Eastern Virginia Medical School-Sentara Healthcare Analytics and Delivery Science Institute, Norfolk, VA, USA.
Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA.
BMC Public Health. 2023 Sep 8;23(1):1749. doi: 10.1186/s12889-023-16614-7.
Amidst the COVID-19 pandemic, there has been growing concern about the declining mental health and healthy behaviors compared to pre-pandemic levels. Despite this, there is a lack of longitudinal studies that have examined the relationship between health behaviors and mental health during the pandemic. In response, the statewide COVIDsmart longitudinal study was launched. The study's main objective is to better understand the effects of the pandemic on mental health. Findings may provide a foundation for the identification of public health strategies to mitigate future negative impacts of the pandemic.
Following online recruitment in spring of 2021, adults, ages 18 to 87, filled out social, mental, economic, occupational, and physical health questionnaires on the digital COVIDsmart platform at baseline and through six monthly follow-ups. Changes in the participant's four health behaviors (e.g., tobacco and alcohol consumption, physical activity, and social media use), along with sex, age, loneliness score, and reported social and economic (SE) hardships, were analyzed for within-between group associations with depression and anxiety scores using Mixed Models Repeated Measures.
In this study, of the 669 individuals who reported, the within-between group analysis indicated that younger adults (F = 23.81, p < 0.0001), loneliness (F = 234.60, p < 0.0001), SE hardships (F = 31.25, p < 0.0001), increased tobacco use (F = 3.05, p = 0.036), decreased physical activity (F = 6.88, p = 0.0002), and both positive and negative changes in social media use (F = 7.22, p = 0.0001) were significantly associated with worse depression scores. Additionally, females (F = 6.01, p = 0.015), younger adults (F = 32.30, p < 0.0001), loneliness (F = 154.59, p < 0.0001), SE hardships (F = 22.13, p < 0.0001), increased tobacco use (F = 4.87, p = 0.004), and both positive and negative changes in social media use (F = 3.51, p = 0.016) were significantly associated with worse anxiety scores. However, no significant changes were observed in the within-between group measurements of depression and anxiety scores over time (p > 0.05). Physical activity was not associated with anxiety nor was alcohol consumption with both depression and anxiety (p > 0.05).
This study demonstrates the longitudinal changes in behaviors within the context of the COVID-19 pandemic. These findings may facilitate the design of preventative population-based health approaches during the COVID-19 pandemic or future pandemics.
在 COVID-19 大流行期间，人们越来越担心与大流行前相比，心理健康和健康行为呈下降趋势。尽管如此，仍缺乏纵向研究来检查大流行期间健康行为与心理健康之间的关系。有鉴于此，开展了全州范围的 COVIDsmart 纵向研究。该研究的主要目的是更好地了解大流行对心理健康的影响。研究结果可能为确定减轻大流行未来负面影响的公共卫生策略提供基础。
在 2021 年春季在线招募后，18 至 87 岁的成年人在基线和六次每月随访时通过数字 COVIDsmart 平台填写社会、心理、经济、职业和身体健康问卷。使用混合模型重复测量法分析参与者的四种健康行为（例如，吸烟和饮酒、身体活动和社交媒体使用）的变化，以及性别、年龄、孤独评分以及报告的社会和经济（SE）困难，与抑郁和焦虑评分之间的组内-组间关联。
在这项研究中，在报告的 669 人中，组内-组间分析表明，年轻人（F=23.81，p<0.0001）、孤独（F=234.60，p<0.0001）、SE 困难（F=31.25，p<0.0001）、吸烟增加（F=3.05，p=0.036）、体力活动减少（F=6.88，p=0.0002）以及社交媒体使用的积极和消极变化（F=7.22，p=0.0001）与抑郁评分恶化显著相关。此外，女性（F=6.01，p=0.015）、年轻人（F=32.30，p<0.0001）、孤独（F=154.59，p<0.0001）、SE 困难（F=22.13，p<0.0001）、吸烟增加（F=4.87，p=0.004）以及社交媒体使用的积极和消极变化（F=3.51，p=0.016）与焦虑评分恶化显著相关。然而，随着时间的推移，抑郁和焦虑评分的组内-组间测量未观察到显著变化（p>0.05）。体力活动与焦虑无关，酒精摄入与抑郁和焦虑均无关（p>0.05）。
本研究展示了 COVID-19 大流行背景下行为的纵向变化。这些发现可能有助于设计 COVID-19 大流行期间或未来大流行期间基于人群的预防保健方法。
