COVID transmission-related concerns impact on physical activity behavior: data from the iCare study.

Objective: We explored the relationship between COVID-19 transmission-related concerns and reduced physical activity during COVID (RPAC). Methods: We analyzed data from 2,543 participants across Argentina, Brazil, Colombia, Canada, and the USA with at least 200 participants per country. The two primary concerns assessed were: a) fear of being infected, and 2) concern about personal health if infected. Participants were asked to report changes in their physical activity (PA) behavior since COVID-19 pandemic started. Results: The sample was predominantly female (75.7%), with 66.9% aged between 30-64 years. The prevalence of participants who reported RPAC remained stable in South American countries but increased in Canada (+7.8 percentage points [p.p.]; p = 0.001) and decreased in the USA (-9.7 pp; p = 0.003). Concerns about personal health were significantly associated with RPAC in South America (PR = 1.47; 95% CI: 1.09; 1.97), while no association was found in North America. Notably, participants from Colombia (PR = 1.90; 95% CI: 1.09; 3.31), and the USA (PR = 1.48; 95% CI: 1.01; 2.17) were more likely to report RPAC due to COVID-19 concerns. Conclusion: While participants reduced their PA behavior in South American countries and Canada during the first 15 months of the pandemic, COVID 19-related concerns stayed high. In contrast in the USA less participants reported RPAC, as concerns decreased, suggesting a shift in PA behavior as COVID-19-related concerns lessened.