The Relationship Between Risk Perception, Physical Activity, and Adolescent Mental Health: A Cross-Lagged Analysis

BACKGROUND: During the novel coronavirus pandemic, the prevalence of anxiety and depressive symptoms among adolescents rose dramatically to 31% and 34%, respectively. This study aims to elucidate the relationship between perceived disease risk, physical activity, and adolescent mental health, questioning whether physical activity maintains its protective role amidst heightened disease risk. METHODS: In a longitudinal study design, questionnaires were administered twice, in December 2022 and January 2023, to a cohort of students across five high schools. These questionnaires measured adolescents’ perception of disease risk, their physical activity levels, and their mental health status during the pandemic. A total of 344 students participated in this study. RESULTS: The data revealed significant gender differences in risk perception, with gender difference effects of 0.255 (d=0.416) and 0.195 (d=0.402) across both indicators, and in mental health, with gender difference effects of 0.159 (d=0.262) and 0.179 (d=0.278). Risk perception at Time 1 was found to be a significant predictor of both physical activity and mental health (β values of 0.28 and 0.19, P < 0.01, respectively). Physical activity at Time 1 was also a significant predictor of mental health at Time 2 (β = 0.33, P < 0.01). Moreover, physical activity mediated the relationship between risk perception and mental health, as suggested by a significant indirect effect (mediator effect of 0.012, Z value of 0.112, and a Bootstrap 95% CI excluding 0). CONCLUSION: This study underscores a longitudinal relationship between adolescents’ perception of disease risk, physical activity, and mental health. It highlights the potential benefits of promoting physical activity awareness among adolescents as a strategy to improve mental health outcomes during pandemics.