Daily park use, physical activity, and psychological stress: A study using smartphone-based ecological momentary assessment amongst a multi-ethnic Asian cohort

Objective: To investigate a) daily patterns of park use, leisure-time physical activity and stress, b) relationship of daily park use and leisure-time physical activity with stress; and c) the combined effects of daily park use and leisure-time physical activity on stress, and whether associations of daily park use and leisure-time physical activity with stress are independent. Methods: Singapore citizens/permanent residents 21-75 years-of-age from the Multi-Ethnic Cohort were enrolled into this study. Participants received mobile Ecological Momentary Assessment (mEMA) mini-surveys for up to nine days via their smartphone, with daily questions on park use and leisure-time physical activity, and perceived stress level in the evening. Descriptive statistics summarized demographics, day-to-day variation in park use, leisure-time physical activity and stress. Logistic regression models using generalized estimating equations assessed relationships of daily park use and leisure time physical activity with stress. Results: A total of 605 participants providing 4678 EMA responses to mini-surveys were included in the analyses. Participants who visited parks during a day were less stressed on the same evening than those who did not visit parks (OR = 0.67; 95% CI = 0.58-0.77). Likewise, participants who were physically active during a day were less stressed on the same evening than those who were not physically active (OR = 0.73; 95% CI = 0.64-0.82). Daily park use and leisure-time physical activity on the same day was also associated with less stress (OR = 0.58; 95% CI = 0.49-0.69), and this measure of association was lower than those comparing daily engagement in only 1 of the 2 activities. The effects of park use and physical activity on lower perceived stress were independent. Conclusions: Both daily park use and leisure time physical activity during the day were associated with reduced evening stress. These relationships were independent of one another, suggesting that each activity on its own is beneficial to reducing stress amongst adults in urban settings.