Association between the Perception of Behavior Change and Habitual Exercise during COVID-19: A Cross-Sectional Online Survey in Japan.

In general, the perception of behavior change may be associated with habitual exercise. However, this association might not be well-understood due to the state of emergency of the COVID-19 pandemic. This study collected data from 1499 internet users aged 20-86 years living in Japan who participated in the online survey from 26 to 27 February 2021. Having a perception of behavior change was defined as preparation, action, and maintenance of the transtheoretical model. The habitual exercise was defined as 600 metabolic equivalent min/week or more based on the International Physical Activity Questionnaire. Multivariate logistic regression analysis was used to calculate the odds ratio of habitual exercise and a 95% confidence interval was estimated after adjusting for related factors. We found that perception of behavior change was positively associated with habitual exercise (adjusted odds ratio = 2.41, 95%CI = 1.89-3.08), and similar associations were found in states of emergency (2.69, 1.97-3.69) and non-emergency (2.01, 1.34-3.01). Moreover, women were negatively associated in all analyses with habitual exercise compared to men (0.63, 0.49-0.80; 0.65, 0.44-0.96; 0.62, and 0.45-0.84, respectively). Thus, the perception of behavior change may be involved in the implementation of habitual exercise, suggesting that women face difficulties in engaging in habitual exercise.