Exploring Sedentary Time as a Moderator in the Relationship Between COVID-19 Symptom Burden and Mental Health Outcomes in 4 African Countries

14/08/2026

AI Summary

Sedentary time varied across countries; Nigeria and Tanzania had lower median sitting times than Botswana and Ghana.
Sedentary time moderated the positive association between COVID-19 symptom burden and depressive symptoms overall, with stronger effects at higher sitting time.
At country level, the moderating effect was significant only in Ghana, indicating context specific influences on mental health outcomes.

AI Summary

In this study, sedentary time during COVID-19 and its moderating role in the relationship between COVID-19 symptom burden and mental health outcomes were examined in Botswana, Ghana, Nigeria, and Tanzania.

Overall, sedentary time moderated the positive relationship between COVID-19 symptom burden and depressive symptoms (B = 0.60, P =.012), with stronger associations at higher sitting time (simple slope: B = 2.27, P <.001).

Basic summary

J Phys Act Health. 2026 Aug 12:1-11. doi: 10.1123/jpah.2025-0511. Online ahead of print.

ABSTRACT

BACKGROUND: Physical inactivity and mental distress were prevalent across African populations during COVID-19. However, limited research has explored the role of sedentary time in shaping mental health outcomes during the pandemic. In this study, sedentary time during COVID-19 and its moderating role in the relationship between COVID-19 symptom burden and mental health outcomes were examined in Botswana, Ghana, Nigeria, and Tanzania.

METHODS: Cross-sectional data (April 2020 to November 2022) from 3125 adults (male = 52.3%, Mage = 27.05, SD = 8.91) were analyzed. Participants completed self-report measures of COVID-19 symptoms (eg, persistent cough and unusual fatigue), physical activity and sedentary time (International Physical Activity Questionnaire-Short Form), as well as anxiety (Generalized Anxiety Disorder 7) and depressive symptoms (Patient Health Questionnaire).

RESULTS: Median sedentary time per day was lower in Nigeria (median = 120, interquartile range = 150) and Tanzania (median = 120, interquartile range = 180) than in Botswana and Ghana (median = 180, interquartile range = 180). Overall, sedentary time moderated the positive relationship between COVID-19 symptom burden and depressive symptoms (B = 0.60, P = .012), with stronger associations at higher sitting time (simple slope: B = 2.27, P < .001). At the country level, this moderating effect was observed only in Ghana (B = 1.38, P < .001; simple slope: B = 2.40, P < .001).

CONCLUSIONS: These findings highlight cross-country variation in sedentary time during the pandemic and suggest that greater sedentary time exacerbated the relationship between COVID-19 symptom burden and depressive symptoms, particularly in Ghana. Context-specific factors and differing pandemic responses may help explain these country-level differences.

PMID:42595330 | DOI:10.1123/jpah.2025-0511

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