Document Type : Original Article
Author
Abstract
BACKGROUND: Social distancing policy during the COVID‑19 pandemic may affect physical activity
levels. This study aimed to compare physical activity levels before and during the pandemic and to
explore physical activity correlates among Indonesian young adults.
MATERIALS AND METHODS: This longitudinal study was conducted before the pandemic (n = 141)
in September 2019 and was followed by an online follow‑up survey during the pandemic
(79% response rate) in September 2020. Physical activity was measured using the global physical
activity questionnaire and was classified into “sufficient” and “insufficient.” The potential correlates
of physical activity were constructs from social‑cognitive theory and health belief model. Those were
measured using a validated questionnaire in the follow‑up survey. Physical activity levels before and
during pandemics were compared using the Wilcoxon signed‑rank test. Simple logistic regressions
were used to assess the relationships between each potential correlate and physical activity status
during the pandemic.
RESULTS: Physical activity levels decreased significantly during the pandemic, mostly in the
work‑related domain. Participants with favorable physical activity‑related constructs were more likely
to be physically active. The odds ratio ranged from 3.41 (95% confidence interval [CI] = 1.15–10.11)
in participants with higher self‑efficacy to 4.50 (95% CI = 1.44–14.06) in those with higher outcome
expectations of physical activity.
CONCLUSION: A significant decline in physical activity during the COVID‑19 pandemic among
Indonesian young adults was confirmed. The application of behavioral change theories for explaining
physical activity status during the pandemic in this population is also supported. It is recommended
to incorporate these constructs to develop physical activity interventions in this target population.
Keywords
1. El‑Solh AA, Meduri UG, Lawson Y, Carter M, Mergenhagen KA.
Clinical course and outcome of COVID‑19 acute respiratory
distress syndrome: Data from a National repository. J Intensive
Care Med 2021;36:664‑72.
2. INSPIRATION Investigators; Sadeghipour P, Talasaz AH,
Rashidi F, Sharif‑Kashani B, Beigmohammadi MT, et al. Effect of
intermediate‑dose vs. standard‑dose prophylactic anticoagulation
on thrombotic events, extracorporeal membrane oxygenation
treatment, or mortality among patients with COVID‑19 admitted
to the intensive care unit: The INSPIRATION randomized clinical
trial. JAMA 2021;325:1620‑30.
3. Sarkodie SA, Owusu PA. Global assessment of environment,
health and economic impact of the novel coronavirus (COVID‑19).
Environ Dev Sustain 2021; 23:5005–5015.
4. Mofijur M, Fattah IM, Alam MA, Islam AB, Ong HC, Rahman SM,
et al. Impact of COVID‑19 on the social, economic, environmental
and energy domains: Lessons learnt from a global pandemic.
Sustain Prod Consum 2021;26:343‑59.
5. Dwinantoaji H, Sumarni D. Human security, social stigma, and
global health: The COVID‑19 pandemic in Indonesia. J Med
Sci (Berkala Ilmu Kedokteran) 2020;52:158‑165.
6. Xiao Y, Tang B, Wu J, Cheke RA, Tang S. Linking key intervention
timing to rapid decline of the COVID‑19 effective reproductive
number to quantify lessons from mainland China. Int J Infect Dis
2020;97:296‑8.
7. Baker MG, Wilson N, Anglemyer A. Successful Elimination
of Covid‑19 Transmission in New Zealand. N Engl J Med
2020;383:e56.
8. Sari DK, Amelia R, Dharmajaya R, Sari LM, Fitri NK. Positive
correlation between general public knowledge and attitudes
regarding COVID‑19 outbreak 1 month after first cases reported
in Indonesia. J Community Health 2021;46:182‑9.
9. Syuhada K, Wibisono A, Hakim A, Addini F. COVID‑19 risk
data during lockdown‑like policy in Indonesia. Data Brief
2021;35:106801.
10. Rimbawati PR. Indonesia’s Response to COVID‑19: Between
economics, public health, and social media. In: The Reshaping
of China‑Southeast Asia Relations in Light of the COVID‑19
Pandemic. Springer, Singapore; 2021. p. 137‑65.
11. Irawan MZ, Belgiawan PF, Joewono TB, Bastarianto FF,
Rizki M, Ilahi A. Exploring activity‑travel behavior changes
during the beginning of COVID‑19 pandemic in Indonesia.
Transportation (Amst) 2021:1‑25.
12. Dwidienawati D, Tjahjana D, Pradipto YD, Gandasari D. The
impact of mobility restriction on happiness and satisfaction in life
during COVID‑19 outbreak in Indonesia. Journal Of Southwest
Jiaotong University 2021; 56:111‑123
13. Abidah A, Hidaayatullaah HN, Simamora RM, Fehabutar D,
Mutakinati L. The impact of COVID‑19 to Indonesian education
and its relation to the philosophy of “Merdeka Belajar”. Stud
Philos Sci Educ 2020;1:38‑49.
14. Stockwell S, Trott M, Tully M, Shin J, Barnett Y, Butler L, et al.
Changes in physical activity and sedentary behaviours from
before to during the COVID‑19 pandemic lockdown: A systematic
review. BMJ Open Sport Exerc Med 2021;7:e000960.
15. Laddu DR, Lavie CJ, Phillips SA, Arena R. Physical activity for
immunity protection: Inoculating populations with healthy living
medicine in preparation for the next pandemic. Prog Cardiovasc
Dis 2021;64:102‑4.
16. da Silveira MP, da Silva Fagundes KK, Bizuti MR, Starck É,
Rossi RC, de Resende E Silva DT. Physical exercise as a tool to
help the immune system against COVID‑19: An integrative review
of the current literature. Clin Exp Med 2021;21:15‑28.
17. Nigro E, Polito R, Alfieri A, Mancini A, Imperlini E, Elce A,
et al. Molecular mechanisms involved in the positive effects of
physical activity on coping with COVID‑19. Eur J Appl Physiol
2020;120:2569‑82.
18. Wood CJ, Clow A, Hucklebridge F, Law R, Smyth N. Physical
fitness and prior physical activity are both associated with less
cortisol secretion during psychosocial stress. Anxiety Stress
Coping 2018;31:135‑45.
19. Arovah NI, Kushartanti BM. Moderate vigorous physical activity
and clinical parameters in adults with type 2 diabetes mellitus.
Rom J Diabetes Nutr Metab Dis 2019;26:107‑17.
20. Marques‑Aleixo I, Santos‑Alves E, Balça MM, Rizo‑Roca D,
Moreira PI, Oliveira PJ, et al. Physical exercise improves brain cortex and cerebellum mitochondrial bioenergetics and alters
apoptotic, dynamic and auto (mito) phagy markers. Neuroscience
2015;301:480‑95.
21. Simpson RJ, Kunz H, Agha N, Graff R. Exercise and the
regulation of immune functions. Prog Mol Biol Transl Sci
2015;135:355‑80.
22. Arovah NI, Kushartanti BW. The acute effect of a moderate
intensity ergocycle exercise on the coagulation parameters in
type 2 diabetes mellitus patients: A feasibility study. Clin Diabetol
2020;9:219‑25.
23. Zheng Q, Cui G, Chen J, Gao H, Wei Y, Uede T, et al. Regular
exercise enhances the immune response against microbial
antigens through up‑regulation of toll‑like receptor signaling
pathways. Cell Physiol Biochem 2015;37:735‑46.
24. Sallis R, Young DR, Tartof SY, Sallis JF, Sall J, Li Q, et al. Physical
inactivity is associated with a higher risk for severe COVID‑19
outcomes: A study in 48 440 adult patients. Br J Sports Med
2021;55:1099‑105.
25. Ghassab‑Abdollahi N, Shakouri SK, Aghdam AT,
Farshbaf‑Khalili A, Abdolalipour S, Farshbaf‑Khalili A.
Association of quality of life with physical activity, depression,
and demographic characteristics and its predictors among medical
students. J Educ Health Promot 2020;9:147.
26. Rhodes RE, McEwan D, Rebar AL. Theories of physical activity
behaviour change: A history and synthesis of approaches. Psychol
Sport Exerc 2019;42:100‑9.
27. Murray JM, Brennan SF, French DP, Patterson CC, Kee F,
Hunter RF. Effectiveness of physical activity interventions in
achieving behaviour change maintenance in young and middle
aged adults: A systematic review and meta‑analysis. Soc Sci Med
2017;192:125‑33.
28. Avery L, Flynn D, van Wersch A, Sniehotta FF, Trenell MI.
Changing physical activity behavior in type 2 diabetes:
Asystematic review and meta‑analysis of behavioral interventions.
Diabetes Care 2012;35:2681‑9.
29. Qiu S, Cai X, Chen X, Yang B, Sun Z. Step counter use in type 2
diabetes: A meta‑analysis of randomized controlled trials. BMC
Med 2014;12:36.
30. Mirzaei A, Kazembeigi F, Kakaei H, Jalilian M, Mazloomi S,
Nourmoradi H. Application of health belief model to predict
COVID‑19‑preventive behaviors among a sample of Iranian adult
population. J Educ Health Promot 2021;10:69.
31. Arceo E, Jurado JE, Cortez LA, Sibug N, Sarmiento GL,
Lawingco AC, et al. Understanding COVID‑19 preventive
behavior: An application of the health belief model in the
Philippine setting. J Educ Health Promot 2021;10:228.
32. Luszczynska A, Schwarzer R. Social cognitive theory. Predicting
Health Behav 2005;2:127‑69.
33. Young MD, Plotnikoff R, Collins C, Callister R, Morgan P. Social
cognitive theory and physical activity: A systematic review and
meta‐analysis. Obes Rev 2014;15:983‑95.
34. Tison GH, Avram R, Kuhar P, Abreau S, Marcus GM, Pletcher MJ,
et al. Worldwide effect of COVID‑19 on physical activity:
A descriptive study. Ann Intern Med 2020;173:767‑70.
35. Armstrong T, Bull F. Development of the world health
organization Global Physical Activity Questionnaire (GPAQ).
J Public Health 2006;14:66‑70.
36. Bull FC, Maslin TS, Armstrong T. Global Physical Activity
Questionnaire (GPAQ): Nine country reliability and validity
study. J Phys Act Health 2009;6:790‑804.
37. Champion VL, Skinner CS. The health belief model. In: Health
Behavior and Health Education: Theory, Research, and Practice.
Vol. 4. Jossey‑Bass, San Francisco; 2008. p. 45‑65.
38. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation
of instruments or scales for use in cross‑cultural health care
research: A clear and user‑friendly guideline. J Eval Clin Pract
2011;17:268‑74.
39. Bachtiar F, Utari D, Maharani FT, editors. Physical Activity
Levels of Adults During Covid‑19 Quarantine in Indonesia:
A Cross‑Sectional Descriptive Study. International Conference
of Health Development COVID‑19 and the Role of Healthcare
Workers in the Industrial Era (ICHD 2020) Atlantis Press; 2020.
40. Masnarivan Y, Haq A, Putri AP, editors. Study of COVID‑19
Prevention: Diet and Physical Activity During Large‑Scale Social
Restrictions in West Sumatera. International Conference of Health
Development COVID‑19 and the Role of Healthcare Workers in
the Industrial Era (ICHD 2020) Atlantis Press; 2020.
41. Robinson E, Boyland E, Chisholm A, Harrold J, Maloney NG,
Marty L, et al. Obesity, eating behavior and physical activity
during COVID‑19 lockdown: A study of UK adults. Appetite
2021;156:104853.
42. Gallo LA, Gallo TF, Young SL, Moritz KM, Akison LK. The
impact of isolation measures due to COVID‑19 on energy intake
and physical activity levels in Australian university students.
Nutrients 2020;12:1865.
43. Miljanovic Damjanovic V, Obradovic Salcin L, Zenic N, Foretic N,
Liposek S. Identifying predictors of changes in physical activity
level in adolescence: A prospective analysis in Bosnia and
Herzegovina. Int J Environ Res Public Health 2019;16:2573.
44. Lesser IA, Nienhuis CP. The impact of COVID‑19 on physical
activity behavior and well‑being of Canadians. Int J Environ Res
Public Health 2020;17:3899.
45. Plotnikoff RC, Costigan SA, Karunamuni N, Lubans DR. Social
cognitive theories used to explain physical activity behavior in
adolescents: A systematic review and meta‑analysis. Prev Med
2013;56:245‑53.
46. White SM, Wójcicki TR, McAuley E. Social cognitive influences
on physical activity behavior in middle‑aged and older adults.
J Gerontol B Psychol Sci Soc Sci 2012;67:18‑26.
47. Ayotte BJ, Margrett JA, Hicks‑Patrick J. Physical activity in
middle‑aged and young‑old adults: The roles of self‑efficacy,
barriers, outcome expectancies, self‑regulatory behaviors and
social support. J Health Psychol 2010;15:173‑85.
48. Sterdt E, Liersch S, Walter U. Correlates of physical activity of
children and adolescents: A systematic review of reviews. Health
Educ J 2014;73:72‑89.
49. Zhang KM, Tulloch HE, Brunet J, Pipe AL, Reid RD, Prince SA,
et al. What motivates nurses to exercise? Determinants of physical
activity among Canadian nurses using self‑determination theory.
Ann Behav Med 2020;54:381‑90.
50. Kaushal N, Keith N, Aguiñaga S, Hagger MS. Social cognition
and socioecological predictors of home‑based physical activity
intentions, planning, and habits during the COVID‑19 pandemic.
Behav Sci (Basel) 2020;10:133.
51. Heukelum S. Physical Activity and Change in Vigorous Physical
Activity during the COVID‑19 Confinement in the Netherlands:
Possible Associations with Perceived Vulnerability, Self‑efficacy
and Big‑Five Personality Traits: University of Twente; 2020.
Clinical course and outcome of COVID‑19 acute respiratory
distress syndrome: Data from a National repository. J Intensive
Care Med 2021;36:664‑72.
2. INSPIRATION Investigators; Sadeghipour P, Talasaz AH,
Rashidi F, Sharif‑Kashani B, Beigmohammadi MT, et al. Effect of
intermediate‑dose vs. standard‑dose prophylactic anticoagulation
on thrombotic events, extracorporeal membrane oxygenation
treatment, or mortality among patients with COVID‑19 admitted
to the intensive care unit: The INSPIRATION randomized clinical
trial. JAMA 2021;325:1620‑30.
3. Sarkodie SA, Owusu PA. Global assessment of environment,
health and economic impact of the novel coronavirus (COVID‑19).
Environ Dev Sustain 2021; 23:5005–5015.
4. Mofijur M, Fattah IM, Alam MA, Islam AB, Ong HC, Rahman SM,
et al. Impact of COVID‑19 on the social, economic, environmental
and energy domains: Lessons learnt from a global pandemic.
Sustain Prod Consum 2021;26:343‑59.
5. Dwinantoaji H, Sumarni D. Human security, social stigma, and
global health: The COVID‑19 pandemic in Indonesia. J Med
Sci (Berkala Ilmu Kedokteran) 2020;52:158‑165.
6. Xiao Y, Tang B, Wu J, Cheke RA, Tang S. Linking key intervention
timing to rapid decline of the COVID‑19 effective reproductive
number to quantify lessons from mainland China. Int J Infect Dis
2020;97:296‑8.
7. Baker MG, Wilson N, Anglemyer A. Successful Elimination
of Covid‑19 Transmission in New Zealand. N Engl J Med
2020;383:e56.
8. Sari DK, Amelia R, Dharmajaya R, Sari LM, Fitri NK. Positive
correlation between general public knowledge and attitudes
regarding COVID‑19 outbreak 1 month after first cases reported
in Indonesia. J Community Health 2021;46:182‑9.
9. Syuhada K, Wibisono A, Hakim A, Addini F. COVID‑19 risk
data during lockdown‑like policy in Indonesia. Data Brief
2021;35:106801.
10. Rimbawati PR. Indonesia’s Response to COVID‑19: Between
economics, public health, and social media. In: The Reshaping
of China‑Southeast Asia Relations in Light of the COVID‑19
Pandemic. Springer, Singapore; 2021. p. 137‑65.
11. Irawan MZ, Belgiawan PF, Joewono TB, Bastarianto FF,
Rizki M, Ilahi A. Exploring activity‑travel behavior changes
during the beginning of COVID‑19 pandemic in Indonesia.
Transportation (Amst) 2021:1‑25.
12. Dwidienawati D, Tjahjana D, Pradipto YD, Gandasari D. The
impact of mobility restriction on happiness and satisfaction in life
during COVID‑19 outbreak in Indonesia. Journal Of Southwest
Jiaotong University 2021; 56:111‑123
13. Abidah A, Hidaayatullaah HN, Simamora RM, Fehabutar D,
Mutakinati L. The impact of COVID‑19 to Indonesian education
and its relation to the philosophy of “Merdeka Belajar”. Stud
Philos Sci Educ 2020;1:38‑49.
14. Stockwell S, Trott M, Tully M, Shin J, Barnett Y, Butler L, et al.
Changes in physical activity and sedentary behaviours from
before to during the COVID‑19 pandemic lockdown: A systematic
review. BMJ Open Sport Exerc Med 2021;7:e000960.
15. Laddu DR, Lavie CJ, Phillips SA, Arena R. Physical activity for
immunity protection: Inoculating populations with healthy living
medicine in preparation for the next pandemic. Prog Cardiovasc
Dis 2021;64:102‑4.
16. da Silveira MP, da Silva Fagundes KK, Bizuti MR, Starck É,
Rossi RC, de Resende E Silva DT. Physical exercise as a tool to
help the immune system against COVID‑19: An integrative review
of the current literature. Clin Exp Med 2021;21:15‑28.
17. Nigro E, Polito R, Alfieri A, Mancini A, Imperlini E, Elce A,
et al. Molecular mechanisms involved in the positive effects of
physical activity on coping with COVID‑19. Eur J Appl Physiol
2020;120:2569‑82.
18. Wood CJ, Clow A, Hucklebridge F, Law R, Smyth N. Physical
fitness and prior physical activity are both associated with less
cortisol secretion during psychosocial stress. Anxiety Stress
Coping 2018;31:135‑45.
19. Arovah NI, Kushartanti BM. Moderate vigorous physical activity
and clinical parameters in adults with type 2 diabetes mellitus.
Rom J Diabetes Nutr Metab Dis 2019;26:107‑17.
20. Marques‑Aleixo I, Santos‑Alves E, Balça MM, Rizo‑Roca D,
Moreira PI, Oliveira PJ, et al. Physical exercise improves brain cortex and cerebellum mitochondrial bioenergetics and alters
apoptotic, dynamic and auto (mito) phagy markers. Neuroscience
2015;301:480‑95.
21. Simpson RJ, Kunz H, Agha N, Graff R. Exercise and the
regulation of immune functions. Prog Mol Biol Transl Sci
2015;135:355‑80.
22. Arovah NI, Kushartanti BW. The acute effect of a moderate
intensity ergocycle exercise on the coagulation parameters in
type 2 diabetes mellitus patients: A feasibility study. Clin Diabetol
2020;9:219‑25.
23. Zheng Q, Cui G, Chen J, Gao H, Wei Y, Uede T, et al. Regular
exercise enhances the immune response against microbial
antigens through up‑regulation of toll‑like receptor signaling
pathways. Cell Physiol Biochem 2015;37:735‑46.
24. Sallis R, Young DR, Tartof SY, Sallis JF, Sall J, Li Q, et al. Physical
inactivity is associated with a higher risk for severe COVID‑19
outcomes: A study in 48 440 adult patients. Br J Sports Med
2021;55:1099‑105.
25. Ghassab‑Abdollahi N, Shakouri SK, Aghdam AT,
Farshbaf‑Khalili A, Abdolalipour S, Farshbaf‑Khalili A.
Association of quality of life with physical activity, depression,
and demographic characteristics and its predictors among medical
students. J Educ Health Promot 2020;9:147.
26. Rhodes RE, McEwan D, Rebar AL. Theories of physical activity
behaviour change: A history and synthesis of approaches. Psychol
Sport Exerc 2019;42:100‑9.
27. Murray JM, Brennan SF, French DP, Patterson CC, Kee F,
Hunter RF. Effectiveness of physical activity interventions in
achieving behaviour change maintenance in young and middle
aged adults: A systematic review and meta‑analysis. Soc Sci Med
2017;192:125‑33.
28. Avery L, Flynn D, van Wersch A, Sniehotta FF, Trenell MI.
Changing physical activity behavior in type 2 diabetes:
Asystematic review and meta‑analysis of behavioral interventions.
Diabetes Care 2012;35:2681‑9.
29. Qiu S, Cai X, Chen X, Yang B, Sun Z. Step counter use in type 2
diabetes: A meta‑analysis of randomized controlled trials. BMC
Med 2014;12:36.
30. Mirzaei A, Kazembeigi F, Kakaei H, Jalilian M, Mazloomi S,
Nourmoradi H. Application of health belief model to predict
COVID‑19‑preventive behaviors among a sample of Iranian adult
population. J Educ Health Promot 2021;10:69.
31. Arceo E, Jurado JE, Cortez LA, Sibug N, Sarmiento GL,
Lawingco AC, et al. Understanding COVID‑19 preventive
behavior: An application of the health belief model in the
Philippine setting. J Educ Health Promot 2021;10:228.
32. Luszczynska A, Schwarzer R. Social cognitive theory. Predicting
Health Behav 2005;2:127‑69.
33. Young MD, Plotnikoff R, Collins C, Callister R, Morgan P. Social
cognitive theory and physical activity: A systematic review and
meta‐analysis. Obes Rev 2014;15:983‑95.
34. Tison GH, Avram R, Kuhar P, Abreau S, Marcus GM, Pletcher MJ,
et al. Worldwide effect of COVID‑19 on physical activity:
A descriptive study. Ann Intern Med 2020;173:767‑70.
35. Armstrong T, Bull F. Development of the world health
organization Global Physical Activity Questionnaire (GPAQ).
J Public Health 2006;14:66‑70.
36. Bull FC, Maslin TS, Armstrong T. Global Physical Activity
Questionnaire (GPAQ): Nine country reliability and validity
study. J Phys Act Health 2009;6:790‑804.
37. Champion VL, Skinner CS. The health belief model. In: Health
Behavior and Health Education: Theory, Research, and Practice.
Vol. 4. Jossey‑Bass, San Francisco; 2008. p. 45‑65.
38. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation
of instruments or scales for use in cross‑cultural health care
research: A clear and user‑friendly guideline. J Eval Clin Pract
2011;17:268‑74.
39. Bachtiar F, Utari D, Maharani FT, editors. Physical Activity
Levels of Adults During Covid‑19 Quarantine in Indonesia:
A Cross‑Sectional Descriptive Study. International Conference
of Health Development COVID‑19 and the Role of Healthcare
Workers in the Industrial Era (ICHD 2020) Atlantis Press; 2020.
40. Masnarivan Y, Haq A, Putri AP, editors. Study of COVID‑19
Prevention: Diet and Physical Activity During Large‑Scale Social
Restrictions in West Sumatera. International Conference of Health
Development COVID‑19 and the Role of Healthcare Workers in
the Industrial Era (ICHD 2020) Atlantis Press; 2020.
41. Robinson E, Boyland E, Chisholm A, Harrold J, Maloney NG,
Marty L, et al. Obesity, eating behavior and physical activity
during COVID‑19 lockdown: A study of UK adults. Appetite
2021;156:104853.
42. Gallo LA, Gallo TF, Young SL, Moritz KM, Akison LK. The
impact of isolation measures due to COVID‑19 on energy intake
and physical activity levels in Australian university students.
Nutrients 2020;12:1865.
43. Miljanovic Damjanovic V, Obradovic Salcin L, Zenic N, Foretic N,
Liposek S. Identifying predictors of changes in physical activity
level in adolescence: A prospective analysis in Bosnia and
Herzegovina. Int J Environ Res Public Health 2019;16:2573.
44. Lesser IA, Nienhuis CP. The impact of COVID‑19 on physical
activity behavior and well‑being of Canadians. Int J Environ Res
Public Health 2020;17:3899.
45. Plotnikoff RC, Costigan SA, Karunamuni N, Lubans DR. Social
cognitive theories used to explain physical activity behavior in
adolescents: A systematic review and meta‑analysis. Prev Med
2013;56:245‑53.
46. White SM, Wójcicki TR, McAuley E. Social cognitive influences
on physical activity behavior in middle‑aged and older adults.
J Gerontol B Psychol Sci Soc Sci 2012;67:18‑26.
47. Ayotte BJ, Margrett JA, Hicks‑Patrick J. Physical activity in
middle‑aged and young‑old adults: The roles of self‑efficacy,
barriers, outcome expectancies, self‑regulatory behaviors and
social support. J Health Psychol 2010;15:173‑85.
48. Sterdt E, Liersch S, Walter U. Correlates of physical activity of
children and adolescents: A systematic review of reviews. Health
Educ J 2014;73:72‑89.
49. Zhang KM, Tulloch HE, Brunet J, Pipe AL, Reid RD, Prince SA,
et al. What motivates nurses to exercise? Determinants of physical
activity among Canadian nurses using self‑determination theory.
Ann Behav Med 2020;54:381‑90.
50. Kaushal N, Keith N, Aguiñaga S, Hagger MS. Social cognition
and socioecological predictors of home‑based physical activity
intentions, planning, and habits during the COVID‑19 pandemic.
Behav Sci (Basel) 2020;10:133.
51. Heukelum S. Physical Activity and Change in Vigorous Physical
Activity during the COVID‑19 Confinement in the Netherlands:
Possible Associations with Perceived Vulnerability, Self‑efficacy
and Big‑Five Personality Traits: University of Twente; 2020.
)