UK Adults’ Exercise Locations, Use of Digital Programs and Associations with Physical Activity During the COVID-19 Pandemic: Longitudinal Analysis of Data from the Health Behaviors During the COVID-19 Pandemic Study (Preprint)

Abstract

Digital physical activity (PA) program use has been associated with higher PA guideline adherence during COVID-19 pandemic confinements. However, little is known longitudinally about exercise locations (inside vs outside the home environment), digital program use and their associations with moderate-to-vigorous PA (MVPA) and muscle-strengthening activities (MSA) during the pandemic.

To assess the relationship between exercise location and use of digital programs with PA guideline adherence during the COVID-19 pandemic; to describe how individuals exercised inside and outside of their home environments; to explore which socio-demographic and contextual predictors were associated with exercise locations and digital PA program use.

UK adults (N=1,938) who participated in the 1-month follow-up survey of the HEBECO study (FU1, June/July 2020) and at least one more follow-up survey (FU2, August/September; FU3, November/December 2020) and who engaged in any MVPA or MSA were included. Participants reported exercise locations, types of exercises inside and outside their homes including digital programs (online or app-based fitness classes/programs), MVPA and MSA. Generalized linear mixed models assessed associations of exercise location and digital PA program use with PA guideline adherence (MVPA, MSA, full (combined) adherence), and predictors of exercise location and digital program use.

As the pandemic progressed, UK adults were less likely to exercise inside or to use digital PA programs compared with periods of initial confinement: 60% (weighted n=1,024), 50% (786) and 49% (723) did any exercise inside their homes at FU1, FU2 and FU3, respectively. Twenty-two percent (385), 17% (265) and 16% (241) used digital PA programs, respectively. Most participants who exercised inside indicated using already owned indoor equipment, digital PA programs or own workout routines, while MVPA and gentle walking were the most frequently reported exercise types outside people’s homes. Being female, non-white, having a condition limiting PA, indoor space, a lower BMI and living in total isolation were associated with increased odds to exercise inside one’s home or garden compared with outside only. Digital PA programs users were more likely to be younger, female, highly educated, have indoor space to exercise and a lower body mass index (BMI). While exercising inside was positively associated with MSA and exercising outside with MVPA guideline adherence, both inside (vs outside only) and outside activities (vs inside only) contributed to full PA guideline adherence (OR=5.05, 95% CI 3.17-8.03, and OR=1.89, 95% CI 1.10-3.23). Digital PA program use was associated with higher odds of MSA (OR ranges=3.97-8.71) and full PA (OR ranges=2.24-3.95), but not with MVPA guideline adherence.

During the COVID-19 pandemic, full PA guideline adherence was associated with exercising inside and outside of one’s home environment and using digital PA programs. More research is needed to understand reach, long-term adherence, and differences between digital PA programs.