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COMPLETED: Development of policy recommendations to reduce the impact of COVID-19 on physical activity and mental health in individuals with multimorbidity: a mixed method study.


Principle Investigator – Professor Mari-Carmen Portillo (University of Southampton)


  • Dr Danielle Lambrick (University of Southampton) 

  • Dr James Faulkner (University of Winchester)

  • Dr Leire Ambrosio Gutierrez (University of Southampton) 

  • Associate Professor Beth Stuart (University of Southampton),

  • Professor Suzanne McDonough (Royal College of Surgeons in Ireland)

  • Professor Melitta McNarry (Swansea University)

  • Dr Jacqui Morris (University of Dundee)

  • Dr James Steele (Solent University)

  • Mr Eric Compton (PPI Representative)

  • Ms Katherine Baker (University Hospital Southampton)

  • Mr Jack Shakespeare (UK Active)

  • Dr Matthew Wade (UK Active)

Start: January 2021

End: June 2022

Aim of the research: To understand the impact of COVID-19 and government restrictions on physical activity and mental health of people with long-term conditions, and propose recommendations to support and sustain their physical activity during and after COVID-19 or other pandemics. The findings of our study will inform stakeholder events across the UK including participants and policy-makers to draw action plans together.

Background to the research: People, including those with long-term conditions, were told to use physical distancing, self-isolation and/or shielding during COVID-19 to protect themselves and others. Government guidance on physical activity may or may not have explained to people how to be physically active and take part in exercise during COVID-19. Physical activity has a positive effect on physical and mental health, so understanding the impact of COVID-19 on physical activity behaviours (amount, type and intensity of physical activity, resources) of people with or without long-term conditions is important.

What did we find out?

  • General physical activity (PA) guidelines are not suitable for people with long term conditions (LTCs). Existing generic PA guidelines by the World Health Organization are not suitable for everyone because  differences in age, gender, physical abilities, PA preferences, and LTC severity may affect why people choose not to exercise

  • Online resources are not accessible for all populations. During COVID-19 pandemic, provision of PA information was most commonly available online. Hence, PA programmes designed for the general population may not be appropriate for clinical groups from a safety perspective

  • People living with one LTC engaged in more moderate and high intensity PA compared to those with multiple LTCs

  • People living with one LTC present better overall quality of life and lower anxiety and depression than those living with multiple LTCs

  • Physical activity guidelines should be specific. Local and national government guidelines were identified as unclear for those living with LTCs and should be more specific regarding what people who were shielding could and could not do

What difference could this make?

  • Developing health and social care strategies to sustain PA, optimise online/offline resources and communication to promote individuals with LTCs can remain physically active

  • Helping policy and guidelines development, particularly for  those living with multiple LTCs

Why is this important?

Understanding the impact of COVID-19 on physical activity and mental health is beneficial to informing LTC policy development, to better support people living with LTCs to be physically active during future periods of mobility restriction and/or pandemics

Findings emerged in this project, will support

The development of more tailored and person-centred physical activity (PA) guidelines. in the case of individuals who are advised to shield, guidance should be provided on how they can be physically active within and around their homes. For example, tailor their PA according to how they manage and cope with their LTC and its changeability is recommended

Prioritising vulnerable groups is recommended. Therefore, people with LTCs are an important and specific group to consider when designing and delivering PA guidelines during shielding or social-distancing periods

How we are sharing our findings

Policy recommendations have been developed that capture strategies to sustain Physical Activity and optimise online/offline resources and communication to promote individuals with Long Term Conditions can remain physically active.

Policy Brief
Download PDF • 3.53MB

Findings from the quantitative and qualitative phase of the project informed stakeholder engagement activities across all counties of the UK. Representatives from macro, meso and micro levels were approached as well as Patients and Public contributors.

Publication: Full article: Accessibility and applicability of physical activity guidelines and recommendations for adults living with long term conditions during COVID-19 (

Conference: Presented mixed methods results of the project in an international congress - 7th World conference on qualitative research (25-27 January 2023)

Development of recommendations co-developed at event January 2023

Podcast planned for 2023

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