Introduction
Healthcare professionals (HCPs) may be particularly vulnerable to the mental health impact of the coronavirus disease 2019 (COVID-19) pandemic.1 While the association is likely to be bidirectional, one potential modifiable factor to improve mental health in HCPs is the improved lifestyle,2–6 including physical activity, diet, smoking and alcohol intake.7 Due to the potential for developing chronic physical diseases and mental health issues, which could lead to work absences and reduced quality of patient care, there is an urgent need to understand the lifestyle impact of the pandemic and its association with mental health in HCPs.
The lifestyle impact of the pandemic on the general population is evident, particularly regarding lockdown measures.8–16 Recent research has also found that essential workers, primarily consisting of HCPs, had worsened lifestyle compared with non-essential workers during the pandemic,17 and worse lifestyle has been associated with worse mental health in HCPs and essential workers in several cross-sectional studies.3 5 6 18 19 Despite this, one study observed no association between problem drinking and mental health status in UK intensive care HCPs.20 Longitudinal studies assessing change in mental health associated with lifestyle over time in HCPs are lacking. As such, the possible value of lifestyle as a modifiable factor to improve mental health in HCPs remains unclear, since cross-sectional studies provide ‘snapshot’ associations. Moreover, any consistencies between studies could be due to assessing specific domains of lifestyle (e.g. problem drinking20), in contrast to overall lifestyle.
The COVID-19 Disease and Physical and Emotional Well-being of Health Care Professionals (CoPE-HCP) project aimed to examine how the pandemic impacts specific lifestyle domains in HCPs and to examine the association between overall lifestyle changes and mental health in HCPs at two points during the pandemic. Importantly, this study aimed to examine whether an improved lifestyle over a period during the pandemic is associated with improved mental health and well-being in HCPs. We hypothesised that there would be worsened lifestyles in HCPs as compared with the beginning of the pandemic and that these would be associated with adverse mental health status in HCPs at baseline and follow-up. Lastly, we hypothesised that an improved lifestyle would be associated with improved mental health symptoms and well-being over the same period. If proven, these findings will inform further strategies for the well-being of employees and the public in pandemics and other similar settings.