Behavior
The relationship of perceived stress between 24-hour movement behaviors and psychological distress among undergraduate students from low-income regions Shirley Cunha Feuerstein* Shirley Cunha Feuerstein Maria Isabela Alves de Almeida Silva Benjamin Baird Ana Clara Arrais Rosa Barbara Saldanha Lima Andrea Ramirez Varela Leticia Ribeiro Borges Armando Rodrigues de Alencar Santos Marcia Ferreira Sales Kliver Antonio Marin Augusto Cesar Ferreira De Moraes Marcus Vinícius Nascimento-Ferreira
Aim: To investigate the mediating effect of perceived stress on the association between 24-hour movement behavior and psychological distress among undergraduate students from low-income regions.
Methods: We assessed a total of 507 students from two Brazilian cities (Gini indices up to 0.56): 68.7% female, age up to 20 years (68.7%), 71.9% non-white, and 43.6% with a monthly household income below US$260.15. We assessed perceived stress using the Perceived Stress Scale (PSS) and psychological distress using the Brief Symptom Inventory 18 (BSI-18). The exposure was perceived stress and adherence to 24-hour movement guidelines, while the outcome was psychological distress (somatization, depression, anxiety), assessed using multilevel linear regression. The associations were expressed as beta (β) coefficients with 95% CIs. Perceived stress served as exposure and mediator, assessed through self-efficacy and helplessness. Confounding variables retained in the adjusted multilevel model were included as covariates. We assessed model fit using root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR). A good fit was defined as RMSEA ≤ 0.06 and SRMR ≤ 0.0838.
Results: Our multilevel linear regression analysis revealed that 24-hour movement behaviors (β = -1.3, 95% CI: -2.4 to -0.3) and self-efficacy (β = -0.3, 95% CI: -0.5 to -0.1) were negatively associated with psychological distress, while helplessness showed a positive association (β = 1.8, 95% CI: 1.6 to 1.8). Structural equation modeling indicated significant indirect effects for self-efficacy (β = -0.8, 95% CI: -1.3 to -0.2) and helplessness (β = -1.5, 95% CI: -2.5 to -0.5), mediating 25.1% and 51.4% of the total effect, respectively.
Conclusions: Healthy daily movement behaviors are inversely associated with psychological distress among undergraduate students from economically disadvantaged regions, with perceived stress serving as a mediating mechanism through self-efficacy and helplessness pathways.