key: cord-0992826-g2b3s53x
authors: Schnitzer, Martin; Schöttl, Stefanie Elisabeth; Kopp, Martin; Barth, Michael
title: COVID-19 stay-at-home order in Tyrol, Austria: Sport and exercise behaviour in change?
date: 2020-06-26
journal: Public Health
DOI: 10.1016/j.puhe.2020.06.042
sha: b6289dfdc68ab4e3a388d144ac244f967c407c4c
doc_id: 992826
cord_uid: g2b3s53x

Abstract Objectives The aim of the study was to investigate differences in the frequency and types of engagement in sport before, during, and after the COVID-19 stay-at-home order in Tyrol, Austria. Study design A representative population survey was conducted. Methods A sample of Tyroleans (N = 511) were questioned by a market research institute via online questionnaire or telephone survey. Results During the stay-at-home order survey participants did less sport than before and after the restrictions. However, within-group analyses revealed increasing sport participation in less active groups when comparing the pre- and post-COVID-19 period. Conclusions Despite the restrictions during the stay-at-home order, respondents did sport and promoted their health. Nevertheless, it is still necessary to investigate the long-term effects of the COVID-19 crisis on sport and exercise behaviour as well as the extent to which sport policy measures may be able increase sport participation.

Since the outbreak of COVID-19 in China in early December 2019 1 , the virus has continued to spread and reached almost every country in the world. Global disease control represents a major challenge. Governments and local authorities have to take political decisions balancing different interests and weighing the benefits and costs of the measures. On the side of benefits, measures may reduce the infection rate, prevent overloading the health care system, and-finally-save human lives 2 . On the side of costs, quarantine and isolation measures may lead to mental and social problems 4 and have huge impacts on the global economy 3 .

The relationship between COVID-19 and sport and exercise behaviour has already been addressed in the literature, and the importance of exercising during the COVID-19 period was highlighted 5 . However, only few studies have considered changes in sport participation during stay-at-home orders or other drastic regulations established to prevent further spread of the virus 5 6 7 8 . The extent to which a population's engagement in sport changed comparing the period before, during, and after restrictions has not yet been investigated. The Austrian province of Tyrol represents an interesting case for such research: On the one hand, the population of this region exhibits above-average participation in sport 9 ; on the other hand, high infection rates have prompted policy-makers to introduce drastic measures limiting people in everyday life and also in exercising. In contrast to other Austrian provinces, any kind of outdoor sport was prohibited in Tyrol until 7 April, including jogging and hiking 5 .

The objective of this study was therefore three-fold: firstly, to examine the change in sport and exercise behaviour over three periods-i.e., before COVID-19 stay-at-home order (PRE-C19), during COVID-19 stay-at-home order (DURING-C19), and after COVID-19 stay-at-home order (POST-C19)-; secondly, to investigate whether or not the surveyed Tyroleans found the implemented COVID-19 (sport) restrictions appropriate; and thirdly, to describe respondents' recommendations for future (sport) policies.

From 27 April to 4 May a representative stratified survey was conducted (N = 511) online as well as by telephone. The maximum fluctuation range of the overall results was + 4%. 53% of respondents were female and 47% male. Most of the respondents (59%) were between 25 and 59 years of age. 21% of the surveyed population lived in the state capital Innsbruck and 79% in the various counties of Tyrol. More than half of the sample (57%) were employed; the others were either in education, retired, or working in the household. For better comparability, sport and exercise behaviour was measured with the questionnaire of the Eurobarometer 472 study 10 , which had also been applied in a previous sport participation study carried out in Tyrol in autumn 2019 9 . The perceived appropriateness of the COVID-19 regulations implemented by the government was measured with a Likert scale (1 = strongly agree to 5 = strongly disagree), and suggestions for future (sport) policies were collected with open questions grouped by topic. The results of the current study and the previous studies are displayed in Table 1 . Table 1 here > Within the study at hand, the participants were asked how often they engaged in sport or exercising before, during, and after the COVID-19 stay-at-home order. This revealed interesting results: Firstly, 19% of the respondents indicated that they had never or only seldom engaged in sport in the PRE-C19 period; this percentage more than doubled (41%) within the DURING-C19 period and fell again in the POST-C19 period (35%). Secondly, the majority of respondents (58%) did sport once to twice or three to four times a week in the PRE-C19 period; for the POST-C19 period this figure was 47%, while the lowest value (36%) was registered for the DURING-C19 period. Thirdly, remarkable results in terms of a change in sport participation between the PRE-C19 and POST-C19 period were found at an individual level: 30 % of those who had previously exercised 5 times a week or more showed a reduced sport participation frequency in the POST-C19 period; for the category "3 to 4 times a week" the respective figure was 33%. On the contrary, among those who had previously engaged in sport only once or twice a week, one to three times a month, or seldom the percentage of people who became more active in the POST-C19 period were 35%, 45%, and 44%. However, the ceiling and floor effect of the highest and lowest categories of physical activity must be considered here.

Before the restrictions, the respondents engaged in outdoor sport, such as biking (30%), walking (25%), hiking (24%), jogging (13%), or mountain biking (6%). During the quarantine measures, the respondents primarily went for a walk (32%). Other outdoor activities were prohibited and (thus) practised less frequently or not at all (hiking: 20%, jogging: 11%, mountain biking: 0%). In contrast, engagement in different forms of home training, such as fitness exercises (11%), aerobic/gymnastics (11%), or forms of home workout (6%), increased in comparison to before the COVID-19 stay-at-home order. After the drastic restrictions were lifted, the survey participants increasingly engaged in outdoor sport, such as hiking (29%), walking (28%), biking (28%), or jogging (18%), whereas participation in home training declined compared to the DURING-C19 period.

In total, 65% of the respondents found that the overall regulations implemented in context of the COVID-19 crisis in Tyrol were appropriate. 57% of the respondents agreed with the measures on practicing sport; however, 18% did not support these measures. Answering the open question relating to sport policy recommendations, 22% of the participants spoke out in favour of promoting mass sport and supporting small sports clubs in their POST-C19 activities. Moreover, 7% of the respondents stated that politicians should establish appropriate COVID-19 precautions and rules for practising sport (7%), while 12% wanted sport to continue as it was before the pandemic. However, the majority of respondents (48%) did not answer the open questions.

In summary, the surveyed Tyroleans did less sport in the DURING-C19 than in the PRE-C19 and POST-C19 period. During the stay-at-home order, the collective of respondents switched to home training, largely avoided engaging in prohibited outdoor sport, but went for a walk. The retrospective assessment of sport participation frequency and practiced sport disciplines was in line with an earlier representative population survey 9 . However, it was observed that in certain groups-namely, those with low engagement in sport-up to 45% of the respondents reported increased sport participation frequency in the POST-C19 period compared to the PRE-C19 period. Comparing the percentage of respondents with increased to those with decreased frequency (Table 1 , col. Increase vs. Reduction), brought to light some remarkable results: In the groups of respondents who had done sport only seldom or one to three times a month in the PRE-C19 period, we could identify a difference of 15 and 20 percentage points, respectively; i.e., more people increased than decreased their individual sport participation.

The theory of falling opportunity costs could be used for interpreting the results. On the one hand, we could argue that the increase in sport participation might be associated with the increase in leisure time; on the other hand, there might be a shift in preferences. However, lack of time is the most frequently mentioned reason for not doing sport 10 . Furthermore, these first descriptive results raise the question if one of the most common aims of sport policy-namely, increasing sport participation in people who only rarely do sport-might by partly reached through a crisis, such as the COVID-19 pandemic. However, the reasons for this behaviour change are unclear. Perhaps, preferences have changed and we can hope for a sustainable increase in sport participation. Both explanatory approaches are justified, and presumably, the underlying reasons are a mixture of both. However, whether this change will persist remains unclear.

Even though this study has some limitations (e.g., retrospective survey method, no inferential statistics), our observations raised several questions in the context of the persistence of behaviour changes and their reasons. This is an area where further research could be started. Table 1 Frequency of exercising or playing sport (N = 511) in the PRE-C19 (before the stay-at home order on 16 March 2020), DURING-C19 (between 16 March and 7 April 2020), and POST-C19 (from 7 April 2020 onwards) period in comparison to the results of the Eurobarometer 472 10 

• In general, participants did less sport during the COVID-19 stay-at-home order • Within-group analyses showed increasing sport participation in less active groups • Respondents adhered to the outdoor sport ban and did home training instead • Appropriateness of regulations implemented in context of the COVID-19 were measrued • Crises such as COVID-19 might have a long-term impact on sport participation

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