Longitudinal associations among post-displacement stressors, physical activity, and mental health in Farsi- and Dari-speaking refugees and asylum-seekers in Australia

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Abstract

Background

Post-displacement stressors affect mental health among refugees and asylum-seekers, yet the behavioral mechanisms underpinning this relationship remain understudied.

Objective

To examine the role of physical activity in the relationship between post-displacement stressors and mental health outcomes among Farsi/Dari speaking refugees and asylum-seekers in Australia.

Methods

Data were drawn from a longitudinal community-based cohort study of 343 Farsi and Dari speaking refugees and asylum-seekers (80 female, 23.3%) in Australia conducted between 2017 and 2019. Data from post-displacement stressors measured at the baseline, physical activity at one-year follow-up, and mental health outcomes (symptoms of posttraumatic stress disorder (PTSD) and depression and personal mastery) at two-year follow-up were included in the study. Longitudinal path analyses were conducted to test the mediating role of moderate-to-vigorous physical activity and sedentary behaviour in the associations between post-displacement stressors and mental health outcomes.

Results

After controlling for baseline levels of depression and PTSD, traumatic events, and key demographic characteristics, post-displacement stressors significantly predicted less moderate-to-vigorous physical activity (MVPA) (β = −0.18, 95% CI [−0.292, −0.056]) and more sedentary behavior (β = 0.13, 95% CI [0.011, 0.243]) at one-year follow-up. Less MVPA, in turn, significantly predicted greater symptoms of depression (β = −0.21, 95% CI [−0.353, −0.060]) and lower level of personal mastery (β = 0.19, 95% CI [0.033, 0.327]) while greater time spent in sedentary behavior predicted greater symptoms of depression (β = 0.21, 95% CI [0.060, 0.359]), PTSD (β = 0.24, 95% CI [0.096, 0.386], and lower personal mastery ((β = −0.18, 95% CI [−0.336, −0.011]). Significant indirect associations were observed between post-displacement stressors and depressive symptoms and personal mastery through MVPA, and between post-displacement stressors and depressive and PTSD symptoms through sedentary behaviour.

Conclusion

These findings provide the first longitudinal evidence that moderate-to-vigorous physical activity and sedentary behavior partially explain the relationship between post-displacement stressors and subsequent mental health outcomes among refugees and asylum-seekers. Addressing these modifiable behaviors may represent targets for future intervention research to promote mental health during resettlement.

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