Health behaviors and mental health during the COVID-19 pandemic: A longitudinal population-based survey in Germany.

OBJECTIVE: To understand the mental health response to repeated and prolonged stress during the COVID-19 related lockdown and the role of specific health behaviors to buffer against this stress. METHODS: In a longitudinal study with several measurement points covering three months during the COVID-19 pandemic, about 3500 randomly selected participants representative of the German population reported on their mental health (anxiety, depression, loneliness) and health behaviors (screen time, snack consumption, physical activity). RESULTS: Symptoms of anxiety, depression, and loneliness were highest shortly after the lockdown came into effect. Over time, the symptoms were stable or went down slightly, corresponding to patterns of habituation. Among people with higher vulnerability to poor mental health during the lockdown (e.g., women), the proportion with high levels of anxiety, depression, and loneliness was considerably larger. These groups also reported fewer health-promoting behaviors. More screen time, more snacking, and less physical activity were related to higher symptoms of anxiety, depression, and loneliness across all time points. Changes in health behaviors over time mostly did not predict changes in mental health symptoms. CONCLUSIONS: Mental health and engagement in protective health behaviors was lowest at the start of the lockdown. Health behaviors mostly returned to pre-lockdown levels within three months. Engaging in healthier behaviors was associated with better mental health. Policy implications of these findings are discussed. This study provides important insights into (unintended) side effects of an international crisis and can contribute to a better understanding of how to preserve mental health.

Barriers to the Large-Scale Adoption of a COVID-19 Contact Tracing App in Germany: Survey Study.

BACKGROUND: During the COVID-19 pandemic, one way to reduce further transmissions of SARS-CoV-2 is the widespread use of contact tracing apps. Such apps keep track of proximity contacts and warn contacts of persons who tested positive for an infection. OBJECTIVE: In this study, we analyzed potential barriers to the large-scale adoption of the official contact tracing app that was introduced in Germany on June 16, 2020. METHODS: Survey data were collected from 3276 adults during the week the app was introduced using an offline-recruited, probability-based online panel of the general adult population in Germany. RESULTS: We estimate that 81% of the population aged 18 to 77 years possess the devices and ability to install the official app and that 35% are also willing to install and use it. Potential spreaders show high access to devices required to install the app (92%) and high ability to install the app (91%) but low willingness (31%) to correctly adopt the app, whereas for vulnerable groups, the main barrier is access (62%). CONCLUSIONS: The findings suggest a pessimistic view on the effectiveness of app-based contact tracing to contain the COVID-19 pandemic. We recommend targeting information campaigns at groups with a high potential to spread the virus but who are unwilling to install and correctly use the app, in particular men and those aged between 30 and 59 years. In addition, vulnerable groups, in particular older individuals and those in lower-income households, may be provided with equipment and support to overcome their barriers to app adoption.

COVID-19 policies in Germany and their social, political, and psychological consequences.

Many policy analyses on COVID-19 have been focusing on what kind of policies are implemented to contain the spread of COVID-19. What seems equally important to explore are the social and political consequences of the confinement policies. Does the public support strict confinement policies? What are the social, political, and psychological consequences of the confinement policies? The question of how legitimate a policy is among the public is at the core of democratic theory. Its relevance also stems from the expected consequences of public support on behavior: The more someone supports a policy, the more someone is likely to follow the policy even if the policy is not strictly enforced. In this paper, we will focus on Germany, briefly summarize the main policies during the first 6 weeks of confinement and then explore political attitudes, risk perceptions, and the social consequences of the lockdown.