A time compositional analysis of the association between movement behaviors and indicators of mental health in young adults.

BACKGROUND: Movement behaviors (i.e., physical activity [PA], sedentary behaviors [SB], sleep) relate to mental health. Although movement behaviors are often analyzed as distinct entities, they are in fact highly inter-dependent (e.g., if an individual increases sleep, then PA and/or SB must be reduced) and these dependencies should be accounted for in the analysis. We tested whether perceptions of time spent in movement behaviors (i.e., moderate-to-vigorous intensity PA [MVPA], light physical activity [LPA], SB, and sleep) related to depressive symptoms and self-report mental health in young adults using a compositional analysis. We then estimated change in depressive symptoms with reallocation of time across movement behaviors using compositional time-reallocation models. METHODS: Data were drawn from the longitudinal NDIT dataset. Complete data were available for 770 young adults (Mage = 20.3, 55% females). RESULTS: The proportion of time spent in MVPA relative to other movement behaviors related to depressive symptoms non-significantly and to mental health significantly. Reallocating 15 min from MVPA to SB resulted in a significant (0.46 unit) increase in depressive symptoms, and reallocating 15 min of MVPA to LPA was associated with a (0.57) increase in depressive symptoms. CONCLUSION: These results indicate the importance of relative time spent in each movement behavior to mental health. Further research should examine these associations over time.

Cigarette Smoking Trajectories in Adolescent Smokers: Does the Time Axis Metric Matter?

INTRODUCTION: Most studies modeling adolescent cigarette smoking trajectories use age as the time axis, possibly obscuring depiction of the natural course of cigarette smoking. We used a simulated example and real data to contrast smoking trajectories obtained from models that used time since smoking onset or calendar time (age) as the time axis. METHODS: Data were drawn from a longitudinal investigation of 1293 grade 7 students (mean age 12.8 years) recruited from 10 high schools in Montreal, Canada in 1999-2000, who were followed into young adulthood. Cigarette consumption was measured every 3 months during high school, and again at mean ages 20.4 and 24.0. Analyses using time since onset of smoking as the time metric was restricted to 307 incident smokers; analysis using calendar time included 645 prevalent and incident smokers. Smoking status and nicotine dependence (ND) were assessed at mean ages 20.4 and 24.0. Simulated data mimicked the real study during high school. RESULTS: Use of different time metrics resulted in different numbers and shapes of trajectories in the simulated and real datasets. Participants in the calendar time analyses reported more ND in young adulthood, reflecting inclusion of 388 prevalent smokers who had smoked for longer durations. CONCLUSIONS: Choosing the right time metric for trajectory analysis should be balanced against research intent. Trajectory analyses using the time since onset metric depict the natural course of smoking in incident smokers. Those using calendar time offer a snapshot of smoking across ages during a given time period. IMPLICATIONS: This study uses simulated and real data to show that trajectory analyses of cigarette smoking that use calendar time (e.g., age) versus time since onset as the time axis metric tell a different story. Trajectory analyses using the time since onset metric depict the natural course of smoking in incident smokers. Those using calendar time offer a snapshot of smoking across ages during a given time period. Choosing the right time metric should be balanced against research intent.

Physical activity motives have a direct effect on mental health.

Physical activity (PA) motives are associated with both moderate-to-vigorous intensity PA (MVPA) and mental health. Studies examining whether PA motives relate directly to mental health or indirectly through MVPA are lacking. This study examined the direct effect of five PA motives (i.e., enjoyment, competence, fitness, social, appearance) on mental health and their indirect effects through MVPA in adolescents. A total of 424 participants (57.1% females) ages 14-15 years from the longitudinal MATCH study were included. Mediation analyses, based on the counterfactual framework, assessed the natural direct effect of PA motives on mental health, and the natural indirect effects through MVPA. Separate models were conducted for each PA motive. Natural direct effects were observed for enjoyment ( ß Ì‚ [95%CI] = 2.12 [0.34, 3.90]), competence ( ß Ì‚ [95%CI] = 1.58[0.28, 2.88]), fitness ( ß Ì‚ [95%CI] = 1.42[0.04, 2.80]), and social ( ß Ì‚ [95%CI] = 2.32[1.03, 3.60]) motives. No natural direct effects were observed for appearance motives. A natural indirect effect through MVPA was observed for fitness motives, and no other natural indirect effects were found. Interventions and public health strategies in adolescents need to acknowledge the importance of enjoyment, competence social and fitness motives in PA to promote mental health, and integrate specific recommendations on the importance of the reasons why adolescents participate in PA.

Association between pattern of team sport participation from adolescence to young adulthood and mental health.

We examined relationships between pattern of team sport participation during the transition from adolescence to young adulthood (ie, non-participants, initiators, discontinuers, sustainers) and indicators of mental health. Data on team sport participation and mental health from high school to young adulthood were drawn from the longitudinal NDIT study. After controlling for demographics, physical activity, and previous mental health, one-way MANCOVA and ANCOVAs indicated that pattern of team sport participation was associated with stress, F(2,706) =8.28, p < .01, and coping, F(2,706) = 10.66, p < .01 in young adulthood. Compared to non-participants (24% of sample) or those who discontinued team sport after adolescence (51%), individuals who sustained team sport participation from adolescence to young adulthood (22%) reported lower stress and better coping levels. Bivariate regression analysis indicated that, compared to non-participants, team sport sustainers were less likely to experience panic disorder symptoms (OR =0.57, 95% CI [0.34, 0.94], p = .03). There were too few team sport initiators (2%) to be included in analyses. Sustained team sport participation during the transition from adolescence to young adulthood may promote better mental health. Further research is needed to ascertain causality and develop strategies to encourage individuals to join sport teams during adolescence and sustain participation while transitioning to young adulthood.

E-cigarettes and youth: Patterns of use, potential harms, and recommendations.

Electronic cigarette (e-cigarette) use has risen to unprecedented levels among youth in the United States. In this review, we discuss the patterns of use underlying the current youth vaping epidemic, potential harms from e-cigarette use, and the regulatory, public health, and clinical responses to e-cigarette use among youth. Between 2017 and 2018, past 30-day use of nicotine e-cigarettes among high school seniors nearly doubled, from 11% to 21%, representing the largest recorded increase for any adolescent substance use in over four decades. There are concerns that e-cigarette use could renormalize smoking behaviors, lead to the uptake of conventional cigarette use by youth, and have adverse effects in the developing brain and lungs of adolescents. Prevention and harm reduction efforts thus far have focused on policies to prevent youth access to vaping products and on public health strategies to expose the risks of youth vaping. However, it remains unclear if ongoing initiatives are sufficient to curb e-cigarette use by youth. Most health professionals agree that youth exposure to e-cigarettes needs to be addressed but feel uninformed, rely on unconventional information sources such as the media and their patients, and report that routine screening procedures concerning e-cigarettes are lacking. A coordinated effort from policy makers, public health agencies, parents, educators, health practitioners, and researchers is essential to mitigate harms from e-cigarette use in this vulnerable population.

Parental Cannabis Use Is Associated with Cannabis Initiation and Use in Offspring.

OBJECTIVES: To assess, before legalization in Canada, whether parental cannabis use is associated with initiation of use in adolescent offspring or with use in young-adult offspring. STUDY DESIGN: Data were available in 2 longitudinal studies in Montréal, Canada. In AdoQuest, 1048 parents with children in grade 6 reported past-year cannabis use. Cannabis initiation among offspring was measured in grade 7, 9, and/or 11. In the Nicotine Dependence in Teens study, cannabis use data were available for 584 participants (mean age 24 years) and their parents (ie, 542 offspring-mother pairs, 438 offspring-father pairs). The association between parental and offspring cannabis use was estimated using multivariable logistic regression in both studies. RESULTS: In AdoQuest, grade 6 never-users were 1.8 times more likely to initiate cannabis during high school if their parents reported past-year use. In the Nicotine Dependence in Teens study, the aORs (95% CI) for past-year cannabis use among adult offspring were not different for "mother uses cannabis" (2.8 [1.4-5.8]) or "father uses cannabis" (2.1 [1.2-3.8]). Participants with 1 or 2 cannabis-using parents were 1.7 and 7.1 times more likely to use cannabis, respectively, than participants with non-using parents. CONCLUSIONS: To enable informed decision-making about their own cannabis use, parents need to be aware that children of cannabis users are more likely to use cannabis in adolescence and young adulthood.

Social disparities in children's exposure to secondhand smoke in privately owned vehicles.

INTRODUCTION: Secondhand smoke (SHS) can quickly attain high concentrations in cars, posing health risks to passengers and especially to children. This paper assesses whether there are social disparities in children's exposure to SHS in privately owned vehicles. METHODS: On weekday mornings and afternoons from September to November 2011, trained observers were stationed at 100 selected street intersections in Montreal, Canada. For each car transporting at least one passenger aged 0-15 years travelling through the intersection, observers recorded the estimated age of the youngest child in the car, whether any occupant was smoking and the licence plate number of the car. Licence plate numbers were linked to an area material deprivation index based on the postal code of the neighbourhood in which the car was registered. RESULTS: Smoking was observed in 0.7% of 20 922 cars transporting children. There was an apparent dose-response in the association between area material deprivation level and children's exposure to SHS in cars. Children travelling in cars registered in the most disadvantaged areas of Montreal were more likely to be exposed to SHS than children travelling in cars registered in the most advantaged areas (unadjusted OR=3.46, 95% CI 1.99 to 6.01). CONCLUSIONS: This study revealed social disparities in children's exposure to SHS in privately owned vehicles.

Psychometric Evaluation of the Mental Health Continuum-Short Form in French Canadian Young Adults.

OBJECTIVE: To examine the factor structure, internal consistency, reliability, sex invariance, and discriminant validity of the French Canadian version of the Mental Health Continuum-Short Form (MHC-SF). METHOD: A total of 1485 French-speaking postsecondary students in Quebec, Canada (58% female; mean age = 18.4, SD = 2.4), completed the MHC-SF. Confirmatory factor analysis (CFA) was used to assess the factorial structure of the MHC-SF. Internal consistency was assessed with Cronbach's alpha, and reliability was assessed with the rho reliability coefficient. Invariance testing across sex was conducted using multigroup CFA comparing 4 increasingly restrictive models, and discriminant validity was examined against the Hospital Anxiety and Depression Scale (HADS) using Pearson correlation coefficients and CFA. RESULTS: CFA supported the correlated 3-factor structure of the MHC-SF, with emotional, social, and psychological well-being subscales. The scale and each subscale items had internal consistency coefficients (Cronbach's alphas) above .70 and reliability coefficients (Jöreskog's rho) ranging from .79 to .90. Based on the multigroup CFA, configural, metric, scalar, and error variance invariance of the MHC-SF was observed across sex. Finally, the 2-continua model, suggesting that mental health and mental illness are distinct but related dimensions, was supported by both moderate inverse correlations between MHC-SF and HADS subscale scores and the 2-factor structure in CFA. CONCLUSIONS: These data support the multidimensional structure of the MHC-SF and provide evidence of internal consistency, reliability, and invariance across sex. The MHC-SF is a valid and reliable measure of mental health that is distinct from mental illness among French Canadian young adults.

Volume and social context of physical activity in association with mental health, anxiety and depression among youth.

There is growing interest in physical activity (PA) to prevent mental disorders in youth. However, few studies examine the association between PA and mental health. Further, how PA volume and context relate to mental health and mental disorders remains unclear, especially among youth in transition to adulthood. This study examined the cross-sectional associations among PA volume and context, mental health, and symptoms of anxiety and depression in post-secondary students. A total of 1527 post-secondary students (97.4% were age 16-24years) recruited in a CEGEP in Quebec, Canada completed a self-report questionnaire during class-time in October 2013. Multivariate linear regression was used to model the associations between PA volume and context and mental health, anxiety and depression controlling for sex, age and perceived socioeconomic status. Volume of moderate-to-vigorous leisure time PA (MVPA) was positively associated with mental health (ß (95% CI)=0.072 (0.045, 0.099)) and inversely associated with symptoms of anxiety (-0.011 (-0.020, -0.001)) and depression (-0.010 (-0.017, -0.003)). Volume including all PA intensities was associated with mental health (0.052 (0.028, 0.076)). After controlling for PA volume, active youth involved in team sports had better mental health than those who engaged in PA individually. PA volume and the social context of PA are independently associated with mental health among youth. MVPA is inversely associated with anxiety and depressive symptoms.

Determinants of sustained binge drinking in young adults.

BACKGROUND: Binge drinking occurs frequently among young adults, posing risks to health and safety. Little is known, however, about which drinkers continue to binge later into adulthood. We sought to identify predictors of sustained binge drinking behaviors in young adulthood. METHODS: Participants from the Nicotine Dependence in Teens (NDIT) cohort (n = 609, 53% female) completed self-report questionnaires in 20 survey cycles (SCs) during secondary school between 1999 and 2005, and in 2 postsecondary school SCs in 2007 to 2008 (SC 21; Mage = 20 years) and 2011 to 2012 (SC 22; Mage = 24 years). Participants reporting past-year binge drinking in both SCs 21 and 22 were categorized as sustainers (n = 517). Using multivariable logistic regression, we investigated 25 potential predictors of sustained binge drinking, binge-drinking frequency, and change in frequency over time among sustainers. RESULTS: Compared with stoppers, sustainers (85% of participants) were more likely to be younger, male, and to have no college/university education. Sustainers began drinking alcohol and binge drinking earlier, drank at least monthly during more secondary school grades, binged more frequently at age 20, and scored higher on impulsivity and novelty seeking in adolescence. Among sustainers, frequent binge drinkers were more likely to be male, to be nonstudents, to score higher on novelty seeking, and to have reported more depressive symptoms in adolescence. Sustainers who decelerated their binge frequency between SCs 21 and 22 were more likely to be female, to have achieved a higher level of education, and to report more depressive symptoms in SC 21. CONCLUSIONS: The determinants of sustained binge drinking are similar to predictors of binge drinking reported in the literature. Early identification of, and intervention with, youth who are impulsive, inclined toward novelty seeking, and who report higher levels of early sub clinical depressive symptoms might forestall their involvement in risky alcohol use.

Physical activity motivation mediates the association between depression symptoms and moderate-to-vigorous physical activity.

OBJECTIVE: To test if motivational regulations (i.e., amotivation, external, introjected, identified, and intrinsic) mediate the association between depression symptoms and moderate-to-vigorous physical activity (MVPA) in young adults. METHOD: A total of 319 young adults from Montreal, Quebec participating in the Nicotine Dependence in Teens (NDIT) study provided self-report data on depression symptoms at age 20 (SD=0.7 years) and motivational regulations at age 24 (SD=0.7 years). MVPA was assessed using a self-report questionnaire at age 20 (i.e., at the same time motivation was measured) and using accelerometers one month later. Multiple mediation analysis with bootstrapping was employed to analyze the data. RESULTS: Controlling for age, sex and self-reported MVPA at age 20 years; introjected regulation was a significant mediator of the association between depression symptoms and MVPA (R(2) adj=0.12; point estimate=-0.0011; BCa CI=-0.15 to -0.01). CONCLUSION: Depression symptoms may undermine controlling forms of motivation, resulting in decreased MVPA. Intervention strategies may be needed to address depression symptoms in young adults to promote sustained MVPA.

Symptoms of depression are longitudinally associated with sedentary behaviors among young men but not among young women.

OBJECTIVE: A habitual sedentary lifestyle is associated with adverse health outcomes; however, the predictors of sedentary behaviors have not been sufficiently explored to inform the development and delivery of effective interventions to reduce sedentary behaviors. This study examined whether reports of symptoms of depression could predict weekly time spent in sedentary behaviors (i.e., television watching, computer use) 4years later. METHOD: Self-reported symptoms of depression were assessed at age 20years (2007-08), and television watching time and computer use were assessed at age 24years (2011-12) in 761 adults (45% men) participating in the Nicotine Dependence in Teens study. Data were analyzed using linear regression analysis, with separate models for men and women. RESULTS: After controlling for past sedentary behavior, symptoms of depression at age 20years predicted more computer use 4years later in men (R(2)=.21, ß=.13, p<.05), but not in women. Symptoms of depression did not predict television watching. CONCLUSIONS: Results highlight the need to distinguish between types of sedentary behaviors as their predictors may differ. Further, they provide support for the hypothesis that psychological factors, in this case symptoms of depression, may relate to select sedentary behaviors in young men.

Home smoking bans may increase the risk of smoking onset in children when both parents smoke.

INTRODUCTION: Our objective was to determine if there is effect modification by home smoking bans in the association between parental smoking and cigarette smoking onset in children. METHODS: Data on smoking onset, number of parents who smoke, and home smoking rules were collected from children who had never smoked in self-report questionnaires in grades 5, 7, 9, and 11. The association between number of parents who smoke and smoking onset in children was tested in pooled logistic regression in 2 groups defined by the presence or absence of a complete home smoking ban. RESULTS: In homes without a complete ban and relative to participants with no parents who smoke, the odds ratio (95% confidence interval [OR (95% CI]) for smoking onset was 1.5 (1.1-1.9) when one parent smoked and 1.4 (1.0-2.1) when both parents smoked. In homes with a complete ban, the OR (95% CI) was 1.6 (1.1-2.3) if one parent smoked, but 4.9 (2.4-9.9) if both parents smoked. CONCLUSION: The association between number of parents who smoke and smoking onset in children was modified by the presence of a complete home smoking ban. In homes with a complete smoking ban in which both parents smoke, it may be prudent those parents communicate clearly with their children about their reasons for implementing the ban as well as about their reasons for continuing to smoke.

Sustained waterpipe use among young adults.

INTRODUCTION: Waterpipe smoking is increasingly popular among North American youth. However, the extent to which waterpipe use is sustained over time is not known. The objective of this study was to describe the frequency and the predictors of sustained waterpipe use over 4 years among young adults. METHODS: Data were available in a prospective cohort investigation of 1,293 seventh-grade students recruited in a convenience sample of 10 secondary schools in Montreal, Canada, in 1999. Data on past-year waterpipe use were collected from 777 participants when they were age 20 years on average (in 2007-2008) and again when they were age 24 years (in 2011-2012) in mailed self-report questionnaires. Twenty potential predictors of sustained waterpipe use were tested, each in a separate multivariable logistic regression model. RESULTS: About 51% of 182 waterpipe users at age 20 reported waterpipe use 4 years later. Most sustained users (88%) smoked a waterpipe less than once a month. Parental smoking, being currently employed, less frequent cigarette smoking, and more frequent marijuana use were associated with sustained waterpipe use. CONCLUSIONS: Half of the young adults who used waterpipe during young adulthood reported use 4 years later. Young adults who sustain waterpipe use appear to do so as an activity undertaken occasionally to socialize with others.

Measurement invariance of the depressive symptoms scale during adolescence.

BACKGROUND: This study examined (1) the factor structure of a depressive symptoms scale (DSS), (2) the sex and longitudinal invariance of the DSS, and (3) the predictive validity of the DSS scale during adolescence in terms of predicting depression and anxiety symptoms in early adulthood. METHODS: Data were drawn from the Nicotine Dependence in Teens (NDIT) study, an ongoing prospective cohort study of 1,293 adolescents. RESULTS: The analytical sample included 527 participants who provided complete data or had minimal missing data over follow-up. Confirmatory factor analysis revealed that an intercorrelated three-factor model with somatic, depressive, and anxiety factors provided the best fit. Further, this model was invariant across sex and time. Finally, DSS scores at Time 3 correlated significantly with depressive and anxiety symptoms measured at Time 4. CONCLUSIONS: Results suggest that the DSS is multidimensional and that it is a suitable instrument to examine sex differences in somatic, depressive, and anxiety symptoms, as well as changes in these symptoms over time in adolescents. In addition, it could be used to identify individuals at-risk of psychopathology during early adulthood.

Gender differences in reasons to quit smoking among adolescents.

It is well established that many adolescents who smoke want to quit, but little is known about why adolescents want to quit and if reasons to quit differ across gender. The objective of this study was to determine if reasons to quit smoking differ in boys and girls. Data on the Adolescent Reasons for Quitting (ARFQ) scale were collected in mailed self-report questionnaires in 2010-2011 from 113 female and 83 male smokers aged 14-19 years participating in AdoQuest, a longitudinal cohort study of the natural course of the co-occurrence of health-compromising behaviors in children. Overall, the findings indicate that reasons to quit in boys and girls appear to be generally similar, although this finding may relate to a lack of gender-oriented items in the ARFQ scale. There is a need for continued research to develop and test reasons to quit scales for adolescents that include gender-oriented items.

Regulatory Strategies for Preventing and Reducing Nicotine Vaping Among Youth: A Systematic Review.

INTRODUCTION: Many jurisdictions have implemented different regulatory strategies to reduce vaping among youth. The objective of this systematic review is to synthesize the evidence of the effectiveness of different regulatory strategies for preventing and reducing nicotine vaping among youth. METHODS: Five electronic databases were searched from January 1, 2004 to July 17, 2022 for primary studies examining state/provincial or national regulations targeting vaping among youth (aged 12-21 years) in high-income countries. The primary outcome was vaping prevalence. Included studies were qualitatively synthesized through systematic review. RESULTS: The systematic review included 30 studies. There was insufficient evidence to recommend age restrictions (n=16), restrictions on location of use (n=1), and mixed/combined regulations (n=3). Flavor bans (n=4), sales licenses (n=2), and taxation (n=2) were generally shown to be associated with decreased rates of youth vaping. Warning labels (n=2) were associated with a decreased desire to initiate vaping. Included studies had moderate-to-serious risks of bias. DISCUSSION: Although several regulatory interventions have been shown to be effective at reducing vaping among youth, evidence is insufficient to recommend a specific type of regulation. Regulatory authorities could implement various regulations targeting the price, accessibility, and desirability (i.e., flavors and packaging) of E-cigarettes.

Interventions for Preventing E-Cigarette Use Among Children and Youth: A Systematic Review.

INTRODUCTION: Many nonregulatory interventions targeting children and youth have been implemented at three levels: directed at the individual (e.g., interactive video games), delivered to students at school (e.g., campus bans), and launched in the community (e.g., mass media campaigns). This systematic review aims to synthesize the evidence on the effectiveness of interventions aimed at preventing e-cigarette initiation among children and youth. METHODS: MEDLINE, CINAHL, Embase, APA PsycINFO, and Web of Science Core Collection were searched for papers published between January 1, 2004 and September 1, 2022 that reported more than one outcome on vaping prevention among individuals aged less than 21-years-old: vaping prevalence/incidence, initiation intentions, knowledge/attitudes, and other tobacco product use prevalence/initiation intentions. Interventions were at the individual, school, or community level. The risk of bias was assessed using ROBINS-I and RoB 1. RESULTS: Thirty-nine publications met the eligibility criteria. Fourteen individually-based (4 parental monitoring, 3 video games, 2 text messages, 3 graphic message themes, 2 healthcare), 19 school-based (14 educational and skill interventions, 5 vape-free policies/bans), and 6 community-based (3 social media, 3 mass media campaigns) interventions were reported. E-cigarette initiation prevention was observed with high perceived parental monitoring; however, the cross-sectional study designs precluded causal claims. There was promising but limited evidence that social-emotional skills curricula and peer leader programming prevented vaping initiation. DISCUSSION: Some individual- and school-based interventions showed promise for preventing e-cigarette initiation among children and youth.

Effect of anti-smoking legislation on school staff smoking may dissipate over time.

This study describes student perceptions of school staff smoking before and after implementation of legislation prohibiting smoking on school grounds. Students completed self-report questionnaires before (grade 6) and after (grade 7, 9 and 11) the law. The percentage of students reporting that school staff smoked in areas where smoking is forbidden was 19%, 32% and 33% in grade 7, 9 and 11, respectively. The mean(SD) score for the frequency with which students saw school staff smoking decreased after the ban but increased thereafter [2.5(1.1), 1.9(1.0), 2.4(1.1) and 2.3(1.1)] in grade 6, 7, 9 and 11, respectively [F(2.861,1662.229) = 45.350, P < 0.001]. These data suggest that the effect of the law dissipated over time.

The Change in Exergaming From Before to During the COVID-19 Pandemic Among Young Adults: Longitudinal Study.

BACKGROUND: Exergaming may be an important option to support an active lifestyle, especially during pandemics. OBJECTIVE: Our objectives were (1) to explore whether change in exergaming status (stopped, started or sustained exergaming, or never exergamed) from before to during the COVID-19 pandemic was related to changes in walking, moderate-to-vigorous physical activity (MVPA) or meeting MVPA guidelines and (2) to describe changes among past-year exergamers in minutes per week exergaming from before to during the pandemic. METHODS: A total of 681 participants (mean age 33.6; SD 0.5 years; n=280, 41% male) from the 22-year Nicotine Dependence in Teens (NDIT) study provided data on walking, MVPA, and exergaming before (2017 to 2020) and during (2021) the COVID-19 pandemic. Physical activity (PA) change scores were described by change in exergaming status. RESULTS: We found that 62.4% (n=425) of the 681 participants never exergamed, 8.2% (n=56) started exergaming during the pandemic, 19.7% (n=134) stopped exergaming, and 9.7% (n=66) sustained exergaming. Declines were observed in all 3 PA indicators in all 4 exergaming groups. The more salient findings were that (1) participants who started exergaming during COVID-19 reported the highest MVPA levels before and during the pandemic and declined the least (mean -35 minutes/week), (2) sustained exergamers reported the lowest MVPA levels during the pandemic (median 66 minutes/week) and declined the most in MVPA (mean change of -92 minutes/week) and in meeting MVPA guidelines (-23.6%). During the pandemic, starting exergamers reported 85 minutes of exergaming per week and sustained exergamers increased exergaming by a median 60 minutes per week. CONCLUSIONS: Although starting and sustaining exergaming did not appear to help exergamers maintain prepandemic PA levels, exergaming can contribute a substantial proportion of total PA in young adults and may still represent a useful option to promote PA during pandemics.