Your study revealed major lifestyle and mental health disruptions among University of Pittsburgh students during the COVID-19 pandemic. For example, you found that 61% of the participants were at risk for depression, which was a 90% increase over the baseline rate of 32% two months earlier, prior to COVID-19. What do you think could be some of the factors associated with this rise in depression (beyond physical activity)?
As we document in the paper, the COVID-19 pandemic has disrupted the way students live, learn, and interact. On top of changes in physical activity and sleep habits, we also see big changes in how students spend their time, with a large increase in the number of hours students spend on screens (video games, browsing the web, etc., without considering online learning), which more than doubled at the onset of the pandemic. At the same time, we observed that time spent socializing declined by over half, to less than 30 minutes per day. The lack of social interactions might have contributed to the large rise in depression. At the beginning of the pandemic, students suddenly had to move away from campus, missing out on many opportunities to socialize. There are also other factors that we did not measure, which likely affected depression rates — for example the difficulties related to the move to online education or the concerns over family and friends getting infected.
Your team did find a link between physical activity and mental health, so you randomized half your participants to receive incentives for walking at least 10,000 steps per day for 2 weeks. While this intervention did lead to increased steps and physical activity, your team found that this did not translate to improvements in mental health. What do you make of that?
That’s correct. Motivated by the link between reduction in physical activity and depression we observed in our data, as well as by prior work suggesting that improving exercising could help mental well-being, we randomized half the participants to receive incentives for walking at least 10,000 steps per day for 2 weeks. The intervention helped restore pre-pandemic levels of exercising in the treated group. However, it did not have any meaningful impact on mental well-being. This result opens up a few possibilities. One possibility is the intervention was too short. Indeed, other work on physical activity and mental health has focused on interventions that encourage exercising over a more extended period. In our context, the decline in physical activity (and in mental health) happened rapidly, over the course of a few weeks, but it could be that restoring mental health requires a longer intervention. Another possibility is that the restoration of physical activity may be more effective if done in conjunction with the restoration of other lifestyle habits that have been disrupted by the pandemic (e.g., social interactions). Finally, another possibility is that the relationship between mental health and disruptions in physical activity during COVID-19 is driven more by mental health rather than lifestyle, and that changes in lifestyle may be symptoms of depression. More work is needed to further understand these possibilities and shed more light on the link between lifestyle habits and well-being.
What do you think colleges and universities should do with this information?
The large rise in depression rates we observed in our study — which was also documented by other work — is alarming. We continued tracking lifestyle and depression last fall 2020 and this spring 2021, and although the rates of depression are lower now than they were at the onset of the pandemic, we still see higher prevalence of depression symptoms than we saw before the beginning of the pandemic. My collaborators and I think colleges and universities should raise awareness and normalize the discussion around mental health in order to minimize the stigma associated with seeking help. As the pandemic continues to unfold, it would be also important to create opportunities for students to remain engaged and connected and to consider more flexible approaches to deadlines given the frequency of pandemic burnout. Finally, we think universities should start considering students’ physical and mental health together, as the two are closely connected.
What’s next for you? What are you working on now?
We are continuing to track lifestyle behavior among college students using wearable trackers with the goal of understanding habit formation in the field. As part of this effort, we also plan to continue tracking mental well-being and potentially design interventions to improve it. I am very excited about another project that is highly relevant right now: encouraging take-up of the COVID-19 vaccine via RCTs with a large hospital. I am working on field projects in the area, with a fantastic team of collaborators including Hengchen Dai from UCLA, and I hope to have more to share soon!