Resilience as Key Factor in Adolescent Physical and Mental Health During the COVID-19 Crisis

Moderation and mediation analyses were conducted to examine whether associations between resilience and physical and mental health varied across demographic and socioeconomic groups, and whether resilience mediated the associations between COVID-19-related experiences and health outcomes. ● This entry provides metadata only The underlying dataset is not publicly available, as it is owned by the Dutch Health Monitor partners. ● Conditions for access Access to the underlying data is strictly governed through controlled access procedures.

Researchers may request access through the official procedure established by the GGD, RIVM, and CBS, available here: Explanation and criteria for requesting Health Monitor data. Accordingly, this submission provides only metadata describing the project, its purpose, data collection methods, limitations, the structure of the underlying data, its value for potential reuse, and the conclusions derived from the data analysis. ● Ethics approval Ethical approval was obtained from the Erasmus School of Social and Behavioural Sciences (ESSB) Ethics Committee (#ETH2324-0333). ● Consent Participants and their parents received an information letter prior to the study and were given the option to opt out of the study.

Filling in the questionnaire that followed this information letter resulted in consent of the study.

Background

The survey, conducted by the Municipal Health Services (GGD), GGD GHOR Nederland, and the National Institute for Public Health and the Environment (RIVM), examined the effects of COVID-19 on adolescents' lifestyle, resilience, and mental and physical health. Purpose The paper aims to examine whether the associations between resilience and mental and physical health vary across demographic and socioeconomic groups, and whether resilience mediates the associations between COVID-19-related experiences and health outcomes.

Data Collection and

Methods

This cross-sectional study performed secondary analyses of data from the Youth Health Survey COVID-19 2021. The survey, conducted by the Municipal Health Services (GGD), GGD GHOR Nederland, and the National Institute for Public Health and the Environment (RIVM), examined the effects of COVID-19 on adolescents' lifestyle, resilience, and mental and physical health. This study analyzed data from three regional public health services: GGD Rotterdam-Rijnmond (7,554 students), GGD Haaglanden (5,229 students), and VG Gelderland-Midden (2,316 students), representing two highly urbanized regions and one less urbanized region.

Most students completed online questionnaires, with paper-based surveys used when necessary. The following variables were analyzed: mental health, physical health, resilience (sense of mastery, sense of relatedness and emotional reactivity), COVID-19 variables (influence of COVID-19 measures on daily life and needing extra help during COVID-19) and demographic and socio-economic characteristics (gender, age, education level, parental financial difficulty).

Descriptive statistics were calculated for all demographic and socio-economic variables. Correlations between the COVID-19 variables, resilience variables and physical and mental health outcomes were examined. To examine which groups of adolescents were most vulnerable to poorer physical and mental health and whether the association between resilience and health differed across these groups, effect modification analyses were conducted for gender, age, educational level, and financial difficulty.

Interaction terms were added to the regression models and tested for statistical significance. Examining the role of the different resilience dimensions in the association between adolescents' COVID-19 experiences and their physical and mental health was done with three separate mediations, one for each resilience dimension. The influence of COVID-19 on daily life and the need for extra help during the pandemic were included as predictors, resilience dimensions as mediators, and physical and mental health as outcomes.

All analyses were adjusted for gender, age, educational level, and financial difficulty. Mediation was conducted with a multilevel regression framework to account for the hierarchical structure of the data (students nested within schools). Statistical significance and 95% confidence intervals for indirect effects were assessed using the Sobel test.

All analyses were run using IBM SPSS Statistics version 26. Research Limitations Several limitations should be considered when interpreting these findings. First, the data were collected before the present research questions were formulated, necessitating the use of proxy measures for sense of mastery, sense of relatedness, and emotional reactivity.

However, the selected proxies closely reflected the underlying constructs and were combined only after statistical testing confirmed their suitability. Second, all measures were self-reported, which may have introduced reporting bias. Nevertheless, because the constructs of interest were subjective, self-report was considered appropriate.

The cross-sectional design prevents conclusions about causality, but even so, the design was appropriate for examining associations among COVID-19 experiences, resilience, and health. Finally, bootstrapping was not feasible because of the substantial computational burden associated with the large sample size. Instead, indirect effects were estimated using the Sobel test, which is considered appropriate for large samples.

Data Structure and Relationships Between Files The repository contains a README file describing the study’s purpose, methodology, data-access conditions, and analytical procedures. The repository also contains the base questionnaire for the COVID-19 Health Monitor Youth 2021, conducted by the Municipal Public Health Services (GGDs), GGD GHOR Nederland, and the National Institute for Public Health and the Environment (RIVM).

The questionnaire documents the survey items underlying the variables used in the study, including measures related to adolescents’ demographic and socioeconomic characteristics, COVID-19 experiences, resilience, and mental and physical health. The README explains which questionnaire items were selected and analyzed to address the study’s research questions. Value of the data for potential reuse Although the dataset itself could not be included in this repository because it is owned by the Dutch Health Monitor partners, the repository provides detailed documentation of the analytical procedures and methodology used to address the research questions.

This documentation supports transparency and reproducibility and may help other researchers replicate or adapt the analytical approach for related research. The repository also provides instructions for requesting access to the dataset from the Dutch Health Monitor partners. Conclusion Resilience was associated with better health, but associations varied across groups.

Resilience-building interventions may help prepare adolescents for future adversities.