JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has imposed global health crisis. In response to the same, social isolation measures had been implemented across many countries to contain the spread of the virus. Though essential for controlling the viral spread, such measures if implemented for long durations are expected to modify lifestyle behaviors such as the increased adoption of unhealthy nutrition and sedentary behavior.

Objective:

Given the lack of enough real-time data on the public response on the lifestyle-behavior changes during the health crisis of COVID-19 pandemic, we decided to conduct a cross-national survey on the health perceptions of general public and their influence on the status of adopted lifestyle behaviors across respondents from different countries.

Methods:

A cross-national web-based open-labeled survey was administered using Google forms during the month of April-2020. The settings were China, Japan, Italy, and India. There were two primary outcomes; 1) composite subjective health status 2) adoption of recommended lifestyle behaviors. Statistical associations were assessed with regression analyses.

Results:

There was a low-moderate representation of very good/excellent response to self-rated measures of physical and mental health across the nations (40.3% and 28.0%); however, 78.4% of respondents adopted healthy lifestyle choices. Female gender (OR=1.35, 95%CI=1.07-1.69), increased family cohesion (FC) (OR=1.48, 95% CI=1.04-2.11) and self-rated mental health (OR=1.69, 95% CI, 1.35-2.1)] were significant predictors of adoption of at least-2 healthy lifestyle choices (AHLC). Importantly, perception related to the pandemic situation strongly predicted AHLC (OR=5.27, 95% CI=3.61-7.69), and incorporation of this variable in the regression model attenuated the association between HLC and FR.

Conclusions:

Interestingly, we observed significantly positive public responses towards adopting healthy lifestyle choices amidst the fear of COVID-19 indicating fair motivation for self-care. Positive perception of self-rated health and increased FC seemed to buffer the void of social disconnectedness. Importantly, health-seeking public perception about the pandemic played a critical role in AHLC and mediated the influence of FC on behavior. Such favorable behavioral changes should be bolstered through enhanced health awareness, realistic communications and issue of advisory guidelines.