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Objective: To understand the mental health response to repeated and prolonged stress during the COVID-19 related lockdown and the role of specific health behaviors to buffer against this stress., Methods: In a longitudinal study with several measurement points covering three months during the COVID-19 pandemic, about 3500 randomly selected participants representative of the German population reported on their mental health (anxiety, depression, loneliness) and health behaviors (screen time, snack consumption, physical activity)., Results: Symptoms of anxiety, depression, and loneliness were highest shortly after the lockdown came into effect. Over time, the symptoms were stable or went down slightly, corresponding to patterns of habituation. Among people with higher vulnerability to poor mental health during the lockdown (e.g., women), the proportion with high levels of anxiety, depression, and loneliness was considerably larger. These groups also reported fewer health-promoting behaviors. More screen time, more snacking, and less physical activity were related to higher symptoms of anxiety, depression, and loneliness across all time points. Changes in health behaviors over time mostly did not predict changes in mental health symptoms., Conclusions: Mental health and engagement in protective health behaviors was lowest at the start of the lockdown. Health behaviors mostly returned to pre-lockdown levels within three months. Engaging in healthier behaviors was associated with better mental health. Policy implications of these findings are discussed. This study provides important insights into (unintended) side effects of an international crisis and can contribute to a better understanding of how to preserve mental health., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: During the COVID-19 pandemic, one way to reduce further transmissions of SARS-CoV-2 is the widespread use of contact tracing apps. Such apps keep track of proximity contacts and warn contacts of persons who tested positive for an infection., Objective: In this study, we analyzed potential barriers to the large-scale adoption of the official contact tracing app that was introduced in Germany on June 16, 2020., Methods: Survey data were collected from 3276 adults during the week the app was introduced using an offline-recruited, probability-based online panel of the general adult population in Germany., Results: We estimate that 81% of the population aged 18 to 77 years possess the devices and ability to install the official app and that 35% are also willing to install and use it. Potential spreaders show high access to devices required to install the app (92%) and high ability to install the app (91%) but low willingness (31%) to correctly adopt the app, whereas for vulnerable groups, the main barrier is access (62%)., Conclusions: The findings suggest a pessimistic view on the effectiveness of app-based contact tracing to contain the COVID-19 pandemic. We recommend targeting information campaigns at groups with a high potential to spread the virus but who are unwilling to install and correctly use the app, in particular men and those aged between 30 and 59 years. In addition, vulnerable groups, in particular older individuals and those in lower-income households, may be provided with equipment and support to overcome their barriers to app adoption., (©Annelies G Blom, Alexander Wenz, Carina Cornesse, Tobias Rettig, Marina Fikel, Sabine Friedel, Katja Möhring, Elias Naumann, Maximiliane Reifenscheid, Ulrich Krieger. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.03.2021.)