Purpose The spread of COVID-19 and the associated stay-at-home orders and shutdowns of gyms and fitness centers has drastically influenced health behaviors leading to widespread reductions in physical activity (PA). The recent Call to Action from the American College of Sports Medicine has promoted "innovative strategies to promote PA during the COVID-19 pandemic". We aimed to identify individual-level factors that protected against declines in PA levels amid the COVID-19 restrictions. Methods We utilized the Pennington Biomedical COVID-19 Health Behaviors Survey for our analyses and used mixed-effect linear and generalized linear models to estimate the effects of individual-level factors on changes in PA levels during the COVID-19 restrictions. Results Participants (n=4,376) provided information on PA behaviors before and during the COVID-19 shutdown. Overall, PA levels declined by a mean (SD) of 112 (1,460) MET minutes/week during the COVID-19 shutdown; however, changes in PA were heterogeneous, with 55% of the participants reporting increases in or maintenance of PA during that time. Several social and demographic factors were significantly related to declines in PA, including high pre-pandemic PA levels, living alone (difference=118 MET minutes/week), low household income (difference between the highest and lowest income group=363 MET minutes/week), COVID-19-related changes in income (difference=110 MET minutes/week), and loss of employment (difference=168 MET minutes/week). Substitution of pre-pandemic gym attendance with the purchase and use of home exercise equipment or exercise through virtual fitness platforms promoted increases in PA during the COVID-19 shutdown. Conclusions While promoting PA through the COVID-19 pandemic, it is important to consider demographic factors, which greatly influence health behaviors and implementation of, and access to, replacement behaviors. Promotion of such strategies could help maintain PA levels during potential future stay-at-home orders. * Denotes co-first authorship Accepted for Publication: 21 December 2020 Corresponding Author: Leanne M. Redman, PhD, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, T. 1-225-763-0947 E. leanne.redman@pbrc.edu This work was partially supported by a NORC Center Grant # P30DK072476 entitled "Nutrition and Metabolic Health Through the Lifespan" sponsored by NIDDK. In addition, this work was supported in part by U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center. C.H. is supported by an NIH NIDDK National Research Service Award (T32DK064584). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflict of Interest. None of the authors declare a conflict of interest. The results of the present study do not constitute endorsement by ACSM. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections. © 2021 American College of Sports Medicine
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