Abstract
The COVID-19 pandemic has changed routines and habits, raising stress and anxiety levels of individuals worldwide. The goal of this qualitative study was to advance the understanding of how pandemic-related changes affected sleep, diet, physical activity (PA), and stress among adults. We conducted semi-structured, qualitative interviews with 185 participants and selected 33 interviews from a represented sample based on age, race, and gender for coding and analysis of themes. After coding for thematic analysis, results demonstrated four primary themes: sleep, diet, PA, and stress. Sleep sub-themes such as poorer sleep quality were reported by 36% of our participants, and 12% reported increased an frequency of vivid dreams and nightmares. PA was decreased in 52% of our participants, while 33% experienced an increase and 15% experienced no change in PA. Participants also reported having an improved diet, mostly among women. Stress was elevated in 79% of our participants and was more likely to be discussed by women. Many participants reported how stress was involved in precipitating health behavior change, especially for sleep. Increased stress was also linked to elevated anxiety and depression among participants. The results of this qualitative study demonstrate how managing stress could have a beneficial effect on promoting health behaviors and mental health during the COVID-19 pandemic and beyond.
Highlights
The COVID-19 pandemic is the most significant public health emergency affecting the entire world in the past 100 years
Our results demonstrate that stress and health behaviors were closely interrelated during the COVID-19 pandemic
The relationship between stress and critical health behaviors presented through our study results demonstrates the need for greater financial investment towards research in these areas to understand in greater detail the negative implications of COVID-19 on sleep, diet, physical activity (PA), and stress
Summary
The COVID-19 pandemic is the most significant public health emergency affecting the entire world in the past 100 years. A study in the Netherlands reported that 20% of adults who described themselves as “good sleepers” before the pandemic experienced disrupted sleep during the COVID-19 lockdown [3]. Another study conducted in Italy showed that 15% of participants reported pre-pandemic difficulties initiating sleep, this rose to 42% during the lockdown period [4]. 48.6% of a total of 3533 respondents from Italy self-reported weight gain during the pandemic [5]. In Spain, one survey reported that participants experienced a 12.8% decrease in PA during the COVID-19 lockdown [8]. A study in Brazil reported that prior to the COVID-19 pandemic period, 69% of participants were classified as “very active”, while during the social distancing period, this percentage dropped to 39% [9]. A crosssectional analysis in Italy showed that approximately half of their enrolled sample of 384 had decreased PA [10]
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