Introduction
Methods
Study design
Questionnaire design
Socio-demographic information
Lifestyle behaviours
Mental health
Psychosocial health
Open ended questions
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Thinking back to COVID-19 lockdown, what would you say was the biggest difference made to your physical activity (in other words, any changes to your physical activity preferences, types of physical activity, physical activity intensity, etc.)? Please describe those changes.
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Thinking back to COVID-19 lockdown, what would you say had been the biggest difference you made to your diet (in other words, any changes to your food preferences, types of food, food preparation, cooking, alcohol intake etc.)? Please describe what changed.
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Describe what may have affected (positively and/or negatively) your mental well-being during the COVID-19 lockdown period?
Data analysis
Results
Participants
Characteristics | % |
---|---|
Age (546) | |
18–24 | 11.9 |
25–34 | 13.6 |
35–44 | 14.8 |
45–54 | 20.5 |
55–64 | 21.1 |
65+ | 18.1 |
Sex (540) | |
Male | 25.4 |
Female | 74.6 |
Residential location (544) | |
Urban | 87.7 |
Rural | 12.3 |
Education (294) | |
Bachelor degree or higher | 69.7 |
Diploma or certificate in Trade/apprenticeship | 18.0 |
Completed high school | 10.9 |
Did not complete high school | 1.4 |
Household income (265) | |
Under $40,000 | 12.5 |
$40,000–$100,000 | 37.0 |
$100,000 and above | 50.6 |
Employment during lockdown (291) | |
Employed (Inc self-employment) | 64.9 |
Unemployed | 6.9 |
Student | 6.9 |
Retired | 17.2 |
Other | 4.1 |
Changes in physical activity
Compared to those who decreased their level of physical activity during lockdown, many that reported increased level of physical activity felt they had more time to do so (χ2 = 69.33, p < 0.001, n = 391, d = 0.93) and that it helped their mental health (χ2 = 22.45, p < 0.001, n = 391, d = 0.49):Change of activity from swimming to the walking. (23 yo male)
For others, working from home reduced their usual level of physical activity:Not having the commute to work in the morning meant I had an hour to do home workout using a fitness app before work, without having to wake up any earlier. (25 yo female)
Those who decreased their physical activity often did so because of limited options, fear of increased risk of infection, reduced team sports activity, and inability to remain motivated.As I was working from home, I was sitting more as opposed to being active pre-covid (going up and down stairs, taking public transport, walking). Sitting more translated to being less active. (33 yo female)
I didn’t feel I had the desire to exercise while my yoga studio was closed. There was too much panic around cleanliness and distancing that I felt it best to stay home. (29 yo female)
Lack of motivation. Feeling down. Watching too much tv. (60 yo female)
Persons | Males | Females | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Lockdown | post-lockdown | Lockdown | post-lockdown | Lockdown | post-lockdown | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Very active | 40 | 8.8 | 55 | 12.0 | 9 | 8.0 | 16 | 14.0 | 31 | 9.1 | 39 | 11.3 |
Active | 114 | 25.1 | 130 | 28.3 | 32 | 28.6 | 38 | 33.3 | 82 | 24.0 | 92 | 26.6 |
Moderately active | 141 | 31.1 | 175 | 38.0 | 31 | 27.7 | 36 | 31.6 | 110 | 32.2 | 139 | 40.2 |
Not very active | 119 | 26.2 | 83 | 18.0 | 27 | 24.1 | 22 | 19.3 | 92 | 26.9 | 61 | 17.6 |
Not active at all | 40 | 8.8 | 17 | 3.7 | 13 | 11.6 | 2 | 1.8 | 27 | 7.9 | 15 | 4.3 |
Total | 454 | 100.0 | 460 | 100.0 | 112 | 100.0 | 114 | 100.0 | 342 | 100.0 | 346 | 100.0 |
Wilcoxon sign ranked test (Z) | −5.48***, d = 0.37 | −3.56***, d = 0.49 | −4.18***, d = 0.32 |
Persons | Males | Females | ||||
---|---|---|---|---|---|---|
n | % | n | % | n | % | |
Increase | 70 | 15.4 | 14 | 12.5 | 56 | 16.4 |
Same | 229 | 50.4 | 57 | 50.9 | 172 | 50.3 |
Decrease | 155 | 34.1 | 41 | 36.6 | 114 | 33.3 |
Total | 454 | 100.0 | 112 | 100.0 | 342 | 100.0 |
Kolmogorov-Smirnov Test (t) | t = 0.27*** | t = 0.28*** | t = 0.26*** |
Relative change in physical activity (%) | ||||
---|---|---|---|---|
Coded responses | Increased (n = 89) | Same (n = 267) | Decreased (n = 202) | Total (n = 562) |
Routine changed | 45.8 | 33.1 | 21.5 | 31.1 |
More sedentary | 6.8 | 13.8 | 36.2 | 20.4 |
Limited options | 1.7 | 18.8 | 27.7 | 19.0 |
No change | 8.5 | 25.4 | 6.2 | 16.1 |
Had more time for PA | 33.9 | 9.9 | 0.8 | 10.5 |
Substitutes for gym | 3.4 | 6.6 | 10.8 | 7.5 |
Exercised at home | 8.5 | 6.6 | 6.2 | 6.7 |
Fear of infection reduced PA | – | 5.0 | 8.5 | 5.4 |
Made more effort PA | 3.4 | 3.9 | 6.9 | 5.1 |
Social distancing impacted on PA | 15.3 | 5.5 | – | 5.1 |
Online exercise videos | 5.1 | 3.3 | 5.4 | 4.6 |
Reduced team sports | – | 4.4 | 4.6 | 3.8 |
PA helped with MH | 13.6 | 1.7 | 0.8 | 3.2 |
Reduced PA over time period | 1.7 | 1.1 | 6.2 | 2.9 |
Job loss reduced PA | – | 0.6 | 3.1 | 1.3 |
More infection awareness from PA | – | 0.6 | 2.3 | 1.1 |
Other | 3.4 | 7.2 | 8.5 | 7.0 |
Changes in food and alcohol consumption
Increased (%) | Same (%) | Decreased (%) | Wilcoxon Sign Rank (Z) | Cohen’s d | |
---|---|---|---|---|---|
Daily number of serves (373) | |||||
Vegetables | 12.6 | 74.5 | 12.9 | − 0.24 | 0.02 |
Fruit | 14.2 | 73.2 | 12.6 | −0.39 | 0.04 |
Grain | 22.0 | 69.4 | 8.6 | −4.83*** | 0.36 |
Meat | 13.1 | 78.8 | 8.0 | −1.70 | 0.18 |
Snack meals per week (372) | 20.4 | 66.7 | 12.9 | − 3.35*** | 0.25 |
Consumption of soft drinks | |||||
Days per week (389) | 11.6 | 84.1 | 4.4 | −3.37*** | 0.24 |
Cups per day (130) | 23.1 | 67.7 | 9.2 | 3.35*** | 0.24 |
Alcohol consumption | |||||
Days per week (370) | 35.1 | 55.9 | 8.9 | −8.31*** | 0.64 |
Standard drinks per day (363) | 23.1 | 66.4 | 10.5 | −3.08** | 0.23 |
Persons (%) | Males (%) | Females (%) | |
---|---|---|---|
What were the biggest differences to your diet during lockdown? | |||
n | 466 | 105 | 359 |
No changes | 26.8 | 40.0 | 22.7 |
Cooked more | 23.9 | 14.1 | 27.1 |
Ate less healthy food | 18.6 | 21.2 | 17.8 |
Drank more alcohol | 16.1 | 12.9 | 17.1 |
Ate healthier food | 13.5 | 12.9 | 13.4 |
Consumed more food | 12.7 | 3.5 | 15.6 |
Had more takeaway | 7.6 | 7.1 | 7.8 |
Ate less food | 5.9 | 7.1 | 5.6 |
Drank less alcohol | 3.1 | 1.2 | 3.7 |
Other | 3.1 | 3.6 | 2.6 |
What were the biggest differences to your dining practices during lockdown? | |||
n | 487 | 112 | 373 |
Ate out less | 48.3 | 49.4 | 48.1 |
More takeaway | 28.4 | 32.1 | 27.4 |
More cooking at home | 16.8 | 9.9 | 18.9 |
No difference | 16.5 | 23.5 | 14.4 |
More food deliveries | 8.8 | 3.7 | 10.4 |
Less deliveries due to COVID fear | 6.3 | 6.2 | 6.3 |
Eat healthier | 4.0 | – | 5.2 |
More unhealthy food | 2.6 | 3.7 | 1.9 |
More alcohol | 1.4 | 1.2 | 1.1 |
Weight gain | 1.4 | 1.2 | 1.5 |
Other | 4.0 | 7.4 | 3.0 |
Many people reported cooking more often (χ2 = 7.48, p = 0.006, d = 0.26). Many also reported eating less healthy food with a similar number saying they drank more alcohol, with responses from males and females not detected to be significantly different.No real change to diet, although I tended to cook more elaborate meals due to having more time. (29 yo male).
I cooked more comfort food and large meals I could freeze and starting drinking alcohol earlier in the afternoon than before Covid-19. (71 yo female)
In response to the question “What would you say was the biggest difference you made to your dining practice during the lockdown?”, most people replied that they ‘ate out less’ (48%) followed by ‘more take away food’ (28%) and more ‘home delivery’ (9%). However, as highlighted by the quotes below, the reasons underpinning this change in behaviour varied:More fast food, less home cooked meals. Higher preference for unhealthy foods. (23 yo male)
Less dining out... More take away food for the first few months as we wanted to support local businesses however this got quite expensive quickly. (28 yo female)
We avoided supermarkets and enjoyed home delivery by Woolworths. We ceased dining out at restaurants and with friends. (71 yo male)
Almost a fifth of respondents indicated they cooked more at home as a result of the lockdown although this was more commonly reported by females (χ2 = 6.60, p = 0.010, d = 0.24).We got hello fresh delivered during lockdown which we did have before sometimes, but we choose it because we didn’t want to go the grocery store and it was easy and healthy. We are out less because of the restaurants closing. (23 yo female)
I used to dine out at least once a week but that stopped when restaurants closed. I cooked a lot more than I had previously and also got food deliveries. I started to get a bit more creative in the kitchen due to some food shortages when people were stockpiling. (31 yo female)
The proportion of people who reported increased food deliveries (8.8%) was similar to those who claimed to reduce their number of deliveries due to fear of COVID-19 (6.3%).I cooked a lot more roasts as I was home all day and could better monitor the oven. (27 yo female)
More deliveries. More take out. (57 yo female)
We didn't want to risk take-away food so had none. (53 yo female)
Changes in mental health and psychosocial health
Persons | Males | Females | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Lockdown | Post-lockdown | Lockdown | Post-lockdown | Lockdown | Post-lockdown | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Likely to be well | 208 | 60.5 | 254 | 72.0 | 57 | 67.9 | 66 | 78.6 | 151 | 58.3 | 188 | 70.1 |
Moderate distress | 50 | 14.5 | 39 | 11.0 | 13 | 15.5 | 6 | 7.1 | 36 | 13.9 | 32 | 11.9 |
Mild mental disorder | 36 | 10.5 | 22 | 6.2 | 5 | 6.0 | 8 | 9.5 | 31 | 12.0 | 14 | 5.2 |
Severe mental disorder | 50 | 14.5 | 38 | 10.8 | 9 | 10.7 | 4 | 4.8 | 41 | 15.8 | 34 | 12.7 |
Total | 344 | 100.0 | 353 | 100.0 | 84 | 100.0 | 84 | 100.0 | 259 | 100.0 | 268 | 100.0 |
Wilcoxon sign rank (Z) | −5.21***, d = 0.41 | −2.98**, d = 0.47 | −4.49***, d = 0.39 |
Depression | Anxiety | Stress | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Lockdown | Post-lockdown | Lockdown | Post-lockdown | Lockdown | Post-lockdown | |||||||
% | n | % | n | % | n | % | n | % | n | % | n | |
Persons | ||||||||||||
Normal | 193 | 65.0 | 216 | 72.2 | 237 | 80.1 | 246 | 82.0 | 226 | 80.7 | 252 | 85.1 |
Mild | 32 | 10.8 | 30 | 10.0 | 16 | 5.4 | 19 | 6.3 | 20 | 7.1 | 15 | 5.1 |
Moderate | 36 | 12.1 | 26 | 8.7 | 14 | 4.7 | 9 | 3.0 | 19 | 6.8 | 9 | 3.0 |
Severe | 10 | 3.4 | 10 | 3.3 | 10 | 3.4 | 9 | 3.0 | 14 | 5.0 | 17 | 5.7 |
Extremely severe | 26 | 8.8 | 17 | 5.7 | 19 | 6.4 | 17 | 5.7 | 1 | 0.4 | 3 | 1.0 |
Wilcoxon sign rank (Z) | −2.71**, d = 0.22 | −0.98, d = 0.08 | −1.99*, d = 0.17 | |||||||||
Males | ||||||||||||
Normal | 46 | 65.7 | 46 | 65.7 | 59 | 84.3 | 60 | 84.5 | 55 | 84.6 | 60 | 85.7 |
Mild | 6 | 8.6 | 6 | 8.6 | 3 | 4.3 | 5 | 7.0 | 6 | 9.2 | 3 | 4.3 |
Moderate | 9 | 12.9 | 9 | 12.9 | 3 | 4.3 | 1 | 1.4 | 2 | 3.1 | 3 | 4.3 |
Severe | 2 | 2.9 | 2 | 2.9 | – | 0.0 | 1 | 1.4 | 2 | 3.1 | 3 | 4.3 |
Extremely severe | 7 | 10.0 | 7 | 10.0 | 5 | 7.1 | 4 | 5.6 | – | 0.0 | 1 | 1.4 |
Wilcoxon sign rank (Z) | −1.89, d = 0.32 | −0.30, d = 0.05 | −0.81, d = 0.14 | |||||||||
Females | ||||||||||||
Normal | 146 | 64.6 | 163 | 71.8 | 177 | 78.7 | 185 | 81.1 | 170 | 79.4 | 191 | 84.9 |
Mild | 26 | 11.5 | 24 | 10.6 | 13 | 5.8 | 14 | 6.1 | 14 | 6.5 | 12 | 5.3 |
Moderate | 27 | 11.9 | 18 | 7.9 | 11 | 4.9 | 8 | 3.5 | 17 | 7.9 | 6 | 2.7 |
Severe | 8 | 3.5 | 8 | 3.5 | 10 | 4.4 | 8 | 3.5 | 12 | 5.6 | 14 | 6.2 |
Extremely severe | 19 | 8.4 | 14 | 6.2 | 14 | 6.2 | 13 | 5.7 | 1 | 0.5 | 2 | 0.9 |
Wilcoxon sign rank (Z) | −2.09*, d = 0.20 | −0.87, d = 0.08 | −1.82, d = 0.18 |
Lack of social contact, confinement at home, concern about my own health and that of family members, worry about job security, despair at the mistakes made by governments and irresponsibility, ignorance and selfishness displayed by some people, the sense that the situation was bad and made still worse by foolishness and malice. (52 yo male)
Others reported a positive effect of the lockdown:Being locked in a house 100% of the time with my significant other was “detrimental” to our relationship. We just kept getting on each other’s nerves. (41 yo male)
During the lockdown period, significantly fewer respondents (52%) reported always or usually having control over their general lives compared to 72% in the post-lockdown period. Similar significant findings were observed in both sexes (Table 9). Control factors described included:Increased physical exercise indoors and outdoors, spending more time more frequently with family, and more time watching videos. I enjoyed [it] all [and it] affected my mental health positively. (30 yo male)
Increased stress due to alarm and panic buying, and sense that society was beginning to destabilise in certain ways. Heightened alertness to the risk of contracting Covid-19. Sense of restriction on movement outside the house. Increased worry over health and future of older relatives and friends. (28 yo male)
Similar significant differences were also observed for the questions about level of control over one’s personal life and health for all respondents (Z = − 5.13, p < 0.001, d = 0.43; Z = − 5.81, p < 0.001, d = 0.50), for males (Z = − 2.67, p = 0.008, d = 0.46; Z = − 3.63, p < 0.001, d = 0.64), and females (Z = − 4.41, p < 0.001, d = 0.43; Z = − 4.54, p < 0.001, d = 0.44).Missed family milestones (eg. grandchildren's birthdays), difficult to visit mother in Aged Care (long travel time for very short visit). (68 yo female)
Persons | Males | Females | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Lockdown | Post-lockdown | Lockdown | Post-lockdown | Lockdown | Post-lockdown | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Always | 68 | 23.0 | 92 | 30.9 | 20 | 28.2 | 25 | 35.2 | 48 | 21.4 | 67 | 29.9 |
Often | 85 | 28.7 | 122 | 40.9 | 20 | 28.2 | 26 | 36.6 | 65 | 29.0 | 96 | 42.9 |
Sometimes | 76 | 25.7 | 50 | 16.8 | 17 | 23.9 | 13 | 18.3 | 58 | 25.9 | 36 | 16.1 |
Rarely | 49 | 16.6 | 25 | 8.4 | 8 | 11.3 | 5 | 7.0 | 41 | 18.3 | 20 | 8.9 |
Never | 18 | 6.1 | 9 | 3.0 | 6 | 8.5 | 2 | 2.8 | 12 | 5.4 | 7 | 3.1 |
Total | 296 | 100.0 | 298 | 100.0 | 71 | 100.0 | 71 | 100.0 | 224 | 100.0 | 226 | 100.0 |
Wilcoxon sign rank (Z) | −14.91***, d = 1.54 | −7.32***, d = 1.56 | −12.98***, d = 1.55 |
Unable to meet with friends and family. Unable to visit family back in my country of origin, hearing and reading bad news about [the] pandemic, feeling lonely, working at the University campus which was deserted, no extra activities after work. (39 yo female)
Persons | Males | Females | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Lockdown | Post-lockdown | Lockdown | Post-lockdown | Lockdown | Post-lockdown | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Not lonely | 91 | 30.8 | 135 | 45.2 | 20 | 28.2 | 35 | 48.6 | 71 | 31.8 | 100 | 44.2 |
Moderately | 90 | 30.5 | 77 | 25.8 | 27 | 38.0 | 20 | 27.8 | 62 | 27.8 | 57 | 25.2 |
Severely | 114 | 38.6 | 87 | 29.1 | 24 | 33.8 | 17 | 23.6 | 90 | 40.4 | 69 | 30.5 |
Total | 295 | 100.0 | 299 | 100.0 | 71 | 100.0 | 72 | 100.0 | 223 | 100.0 | 226 | 100.0 |
Wilcoxon sign rank (Z) | −5.47***, d = 0.46 | −3.55***, d = 0.62 | −4.41***, d = 0.43 |
Awareness and impact of health and safety campaigns
None, we've always had clean practices. (59 yo male)
In response to the question about what health promotion or safety material they would like in the advent of another outbreak, many wanted better and timelier information about the outbreak with others requesting more physical, nutritional, and mental health support information.I stopped listening to media, government and experts as their data has been shown to constantly conflict and later turn out to be false, an over statement or misstated to the public to create fear. (45 yo male)
I think overall the information is already out there. During the first lock down governments were struggling to organise their messages as they were naturally making it up as they went along. They are a lot better at staying on message now and talking plainly and openly about what happens. (63 yo male)
When those changes identified as significantly different between the lockdown and post-lockdown period were further analysed by those who either increased or decreased their behaviours, some significant variations were observed. For example, as shown in Table 11, differences in recall of health promotion campaigns were observed between those who increased or decreased their level of physical activity, daily alcohol intake or the number of standard drinks per day.Just make the requirements clear and easily found. Keep them updated at the same location rather than putting changes or new requirements in announcements. (39 yo male)
Persons (%) | Increase (%) | Decrease (%) | x2 | d | |
---|---|---|---|---|---|
Recall of health promotion campaigns (411) | |||||
Washing hands | 51.7 | ||||
Social distancing | 39.6 | ||||
By change in physical activity | 52.4 | 31.6 | 4.96* | 0.41 | |
By change in daily alcohol consumption | 36.0 | 66.7 | 4.86* | 0.48 | |
By change in number of standard drinks per day | 29.2 | 57.9 | 6.03* | 0.62 | |
Can’t recall any | 23.5 | ||||
Mental health | 13.9 | ||||
Coughing into elbow | 9.6 | ||||
Personal changes in behaviour (353) | |||||
No change in behaviour | 38.2 | ||||
By change in stress levels (DASS-21) | 33.3 | 66.7 | 4.50* | 0.32 | |
Washed hands properly | 33.6 | ||||
Socially distanced | 33.2 | ||||
By change in physical activity | 44.7 | 21.6 | 6.46* | 0.49 | |
By change in number of standard drinks per day | 22.7 | 54.5 | 7.77* | 0.72 | |
Used sanitizer | 18.2 | ||||
Coughed into elbow | 5.0 | ||||
Suggestions for future safety or health promotion campaigns (244) | |||||
No need for anything different | 30.5 | ||||
Better access to timely WA specific information | 20.0 | ||||
More about how to maintain physical, nutritional, and mental well-being | 15.2 | ||||
By change in grain consumption | 22.0 | 0.0 | 4.66* | 0.59 | |
Clearer direction as to when and where to wear masks | 12.9 |
[Recalled] Physical activity one from the government and lifeline doing their thing for mental health. (21 yo female)
[Behavioural change] Spatial distancing, Washing hands properly and often, Coughing into elbow, Avoiding contact, Maintaining exercise. (60 yo, unknown)
[Future information suggestion] Information for people with respiratory conditions - more information so we don't get anxious. (41 yo female)