COVID-19 Stressors and Health Behaviors: A Multilevel Longitudinal Study across 86 Countries

Shian-Ling Keng; Michael Vicente Stanton; LeaAnn B. Haskins; Carlos A. Almenara; Jeannette Ickovics; Antwan Jones; Diana Grigsby-Toussaint; Maximilian Agostini; Jocelyn J. Bélanger; Ben Gützkow; Jannis Kreienkamp; Edward P. Lemay; Michelle R. vanDellen; Georgios Abakoumkin; Jamilah Hanum Abdul Khaiyom; Vjolica Ahmedi; Handan Akkas; Mohsin Atta; Sabahat Cigdem Bagci; Sima Basel; Edona Berisha Kida; Allan B. I. Bernardo; Nicholas R. Buttrick; Phatthanakit Chobthamkit; Hoon-Seok Choi; Mioara Cristea; Sára Csaba; Kaja Damnjanović; Ivan Danyliuk; Arobindu Dash; Daniela Di Santo; Karen M. Douglas; Violeta Enea; Daiane Gracieli Faller; Gavan J. Fitzsimons; Alexandra Gheorghiu; Ángel Gómez; Ali Hamaidia; Qing Han; Mai Helmy; Joevarian Hudiyana; Bertus F. Jeronimus; Ding-Yu Jiang; Veljko Jovanović; Željka Kamenov; Anna Kende; Tra Thi Thanh Kieu; Yasin  Koç; Kamila Kovyazina; Inna Kozytska; Joshua Krause; Arie W. Kruglanski; Anton Kurapov; Maja Kutlaca; Nóra Anna Lantos; Cokorda Bagus Jaya Lesmana; Winnifred R. Louis; Adrian Lueders; Marta Maj; Najma Iqbal Malik; Anton P. Martinez; Kira O. McCabe; Jasmina Mehulić; Mirra Noor Milla; Idris Mohammed; Erica Molinario; Manuel Moyano; Hayat Muhammad; Silvana Mula; Hamdi Muluk; Solomiia Myroniuk; Reza Najafi; Claudia F. Nisa; Boglárka Nyúl; Paul A. O'Keefe; Jose Javier Olivas Osuna; Evgeny N. Osin; Joonha Park; Gennaro Pica; Antonio Pierro; Jonas H. Rees; Anne-Margit Reitsema; Elena Resta; Marika Rullo; Michelle K. Ryan; Adil Samekin; Pekka Santtila; Edyta Sasin; Birga M. Schumpe; Heyla A. Selim; Wolfgang Stroebe; Robbie M. Sutton; Eleftheria Tseliou; Akira Utsugi; Jolien Anne van Breen; Caspar J. van Lissa; Alexandra Vázquez; Robin Wollast; Victoria Wai-Lan Yeung; Somayeh Zand; Iris Lav Žeželj; Bang Zheng; Andreas Zick; Claudia Zúñiga; N. Pontus Leander

doi:10.1016/j.pmedr.2022.101764

COVID-19 Stressors and Health Behaviors: A Multilevel Longitudinal Study across 86 Countries

Shian-Ling Keng, Michael Vicente Stanton, LeaAnn B. Haskins, Carlos A. Almenara, Jeannette Ickovics, Antwan Jones, Diana Grigsby-Toussaint, Maximilian Agostini, Jocelyn J. Bélanger, Ben Gützkow, Jannis Kreienkamp, Edward P. Lemay, Michelle R. vanDellen, Georgios Abakoumkin, Jamilah Hanum Abdul Khaiyom, Vjolica Ahmedi, Handan Akkas, Mohsin Atta, Sabahat Cigdem Bagci, Sima BaselEdona Berisha Kida, Allan B. I. Bernardo, Nicholas R. Buttrick, Phatthanakit Chobthamkit, Hoon-Seok Choi, Mioara Cristea, Sára Csaba, Kaja Damnjanović, Ivan Danyliuk, Arobindu Dash, Daniela Di Santo, Karen M. Douglas, Violeta Enea, Daiane Gracieli Faller, Gavan J. Fitzsimons, Alexandra Gheorghiu, Ángel Gómez, Ali Hamaidia, Qing Han, Mai Helmy, Joevarian Hudiyana, Bertus F. Jeronimus, Ding-Yu Jiang, Veljko Jovanović, Željka Kamenov, Anna Kende, Tra Thi Thanh Kieu, Yasin Koç, Kamila Kovyazina, Inna Kozytska, Joshua Krause, Arie W. Kruglanski, Anton Kurapov, Maja Kutlaca, Nóra Anna Lantos, Cokorda Bagus Jaya Lesmana, Winnifred R. Louis, Adrian Lueders, Marta Maj, Najma Iqbal Malik, Anton P. Martinez, Kira O. McCabe, Jasmina Mehulić, Mirra Noor Milla, Idris Mohammed, Erica Molinario, Manuel Moyano, Hayat Muhammad, Silvana Mula, Hamdi Muluk, Solomiia Myroniuk, Reza Najafi, Claudia F. Nisa, Boglárka Nyúl, Paul A. O'Keefe, Jose Javier Olivas Osuna, Evgeny N. Osin, Joonha Park, Gennaro Pica, Antonio Pierro, Jonas H. Rees, Anne-Margit Reitsema, Elena Resta, Marika Rullo, Michelle K. Ryan, Adil Samekin, Pekka Santtila, Edyta Sasin, Birga M. Schumpe, Heyla A. Selim, Wolfgang Stroebe, Robbie M. Sutton, Eleftheria Tseliou, Akira Utsugi, Jolien Anne van Breen, Caspar J. van Lissa, Alexandra Vázquez, Robin Wollast, Victoria Wai-Lan Yeung, Somayeh Zand, Iris Lav Žeželj, Bang Zheng, Andreas Zick, Claudia Zúñiga, N. Pontus Leander

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Abstract

Anxiety associated with the COVID-19 pandemic and home confinement has been associated with adverse health behaviors, such as unhealthy eating, smoking, and drinking. However, most studies have been limited by regional sampling, which precludes the examination of behavioral consequences associated with the pandemic at a global level. Further, few studies operationalized pandemic-related stressors to enable the investigation of the impact of different types of stressors on health outcomes. This study examined the association between perceived risk of COVID-19 infection and economic burden of COVID-19 with health-promoting and health-damaging behaviors using data from the PsyCorona Study: an international, longitudinal online study of psychological and behavioral correlates of COVID-19. Analyses utilized data from 7,402 participants from 86 countries across three waves of assessment between May 16 and June 13, 2020. Participants completed self-report measures of COVID-19 infection risk, COVID-19-related economic burden, physical exercise, diet quality, cigarette smoking, sleep quality, and binge drinking. Multilevel structural equation modeling analyses showed that across three time points, perceived economic burden was associated with reduced diet quality and sleep quality, as well as increased smoking. Diet quality and sleep quality were lowest among respondents who perceived high COVID-19 infection risk combined with high economic burden. Neither binge drinking nor exercise were associated with perceived COVID-19 infection risk, economic burden, or their interaction. Findings point to the value of developing interventions to address COVID-related stressors, which have an impact on health behaviors that, in turn, may influence vulnerability to COVID-19 and other health outcomes.

Original language	English
Article number	101764
Journal	Preventive Medicine Reports
Volume	27
Early online date	17 Mar 2022
DOIs	https://doi.org/10.1016/j.pmedr.2022.101764
Publication status	Published - Jun 2022

Keywords

COVID-19
Economic burden
Health behaviors
Infection risk

ASJC Scopus subject areas

Health Informatics
Public Health, Environmental and Occupational Health

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Keng, S-L., Stanton, M. V., Haskins, L. B., Almenara, C. A., Ickovics, J., Jones, A., Grigsby-Toussaint, D., Agostini, M., Bélanger, J. J., Gützkow, B., Kreienkamp, J., Lemay, E. P., vanDellen, M. R., Abakoumkin, G., Khaiyom, J. H. A., Ahmedi, V., Akkas, H., Atta, M., Bagci, S. C., ... Leander, N. P. (2022). COVID-19 Stressors and Health Behaviors: A Multilevel Longitudinal Study across 86 Countries. Preventive Medicine Reports, 27, [101764]. https://doi.org/10.1016/j.pmedr.2022.101764

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title = "COVID-19 Stressors and Health Behaviors: A Multilevel Longitudinal Study across 86 Countries",

abstract = "Anxiety associated with the COVID-19 pandemic and home confinement has been associated with adverse health behaviors, such as unhealthy eating, smoking, and drinking. However, most studies have been limited by regional sampling, which precludes the examination of behavioral consequences associated with the pandemic at a global level. Further, few studies operationalized pandemic-related stressors to enable the investigation of the impact of different types of stressors on health outcomes. This study examined the association between perceived risk of COVID-19 infection and economic burden of COVID-19 with health-promoting and health-damaging behaviors using data from the PsyCorona Study: an international, longitudinal online study of psychological and behavioral correlates of COVID-19. Analyses utilized data from 7,402 participants from 86 countries across three waves of assessment between May 16 and June 13, 2020. Participants completed self-report measures of COVID-19 infection risk, COVID-19-related economic burden, physical exercise, diet quality, cigarette smoking, sleep quality, and binge drinking. Multilevel structural equation modeling analyses showed that across three time points, perceived economic burden was associated with reduced diet quality and sleep quality, as well as increased smoking. Diet quality and sleep quality were lowest among respondents who perceived high COVID-19 infection risk combined with high economic burden. Neither binge drinking nor exercise were associated with perceived COVID-19 infection risk, economic burden, or their interaction. Findings point to the value of developing interventions to address COVID-related stressors, which have an impact on health behaviors that, in turn, may influence vulnerability to COVID-19 and other health outcomes.",

keywords = "COVID-19, Economic burden, Health behaviors, Infection risk",

author = "Shian-Ling Keng and Stanton, {Michael Vicente} and Haskins, {LeaAnn B.} and Almenara, {Carlos A.} and Jeannette Ickovics and Antwan Jones and Diana Grigsby-Toussaint and Maximilian Agostini and B{\'e}langer, {Jocelyn J.} and Ben G{\"u}tzkow and Jannis Kreienkamp and Lemay, {Edward P.} and vanDellen, {Michelle R.} and Georgios Abakoumkin and Khaiyom, {Jamilah Hanum Abdul} and Vjolica Ahmedi and Handan Akkas and Mohsin Atta and Bagci, {Sabahat Cigdem} and Sima Basel and Kida, {Edona Berisha} and Bernardo, {Allan B. I.} and Buttrick, {Nicholas R.} and Phatthanakit Chobthamkit and Hoon-Seok Choi and Mioara Cristea and S{\'a}ra Csaba and Kaja Damnjanovi{\'c} and Ivan Danyliuk and Arobindu Dash and {Di Santo}, Daniela and Douglas, {Karen M.} and Violeta Enea and Faller, {Daiane Gracieli} and Fitzsimons, {Gavan J.} and Alexandra Gheorghiu and {\'A}ngel G{\'o}mez and Ali Hamaidia and Qing Han and Mai Helmy and Joevarian Hudiyana and Jeronimus, {Bertus F.} and Ding-Yu Jiang and Veljko Jovanovi{\'c} and {\v Z}eljka Kamenov and Anna Kende and Kieu, {Tra Thi Thanh} and Yasin Ko{\c c} and Kamila Kovyazina and Inna Kozytska and Joshua Krause and Kruglanski, {Arie W.} and Anton Kurapov and Maja Kutlaca and Lantos, {N{\'o}ra Anna} and Lesmana, {Cokorda Bagus Jaya} and Louis, {Winnifred R.} and Adrian Lueders and Marta Maj and Malik, {Najma Iqbal} and Martinez, {Anton P.} and McCabe, {Kira O.} and Jasmina Mehuli{\'c} and Milla, {Mirra Noor} and Idris Mohammed and Erica Molinario and Manuel Moyano and Hayat Muhammad and Silvana Mula and Hamdi Muluk and Solomiia Myroniuk and Reza Najafi and Nisa, {Claudia F.} and Bogl{\'a}rka Ny{\'u}l and O'Keefe, {Paul A.} and {Olivas Osuna}, {Jose Javier} and Osin, {Evgeny N.} and Joonha Park and Gennaro Pica and Antonio Pierro and Rees, {Jonas H.} and Anne-Margit Reitsema and Elena Resta and Marika Rullo and Ryan, {Michelle K.} and Adil Samekin and Pekka Santtila and Edyta Sasin and Schumpe, {Birga M.} and Selim, {Heyla A.} and Wolfgang Stroebe and Sutton, {Robbie M.} and Eleftheria Tseliou and Akira Utsugi and {van Breen}, {Jolien Anne} and {van Lissa}, {Caspar J.} and Alexandra V{\'a}zquez and Robin Wollast and Yeung, {Victoria Wai-Lan} and Somayeh Zand and {\v Z}e{\v z}elj, {Iris Lav} and Bang Zheng and Andreas Zick and Claudia Z{\'u}{\~n}iga and Leander, {N. Pontus}",

note = "Funding Information: The authors would like to acknowledge Maleyka Mammadova for her assistance with literature review and data coding. This research received support from the New York University Abu Dhabi (VCDSF/75-71015), the University of Groningen (Sustainable Society & Ubbo Emmius Fund), and the Instituto de Salud Carlos III (COV20/00086). The COVID-19 risk perception item measured at baseline was previously reported in unrelated test of effects on subjective well-being and mental health. Publisher Copyright: {\textcopyright} 2022",

year = "2022",

month = jun,

doi = "10.1016/j.pmedr.2022.101764",

language = "English",

volume = "27",

journal = "Preventive Medicine Reports",

issn = "2211-3355",

publisher = "Elsevier",

}

Keng, S-L, Stanton, MV, Haskins, LB, Almenara, CA, Ickovics, J, Jones, A, Grigsby-Toussaint, D, Agostini, M, Bélanger, JJ, Gützkow, B, Kreienkamp, J, Lemay, EP, vanDellen, MR, Abakoumkin, G, Khaiyom, JHA, Ahmedi, V, Akkas, H, Atta, M, Bagci, SC, Basel, S, Kida, EB, Bernardo, ABI, Buttrick, NR, Chobthamkit, P, Choi, H-S, Cristea, M, Csaba, S, Damnjanović, K, Danyliuk, I, Dash, A, Di Santo, D, Douglas, KM, Enea, V, Faller, DG, Fitzsimons, GJ, Gheorghiu, A, Gómez, Á, Hamaidia, A, Han, Q, Helmy, M, Hudiyana, J, Jeronimus, BF, Jiang, D-Y, Jovanović, V, Kamenov, Ž, Kende, A, Kieu, TTT, Koç, Y, Kovyazina, K, Kozytska, I, Krause, J, Kruglanski, AW, Kurapov, A, Kutlaca, M, Lantos, NA, Lesmana, CBJ, Louis, WR, Lueders, A, Maj, M, Malik, NI, Martinez, AP, McCabe, KO, Mehulić, J, Milla, MN, Mohammed, I, Molinario, E, Moyano, M, Muhammad, H, Mula, S, Muluk, H, Myroniuk, S, Najafi, R, Nisa, CF, Nyúl, B, O'Keefe, PA, Olivas Osuna, JJ, Osin, EN, Park, J, Pica, G, Pierro, A, Rees, JH, Reitsema, A-M, Resta, E, Rullo, M, Ryan, MK, Samekin, A, Santtila, P, Sasin, E, Schumpe, BM, Selim, HA, Stroebe, W, Sutton, RM, Tseliou, E, Utsugi, A, van Breen, JA, van Lissa, CJ, Vázquez, A, Wollast, R, Yeung, VW-L, Zand, S, Žeželj, IL, Zheng, B, Zick, A, Zúñiga, C & Leander, NP 2022, 'COVID-19 Stressors and Health Behaviors: A Multilevel Longitudinal Study across 86 Countries', Preventive Medicine Reports, vol. 27, 101764. https://doi.org/10.1016/j.pmedr.2022.101764

TY - JOUR

T1 - COVID-19 Stressors and Health Behaviors: A Multilevel Longitudinal Study across 86 Countries

AU - Keng, Shian-Ling

AU - Stanton, Michael Vicente

AU - Haskins, LeaAnn B.

AU - Almenara, Carlos A.

AU - Ickovics, Jeannette

AU - Jones, Antwan

AU - Grigsby-Toussaint, Diana

AU - Agostini, Maximilian

AU - Bélanger, Jocelyn J.

AU - Gützkow, Ben

AU - Kreienkamp, Jannis

AU - Lemay, Edward P.

AU - vanDellen, Michelle R.

AU - Abakoumkin, Georgios

AU - Khaiyom, Jamilah Hanum Abdul

AU - Ahmedi, Vjolica

AU - Akkas, Handan

AU - Atta, Mohsin

AU - Bagci, Sabahat Cigdem

AU - Basel, Sima

AU - Kida, Edona Berisha

AU - Bernardo, Allan B. I.

AU - Buttrick, Nicholas R.

AU - Chobthamkit, Phatthanakit

AU - Choi, Hoon-Seok

AU - Cristea, Mioara

AU - Csaba, Sára

AU - Damnjanović, Kaja

AU - Danyliuk, Ivan

AU - Dash, Arobindu

AU - Di Santo, Daniela

AU - Douglas, Karen M.

AU - Enea, Violeta

AU - Faller, Daiane Gracieli

AU - Fitzsimons, Gavan J.

AU - Gheorghiu, Alexandra

AU - Gómez, Ángel

AU - Hamaidia, Ali

AU - Han, Qing

AU - Helmy, Mai

AU - Hudiyana, Joevarian

AU - Jeronimus, Bertus F.

AU - Jiang, Ding-Yu

AU - Jovanović, Veljko

AU - Kamenov, Željka

AU - Kende, Anna

AU - Kieu, Tra Thi Thanh

AU - Koç, Yasin

AU - Kovyazina, Kamila

AU - Kozytska, Inna

AU - Krause, Joshua

AU - Kruglanski, Arie W.

AU - Kurapov, Anton

AU - Kutlaca, Maja

AU - Lantos, Nóra Anna

AU - Lesmana, Cokorda Bagus Jaya

AU - Louis, Winnifred R.

AU - Lueders, Adrian

AU - Maj, Marta

AU - Malik, Najma Iqbal

AU - Martinez, Anton P.

AU - McCabe, Kira O.

AU - Mehulić, Jasmina

AU - Milla, Mirra Noor

AU - Mohammed, Idris

AU - Molinario, Erica

AU - Moyano, Manuel

AU - Muhammad, Hayat

AU - Mula, Silvana

AU - Muluk, Hamdi

AU - Myroniuk, Solomiia

AU - Najafi, Reza

AU - Nisa, Claudia F.

AU - Nyúl, Boglárka

AU - O'Keefe, Paul A.

AU - Olivas Osuna, Jose Javier

AU - Osin, Evgeny N.

AU - Park, Joonha

AU - Pica, Gennaro

AU - Pierro, Antonio

AU - Rees, Jonas H.

AU - Reitsema, Anne-Margit

AU - Resta, Elena

AU - Rullo, Marika

AU - Ryan, Michelle K.

AU - Samekin, Adil

AU - Santtila, Pekka

AU - Sasin, Edyta

AU - Schumpe, Birga M.

AU - Selim, Heyla A.

AU - Stroebe, Wolfgang

AU - Sutton, Robbie M.

AU - Tseliou, Eleftheria

AU - Utsugi, Akira

AU - van Breen, Jolien Anne

AU - van Lissa, Caspar J.

AU - Vázquez, Alexandra

AU - Wollast, Robin

AU - Yeung, Victoria Wai-Lan

AU - Zand, Somayeh

AU - Žeželj, Iris Lav

AU - Zheng, Bang

AU - Zick, Andreas

AU - Zúñiga, Claudia

AU - Leander, N. Pontus

N1 - Funding Information: The authors would like to acknowledge Maleyka Mammadova for her assistance with literature review and data coding. This research received support from the New York University Abu Dhabi (VCDSF/75-71015), the University of Groningen (Sustainable Society & Ubbo Emmius Fund), and the Instituto de Salud Carlos III (COV20/00086). The COVID-19 risk perception item measured at baseline was previously reported in unrelated test of effects on subjective well-being and mental health. Publisher Copyright: © 2022

PY - 2022/6

Y1 - 2022/6

N2 - Anxiety associated with the COVID-19 pandemic and home confinement has been associated with adverse health behaviors, such as unhealthy eating, smoking, and drinking. However, most studies have been limited by regional sampling, which precludes the examination of behavioral consequences associated with the pandemic at a global level. Further, few studies operationalized pandemic-related stressors to enable the investigation of the impact of different types of stressors on health outcomes. This study examined the association between perceived risk of COVID-19 infection and economic burden of COVID-19 with health-promoting and health-damaging behaviors using data from the PsyCorona Study: an international, longitudinal online study of psychological and behavioral correlates of COVID-19. Analyses utilized data from 7,402 participants from 86 countries across three waves of assessment between May 16 and June 13, 2020. Participants completed self-report measures of COVID-19 infection risk, COVID-19-related economic burden, physical exercise, diet quality, cigarette smoking, sleep quality, and binge drinking. Multilevel structural equation modeling analyses showed that across three time points, perceived economic burden was associated with reduced diet quality and sleep quality, as well as increased smoking. Diet quality and sleep quality were lowest among respondents who perceived high COVID-19 infection risk combined with high economic burden. Neither binge drinking nor exercise were associated with perceived COVID-19 infection risk, economic burden, or their interaction. Findings point to the value of developing interventions to address COVID-related stressors, which have an impact on health behaviors that, in turn, may influence vulnerability to COVID-19 and other health outcomes.

AB - Anxiety associated with the COVID-19 pandemic and home confinement has been associated with adverse health behaviors, such as unhealthy eating, smoking, and drinking. However, most studies have been limited by regional sampling, which precludes the examination of behavioral consequences associated with the pandemic at a global level. Further, few studies operationalized pandemic-related stressors to enable the investigation of the impact of different types of stressors on health outcomes. This study examined the association between perceived risk of COVID-19 infection and economic burden of COVID-19 with health-promoting and health-damaging behaviors using data from the PsyCorona Study: an international, longitudinal online study of psychological and behavioral correlates of COVID-19. Analyses utilized data from 7,402 participants from 86 countries across three waves of assessment between May 16 and June 13, 2020. Participants completed self-report measures of COVID-19 infection risk, COVID-19-related economic burden, physical exercise, diet quality, cigarette smoking, sleep quality, and binge drinking. Multilevel structural equation modeling analyses showed that across three time points, perceived economic burden was associated with reduced diet quality and sleep quality, as well as increased smoking. Diet quality and sleep quality were lowest among respondents who perceived high COVID-19 infection risk combined with high economic burden. Neither binge drinking nor exercise were associated with perceived COVID-19 infection risk, economic burden, or their interaction. Findings point to the value of developing interventions to address COVID-related stressors, which have an impact on health behaviors that, in turn, may influence vulnerability to COVID-19 and other health outcomes.

KW - COVID-19

KW - Economic burden

KW - Health behaviors

KW - Infection risk

UR - http://www.scopus.com/inward/record.url?scp=85126622555&partnerID=8YFLogxK

U2 - 10.1016/j.pmedr.2022.101764

DO - 10.1016/j.pmedr.2022.101764

M3 - Article

C2 - 35313454

SN - 2211-3355

VL - 27

JO - Preventive Medicine Reports

JF - Preventive Medicine Reports

M1 - 101764

ER -

COVID-19 Stressors and Health Behaviors: A Multilevel Longitudinal Study across 86 Countries

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