Psychological resilience, resilient coping, and health behaviors among adults in Puerto Rico after multiple adverse events.

: Residents of Puerto Rico have recently experienced multiple adverse events, including hurricanes, earthquakes, and political unrest. Such adversity is associated with worse mental and physical health. Psychological resilience and effective coping may mitigate these relations by fostering positive health behaviors, like consuming a high-quality diet and being physically active. However, empirical evidence for these relationships is limited. : We assessed psychological resilience, resilient coping, and health behaviors among two groups of adults in Puerto Rico, before and during the pandemic, in 2019-2023 (total N = 1,342). Resilience and resilient coping were assessed using the Brief Resilience Scale and Brief Resilient Coping Scale. Diet quality was defined by the Alternate Healthy Eating Index from a food frequency questionnaire. We collected data on sleep, physical activity, alcohol intake, and tobacco use using validated questionnaires. : Adjusting for confounders, higher resilience z-scores were associated with being in the highest category of diet quality [OR: 1.25, 95 % CI: 1.04, 1.50]; getting 7-8 h of sleep per night [OR: 1.15, 95 % CI: 1.02,1.30]; and reporting moderate or heavy physical activity (vs. light or sedentary) [OR: 1.17, 95 % CI: 1.02,1.34]. The same patterns were observed for higher resilient coping z-scores, and for categorical measures of resilience and resilient coping. These relationships were stronger among participants interviewed during (vs. before) the COVID-19 pandemic, suggesting that resilience and resilient coping may be particularly relevant during an ongoing stressor. : Identifying supportive strategies to cultivate resilience and effective coping mechanisms may contribute to healthier behaviors, particularly in a vulnerable population.