Longitudinal Analysis of Variations in Daily Step Counts and Long-Term Implications of COVID-19 Waves and Restriction Phases in Qatar's Step Into Health Program: Mixed Methods Study.
Majed L, Sayegh S, et al. • JMIR public health and surveillance • 2026
Significant declines in daily step counts (689 to 1013 steps) were observed at the onset of each COVID-19 wave, followed by recovery after lifting of restrictions, with different patterns emerging by sex, age, and BMI, and qualitative themes revealing that declines were shaped not only by restrictions but also by fear, motivation, and contextual factors.
Key Findings
Results
Significant declines in daily step counts occurred at the onset of each COVID-19 wave.
Declines ranged from 689 to 1013 steps per day at wave onsets (P<.001)
Declines were especially marked at wave 2
The study covered all 3 COVID-19 waves from February 2020 to February 2023, compared with a full pre-COVID-19 year
362 participants from the Step Into Health program contributed daily step count data
Results
Step counts recovered following the lifting of restrictions at each wave.
Recovery involved increases of 609 to 1147 steps following restriction lifting
Linear mixed models examined changes across 19 phases of implementation and lifting of restrictions
Recovery patterns were observed after each of the three waves
Results
Different patterns of change in step count emerged across sex, age, and BMI subgroups.
Sex differences in step count changes were statistically significant (P=.03)
Age group differences were statistically significant (P=.03)
BMI group differences were statistically significant (P=.01)
Larger variations in step count were seen among male individuals, pedometer users, and normal-weight participants
Results
The largest drops in daily step count coincided with increased case severity and Ramadan.
Ramadan was identified as a contextual factor contributing to the largest drops in step counts
Increased COVID-19 case severity was also associated with the largest declines
This finding emerged from analysis of 19 distinct restriction phases
Results
Qualitative analysis identified themes of disrupted routines, reliance on home-based exercise, and media influence as contextualizing factors for activity pattern changes.
9 participants completed semi-structured interviews analyzed thematically and phenomenologically
Interviews were conducted with randomly selected participants from the Step Into Health program
Themes explained subgroup differences in step count variations
Declines in activity were shaped not only by restrictions but also by fear, motivation, and contextual factors
Methods
The study sample consisted of 362 participants with a minority of female participants using both pedometers and mobile phone apps to track steps.
60 of 362 participants (16.6%) were female
170 of 362 participants (47%) used pedometers
192 of 362 participants (53%) used a mobile phone app
Participants were drawn from the Step Into Health community-based program in Qatar
Results
Triangulation of quantitative and qualitative data revealed convergences and divergences between device-measured activity patterns and lived experiences.
Mixed methods design combined linear mixed model analyses with semi-structured interviews
Triangulation was applied to interpret how fear, motivation, and contextual factors shaped activity declines beyond the direct effects of restrictions
Qualitative findings contextualized quantitative patterns including subgroup differences
Majed L, Sayegh S, Dalansi F, Al-Mohannadi A, Cardinale M, Farooq A. (2026). Longitudinal Analysis of Variations in Daily Step Counts and Long-Term Implications of COVID-19 Waves and Restriction Phases in Qatar's Step Into Health Program: Mixed Methods Study.. JMIR public health and surveillance. https://doi.org/10.2196/76860