Assessing the Risk of Cardiovascular Disease during Quarantine

among Grade 12 STEM Students

A Research Presented to the Faculty of the Senior High School

Mayamot National High School

Antipolo City

In Partial Fullfillment of the Requirements for the Strand

Science, Technology, Engineering, and Mathematics

by

Huey Daniel P. Hallare

Bernadine Kesia B. Bolilan

Jastine Mae S. Cruzada

Angelica S. Erispe

Christine Joy S. Pizon

Jewel T. Se

Jerame B. Zuñiga

Researchers

Mr. Jayson Seel Maravilla

Research Adviser
 ABSTRACT

The Coronavirus Disease-2019 (COVID-19), which is caused by Severe Acute

Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has presented a challenge for the

health care systems across the globe. Several precautionary measures, such as quarantine,

have been introduced to suppress the increasing number of cases. However, quarantine

restrictions might influence the lifestyle that can lead to an increased risk of having

cardiovascular diseases (CVDs). This descriptive and causal-comparative research sought to

assess the risk of CVDs among 12-STEM students during the quarantine. This study was

conducted in Mayamot National High School during the first semester of the academic year

2020-2021.

An online survey was distributed to 103 grade 12 STEM students and asked to respond

to the questionnaire to assess the effects of the imposed quarantine on (1) physical activity,

(2) nutritional habits, and (3) mental health. Also, to tests, if there is a significant difference

between the risk of CVDs before and during the quarantine.

The results showed that the quarantine negatively impacts the physical activity,

nutritional habits, and mental health of the 12-STEM students. These results suggest that

quarantine leads to a heightened risk of CVDs. Moreover, findings revealed that there is a

significant increase in the risk of CVDs among 12-STEM students during quarantine

compared to before quarantine.

 CHAPTER I

Introduction and Background of the Study

The newly discovered coronavirus, subsequently named Severe Acute Respiratory

Syndrome Coronavirus 2 (SARS-CoV-2), which causes the Coronavirus Disease-2019

(COVID-19), has presented a hurdle for the health care systems across the world. Currently,

there are no effective medicines or vaccines available to treat COVID-19. Different public

health preventive measures have been introduced by the government to suppress the

increasing number of cases with COVID-19 — one of these is the quarantine.

Parmet & Sinha (2020) define quarantine as the separation of persons or communities

who have been exposed to an infectious disease. Isolation, meanwhile, refers to the

separation of persons who are recognized to be infected. Despite more than 200 days of

quarantine and still counting, one of the longest in the world, the Philippines has one of the

highest numbers of cases in the region.

However, such restrictions may affect the lifestyle leading to an increased burden of

cardiovascular disease or CVD (Mattioli & Ballerini Puviani, 2020). The World Health

Organization [WHO] (2017) listed cardiovascular diseases as the leading cause of death

globally, with an estimate of 17.9 million people died from CVDs in 2016, representing 31% of

all global deaths. Additionally, 35% of the 2016 total deaths in the Philippines were caused by

CVDs, higher than the global average.

Physical inactivity is one of the main consequences of quarantine protocols. The

regulations imposed by the government prohibits outdoor and social activities led to the

reduction of physical activity (Parmet & Sinha, 2020). Moreover, dietary habits are also part of

the consequence of quarantine. The economic crisis caused by the restriction of lockdown

deteriorated food selections; mainly in individuals of lower socioeconomic status (Devi, 2020).

Such an unhealthy diet may lead to an increase in obesity.

WHO (2004) claimed that physical inactivity and an unhealthy diet are among the leading

causes of major non-communicable diseases, such as cardiovascular disease. Some of the

risk factors of CVDs, including high blood pressure, high concentrations of cholesterol in the

blood, inadequate intake of fruit and vegetables, overweight or obesity, and physical inactivity

are closely related to diet and physical activity.

Furthermore, quarantine induces anxiety and stress. According to Brooks et al. (2020), A

recent review on the psychological impact of quarantine announced negative psychological

effects, which include posttraumatic stress symptoms, confusion, and anger. These

psychological effects might alter the physical and eating habits of the people.

Peçanha et al. (2020) stated that even a short term (1-4 weeks) of inactivity was linked

with deleterious consequences to cardiovascular function and structure and increased

cardiovascular risk factors. Similarly, during the 1918 Spanish flu pandemic, an increase in

cardiovascular events have been observed between 7-10 days after the emergence of the flu.

Such events even exceeded other causes of mortality (Collins, 1932).

The impact of lifestyle and behavioral changes caused by the pandemic may be greater

to adolescents, which may put their current and future health under threat. These prompted

the researchers to conduct the study to assess the potential risk of CVDs during the imposed

quarantine in the present day, specifically to the grade 12 STEM students of Mayamot

National High School. The researchers sought to determine if they were vulnerable in

acquiring the said ailment due to the possible changes in their way of life caused by the

COVID-19 pandemic. The researchers also wished to determine if the risk level of grade 12

STEM students to the CVDs is dissimilar before and during the quarantine.

Statement of the Problem

This study aimed to find out and assess the potential cardiovascular risk among grade 12

STEM students in Mayamot National High School during the quarantine. This study also

sought to differentiate the risk of cardiovascular disease among grade 12 STEM students

before and during the imposed quarantine.

 Specifically, the researchers sought to answer these specific questions:

1. What are the influences of the quarantine restrictions on the physical activities

that leads to an increased burden of cardiovascular disease on the grade 12

STEM students?

2. What are the changes caused by the quarantine to the nutritional habits that

heighten the risk of cardiovascular disease on grade 12 STEM students?

3. What are the contribution of mental health on the risk of cardiovascular disease

on the grade 12 STEM students?

Significance of the Study

The researchers aimed to assess the potential risk of Grade 12 STEM students of

Mayamot National High School to cardiovascular diseases because of the quarantine

restrictions. The following benifited to the findings of the study:

Schools - School officials can assess if their students are vulnerable to the risks of

cardivascular disease.

Community - The people can get awareness about what they can do to avoid the potential

risk of having a cardiovascular disease.

Health Experts - Health professionals will have an overview if there will be an increase in

cardiovascular disease burden.

Local Government Units (LGUs) - The government unit can have an insight into the

cardiovascular disease situation in their locality.

Future Researchers - Prospective researchers can use this as a reference to expound on

this study in the future.

Scope and Delimitation

This study aimed to assess the potential risk of grade 12, specifically STEM students of

Mayamot National High School in Antipolo City on having cardiovascular disease during the

quarantine. This study aimed to explain how unhealthy lifestyles, including physical inactivity

and inadequate diet, as well as the mental stress of the students, can contribute to the

increase of the risk of having the disease.

The results of the study were constrained by the main factors. First, respondents of the

study can be improved by having a larger and more diverse population. Second, the

collection of data from people with cardiovascular disease can be included. Third, specialists

that are concerned with nutrition and stress can be an additional variable of the study.

Hypothesis

There is no significant difference between the risk of cardiovascular disease before

quarantine and during quarantine among grade 12 STEM students.

 CHAPTER II

Review of Related Studies and Literature

Physical inactivity has long been regarded as a public health concern globally.

Insufficient physical activity is known as one of the main risk factors for mortality worldwide.

According to WHO (2018), 1 in 4 adults is lacking in physical activity globally. Also, 3 in 4 of

the adolescent population is inadequately physically active.

Consequently, the WHO launched the More Active People for a Healthier World, a

Global Action Plan which aims to have "a 15% relative reduction in the global prevalence of

physical inactivity in adults and adolescents by 2030" (WHO,2018).

However, in a recent research report published by Guthold et al. (2019), "The majority of

adolescents do not meet current physical activity guidelines." The Philippines has the highest

prevalence of inadequate activity among boys in 2016, with a percentage of 92.8%, while

94.3% in girls, only 2.9% behind the 97.2% of South Korea, which has the highest insufficient

activity prevalence among girls.

Moreover, while there has been a slight decline in the prevalence of insufficient physical

activity in boys since 2001, there was no improvement over time in girls. They have analyzed

that if these trends persist — the target of a 15% reduction worldwide by 2030 will not be

achieved.

Disturbingly, According to Aubert et al. (2018), only 2 in 10 youth worldwide reach the

suggested 60 minutes of Moderate to Vigorous Physical Activity (MVPA) daily. It is foreseen

that because of the ongoing health crisis, the prevalence of physical inactivity will escalate.

Notwithstanding the calls to workout at home during quarantine, only a few people

comply (Mattioli & Puviani, 2020). "The COVID-19 pandemic has created an environment that

promotes reduced amounts of habitual physical activity owing to self-isolation and quarantine

requirements, reduced opportunities to remain physically active and fear of being infected"

(Pinto et al. ,2020).

 Meanwhile, an Unhealthy diet has also been a notable health concern worldwide. Along

with physical inactivity, an unhealthy diet is likewise the leading risk factor for mortality

globally. The WHO (2015) estimates that about 1 in 10 people or approximately 600 million

people worldwide fall ill after eating unsafe food.

The WHO recommends that a person should only consume about 2 grams of sodium or

about 5 grams of salt per day. Yet, in a recent study by Thout et al. (2019), "In all countries,

salt intake levels remain higher than the World Health Organization's recommendation,

highlighting the need for additional global efforts to lower salt intake and monitor salt

reduction strategies."

In an article written by Tacio (2017), he cited that the average salt intake of Filipinos is

nowhere near the WHO recommendation, which reaches 12-15 grams per day. The amount

of salt intake by most Filipinos triples the recommended consumption.

Furthermore, while fats, in general, are needed by the body to function, high

consumption of saturated and trans-fatty acids is linked to heart disease. In an article by

Francisco (2020), Filipinos are not well informed about the problem that arises from eating

lots of trans fats. He also noted that if Filipinos will not be careful, the high consumption of

food containing trans fats will lead to an increase in the risk of mortality and morbidity caused

by coronary heart disease.

Additionally, in an information sheet released by WHO (2018), approximately one in

three people suffer from at least one form of malnutrition. The United Nations Children's Fund

[UNICEF] Philippines (2019) warned that most Filipino children are suffering from inadequate

diets, nutrition, and food systems that are failing them. Filipino adolescents are eating

unhealthy food that does not meet their nutritional needs. Moreover, based on the data

released by the Department of Science and Technology - Food and Nutrition Research

Institute [DOST-FNRI] (2018), 11.6% of Filipino adolescents aged 10-19 are overweight and

obese, which surged up by 2.4% from the 2015 data of 9.2%.

 Despite the numerous agendas taken by different international and local organizations to

suppress hunger and malnutrition, the United Nations' Food and Agriculture Organization

[FAO] (2020) reported that the people affected by hunger are gradually increasing. They also

stated that malnutrition, in its all forms, remains to be a challenge.

The United Nations System Standing Committee on Nutrition [UNSCN] (2020) stated

that the ongoing COVID-19 outbreak disrupted the food system throughout the world. It is

foreseen that the food security and nutritional status of the most vulnerable population groups

will deteriorate further due to the health and socio-economic consequences of the COVID-19

pandemic. Numerous Filipino families are forced to resort to cheap, yet unhealthy food

options (Ramos, 2020).

On the other hand, there is a clear connection between mental health and physical

health (Ohrnberger et al., 2017). Poor physical health can escalate the risk of developing

mental health problems. Similarly, poor mental health negatively impacts physical health,

resulting in an increased risk of some conditions.

For instance, stress is one of the emerging risk factors for CVDs (Kivimäki & Steptoe,

2017). Psychological stress, according to the University of Rochester Medical Center (n.d.),

can cause high levels of a hormone called cortisol, which leads to increase blood cholesterol,

triglycerides, blood sugar, and blood pressure. These will then result in constriction of arteries

that leads to myocardial infarction and induce cardiac irregularities in persons with or without

structural heart disease (Chadda et al., 2016).

"Many people underestimate the impact that stress can have on the body, especially the

heart" (Tabash, 2018). Chronic psychological distress can also indirectly harm the heart.

According to the John Hopkins University School of Medicine (n.d.), stress can cause poor

sleeping habits, unhealthy food choices, and less physical activity.

As the whole world faces the pandemic, the imposed containment measures are

showing detrimental outcomes on the mental health of the general population worldwide.

"Frustration, loneliness, and worries about the future are common reactions and represent
well-known risk factors for several mental disorders, including anxiety, affective, and

post-traumatic stress disorders" (Giallonardo et al., 2020).

Consequently, based on the article by (Bonquin, 2020), the Department of Health (DOH)

reported an alarming spike of calls in the National Center for Mental Health's hotline amid the

pandemic. Moreover, the Filipino youth are the most vulnerable to mental illness because of

the pressure and changing times.

Definition of terms

Cardiovascular Disease is a condition affecting the heart and the blood vessel. It builds up

fatty deposit that inhibit blood flow though the arteries, organ and tissues.

Nutritional Habit is the food choices of an individual in their daily life.

Physical activity is any bodily movement that requires energy.

Psychological distress is a disturbance in the individual’s feelings or emotions due to

conflicts and difficulties to cope with their daily life.

Quarantine is used to restrict someone’s movement intended to prevent the transmission of

a disease or virus.
 CHAPTER III

Research Methodology

Research Design

This study was intended to determine the potential risk of Grade 12 STEM students of

Mayamot National High School in Antipolo City. The researchers considered using

quantitative research. “Quantitative research is the process of collecting and analyzing

numerical data. It can be used to find patterns and averages, make predictions, test-causal

relationships, and generalize results to wider populations” (Bhandari, 2020).

In this particular study, the researchers used descriptive research as the research design.

According to McCombes (2020), descriptive research aims to describe a population, situation,

or phenomenon through a process of systematic data collection that enables them to explain

the situation more accurately. It is descriptive since the study is primarily concerned with

determining the risks of grade 12 STEM students to cardiovascular disease during the

quarantine. Likewise, the researchers used a causal-comparative research design. Its focus

is to establish the differences of variables by comparing two or more groups (Brewer & Khun,

2010). It is causal-comparative since it attempted to differentiate the risks of grade 12 STEM

students during the quarantine from the risks before the quarantine.

Respondents of the Study

The respondents of the study were the grade 12 STEM students of Mayamot National

High School in Antipolo City who experienced quarantine health protocols. The researchers

surveyed the respondents about their physical lifestyle, nutritional habits, and mental health

before and during the imposed quarantine. The researchers selected 103 grade 12 STEM

students as the respondents out of the population of 139 using Slovin's formula. The

researchers decided to pick from the pool of grade 12 STEM students as the respondents

because they were the most eligible in answering the questionnaires regarding these matters.
Sampling Technique

In this study, the researchers utilized simple random sampling (SRS). SRS is a technique

in which every element or member of a population has an equal opportunity of being selected

as part of the sample (Mendoza et al., 1997; Hayes, 2020). Also, SRS is a method intended

to be unbiased (Hayes, 2020), and the researchers believed that using this technique freed

this study from any biased results.

Locale of the Study

This study was conducted in Mayamot National High School in Antipolo City during the

first semester of the academic year 2020-2021. The respondents was given the survey

questions through google forms as the researchers were not allowed and restricted to went

outside because of the on-going pandemic. The researchers chose this place of

implementation because it was more accessible for the researchers to gather data as the

researchers were also from the said school.

Research Instrument

The research instrument used in this study was a survey questionnaire. According to

Johnson & Christensen (2019), it is a type of data collection that is self-reported by each of

the respondents. The researchers opted to use a technology-based questionnaire and

administer an online survey through Google Forms because of the current situation.

To assess the physical lifestyle, nutritional habit, and mental health of each respondent,

the researcher used a 4-point Likert scale for frequency:

4 - Always

3 - Often

2 - Rarely

1 - Never
Data Gathering Procedure

The researchers developed the survey questionnaires. The research experts then

validated the content of the developed questionnaires. After the validation, the researchers

selected 103 grade 12 STEM students using a random number generator and personally

administered the survey to the selected respondents online for data collection.

After collecting the response of the respondents, the researchers tabulated and

computed the obtained data. The researchers then presented, analyzed, and interpreted the

data gathered to answer the research questions that this study was attempting to seek.

Data Analysis

The researchers used descriptive statistics for data analysis. Descriptive statistics is

used in describing and summarizing the features of the accumulated data (Bhandari, 2020;

Trochim, 2020). The measure of central tendency, specifically the Mean, was utilized to

estimate the averages of the data set.

The frequency scale that the researchers used in interpreting the mean is shown below.

Scale Range Verbal Interpretation

4 3.25 – 4.00 Always (A)

3 2.50 – 3.24 Often (O)

2 1.75 – 2.49 Rarely (R)

1 1.00 – 1.74 Never (N)

The researchers also used inferential statistics for data analysis. Inferential statistics is

used in forming inferences from the gathered data, and to reach generalizations to the whole

population (Glen, 2014; Trochim, 2020). The researchers utilized a directional t-test:Paired

two sample for means in comparing the risks of CVDs before and during the quarantine.
 CHAPTER IV

Presentation, Analysis, and Interpretation of Data

This chapter included the presentation, analysis, and interpretation of data that have

been gathered from the survey questionnaires distributed to the respondents.

Mean of the Responses

Table 1

Assessing the Physical Activity of Grade 12 STEM Students Before and During Quarantine

Before Quarantine During Quarantine

Items
(Physical Activity) Verbal Verbal
Mean Mean
Interpretation Interpretation
1. I exercise for at least 4-5
times a week. 2.73 Often (O) 2.64 Often (O)

2. I participate in recreational
activities. 2.69 Often (O) 2.33 Rarely (R)

3. I achieve at least 5,000

step counts or greater a day. 3.01 Often (O) 2.43 Rarely (R)

Overall Mean and Verbal

Interpretation 2.81 Often (O) 2.47 Rarely (R)

Table 1 shows that the physical activity of grade 12 STEM students decreased. The

overall mean and verbal interpretation during quarantine was 2.47 (Rarely), which is 0.34 less

than the 2.81 (Often) of before quarantine. Similar to the study conducted by Pinto et al.

(2020), the prevailing pandemic lessened the opportunity to maintain being physically active

due to the quarantine requirements and built a setting that encourages physical inactivity.

Hence, with the reduction of physical activity, the risk of CVDs among 12-STEM students

might increase.
Table 2

Assessing the Nutritional Habit of Grade 12 STEM Students Before and During Quarantine

Before Quarantine During Quarantine

Items
(Nutritional Habits) Verbal Verbal
Mean Mean
Interpretation Interpretation
1. I do not skip eating
breakfast. 3.13 Often (O) 2.83 Often (O)

2. I eat a variety of nutritional

foods. 3.22 Often (O) 2.70 Often (O)

3. I avoid consuming
unhealthy foods. 2.86 Often (O) 2.49 Rarely (R)

Overlall Mean and Verbal

3.07 Often (O) 2.67 Often (O)
Interpretation

It is seen in table 2 that the nutritional habits of grade 12 STEM students worsened.

While the overall verbal interpretation remains the same, the overall mean drops by 0.40,

from 3.07 (Often) before quarantine to 2.67 (Often) during the quarantine. The food system

across the globe was interrupted by the pandemic (UNSCN, 2020), which can affect the

availability and affordability of nutritional foods. Therefore, the decline in the dietary habit of

12-STEM students can lead to a heightened risk of CVDs.

Table 3

Assessing the Mental Health of Grade 12 STEM Students Before and During Quarantine

Before Quarantine During Quarantine

Items
(Mental Health) Verbal Verbal
Mean Mean
Interpretation Interpretation
1. I do not undereat/overeat
when feeling stressed. 2.84 Often (O) 2.61 Often (O)

2. I can still do physical

activity even if I am mentally 3.01 Often (O) 2.58 Often (O)
drained.
3. I do not
undersleep/overseep when 2.74 Often (O) 2.38 Rarely (R)
psychologically distressed.
4. I do not feel any pain for
no clear physical cause. 3.04 Often (O) 2.54 Often (O)

Overall Mean and Verbal

Interpretation 2.91 Often (O) 2.53 Often (O)
 It is seen in Table 3 that there is a decline in mental health conditions of grade 12 STEM

students. While the overall verbal interpretation remains the same, the overall mean lessened

by 0.38, from 2.91 (Often) before quarantine to 2.53 (Often) during the quarantine. Poor

mental health, such as stress can induce a lack of sleeping habits, physical activity, and

unhealthy food choices (John Hopkins University School of Medicine, n.d.). Therefore, the

drop in the mental health affects the physical activity and nutritional habit of 12-STEM

students which might result in an elevated risk of CVDs.

Significant differences between the CVDs risk of grade 12 STEM students before and

during the quarantine.

Table 4 shows the computed t-value, P-value, and interpretation between the CVDs risk

of grade 12 STEM students before and during the imposed quarantine. A one-tailed paired

t-test was conducted on a sample of 103 grade 12-STEM students to assess if there is an

increase in the risk of CVDs during quarantine as compared to before quarantine.

Table 4

Paired Sample T-test in Comparing the risk of Grade 12 STEM Students to CVDs Before and

During Quarantine

T-critical P-value
Respondents Decision
Mean SD T-value (One (One Remarks
(n=103) to H0
tail) tail)
Before
2.9272 0.4080
Quarantine
8.8137 1.6599 0.0000 Reject H0 Significant
During
2.5534 0.3943
Quarantine

It can be gleaned from the table that there is a significant increase in the risk of grade 12

STEM students to CVDs during the quarantine (M=2.5534, SD=0.3943, n=103) as opposed

to before the quarantine (M=2.9272, SD=0.4080, n=103). The data shows that the computed

t-value is 8.8137 with a P-value of 0.0000, which is less than alpha 0.05. Therefore, the

decision was to reject the null hypothesis.

 CHAPTER V

Summary of Findings, Conclusion, and Recommendation

This study aimed to assess the risk of 12-STEM students to cardiovascular diseases,

and to differentiate the risk before and during the quarantine. This chapter summarized the

findings, gave conclusion and recommendation.

Summary of Findings

1. The prevalence of physical activity among 12-STEM students decreased during the

quarantine.

2. The nutritional habits of 12-STEM students worsened due to quarantine restrictions.

3. The mental health condition of 12-STEM students declined during the quarantine.

Conclusion

1. The 12-STEM students rarely perform any physical activities during quarantine that may

lead to an increased risk of cardiovascular disease.

2. The 12-STEM students lessen their nutritional food intake and increase the unhealthy

food consumption during quarantine that can heighten the risk of cardiovascular disease.

3. The 12- STEM students experienced mental breakdown during quarantine are likely to

decrease their physical activities and nutritional habit that can elevate the risk of

cardiovascular disease.

4. There is a significant increase in the risk of cardiovascular disease among 12-STEM

students during quarantine compared to before quarantine.

Recommendation

1. Grade 12 STEM students must participate in any physical activity to stay fit and healthy.

2. Grade 12 STEM students must practice eating more healthy foods like vegetables and

should avoid the unhealthy food intake.

3. Grade 12 STEM students should socialize and talk to their love ones to avoid

psychological distress during quarantine.

4. Future study may be conducted in a larger and more diverse population.

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 APPENDICES

Department of Education
Region IV-A CALABARZON
CITY SCHOOLS DIVISION OF ANTIPOLO
DISTRICT 1-D
MAYAMOT NATIONAL HIGH SCHOOL
SENIOR HIGH SCHOOL
November 16, 2020

Dear Respondent,

Good day!

We are currrently conducting a research work entitled “Assessing the Risk of

Cardiovascular Disease During Quarantine Among Grade 12 STEM Students”, in partial
fulfillment of the requirements for the strand Science, Technology, Engineering and
Mathematics at Mayamot National High School. Attached here with is a survey questionnaire
to gather data and/or information for the abovementioned research work.

In this connection, may we solicit your kind indulgence and consideration by

answering every question included in this survey questionnaire. Rest assured that any
information will be treated with outmost confidentiality.

Thank you very much for sharing your precious time and effort.

Respectfully yours,

HUEY DANIEL P. HALLARE

BERNADINE KESIA B. BOLILAN

JASTINE MAE S. CRUZADA

ANGELICA S. ERISPE

CHRISTINE JOY S. PIZON

JEWEL T. SE

JERAME B. ZUÑIGA

Researchers

Noted by:

JAYSON SEEL MARAVILLA

Research Adviser
 Department of Education
Region IV-A CALABARZON
CITY SCHOOLS DIVISION OF ANTIPOLO
DISTRICT 1-D
MAYAMOT NATIONAL HIGH SCHOOL
SENIOR HIGH SCHOOL

Name (Optional):___________________________________________________

SURVEY QUESTIONNAIRE ON
“Assessing the Risk of Cardiovascular Disease During Quarantine Among Grade 12
STEM Students”,

Assessing the Physical Activity, Nutritional Habits, and Mental Health of 12-STEM
Students Before and During Quarantine.
Directions: Please complete the questionnaire by putting a check ( / ) on the column which
corresponds to your response.

The following are the descriptive value of the scale used:

4 - Always (A)

3 - Often (O)

2 - Rarely (R)

1 - Never (N)
Before Quarantine During quarantine
4 3 2 1 4 3 2 1
PHYSICAL ACTIVITY
(A) (O) (R) (N) (A) (O) (R) (N)
1. I exercise at least 4-5
times a week.
2. I participate in
recreational activities.
3. I accomplish at least
5,000 step counts or
greater per day.

Before Quarantine During quarantine

4 3 2 1 4 3 2 1
NUTRITIONAL HABIT
(A) (O) (R) (N) (A) (O) (R) (N)
1. I do not skip eating
breakfast.
2. I eat a variety of
nutritional foods.
3. I avoid consuming
unhealthy foods.
 Before Quarantine During quarantine
4 3 2 1 4 3 2 1
MENTAL HEALTH
(A) (O) (R) (N) (A) (O) (R) (N)
1. I do not
undereat/overeat when
feeling stressed.
2. I can still manage to do
physical activity even if I
am feeling
emotionally/mentally
drained.
3. I do not
undersleep/oversleep
when psychologically
distressed.
4. I do not feel any pain for
no clear physical cause.