders in adulthood.

METHODS

Self-reported, publicly available data from 5,114 adolescents who participated in Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) was analyzed from 1994-2009. We included US-based individuals aged 16 years on average and observed them for 15 years. Weighted Poisson regression models estimated the association between aerobic exercise in Wave I (1994, baseline) and anxiety disorders in Wave IV (2009, adulthood), adjusting for sociodemographic characteristics and substance use at baseline.

RESULTS

Overall, 639/5,114 (weighted 12.96%) individuals experienced anxiety disorders at baseline. Age and sex differed significantly across all exercise groups (p's<0.001). Aerobic exercise did not significantly protect against anxiety disorders in adulthood: compared to adolescents who did not exercise at all, those who exercised 1-2 times/week had 0.85 times the prevalence of anxiety disorders during adulthood (95% CI = 0.65, 1.12; p = 0.25). Those who exercised 3-4 times/week had 0.81 times the prevalence (95% CI = 0.61, 1.08, p = 0.15) and those who exercised 5+ times/week had 0.84 times the prevalence (95% CI = 0.63, 1.13, p = 0.25) than those who did not exercise at all.

CONCLUSION

Aerobic Exercise in adolescence did not protect against anxiety disorders in adulthood. More evidence is needed on this association, including using homogeneous measures of exercise and repeated measures methods.

Reducing Anxiety and Enhancing Mindfulness in College Students during COVID-19 through WeActive and WeMindful Interventions

OBJECTIVE

The purpose of this study was to examine the immediate and short-term, sustained effects of two virtual interventions, WeActive, an aerobic and resistance training program, and WeMindful, a mindful exercise, in reducing anxiety and improving mindfulness among college students during the COVID-19 pandemic.

METHODS

Participants were 60 students from a large Midwestern university who were randomly assigned to either the WeActive group (n = 36) or the WeMindful group (n = 24). The WeActive group participated in two virtual 30 min aerobic and resistance training sessions per week (WeActive) and the WeMindful group participated in two virtual 30 min mindful exercise sessions per week for eight weeks. All participants completed the Generalized Anxiety Disorder scale and the Five Facet Mindfulness Questionnaire through Qualtrics at three time points: one week prior to (pre-test), one week after (post-test), and six weeks after (follow-up) the intervention.

RESULTS

A repeated-measures ANOVA revealed a significant main effect of time on anxiety (F = 7.51, η2 = 0.036, p = 0.001) in both groups. WeActive significantly decreased anxiety scores between the pre-test and follow-up (t = 2.7, p = 0.027) and post-test and follow-up (t = 3.1, p = 0.007), and WeMindful significantly decreased anxiety scores between the post-test and follow-up (t = 0.641, p = 0.028). For mindfulness, there was a significant main effect of time in both groups (F = 3.91, η2 = 0.009, p = 0.025), where only WeMindful significantly increased mindfulness from the pre-test to follow-up (t = -2.7, p = 0.025).

CONCLUSIONS

Anxiety decreased significantly in both the WeActive and WeMindful groups and mindfulness increased significantly in the WeMindful group. Furthermore, the decrease in anxiety was sustained in a short-term period following the end of the intervention.

Effect of an online posture exercise program during the COVID-19 pandemic on students' musculoskeletal pain and quality of life

BACKGROUND

Prolonged sitting and poor posture can contribute to musculoskeletal pain and have a negative effect on health-related quality of life (HRQoL) among young adults. Any prolonged posture leads to static loading of soft tissues and causes discomfort. Seated posture leads to inactivity causing an accumulation of metabolites, accelerating disk degeneration and musculoskeletal pain. Regular exercise has major contributions to the prevention and treatment of some health problems such as musculoskeletal disorders.

OBJECTIVE

This study aimed to assess the impact of online posture exercises on musculoskeletal pain and health related quality of life among university students receiving distance education during the COVID-19 pandemic.

METHODS

This randomized controlled trial involved 72 students divided into intervention (n= 35) and control (n= 37) groups. The intervention group followed an 8-week online stretching and posture exercise program. Baseline and 8-week results were measured using the SF-36 QoL Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ).

RESULTS

Students spent an average of 5.4 ± 2.5 hours daily at computers. While there was no difference between the scores of any region in the CMDQ in the control group, there was a decrease in the neck, right shoulder, left shoulder, waist, left upper leg, right lower leg, and left lower leg discomfort scores in the intervention group (p< 0.05). There was a significant difference between the intervention and control groups in the total score of SF-36 and the sub-dimensions of vitality and mental health (p< 0.05).

CONCLUSION

The online posture exercise program led to notable reductions in musculoskeletal pain and improvements in QoL among university students. Examining the effectiveness of online exercise programs in different age groups is important for health benefits during quarantines.

Association between physical activity levels and anxiety or depression among college students in China during the COVID-19 pandemic: A meta-analysis

BACKGROUND

This meta-analysis aimed to investigate the links between the level of physical activity and the risk of anxiety or depression among college students in China during the Coronavirus Disease 2019 pandemic.

METHODS

Eligible studies were searched from the PubMed, Embase, and Web of Science databases. The associations between them were assessed with odd ratio (OR) and 95% confidence interval (CI). The heterogeneity of the included studies was evaluated and subgroup analysis was performed. Sensitivity analysis was executed using leave-one-out method. Publication bias of included studies was evaluated. Ten studies with moderate quality were included.

RESULTS

Physical activity levels of college students were associated with reduced risk of depression (OR [95%CI] = 0.69 [0.58, 0.82], P < .001) and anxiety (OR [95%CI] = 0.71 [0.62, 0.80], P < .001). The measurement scale of depression or anxiety and whether multi-factor correction was performed or not did not influence the pooled results. The pooled results of depression and anxiety were stable and were not significantly influenced by a single study. No publication bias was observed in the included studies reporting depression and anxiety.

CONCLUSION

The physical activity level of college students is negatively correlated with anxiety and depression in China during the pandemic. During the Coronavirus Disease 2019 pandemic, it is necessary to strengthen the construction of university physical education courses. As an organized form of physical activity, physical education classes are a necessary and effective way to increase physical activity among college students.

Exercise Effect on Mental Health in Isolating or Quarantining Adults

INTRODUCTION: In response to coronavirus disease 2019 (COVID-19), travelers are typically subject to quarantine, which is often associated with poorer mental health (MH). While the protective benefits of community-based exercise are widely recognized, the degree to which this extends to the confined setting is unknown. This systematic review aims to evaluate the effect of exercise on MH in isolating or quarantining adults.METHODS: A literature search of Ovid MEDLINE, APA PsycInfo, and the Cochrane Database of Systematic Reviews limited to January 2019-September 2021 inclusive yielded five eligible studies.RESULTS: Data comprised a total of 2755 college and university students, most of whom were confined. Depending on the scale used, 24.9-76.7% of respondents demonstrated impaired MH, which improved with physical activity (PA), especially when regular and moderate or vigorous. The frequency, duration, and participants of exercise increased as lockdown progressed. One study showed that while sleep, diet, and PA all have an impact on MH, PA was the factor most strongly correlated with MH.DISCUSSION: Physical fitness should be optimized before and maintained during quarantine while exercise space and equipment should be accessible. Importantly, the sustainability of persistent quarantine must be considered given the pervasiveness of COVID-19.Chu V, Newman DG. Exercise effect on mental health in isolating or quarantining adults. Aerosp Med Hum Perform. 2023; 94(9):686-695.

The impact of COVID-19 on students' anxiety and its clarification: a systematic review

Introduction

Since the emergence of COVID-19 in 2019, every country in the world has been affected to varying degrees. Long-term psychological pressure and anxiety will inevitably damage the physical and mental health of students. This study aimed to examine the effects of the COVID-19 pandemic on students who experienced stress and anxiety and to clarify which intervention was more effective.

Methods

A comprehensive literature search was conducted between January 2020 and December 2022 using online databases such as PubMed, Web of Science, Scopus, and Google Scholar by using the following keywords in combination: "COVID-19," "stress," "anxiety," "depression," and "intervention." The retrieved literature was screened and reviewed.

Results

A total of 2,924 articles were retrieved using subject and keyword searches. After screening through the titles and abstracts, 18 related studies were retained. Their review revealed that: (1) most studies did not use medication to control stress and anxiety; (2) the standard methods used to reduce stress and anxiety were religion, psychological counseling, learning more about COVID-19 through the media, online mindfulness courses, improving sleep quality, and physical exercise; (3) the most effective interventions were physical activity and raising awareness about COVID-19 through the media and online mindfulness programs. However, some studies show that physical activity cannot directly relieve psychological stress and anxiety.

Conclusion

Limited interventions are effective, but learning more about COVID-19 and using active coping strategies may help reduce stress and anxiety. The implications of COVID-19 are also discussed.

Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

BACKGROUND

The coronavirus disease (COVID-19) and universal mitigation strategies have fundamentally affected peoples' lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID-19 pandemic.

METHODS

Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2-24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size.

RESULTS

A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher's z = - 0.198, p < 0.001) and positive (Fisher's z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information.

CONCLUSIONS

PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).

The effect of physical exercise on the anxiety of college students in the post-pandemic era: The mediating role of social support and proactive personality

In order to study the current situation of the anxiety of college students in the post-pandemic era and the effect of physical exercise on anxiety, this study explores the influence of social support and proactive personality as mediating variables on the anxiety of college students from the perspective of physical exercise. Firstly, anxiety symptoms and anxious emotions are defined. Secondly, a questionnaire survey is conducted for a well-known university in a certain city, and different questionnaire scales are developed from the physical exercise, anxiety, social support, and proactive personality assessment of college students. Finally, the results of the survey are statistically analyzed to explore the relieving effect of physical exercise on anxiety. The results reveal that there is a significant gender difference in the level of physical exercise, and the amount of physical exercise of the male students is generally higher than that of female students. In addition, the intensity, time, and frequency of exercise of male students are more than that of female students, but there is no obvious difference between them and whether they were only children. Physical exercise habits, social support, proactive personality traits, and anxiety of college students have a significant correlation. Through the analysis of the chain mediation effect, Ind2 (0.0140) is the largest coefficient among the three paths, indicating that the path of influencing social support through physical exercise habits, followed by affecting proactive personality traits, and then impacting anxiety has the strongest explanatory force. According to the results, strategies to relieve the anxiety of college students are given. This study can provide a reference for the research on the methods to alleviate their anxiety under the influence of the epidemic.

Associations of parent-child exercise with family relations and parental mental health during the COVID-19 pandemic

BACKGROUND

Due to COVID-19 pandemic and behavior restrictions, deterioration of family relations and mental health in child-rearing households has been reported. This study examined whether frequent parent-child exercise (PCE) is associated with improved family relations and parental mental health under COVID-19.

METHODS

Using data from the Japan COVID-19 and Society Internet Survey (JACSIS), a nationwide survey conducted in August-September 2020, we extracted respondents with children aged 6 to 18 years (n = 2960). Logistic regression was performed to investigate the association between PCE frequency and changes in family relations and parental mental health.

RESULTS

Compared with participants with 6-12-years old children, those with 13-18-years old children reported less PCE. Among participants with 6-12-years old children, compared to those without PCE, those conducted PCE more than once per week reported more improved relation with children and greater happiness (ORs ≥ 1.69), controlling covariates. Those conducted PCE 3 or more times a week also reported decreased loneliness (OR = 0.68). Whereas PCE conducted 1-2 times a month was not associated with any changes in participants with children of 6-12-years old, it was associated with more improved relations with children and spouses in participants with children of 13-18-years old (ORs ≥ 1.98).

DISCUSSION

This study is the first to investigate the association of PCE with family relations and parental mental health under COVID-19. Our results suggest that PCE may enhance family relations and parental mental health and the effect may differ according to child's age.

Digital technologies for mental health improvements in the COVID-19 pandemic: a scoping review

Digital technologies have been used to support mental health services for two decades, but the COVID-19 pandemic created a particular opportunity for greater utilization and more data-driven assessment of these digital technologies. This research aims to offer a scoping review of the characteristics and effectiveness of digital interventions that were employed to improve mental health in the real context of COVID-19 pandemic. A combination of search terms was applied for automatic search of publications in the relevant databases. The key features of included studies were extracted, including the intervention, participant, and study details. A total of 20 eligible studies were included in the final review, which were conducted across different geographic regions and among diverse cultural groups. Among them, fourteen studies mainly reported the impact of digital technologies on general population, while only one published study developed specific interventions for the isolated COVID-19 depressed patients in hospitals. Digital technologies identified in this review were mainly developed via web-based and mobile-based platforms, such as social networking and video conferencing applications. But less than half of them were aligned with theoretical approaches from standardized psychological treatments. Most of the studies have reported positive effects of digital technologies, either on improving general mental and emotional well-being or addressing specific conditions (e.g., depression, stress, and anxiety). This scoping review suggests that digital technologies hold promise in bridging the mental health-care gap during and after the COVID-19 pandemic, and calls for more rigorous studies to identify pertinent features that are likely to achieve more effective mental health outcomes.

Pre- and Post-Pandemic (COVID-19) Mental Health of International Students: Data from a Longitudinal Study

Purpose

International students are highly vulnerable to the risk of mental health worsening before and during the pandemic (COVID-19). This study investigated international students' mental health pre- and post-pandemic (COVID-19).

Methods

It is a longitudinal study, and data were collected online, pre-pandemic (N = 470) and during the pandemic (N = 420). Using a random sampling technique, a self-administered questionnaire was used to measure mental health, including depression and anxiety.

Results

Findings show that international students' mental health was good in pre-pandemic. Meanwhile, international students were found to be more depressed and anxious during the pandemic. Findings also investigated that in the pre-pandemic phase, young students' and mainly females' mental health was worsened.

Conclusion

This study concluded that students' mental problems are alarming, so the university should provide psychological services for the student's mental health. Post-pandemic is leaving long-lasting psychological effects and will require further investigation.

Relationship between physical activity and individual mental health after traumatic events: a systematic review

Background: Traumatic events can cause social tension, anxiety, panic and other psychological crises, and can even cause post-traumatic stress disorder (PTSD) and suicide. Physical activity has a good role in promoting mental health, and has a great application prospect in individual psychological intervention after traumatic events. However, no systematic review of the relationship between physical activity and individual mental health after traumatic events affecting many people has been published so far, which makes it impossible for people to understand the research status in this field from a holistic perspective.Objective: This review explores the relationship between physical activity and individual psychology, physiology, subjective quality of life and well-being after traumatic events, so as to provide some valuable clues or enlightenment for individual psychological intervention after traumatic events.Method: Relevant literature was searched in five databases, summarised, sorted and studied.Results: Thirty-three study papers were included in this review, the main study findings include: (1) Physical activity is positively correlated with individual mental resilience and subjective well-being after traumatic events, and negatively correlated with anxiety, depression, tension and PTSD. (2) Individuals with higher levels of physical activity have better mental health status after traumatic events than those who do not regularly engage in physical activity. (3) Physical activity can promote sleep quality, self-efficacy, subjective quality of life and various physiological functions of those experiencing traumatic events. (4) Physical activity (including exercise) is regarded as one of the preferred nursing measures to buffer against mental stress and maintain physical and mental health for those experiencing traumatic events.Conclusion: The level of physical activity is positively correlated with individual physical and mental health before and after traumatic events. Physical activity can be used as one of the effective measures to improve individual mental health after traumatic events.

Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study

BACKGROUND

The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts.

OBJECTIVE

This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents.

METHODS

Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel.

RESULTS

There was strong between-panel agreement (panel 1: r_s = 0.76, p < 0.01; panel 2: r_s = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures".

CONCLUSIONS

The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.

Physical Activity, Burnout, and Engagement in Latin American Students of Higher Education During the COVID-19 Pandemic

The coronavirus-disease-2019 (COVID-19) pandemic has had a devastating physical and psychological impact on society, especially on students. In this study, we describe the levels of physical activity (Physical-Activity-Questionnaire-Short-Form (IPAQ-SF)), Burnout (School-Burnout-Inventory for students (SBI-U)) and engagement (Utrecht-Work-Engagement-Scale-9 items (UWES-9S)) in a cohort of Latin American higher education students during the COVID-19 pandemic in 2020. We also determined whether physical activity, Burnout, and engagement are related according to gender and area of study. Self-reported data from 571 Latin American students (64.79% women, 34.15% men; average age 25.24 ± 5.52 years) were collected via an online survey questionnaire. Spearman correlation analyses evaluated the associations between physical activity, Burnout, and engagement. Comparative analyses by gender and field of study were also performed. The results showed no correlation or association in the linear regression between the IPAQ-SF and SBI-U scores or between the IPAQ-SF and the UWES-9S scores. By gender, men had higher IPAQ-SF scores (p < 0.05) and reported higher intensity physical activity than women, but women had higher SBI-U scores (p < 0.05). No difference was found between men and women according to the UWES-9S scores (p = 0.28). There was also no difference in IPAQ-SF scores (p = 0.29) regarding the field of study. Our results suggest that women perform less physical activity than men, which is consistent with higher Burnout. However, physical activity was not associated with Burnout or engagement overall, which indicates that it was insufficient to prevent emotional stress in Latin American higher education students during a pandemic.

Anxiety, Stress and the Resilience of University Students during the First Wave of the COVID-19 Pandemic

The COVID-19 pandemic had an impact on everyone’s daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The present study aimed to assess the psychological difficulties experienced by the university students of Greece during the first wave of the outbreak. Methods: 288 university nursing students completed an electronic questionnaire after consent. The sample included students from all years of study. The questionnaire included demographic data and questions about mental health status, resilience level, coping strategies, positive and negative emotions and an optimism assessment. Results: Depression (44.8%), anxiety (36.8%) and stress (40.3%) were experienced by the students. Females had significantly greater anxiety and stress signs compared to males (p < 0.001). The resilience score was significantly greater in males, as it was for the Positive Affect Score. Students in the fourth year of study used significantly more active/positive coping strategies than students in the first (p = 0.016) or second year of study (p = 0.005). Conclusion: Several students experienced serious mental disorders during the first period of the COVID-19 outbreak. Variables such as gender, year of study, age, positive and negative affect score, life orientation test score and coping strategies were identified as factors contributing to this situation. Special attention must be paid to female students as they mentioned negative emotions more frequently than males. Further research on the academic population could be beneficial to university administrators.

Association of Major Disease Outbreaks With Adolescent and Youth Mental Health in Low- and Middle-Income Countries: A Systematic Scoping Review

IMPORTANCE

Adolescents and young people have been historically understudied populations, and previous studies indicate that during epidemics, these populations, especially in low- and middle-income countries (LMICs), are at high risk of developing mental disturbances.

OBJECTIVE

To identify the existing evidence regarding the association of mental health with outbreaks of the influenza A (H1N1), Zika, Ebola, and SARS-CoV-2 virus in exposed youth and adolescents in LMICs.

EVIDENCE REVIEW

Across 6 databases (Embase, Cochrane Library, PubMed, PsycINFO, Scopus, and Web of Science), the mental health outcomes of adolescents and youth (aged 10-24 years) associated with 4 major pandemic outbreaks from January 2009 to January 2021 in LMICs were reviewed. A group of 3 authors at each stage carried out the screening, selection, and quality assessment using Joanna Briggs Institute checklists. The social determinants of adolescent well-being framework was used as a guide to organizing the review.

FINDINGS

A total of 57 studies fulfilled the search criteria, 55 related to the SARS-CoV-2 (COVID-19) pandemic and 2 covered the H1N1 influenza epidemics. There were no studies associated with Zika or Ebola outbreaks that met screening criteria. The studies reported high rates of anxiety and depressive symptoms among adolescents, including posttraumatic stress disorder, general stress, and health-related anxiety. Potential risk factors associated with poor mental health outcomes included female sex; home residence in areas with strict lockdown limitations on social and physical movement; reduced physical activity; poor parental, family, or social support; previous exposure to COVID-19 infection; or being part of an already vulnerable group (eg, previous psychiatric conditions, childhood trauma, or HIV infection).

CONCLUSIONS AND RELEVANCE

Results of this systematic scoping review suggest that the COVID-19 pandemic and H1N1 epidemic were associated with adverse mental health among adolescents and youth from LMICs. Vulnerable youth and adolescents may be at higher risk of developing mental health-related complications, requiring more responsive interventions and further research. Geographically localized disease outbreaks such as Ebola, Zika, and H1N1 influenza are highly understudied and warrant future investigation.

Lifestyle behaviors and mental health during the coronavirus disease 2019 pandemic among college students: a web-based study

Background

After emerging in China, the novel coronavirus disease 2019 (COVID-19) quickly spread to all parts of the country and became a global public health emergency. The Chinese government immediately took a series of protective and quarantine measures to prevent the spread of the virus, and these measures may have negative effects on behavior and psychological health. This study aimed to examine the associations between factors related to COVID-19 measures and mental health symptoms among Chinese college students in different pandemic areas.

Methods

An online survey was administered to 14,789 college students from February 4 to 12, 2020. After excluding the participants who did not complete the questionnaire, the quality of the questionnaire was checked. Finally, the sample included 11,787 college students from 16 cities and 21 universities in China. The areas included the city of Wuhan (Area 1), the neighboring province of Hubei (Area 2), first-tier cities (Beijing, Shanghai, and Guangzhou [Area 3]), and other provinces (Area 4).

Results

The average age of the participants was 20.51 ± 1.88 years. One-third of the participants were men. In total, 25.9 and 17.8% reported depression and anxiety, respectively. We also explored COVID-19-related factors, such as infection risk, perceived resistance to COVID-19 (or susceptibility to COVID-19 infection), perceived physical symptoms, family or friends, direct or indirect contact with confirmed cases, and having sought psychological counseling, which were significantly associated with anxiety and depression symptoms. Higher screen time, lower physical activity, higher soda and tea beverages (also called sugar sweetened beverages intake), use of alternative medicines or food supplements (including Chinese herbal medicines and vitamins), and decreased meal frequency were all correlated with higher depression and anxiety symptoms (depression: χ² = 25.57 and anxiety: χ² = 39.42). Coping with COVID-19 partially mediated the associations between some related lifestyle behaviors, anxiety, and depression. The conditional process model analysis results supported our hypotheses that lifestyle health behaviors and coping style were both predictors of anxiety and depression symptoms, and their direct and indirect effects were moderated by sex.

Conclusions

Compared with the city of Wuhan, other epidemic areas had a lower risk of mental health problems. Lifestyle health behaviors and coping styles alleviated mental health symptoms. COVID-19-related social stressors were positively associated with mental health symptoms.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14598-4.

Longitudinal Shifts in Movement Behaviors during the COVID-19 Pandemic: Relations to Posttraumatic Stress Disorder among University Students

This study examined the longitudinal changes of movement behaviors and their relationships with posttraumatic stress disorder (PTSD) among university students during the coronavirus disease 2019 in China. A total of 569 university students completed online surveys twice (Time 1: between December 2020 and January 2021; Time 2: between November and December 2021). Physical activity, sedentary behavior, sleep duration and quality, as well as PTSD were self-reported. According to Canadian 24-h movement guidelines, the longitudinal shifts in each movement behavior from Time 1 to Time 2 were divided into four categories (consistently meeting the guidelines, from meeting to not meeting the guidelines, from not meeting to meeting the guidelines, and consistently not meeting the guidelines). Generalized linear mixed models were conducted using 410 valid responses (20.2 ± 1.0 years old at Time 2, 41.2% males). From Time 1 to Time 2, 22.2%, 2.0%, and 45.6% of the students consistently met the physical activity, sedentary behavior, and sleep guidelines, respectively. Compared to those who consistently met the sedentary behavior guideline, students who consistently failed to meet or changed from meeting to not meeting the guidelines had higher levels of PTSD. Students who had poor sleep quality at both time points or changed from good to bad sleep quality had higher levels of PTSD than those who maintained good sleep quality over time. Compared to those who consistently failed to meet the guideline, students who consistently met the PA guideline had higher levels of PTSD. These findings highlight the needs to improve and maintain healthy behaviors for mental health.

Changes in health behaviors and conditions during COVID-19 pandemic strict campus lockdown among Chinese university students

Objective

To explore how a stringent campus lockdown affects the physical activity (PA), sleep and mental health of Chinese university students living in student dormitories during the COVID-19 pandemic.

Methods

Data on PA, sleep and mental health were collected between 24 March and 4 April 2022 from 2084 university students (mean age = 22.4 years, 61.1% male students) via an online questionnaire distributed by the students’ advisers of each dormitory. The Chinese short version of the International Physical Activity Questionnaire (IPAQ-C), Athens Insomnia Scale (CAIS) and General Health Questionnaire 12-item (GHQ-12) were applied. The Mann–Whitney test and Kruskal-Wallis tests were used to evaluate the PA profile differences between genders, before and during the lockdown period and between students’ living environments. Chi-squared (χ2) or Fisher’s exact test was used to assess changes in health behaviors by gender and students’ living environment compared to before the lockdown. A mediation model was used to examine whether sleep disorder mediated the relationship between PA and mental health in different students’ living environments.

Results

Participants reported a significant decrease in weekly total PA levels (63.9%). Mean daily sedentary time increased by 21.4% and daily lying time increased by 10.7% compared to before lockdown. Among the participants, 21.2% had experienced insomnia, and 39.0% reported having high mental distress. Female students reported 10% higher rates of sleep disorders than male students (p < 0.001), and also experienced a higher incidence of mental disorders (p < 0.001). Students living with three roommates had a larger decrease in frequencies and durations of participation in light PA than other students (p < 0.001). PA was negatively associated with sleep and mental health, and sleep disorder was a mediating factor between PA and mental health in the students living with two and three roommates.

Conclusion

This study showed that strict lockdowns within university dormitories during the COVID-19 pandemic had a negative effect on the health of university students by changing their health behaviors, physical activity and sleep. Our findings indicate a need for strategies to promote an active lifestyle for students in space-limited dormitories in order to maintain health during a prolonged lockdown.

The Influence of Occupational Therapy on College Students' Home Physical Exercise Behavior and Mental Health Status under the Artificial Intelligence Technology

The core of occupational therapy is to help patients with mental illness recover their social work, give play to their self-worth, obtain financial resources, and improve their self-confidence. Occupational therapy can help patients relieve symptoms and restore social function, reduce disease recurrence, and improve the reemployment rate and the overall health level of patients. In order to deeply excavate the inner connection between the mental health status and physical exercise status of college students, the physical exercise behavior of college students during home isolation is studied. First, the "physical exercise behavior questionnaire" and "symptom self-assessment scale" were used to investigate the physical exercise behavior and mental health status of college students. Second, descriptive statistics, correlation analysis, independent sample t-test, and variance analysis were carried out on the survey results using mathematical statistics methods and big data technology. The survey results show high reliability, and the Cronbach's α coefficients were all greater than 0.9. There was a positive correlation between physical exercise methods and mental health in general, and the difference in the degree of exercise is significantly different from the mental health of students (p < 0.05). With the increase of exercise intensity, the score of "symptom self-assessment scale" first decreased and then increased, and the exercise intensity of medium and high intensity showed the best psychological state. And the correlation dimension of depression was the highest. This indicated that the students who liked family physical exercise were less likely to suffer from depression. In addition, depression was the most relevant dimension with self demand physical exercise, and interpersonal sensitivity was the most relevant dimension with social expansion physical exercise. The conclusion shows that the more active the students participate in family physical exercise, the healthier their mental state is. Occupational therapy has obvious curative effect on depression, which can improve patients' negative symptoms, their living ability, and social function. Meanwhile, analyzing data through big data technology reduces human workload and improves data processing efficiency and accuracy. The scheme proposed here provides some ideas for the application of big data technology in occupational therapy.

Prevalence of anxiety symptoms among Chinese university students amid the COVID-19 pandemic: A systematic review and meta-analysis

College students in China are particularly vulnerable to worry. In the meanwhile, the COVID-19 pandemic might worsen anxiety symptoms. However, due to the inconsistency of many studies regarding anxiety symptoms, it has proven challenging to provide accurate psychiatric health treatments to undergraduates. Therefore, in order to determine the prevalence of anxiety among Chinese university students during the COVID-19 epidemic, this study will undertake a systematic review and meta-analysis.

English databases (i.e Embase (Ovid), APA PsycInfo, Medline, Pubmed, Cochrane Library) were utilized to identify papers that provide information on the incidence of anxiety among Chinese college students during the pandemic. Two authors evaluated the qualifications of relevant studies, assessed the risk of bias (RoB), and retrieved data. RoB was evaluated using the cross-sectional study quality evaluation criteria from the American Agency for HealthCare Quality and Research (AHRQ). Three hundred seventy-three records were retrieved. Twenty-five studies were eventually included, involving 1,003,743 Chinese college students. The findings of the study identified that the pooled prevalence of anxiety symptoms was 25.0% (95% CI: 21%–29%, P < 0.001), and those among medical-related professionals were lower than those of the general population (22.1% vs. 25%, P < 0.001). In addition, the prevalence of studies with more female respondents was higher than those with fewer female respondents (26.4% vs. 8%). In the later phases of the COVID-19 pandemic compared to the early stages, anxiety prevalence is higher (29.1% vs. 17.2%). Finally, using meta-regression to explore the source of heterogeneity, this study found that the most potential source was whether the graduate students or otherwise.

This meta-analysis revealed that during the COVID-19 pandemic, a quarter of Chinese college students had anxiety symptoms. Therefore, it is necessary to provide continuous psychological assessment and treatment services for college students.

Effects of regular sport activities on stress level in sporting and non-sporting university students

Background

Regular sport has favourable influence on the physical and mental state. Our aim was to analyse the relationship between regular sport activities, body parameters, cortisol level, perceived stress and the frequency of psychosomatic symptoms in male and female university students.

Methods

Subjects were university students (N = 200). They were divided in sporting (more than 7 h week−1: 56 males (sm), 50 females (sf)) and non-sporting (less than 3 h week−1: 44 males (nsm) and 50 females (nsf)) groups. Body composition was estimated by Inbody720-analyser. Stress levels were measured by (1) free cortisol level in saliva measured by using IBL-ELISA kits and (2) questionnaires about psychosomatic symptoms and perceived stress scale.

Results

There were significant subgroup’ differences in body composition (fat%:sm:12.1 ± 6.0 vs. nsm:17.9 ± 6.8; sf:20.8 ± 5.5 vs. nsf:25.4 ± 5.7; muscle%:sm:50.3 ± 3.6 vs. nsm:47.6 ± 3.9; sf:43.8 ± 3.2 vs. nsf:41.7 ± 3.3), and in stress level (total scores:sm:21.0 ± 5.7 vs. nsm:23.3 ± 7.2; sf:25.5 ± 7.0 vs. nsf:28.0 ± 9.7). There were gender differences in the psychosomatic symptoms' frequency (total scores: sm: 14.6 ± 6.3 vs. sf: 20.4 ± 7.4; nsm: 14.9 ± 6.1 vs. nsf: 19.6 ± 8.2). The sporting students had larger muscle, smaller fat percentages, and lower level of stress. Basic level of salivary cortisol revealed significant relation with physical activity: sporting students had lower level of cortisol. This relation was reflected in higher percentage of students with low level of cortisol in the physically active subgroups (s/ns males: 29% vs. 15%; s/ns females: 18% vs. 5%) and in the higher percentage of female students with high level of cortisol in the non-sporting subgroup (27% vs. 11%).

Conclusion

Regular sport activity is positively related with lower stress levels in university students.

The effect of exercise and affect regulation skills on mental health during the COVID-19 pandemic: A cross-sectional survey

BACKGROUND

COVID-19-related confinements pose a threat to mental health. We investigated prevalence rates of symptoms of depression, generalized anxiety and insomnia in German adults. Furthermore, we explored associations of exercise behavior with disorder-specific symptoms and assessed whether specific affect regulation skills enhance the effect of exercise on symptom alleviation.

METHODS

Cross-sectional survey-based data collected during the first lockdown is presented: 4268 adults completed questionnaires on mental health, exercise behavior and Covid-related lifestyle factors. Primary outcome was depression (PHQ-9), secondary outcomes generalized anxiety (PHQ-D) and sleep quality (PSQI). Multiple linear regression analyses were performed to examine the association of exercise behavior with the outcomes.

RESULTS

Analyses resulted in elevated symptoms of psychological distress (probable cases of depressive disorder: 31.2%, anxiety disorder: 7.5%, sleeping disorder: 43.0%). A change towards less exercise during the lockdown was significantly associated with higher levels of depression (t=5.269; β=0.077, p<.001), anxiety (t=3.397; β=0.055, p<.001) and insomnia (t=3.466; β=0.058; p<.001). Physical activity (PA)-related affect regulation enhanced the effect of exercise on mental health.

CONCLUSION

Results suggest a demand for measures which promote the maintenance of exercise during a pandemic and improve PA-related affect regulation to optimize effects of exercise on mental health.

Depression among young adults - risks and protective factors in the COVID-19 pandemic

Purpose

The present study aimed to assess the depression symptoms and predictors of depression in Polish young adults during online learning in the COVID-19 pandemic.

Methods

The online questionnaire, including the Kutcher Adolescent Depression Scale, was distributed to young Poles through school principals. The final sample consisted of 1,500 students between the ages of 18 and 23 attending secondary schools. Multivariable logistic regression assessed the relationships between sociodemographic factors, pandemic stressors, coping behaviours and depressive symptoms.

Results

56% of young Polish adults are experiencing significant depressive symptoms (95% CI: 1.82-13.96). Social isolation was recognized as the main stressor. Many significant predictors of depression were captured. Being female, living in the countryside, talking to parents, and participating in sports and hobbies are found to be protective factors. The following sociodemographic factors are important predictors of depression in young adults: being male, attending a secondary school, living in a large city. Experiencing stress due to pandemic and online learning is one of the risk factors for depression.

Conclusions

The majority of young Poles met the criteria for depressive disorders. The initial findings of the presented study not only highlight the need to address mental health consequences for young people during online learning, but also provide the grounds for the development of post-pandemic interventions.

The Impact of Physical Activity on Mental Health during COVID-19 Pandemic in China: A Systematic Review

The outbreak and spread of novel coronavirus disease (COVID-19) in 2019 was a public health emergency of global concern. As an important health behavior, physical activity (PA) and its impact on mental health have been increasingly explored during the epidemic period. The keywords and references were searched on PubMed, Web of Science, Scopus, Cochrane Library, EBSCO, and CNKI since the inception of an electronic bibliographic database until October 2021. A total of 2979 articles were identified, of which 23 were eligible for inclusion to examine the relationship between PA and mental health during the COVID-19 epidemic. Residents with regular PA, high-intensity PA, and PA duration of 30-60 min or more per day were associated with a lower risk of anxiety, depression, and negative emotions. In contrast, residents with no exercise and physical inactivity were more likely to have anxiety, depression, sleep disturbances, and lower subjective well-being. In addition, the dose-response curve between PA and negative emotions indicated a U-shaped relationship, and there were urban-rural differences in the relationship between emotional status and the levels of PA in adolescents. The findings have significant implications for addressing mental health issues during the current pandemic and future pandemics. Future studies adopting an experimental study design, conducting objective PA measures, and focusing on the vulnerable subpopulations are warranted to further explore the association of PA on mental health during the COVID-19 pandemic.

Anxiety and Its Associated Factors Among School-aged Adolescents in East Jakarta, Indonesia during the Coronavirus Disease-2019 Pandemic

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic can be a significant psychological stressor which is associated with increased levels of anxiety and stress during the COVID-19 pandemic. AIM: To determine adolescent anxiety prevalence and associated risk factors. MATERIALS AND METHODS: An online cross-sectional survey was performed from February to April 2021 at SMPN 9, East Jakarta, on 304 adolescents. The subjects were examined using sociodemographic form and self-report measures of anxiety, COVID-19 knowledge, and physical activity. The statistical significance level was set at p ˂ 0.05. RESULTS: Median age was 14 years (range 12–16) and prevalence of anxiety 19.4%. Multivariable logistic regression findings: gender (adjusted odd ratio [aOR] = 2.50; 95% confidence interval [CI] = 1.26–4.98; p = 0.009), physical activity (aOR = 2.16; 95% CI = 1.15–4.06; p = 0.017;), knowledge level of COVID-19 (aOR = 1.81; 95% CI = 0.99–3.32; p = 0.053); age (aOR = 0.53; 95% CI = 0.19–1.46; p = 0.218); education (aOR = 0.96; 95% CI = 0.35–2.64; p = 0.932). Gender and physical activity were significantly associated with risk of adolescent anxiety. CONCLUSION: Inactive physical activity status increases the risk of adolescent anxiety. Governmental regulations are needed on the planning and implementation of a health education program for increasing physical activity among adolescents to improve physical and mental health. As a follow-up to this study, there is a need for conducting a study to determine changes in prevalence rates of adolescent anxiety during as well as after the pandemic and its associated risk factors with a better design study.

Differential impacts of COVID-19 pandemic on physical activity involvements and exercise habits in people with and without chronic diseases: A systematic review and meta-analysis

Objective

To conduct a systematic review and meta-analysis to summarize evidence regarding differential changes in physical activity (PA) involvements and exercise habits in people with and without chronic diseases during the COVID-19 outbreak.

Data Sources

MEDLINE, Embase, SPORTDiscus, Cumulative Index to Nursing and Allied Health, PsycINFO, Cochrane Library, and Physiotherapy Evidence Database were searched from November 2019 to May 2021.

Study Selection

Two reviewers independently screened cross-sectional and longitudinal studies that investigated changes in PA-related outcomes in people with and without chronic diseases during the pandemic.

Data Extraction

PA-related outcomes and sedentary time were extracted from the included studies. Relevant risk of bias were assessed. Meta-analyses were conducted for each PA-related outcome, if applicable. Quality of evidence of each PA-related outcome was evaluated by Grading of Recommendations Assessment, Development, and Evaluation.

Data Synthesis

Of 1226 identified citations, 36 articles (28 with and 8 without chronic diseases) with 800,256 participants were included. Moderate evidence from wearable sensors supported a significant reduction in pooled estimates of step count (standardized mean differences [SMD]=−2.79, P<.01). Very limited to limited evidence substantiated significant decreases in self-reported PA-related outcomes and significant increases in sedentary behaviors among people with and without chronic diseases. Specifically, pooled estimates of metabolic equivalent-minute per week (SMD=−0.16, P=.02) and PA duration (SMD=−0.07, P<.01) were significantly decreased, while sedentary time (SMD=0.09, P=.04) showed significant increases in the general population (small to large effects). Very limited evidence suggested no significant PA changes among people in a country without lockdown.

Conclusions

During the pandemic, objective and self-reported assessments showed significant reductions in PA in people with and without chronic diseases globally. This mainly occurred in countries with lockdowns. Although many countries have adopted the “live with the coronavirus” policy, authorities should implement population-based strategies to revert the potential lockdown-related long-term deleterious effects on people's health.

Exploration and Strategy Analysis of Mental Health Education for Students in Sports Majors in the Era of Artificial Intelligence

This study aims to explore new educational strategies suitable for the mental health education of college students. Big data and artificial intelligence (AI) are combined to evaluate the mental health education of college students in sports majors. First, the research status on the mental health education of college students is introduced. The internet of things (IoT) on mental health education, a structure based on big data and convolutional neural network (CNN), is constructed. Next, the survey design and questionnaire survey are carried out. Finally, the questionnaire data are analyzed and compared with the mental health status under traditional education. The results show that the CNN model has good accuracy and ability to distinguish symptoms, so it can be applied to the existing psychological work in colleges. In the symptom comparison survey, under the traditional education and big data network, the number of college students with mild mental health problems is found to be 158 (84.9%) and 170 (91.4%), respectively. It indicates that the number of college students with moderate mental health problems decreases significantly. In the comparative investigation of the severity of mental problems, the number of students with normal mental health, subhealth, and serious mental health problems under the background of traditional mental health education is 125 (67.2%), 56 (30.1%), and 5 (2.7%), respectively. The mental health status of college students under the influence of big data networks on mental health education is better than that of traditional mental health education. There are 140 students with normal mental health, a year-on-year increase of 16.7%. In the comparative survey of specific mental disorders, students with obsessive-compulsive symptoms under traditional mental health education account for 22.0% of the total sample, having the largest proportion. In the subhealth psychological group under the big data network on mental health education, the number of hostile students decreases by 7, which is the psychological factor with the most obvious improvement. Hence, the proposed path of mental health education is feasible.

Lockdowns and Physical Activities: Sports in the Time of COVID

As aging causes challenges in several countries globally, more and more people are suffering from bad health conditions. Nowadays, COVID-19 causes many problems—and one of the root causes of these problems is the isolation of people from each other. The aim of our article is to investigate the effects of COVID-19 on people’s physical activity. Physical activity is strongly correlated with health status and health preservation is very important to minimize the negative effects of the pandemic. In order to investigate this topic, we prepared an extended literature review, citing the most important sources of COVID-related health-preservation issues. Our results showed that the negative economic effects of the coronavirus pandemic have caused a decrease in physical activities in several cases. A reduction in possible physical activities has a potential negative effect on the life expectancies of elderly people. In order to underline the importance of physical activities, we prepared an extended literature review, aiming to summarize the available knowledge related to COVID-19. As a conclusion we recommend to strengthen, maintain, and develop available sporting possibilities for people. The most important of these recommendations is the development of physical activities that are available for free.

Effect of COVID-19 outbreak on anxiety among students of higher education; A review of literature

BACKGROUND AND PURPOSE

The Covid-19 pandemic has impacted the mental health of students and exacerbated the prevalence of anxiety among them. The purpose of the literature review was to consolidate evidence for the prevalence of anxiety among students of higher education during the COVID-19 pandemic and to underscore the effect of various pandemic-related factors on this anxiety.

METHODS

A comprehensive literature search was conducted utilizing various databases such as MEDLINE, PsycInfo Google Scholar, ScienceDirect, Scopus, and Embase to identify relevant studies. To be incorporated in this review, studies had to include students of higher education, measure the prevalence of anxiety, and assess anxiety during Covid-19 pandemic.

RESULTS

37 studies met the inclusion criteria and assessed the prevalence of anxiety among students during confinement. Studies showed that more than one-third of the students suffered from anxiety during the early stages of the pandemic. Moreover, being a female, living in rural areas, facing financial hardship, working full-time, spending the quarantine in isolation, worrying about infection for themselves and others, having the uncertainty of the future, having reduced sleep quality, and transitioning to online learning, were factors associated with increased anxiety during the pandemic.

CONCLUSION

Anxiety was shown to be highly prevalent among the student population during the Covid-19 pandemic. Higher education institutions and governments should take action to ensure the safety and the physical, social, and mental wellbeing of the students.

Personalized individual-based exercise prescriptions are effective in treating depressive symptoms of college students during the COVID-19: A randomized controlled trial in China

BACKGROUND

The COVID-19 pandemic has seriously increased depression prevalence among the public, including Chinese college students. However, many exercise cannot be performed as usual under the stay-at-home order. This study was a 12-week three-arm randomized controlled trial using the intention-to-treat principle, aiming to explore and compare the feasibility and effect of individual-based personalized aerobic-exercise and resistance-training prescriptions on depressive symptoms in college students, and conclude with some recommendations for individual-based exercise prescriptions.

METHODS

Eighty-six college students with depressive symptoms were randomized into aerobic-exercise (AE), resistance-training (RT), and wait-list control (WLC) groups. Participants in two experimental groups received 12-week personalized AE and RT prescriptions on their individual situations, respectively. No intervention was implemented on participants in the WLC group. Depressive symptoms and physical activity (PA) were measured by Zung Self-Rating Depression Scale (SDS) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All data were collected at the baseline, 4, 8, and 12 weeks, and 4-week post-intervention.

RESULTS

At 12 weeks, 72.09% of depressive participants improved to "normal." Participants exhibited a statistical reduction in SDS in all 3 groups (p < 0.05) at 12 weeks compared to baseline. Follow-up assessments showed no significant increase in SDS at 4-week post-intervention compared to 12 weeks (p > 0.05). The independent t-test revealed significantly lower SDS in AE and RT group than in WLC group (p _AE < 0.001 and p _RT < 0.05) at 4, 8, and 12 weeks, and 4-week post-intervention. Furthermore, the PA of participants (including total PA and intensities) in both experimental groups represented a significant improvement at 4-week post-intervention compared to baseline (p < 0.05), while no differences were observed in the PA of participants in the WLC group (p > 0.05).

CONCLUSION

Personalized exercise prescriptions have good feasibility as they can increase adherence to intervention and reduce serious adverse events. Besides, individual-based personalized aerobic-exercise and resistance-training prescriptions result in a similar effect in relieving depressive symptoms and improving physical activity in college students. The individual-based exercise programs performed in 45- to 60- min with progressive moderate-to-vigorous intensity, 3 times/week for at least 12 weeks, may reduce depressive symptoms in college students during the COVID-19.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

New Technologies for Promoting Physical Activity in Healthy Children and in Children with Chronic Respiratory Diseases: A Narrative Review

Physical activity (PA) is proven to benefit children and adolescents in several ways. New technologies may provide children with stimulating modalities for organizing their leisure time, accessing fitness programs, and obtaining daily goal reminders and peer support. Due to the current COVID-19 pandemic, following WHO recommendations for PA is difficult for many children, especially for those living in urban areas. Therefore, the use of digital tools to support and maintain PA could be useful in healthy children, as well as in those with chronic respiratory diseases (CRDs). This narrative review aims to summarize the most recent evidence about the role of new technologies in promoting PA in healthy children and in those with CRDs, in supporting PA during the COVID-19 pandemic, and in enhancing psychological wellbeing in this age group. The use of technological devices for promoting PA, such as web/mobile apps and games, has been proven to be effective both in healthy children and in those with CRDs. In conclusion, new technologies are very promising in terms of feasibility, acceptability, and efficacy in promoting PA. Further studies are required to evaluate the long-term health benefits of using these technologies.

The effects of the measures against COVID-19 pandemic on physical activity among school-aged children and adolescents (6-17 years) in 2020: A protocol for systematic review

Background

The pandemic of coronavirus disease (COVID-19) has greatly changed people’s daily lives, forcing countries to take actions, such as school shutdown, lockdown, isolation, and social distancing measures. It remains unclear how the closures, cancellations, and restrictions of schools and courses as a response to the COVID-19 pandemic affect the engagement of school-aged children and adolescents in relation to physical activity (PA).

Methods

The articles in the databases of EBSCO (including AMED, CINAHL Plus, Health Business, Health Source MEDLINE with Full Text, APA PsycArticles, APA PsycINFO, and SPORTDiscus) published during the period from 1 January 2020 to 31 December 2020 will be retrieved, and the data in the selected articles are extracted, including research methods, demographics, and key results. Search outcomes were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Mixed Methods Appraisal Tool (MMAT) will be used to evaluate research quality. Two reviewers are responsible for completing the three tasks, namely selecting the articles that meet the inclusion criteria, extracting data in the articles selected, and evaluating their research quality. All findings, and especially primary outcomes will be summarized in a table format of findings. The results will provide a high-quality synthesis of current evidence for researchers in this subject area.

Aim

The objective of this systematic review is to investigate the effects of the COVID-19 pandemic on PA in children and adolescents aged 6–17 years during 2020. 1). What impact has the COVID-19 pandemic had on PA levels in school-aged children and adolescents? 2). Investigating changes in the locations of school-aged children’s and adolescents’ PA between the pre-COVID-19 period (January 2020) and the COVID-19 period (December 2020).

Results

We hope that this study will provide government authorities and health professionals with the necessary information in guiding actions and allocating resources, so that the situation of physical inactivity in school-aged children and adolescents during the COVID-19 pandemic can be improved, thereby enhancing their physical health.

Protocol registration number

This review was submitted and registered under CRD42020225976 in PROSPERO.

What can internet users' behaviours reveal about the mental health impacts of the COVID-19 pandemic? A systematic review

Objectives

At the end of 2019, an acute infectious pneumonia (coronavirus disease 2019 [COVID-19]) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Wuhan, China, and subsequently spread around the world starting a pandemic. Globally, to date, there have been >118 million confirmed cases, including >2 million deaths. In this context, it has been shown that the psychological impact of the pandemic is important and that it can be associated with an increase in internet searches related to fear, anxiety, depression, as well as protective behaviours, health knowledge and even maladaptive behaviours.

Study design

This is a systematic review.

Methods

This review aims to collect, analyse and synthesise available evidence on novel data streams for surveillance purposes and/or their potential for capturing the public reaction to epidemic outbreaks, particularly focusing on mental health effects and emotions.

Results

At the end of the screening process, 19 articles were included in this systematic review. Our results show that the COVID-19 pandemic had a great impact on internet searches for mental health of entire populations, which manifests itself in a significant increase of depressed, anxious and stressed internet users’ emotions.

Conclusions

Novel data streams can support public health experts and policymakers in establishing priorities and setting up long-term strategies to mitigate symptoms and tackle mental health disorders.

The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced significant disruptions to the routines of many higher education students around the world. It also deprived them of in-person counselling services and social support. These changes have put students at a greater risk of developing mental illness. The objective of this review is to assess the prevalence of depressive symptoms, anxiety symptoms and sleep disturbances in higher education students during the pandemic. A systematic search of English and Chinese databases was conducted current to January 1^st, 2021. The quality of included studies was evaluated using a modified Newcastle-Ottawa scale. Prevalence of depressive symptoms, anxiety symptoms and sleep disturbances were pooled using random-effects meta-analysis. Eighty-nine studies (n=1,441,828) were included. The pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances was 34%, 32% and 33%, respectively. The prevalence values differ based on geographical regions, diagnostic criteria, education level, undergraduate year of study, financial situation, living arrangements and gender. Overall, the prevalence of depressive symptoms and anxiety symptoms synthesized in this study was higher compared to pre-pandemic prevalence in similar populations. Evidently, mental health screening and intervention should be a top priority for universities and colleges during the pandemic.

Mental Health and Behavior of College Students During the COVID-19 Pandemic: Longitudinal Mobile Smartphone and Ecological Momentary Assessment Study, Part II

BACKGROUND

Since late 2019, the lives of people across the globe have been disrupted by COVID-19. Millions of people have become infected with the disease, while billions of people have been continually asked or required by local and national governments to change their behavioral patterns. Previous research on the COVID-19 pandemic suggests that it is associated with large-scale behavioral and mental health changes; however, few studies have been able to track these changes with frequent, near real-time sampling or compare these changes to previous years of data for the same individuals.

OBJECTIVE

By combining mobile phone sensing and self-reported mental health data in a cohort of college-aged students enrolled in a longitudinal study, we seek to understand the behavioral and mental health impacts associated with the COVID-19 pandemic, measured by interest across the United States in the search terms coronavirus and COVID fatigue.

METHODS

Behaviors such as the number of locations visited, distance traveled, duration of phone use, number of phone unlocks, sleep duration, and sedentary time were measured using the StudentLife mobile smartphone sensing app. Depression and anxiety were assessed using weekly self-reported ecological momentary assessments, including the Patient Health Questionnaire-4. The participants were 217 undergraduate students. Differences in behaviors and self-reported mental health collected during the Spring 2020 term, as compared to previous terms in the same cohort, were modeled using mixed linear models.

RESULTS

Linear mixed models demonstrated differences in phone use, sleep, sedentary time and number of locations visited associated with the COVID-19 pandemic. In further models, these behaviors were strongly associated with increased interest in COVID fatigue. When mental health metrics (eg, depression and anxiety) were added to the previous measures (week of term, number of locations visited, phone use, sedentary time), both anxiety and depression (P<.001) were significantly associated with interest in COVID fatigue. Notably, these behavioral and mental health changes are consistent with those observed around the initial implementation of COVID-19 lockdowns in the spring of 2020.

CONCLUSIONS

In the initial lockdown phase of the COVID-19 pandemic, people spent more time on their phones, were more sedentary, visited fewer locations, and exhibited increased symptoms of anxiety and depression. As the pandemic persisted through the spring, people continued to exhibit very similar changes in both mental health and behaviors. Although these large-scale shifts in mental health and behaviors are unsurprising, understanding them is critical in disrupting the negative consequences to mental health during the ongoing pandemic.

Is Physical Activity Associated with Less Depression and Anxiety During the COVID-19 Pandemic? A Rapid Systematic Review

BACKGROUND

The Covid-19 pandemic is affecting the entire world population. During the first spread, most governments have implemented quarantine and strict social distancing procedures. Similar measures during recent pandemics resulted in an increase in post-traumatic stress, anxiety and depression symptoms. The development of novel interventions to mitigate the mental health burden are of utmost importance.

OBJECTIVE

In this rapid review, we aimed to provide a systematic overview of the literature with regard to associations between physical activity (PA) and depression and anxiety during the COVID-19 pandemic.

DATA SOURCE

We searched major databases (PubMed, EMBASE, SPORTDiscus, and Web of Science) and preprint servers (MedRxiv, SportRxiv, ResearchGate, and Google Scholar), for relevant papers up to 25/07/2020.

STUDY ELIGIBILITY CRITERIA

We included observational studies with cross-sectional and longitudinal designs. To qualify for inclusion in the review, studies must have tested the association of PA with depression or anxiety, using linear or logistic regressions. Depression and anxiety must have been assessed using validated rating scales.

STUDY APPRAISAL AND SYNTHESIS METHODS

Effect sizes were represented by fully adjusted standardized betas and odds ratios (OR) alongside 95% confidence intervals (CI). In case standardized effects could not be obtained, unstandardized effects were presented and indicated.

RESULTS

We identified a total of 21 observational studies (4 longitudinal, 1 cross-sectional with retrospective analysis, and 16 cross-sectional), including information of 42,293 (age 6-70 years, median female = 68%) participants from five continents. The early evidence suggests that people who performed PA on a regular basis with higher volume and frequency and kept the PA routines stable, showed less symptoms of depression and anxiety. For instance, those reporting a higher total time spent in moderate to vigorous PA had 12-32% lower chances of presenting depressive symptoms and 15-34% of presenting anxiety.

CONCLUSION

Performing PA during Covid-19 is associated with less depression and anxiety. To maintain PA routines during Covid-19, specific volitional and motivational skills might be paramount to overcome Covid-19 specific barriers. Particularly, web-based technologies could be an accessible way to increase motivation and volition for PA and maintain daily PA routines.

Prevalence of depressive symptoms among Chinese university students amid the COVID-19 pandemic: a systematic review and meta-analysis

AIMS

Chinese university students are at high risk for depressive symptoms and the ongoing coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the mental health of university students. However, existing studies on depressive symptoms in Chinese university students during the COVID-19 pandemic reported a wide range of prevalence estimates, making mental health planning for this population difficult. The objective of this study was to conduct a systematic review and meta-analysis of surveys that assessed the prevalence of depressive symptoms in Chinese university students amid the COVID-19 pandemic.

METHODS

Major Chinese (CNKI, Wanfang, VIP) and English (PubMed, Embase, PsycInfo) databases and preprint platforms were searched to identify cross-sectional studies containing data on the prevalence of depressive symptoms in Chinese university students during the pandemic. Two authors independently retrieved the literature, evaluated the eligibility of potential studies, assessed the risk of bias (RoB) of included studies, and extracted data. RoB was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS

In total, 1177 records were retrieved, and 84 studies involving 1 292 811 Chinese university students during the pandemic were included. None of the included studies were rated as completely low RoB. Statistically significant heterogeneity in the prevalence estimates of included studies was detected (I2 = 99.9%, p < 0.001). The pooled prevalence of depressive symptoms was 26.0% (95%CI: 23.3-28.9%), which was significantly higher in female than in male students (30.8% v. 28.6%, p < 0.001), in postgraduates than in undergraduates (29.3% v. 22.9%, p < 0.001), in students living inside than in those living outside the COVID-19 epicentre (27.5% v. 22.3%, P < 0.001), in students from universities at the epicentre than in those from universities outside the epicentre (26.2% v. 23.1%, p < 0.001), in students who had close contact with COVID-19 than in those who did not (46.0% v. 25.0%, p < 0.001), and in students who had acquaintances or relatives infected with COVID-19 (39.7% v. 24.0%, p < 0.001) than in those who did not. Five sources of heterogeneity were identified from the subgroup analysis: survey period, % of males among the survey sample, scale of depressive symptoms, cutoff score of the scale and level of RoB.

CONCLUSIONS

Over one-fourth of Chinese university students experienced depressive symptoms during the COVID-19 pandemic. Mental health services for this population should include periodic evaluation of depressive symptoms, expanded social support and psychiatric assessment and treatment when necessary. It is also necessary to design depression prevention programmes that target higher-risk cohorts of university students.

Impact of COVID-19 Pandemic on University Students' Physical Activity Levels: An Early Systematic Review

Purpose: This systematic review aimed to analyze the impact that the COVID-19 lockdown had on the amount of physical activity performed by university students. Materials and Methods: A systematic electronic search for studies providing information regarding physical activity levels pre and during COVID-19 pandemic in university students was performed up to 20th October 2020 in the databases Cochrane Library, PubMed, SPORTDiscus, and Web of Science. The risk of bias of external validity quality of included studies was assessed by means of those the Newcastle-Ottawa Scale (NOS). The quality of the evidence for main outcomes was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results and Conclusions: A total of 10 studies were selected. Physical activity levels were assessed by means of questionnaires (10 studies) and accelerometer (1 study). Risk of bias was regarded as low and high in six and four investigations, respectively. The quality of evidence was downgraded to low. A significant reduction of physical activity levels were observed in 9 studies. Compared to pre-lockdown values, five studies showed a reduction of light/mild physical activity (walking) between 32.5 and 365.5%, while seven studies revealed a reduction of high/vigorous physical activity between 2.9 and 52.8%. Walking, moderate, vigorous, and total physical activity levels have been reduced during the COVID-19 pandemic confinements in university students of different countries. Despite of the reductions, those who met the current minimum PA recommendations before the lockdown generally met the recommendations also during the confinements.

Exploring the Neuropsychiatric Sequalae of Perceived COVID-19 Exposure in College Students: A Pilot Digital Phenotyping Study

The urgency to understand the long-term neuropsychiatric sequala of COVID-19, a part of the Post-Acute COVID-19 Syndrome (PACS), is expanding as millions of infected individuals experience new unexplained symptoms related to mood, anxiety, insomnia, headache, pain, and more. Much research on PACS involves cross sectional surveys which limits ability to understand the dynamic trajectory of this emerging phenomenon. In this secondary analysis, we analyzed data from a 4-week observational digital phenotyping study using the mindLAMP app for 695 college students with elevated stress who specified if they were exposed to COVID-19. Students also completed a biweekly survey of clinical assessments to obtain active data. Additionally, passive data streams like GPS, accelerometer, and screen state were extracted from phone sensors and through features the group built. Three hundred and eighty-second number participants successfully specified their COVID-19 exposure and completed the biweekly survey. From active smartphone data, we found significantly higher scores for the Prodromal Questionnaire (PQ) and the Pittsburgh Sleep Quality Index (PSQI) for students reporting exposure to COVID-19 compared to those who were not (ps < 0.05). Additionally, we found significantly decreased sleep duration as captured from the smartphone via passive data for the COVID-19 exposed group (p < 0.05). No significant differences were detected for other surveys or passive sensors. Smartphones can capture both self-reported symptoms and behavioral changes related to PACS. Our results around changes in sleep highlight how digital phenotyping methods can be used in a scalable and accessible manner toward better capturing the evolving phenomena of PACS. The present study further provides a foundation for future research to implement improving digital phenotyping methods.

The Physical Fitness Level of College Students Before and After Web-Based Physical Education During the COVID-19 Pandemic

Background: The COVID-19 pandemic has been an emergency worldwide. Web-based physical education is a choice for college students to keep on their study. The aim of this study was to compare the data of physical fitness of college students before and after web-based physical education. Methods: All the students of 2018 and 2019 in Wuhan University of Technology who had taken the web-based physical education class in 2020 were included in this study. The records of annual physical fitness tests of all the subjects in 2019 and 2020 which were carried out in September were reviewed, including weight, height, body mass index (BMI), vital capacity (VC), 50-m dash, sit-and-reach, standing long jump, male-specific pull-ups and 1,000-m race, and female-specific sit-ups and 800-m race. Results: There were 24,112 male and 9,690 female records of physical fitness tests included in our study. The results of 11,219 male and 4,651 female students who completed both physical fitness tests in 2019 and 2020 were employed for Wilcoxon signed-rank test. Declined performance was observed on male 50-m dash by 0.1 s, male 1,000-m race by 14 s, and female 800-m race by 11 s. Notably, the percentage of male obesity, based on BMI, rose from 10.6 to 15.2% and 17.1 to 21.8% for male overweight; correspondingly, the percentage of male normal weight declined from 55.9 to 51.9% and 16.4 to 11.1% for male thinness. The trend of increasing BMI in males should be paid attention to. Improved results on vital capacity, sit-and-reach, standing long jump for both males and females, female 50-m dash, female sit-ups, and male pull-ups were observed in 2020. All the results of physical fitness tests were significantly different between 2019 and 2020 (p < 0.01) by Wilcoxon signed-rank test. Conclusions: The changes of physical fitness tests before and after web-based physical education suggested that the focus should be placed on improvement for running tests through appropriate alternatives, such as fast running in place and shuttle run. In addition, the simple, convenient, and practical sport that require available equipment and little field should be considered for web-based physical education.

Stress, Emotional Intelligence and the Intention to Use Cannabis in Spanish Adolescents: Influence of COVID-19 Confinement

The disease brought about by the SARS-CoV-2, COVID-19 coronavirus has had an unprecedented global impact. Confinement to control the outbreak may have mental health consequences for the most vulnerable in the population, including adolescents. This study aims to describe and analyze the relationships between the stress variables, Emotional Intelligence and the intention to use cannabis in healthy adolescents, before and after the end of the COVID-19 pandemic containment stage. A comparative correlational study was carried out with validated self-completed questionnaires through an online platform. The sample is made up of adolescents (n = 300) aged 13-17 from two different schools in Ponferrada (León, Spain). The analysis of correlation and differences between the groups indicate that confinement has had effects on the mental health of the adolescents, specifically on the emotional manifestations of stress. Furthermore, significant gender differences were found for stress values and Emotional Intelligence. However, no differences have been found for cannabis use intention.