Background

Extensive research has consistently highlighted the strong association between physical activity and mental health. But few have examined how this association may differ at the between-person and the within-person level. This longitudinal study compares how within-person and between-person changes in physical activity are associated mental health during the COVID-19 pandemic among the American population.

Methods

We analyzed data from the Understanding Coronavirus in America (UCA) survey, a probability-based online panel of American adults. An average of more than 6000 panel members repeatedly participated across 33 waves from the start of the pandemic in March 2020 to January 2023. Measures of physical activity include 1) number of days exercised in the past week (0–7), and 2) whether gone outside to walk, hike, and exercise in the past week (0 = no, 1 = yes), capturing both the frequency and the context (e.g., outdoor) of physical activity. Mental health is indicated using the four-item Patient Health Questionnaire (PHQ-4). We used multilevel Within-Between Random Effects models (REWB) that provide coefficients for both between-individual as well as within-individual associations.

Results

We reported three main findings. First, both within-person and between-person increases in physical activity are significantly associated with lower levels of anxiety and depression regardless of the measure. Second, between-person changes in physical activity are more strongly associated with mental health than within-person changes. Third, a large share of the between-person association (about 32%) can be attributed to structural inequalities captured by status markers such as gender, race, and SES.

Conclusions

Our findings indicate the value of physical activity as a mental health intervention and highlight that both between-individual inequality in physical activity, as well as within-individual changes in physical activity, should be considered. The finding of a stronger between-person association that is largely related to status markers such as gender, race, and SES can be used to develop targeted intervention and prevention strategies to improve mental health through physical activity among the most vulnerable populations.

中文翻译：

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身体活动和心理健康：纵向分析中比较人与人之间的关联

背景

广泛的研究一致强调身体活动与心理健康之间的密切联系。但很少有人研究过这种关联在人与人之间和人内部的层面上有何不同。这项纵向研究比较了 COVID-19 大流行期间美国人口中人内和人间体力活动的变化与心理健康的关系。

方法

我们分析了“了解美国冠状病毒”(UCA) 调查的数据，这是一个基于概率的美国成年人在线小组。从 2020 年 3 月大流行开始到 2023 年 1 月，平均有超过 6000 名小组成员重复参与了 33 波。体力活动的衡量标准包括 1) 过去一周的锻炼天数 (0-7)，以及 2)过去一周是否外出散步、远足和锻炼（0 = 否，1 = 是），记录体育活动的频率和背景（例如户外）。使用四项患者健康问卷 (PHQ-4) 来表明心理健康状况。我们使用多级组内随机效应模型 (REWB)，该模型为个体之间以及个体内部关联提供系数。

结果

我们报告了三个主要发现。首先，无论采取何种措施，人内和人际体力活动的增加都与较低水平的焦虑和抑郁显着相关。其次，人与人之间身体活动的变化比人内部的变化与心理健康的相关性更强。第三，人与人之间的关联（约 32%）可归因于性别、种族和社会经济地位等地位标记所体现的结构性不平等。

结论

我们的研究结果表明了身体活动作为心理健康干预措施的价值，并强调应考虑身体活动中个体之间的不平等以及身体活动中个体内部的变化。人与人之间的联系在很大程度上与性别、种族和社会经济地位等地位标记相关，这一发现可用于制定有针对性的干预和预防策略，通过体育活动改善最弱势群体的心理健康。