Predictors of well-being among college students

Associations between sleep, physical activity, and emotional well-being in emerging young adults: Implications for college wellness program development

Objectives: To examine sleep, physical activity, and their joint associations with physical functioning and affect. Participants: 108 undergraduates completed questionnaires assessing sleep, activity levels, emotional well-being and physical health markers. Results: Participants reported poor sleep quality, suboptimal sleep duration, and inconsistent physical activity. Poor sleep quality was associated with higher fatigue for both active and insufficiently active groups (F = 9.94, p = .002). There was a significant interaction between activity level and sleep duration on negative affect (F = 7.14, p = .009). Students who reported insufficient physical activity and less than 6 hours of sleep had the highest negative affect. Conclusions: Poor sleep quality was associated with increased fatigue. Students who inconsistently exercise and have suboptimal sleep may be at greater risk for affective difficulties. We recommend that college wellness interventions jointly target health behaviors and affect to optimize prevention efforts aimed at addressing physical and mental health outcomes, including depression and chronic illness.

Lifestyle behavior of physiotherapy students from Ecuador upon admission to higher education: a cross-sectional study

Introduction

Admission to university has been identified as a period involving the adoption of unhealthy lifestyle behaviors. However, few studies have addressed the extent of this experience among Latin American university students. The aim of this study was twofold: first, to describe anthropometric variables, body composition, physical activity, sedentary behavior, sleep duration and quality, diet, and alcohol consumption in first-year students entering physiotherapy school at the Universidad de las Americas in Quito, Ecuador; second, to test differences in these variables between sexes.

Methods

A total of 116 students were recruited. Sociodemographic variables, anthropometric indices, body composition, physical activity, sedentary behavior, sleep quality and duration, adherence to 24-hour movement guidelines, physical fitness (i.e., handgrip strength), diet, alcohol consumption, and smoking habits were evaluated.

Results

A total of 50 male (43.1%) and 66 female (56.9%) students were assessed. Overall, the adherence to the 24-hour movement guidelines of the students upon admission to university was 8.6%. Conversely, 86 students (74.1%) did not meet any of the recommendations. Upon admission to university, only 8.6% of the students (female 2.6%; male 6%) met the overall 24-hour movement guidelines. Additionally, 82 students (70.7%) needed changes in diet quality, 81 students (69.8%) had significant sleep disturbances, and 22 students (18.9%) had harmful alcohol consumption. A greater proportion of males met all three 24-h movement recommendations (p = 0.025) than females did. In addition, females reported a greater percentage of occasional smokers (p = 0.025) and a greater prevalence of obesity (p < 0.001), a lower level of physical activity (p < 0.001), and a greater percentage of sleep disturbance (p < 0.001). Conversely, males reported greater waist circumference (p = 0.005), weight (p < 0.001), handgrip strength (p < 0.001), and a greater percentage of harmful alcohol consumption (p < 0.001).

Discussion

Our study showed that upon admission to university, overall adherence to the 24-hour movement guidelines is low among university students. Additionally, a high percentage of students reported unhealthy lifestyle behaviors, with differences according to sex. Our findings could lead to the use of specific sex-specific strategies for the prevention and promotion of movement and lifestyle behaviors during this critical period.

Social cognition, socioeconomic status and subjective well-being of Chinese migrant workers

Subjective well-being is based on the unity of internal and external needs, as well as material and non-material needs. However, existing research lacks consideration of the impact of both objective material conditions and subjective psychological cognition on the subjective well-being of migrant workers. Thus, based on data from the 2017 China General Social Survey, this paper applies ordered logit models and OLS models to investigate the impact of social cognition and socioeconomic status on the subjective well-being of migrant workers and their intergenerational differences. The results indicate that: (1) Social cognition has a significant impact, and the impact of fairness perception is more pronounced than depression perception and class change perception; (2) among socioeconomic status, personal income did not have a significant effect as education level, car ownership and house property ownership; (3) there are intergenerational differences. The emotional state of the older generation is the most critical factor influencing their subjective well-being. In contrast, the new generation is more concerned with their feelings about future expectations. The older generation is more concerned with their house property ownership, while the increase in income, education and car ownership can significantly increase the subjective well-being of the new generation. For this reason, we believe that the Chinese government should gradually change the existing urban and rural management system to create a fair and just social environment; make migrant workers receive the same protection as urban residents and improve the income distribution mechanism; pay attention to the social security of the older generation of migrant workers and the development opportunities of the new generation of migrant workers and their ability to integrate into the city to improve their subjective well-being.

Is the Association Between Alcohol Consumption and Mental Well-Being in University Students Linear, Curvilinear or Absent?

Background: Both alcohol consumption and mental well-being problems have been found to be prevalent in higher educated students and often have severe consequences. However, previous findings of the association between these constructs are mixed, possibly because often linear models are fitted, while some theories suggest a curvilinear association between the two concepts. Objectives: To clarify previously mixed findings, the current study compared curvilinear and linear models for the relationship between alcohol consumption and mental well-being in university students. Because of potential gender differences in this relationship, these models were explored for females and males separately. Data from the first cross-sectional online survey wave of the Healthy Student Life project including 2,631 female and 998 male students was used. The Alcohol Use Disorders Identification Test-consumption was used to measure alcohol consumption. Mental well-being was assessed by six sub-concepts (i.e., depressive symptoms, anxiety, stress, life satisfaction, happiness, and self-rated mental health). Results: For females both linear (for anxiety, life satisfaction, and self-rated mental health) and curvilinear (for depression, stress, and happiness) associations were found, while for males no support for either curvilinear or linear models was found. Conclusions: Results should be interpreted with caution due to the small effect sizes in the relationships for females but may suggest that testing the curvilinear association between alcohol consumption and mental well-being is an important future endeavor.

Differences between Health and Non-Health Science Students in Lifestyle Habits, Perceived Stress and Psychological Well-Being: A Cross-Sectional Study

The aim of this study was to investigate lifestyle habits in health and non-health science students from the University of Split, Croatia, and to evaluate their association with perceived stress and psychological well-being. We surveyed 783 students during February-March 2021. Hierarchical multiple regression analysis was used in the analysis. Health science students spent less time using screens, were sitting less, slept less, but also showed better compliance with the Mediterranean diet compared to non-health science students (10.6% vs. 5.9%). There were no differences in stress and well-being perception between the two study groups. Female gender, lack of sleep, less daily sitting time, anxiety, and lower optimism were associated with higher stress in non-health science students, while anxiousness and more sitting were found to be significant among health students. Well-being among health science students was positively associated with BMI, having had COVID-19, being refreshed after waking up during working days, Mediterranean diet adherence, health perception, optimism, and quality of life, and negatively with TV time and anxiousness. Shorter sleep duration on non-working days, feeling refreshed after waking up on non-working days, higher quality of life and optimism, and lower anxiousness were associated with higher well-being among non-health students. Identifying unhealthy lifestyle habits in students is essential for implementing targeted interventions to better their health outcomes.

Factorial invariance of college students' scores on the Lifestyle Practices and Health Consciousness Inventory

OBJECTIVE

The aims of the present study were to validate college students' scores on the Lifestyle Practices and Health Consciousness Inventory (LPHCI), a screening tool for appraising Global Wellness (combined mental and physical health) and test for differences in Global Wellness across key demographic variables associated with college student health.

METHOD

A non-probability sample of 708 college students across four campus locations in three different cities was recruited to test the LPHCI's psychometric properties.

RESULTS

Factorial invariance testing demonstrated psychometric equivalence in the meaning of Global Wellness between college students across ethnicity, generational status, and help-seeking history. We also found statistically, however, not practically significant demographic differences in Global Wellness between college students by ethnicity and help-seeking history.

CONCLUSION

Findings extend the generalizability of LPHCI scores to a normative sample of college students. Implications for college healthcare providers and directions for future research are discussed.

The effects of life skills of Korean college student athletes on adaptation and satisfaction in college life

OBJECTIVE

To investigate the effects of college student athletes' life skills on adaptation and life satisfaction.

PARTICIPANTS

246 college student athletes (Mage = 20.24 ± 1.11; 75% of males) who were registered in the Korea Sports Association in South Korea.

METHODS

A cross-sectional study design was used. College student athletes completed self-reported surveys in 2019. Study variables include life skills, adaptation to college, and life satisfaction as performed by bivariate analysis, ANOVA, and multiple regression analysis.

RESULTS

Life skills, adaptation to college, and life satisfaction were partially correlated to each other and differed by gender and sport types (p < .05-.01). College student athletes' life skills were significant predictors of adaptation to college life and life satisfaction.

CONCLUSIONS

Developing and establishing life skills programs in and outside of campus may help promoting college student athletes' well-being.

Stress, Sleep, and Resilience Among Rural BSN Students in a New Nursing Program

BACKGROUND

Nursing students experience stress that may impact their sleep and resilience, especially those attending rural campuses that may have potentially limited access to resources.

PURPOSE

The purpose of this study was to examine relationships among perceived stress, sleep quality, resilience, and demographics and predictors of resilience among senior BSN students.

METHODS

In this cross-sectional study, perceived stress, sleep quality, resilience, and demographic data were collected from a senior student cohort attending a new baccalaureate nursing program on a rural Appalachian campus (N = 16). Data were analyzed using descriptive, bivariate, and multiple regression analyses.

RESULTS

Perceived stress significantly associated with sleep quality, resilience, and gender. Perceived stress, sleep quality, and gender significantly explained 61% of the variance in resilience, with perceived stress as the strongest predictor.

CONCLUSIONS

Early collaborative assessment and intervention focused on mitigating stress may promote improved sleep and resilience. Availability of resources for students attending small rural campuses is essential.

Psychological Counseling among University Students Worldwide: A Systematic Review

University counseling services (UCSs) are actively involved in mental health assessment and in supplying interventions aimed at preventing, facing and possibly overcoming psychological problems. However, we do not have a global overview of psychological counseling among universities. This systematic review aims at reviewing the literature on university psychological counseling, including articles documenting: (1) mental health and attitudes regarding help-seeking behaviors and UCSs among university students or counselors, (2) the description of protocols/services among UCSs, (3) the efficacy of psychological counseling/interventions among university students (both face-to-face and internet-delivered interventions). The study followed PRISMA guidelines and was registered on PROSPERO. After defining inclusion and exclusion criteria, a literature search was conducted, identifying 7085 records. Finally, 152 articles met the review eligibility criteria and were included in the qualitative synthesis. Results are divided into seven thematic topics that emerged during the analysis of the literature. The results mainly showed that face-to-face and web-based counseling/psychological interventions improve university students' mental health. Cross-sectional studies showed that many biases exist toward help-seeking behaviors, especially among international students. Both students and counselors must strive to overcome cultural barriers. Available resources for UCSs are scarce and need to be strengthened, as well as efficacy studies through randomized clinical trials.

Sleep Quality and Fatigue during Exam Periods in University Students: Prevalence and Associated Factors

The aim of our study was to assess university students' sleep quality and fatigue before and during the academic exam period and identify potential associated factors. A Web-based survey was completed by 940 students of 20 different Tertiary Institutions including demographics, sleep habits, exercise, caffeine, tobacco, alcohol use, subjective sleep quality (Pittsburgh Sleep Quality Index-PSQI), and fatigue (Fatigue severity scale-FSS) at the beginning of the semester and during the examination period. During the exam period, PSQI (8.9 vs. 6.1, p < 0.001) and FSS scores (36.9 vs. 32.7, p < 0.001) were significantly elevated compared to the pre-exam period. An increase in the PSQI score was associated with age (β = 0.111, p = 0.011), presence of chronic disease (β = 0.914, p = 0.006), and depressive symptoms (β = 0.459, p = 0.001). An increase in the FSS score was associated with female gender (β = 1.658, p < 0.001), age, (β = 0.198, p = 0.010), increase in smoking (β = 1.7, p = 0.029), coffee/energy drinks consumption (β = 1.988, p < 0.001), decreased levels of physical exercise (β = 1.660, p < 0.001), and depressive symptoms (β = 2.526, p < 0.001). In conclusion, our findings indicate that exam periods have a negative impact on the sleep quality and fatigue levels of university students. Potential factors were identified that could contribute to the formulation of strategies for improved sleep quality and wellness.

NCHA variable combination as a method to undertake LGBTQ + student subpopulation analyses

ObjectiveCombine National Collegiate Health Assessment (NCHA) measures indicating LGBTQ + membership into a single variable in order to analyze health responses of this group as compared to their cisgender, heterosexual (cis-het) peers. Participants: Students at a liberal arts university who completed the Spring 2019 NCHA-II study (n = 1107). Methods: Four different NCHA sexual orientation and gender identification variables were combined, creating a new variable to examine the campus LGBTQ + student sub-sample as a single, complete group. That group was then compared to cis-het students across multiple variables. Results: LGBTQ + students reported statistically significant differences for key variables such as suicide attempts, suicidal ideation, and self-harm, as well as for stressors that impact academic success such as discrimination. Conclusions: This analysis indicates that the challenges campus LGBTQ + students face are much different than their cis-het peers. Support from campus community members is suggested to reduce negative impacts for these students.

Exploring Yoga Behaviors among College Students Based on the Multi-Theory Model (MTM) of Health Behavior Change

During college years, perceived stress is the top reported hindrance to well-being and academic success. Data on the acceptance and perceived benefits of yoga among college students are limited. A purposive sample of college students (n = 79) from a course centered on Vinyasa Yoga and Mindfulness Meditation were recruited. Comprehensive yoga journaling data were collected, and a directed content analysis along the constructs of the multi-theory model (MTM) of health behavior change was utilized. The advantages of yoga that emerged were improved physical performance, reduced perceived stress, acceptance of oneself, better well-being, and improved coping. The identified disadvantages were time commitment, lack of motivation, and other competing interests. Learning through small steps, modifications, and identifying multiple sources of confidence helped build behavioral confidence. Practicing at home or at a yoga studio was a common theme for support in the physical environment. Directing negative emotions into purposes was helpful in maintaining the yoga practice. Sustained commitment to the practice also helped maintain the regular performance of yoga. Finally, social support from family, friends, and instructors was vital for continued practice. The study has important ramifications for the development of survey tools for descriptive studies and designing behavior-change yoga interventions in this target population.

Use of Electronic Ecological Momentary Assessment Methodologies in Physical Activity, Sedentary Behavior, and Sleep Research in Young Adults: Systematic Review

BACKGROUND

Recent technological advances allow for the repeated sampling of real-time data in natural settings using electronic ecological momentary assessment (eEMA). These advances are particularly meaningful for investigating physical activity, sedentary behavior, and sleep in young adults who are in a critical life stage for the development of healthy lifestyle behaviors.

OBJECTIVE

This study aims to describe the use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults.

METHODS

The PubMed, CINAHL, PsycINFO, Embase, and Web of Science electronic databases were searched through August 2022. Inclusion criteria were use of eEMA; sample of young adults aged 18 to 25 years; at least 1 measurement of physical activity, sedentary behavior, or sleep; English language; and a peer-reviewed report of original research. Study reports were excluded if they were abstracts, protocols, or reviews. The risk of bias assessment was conducted using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Screening, data extraction, and risk of bias assessments were conducted by independent authors, with discrepancies resolved by consensus. Descriptive statistics and narrative synthesis were used to identify overarching patterns within the following categories guided by the Checklist for Reporting Ecological Momentary Assessments Studies: study characteristics, outcomes and measures, eEMA procedures, and compliance.

RESULTS

The search resulted in 1221 citations with a final sample of 37 reports describing 35 unique studies. Most reports (28/37, 76%) were published in the last 5 years (2017-2022), used observational designs (35/37, 95%), consisted of samples of college students or apprentices (28/35, 80%), and were conducted in the United States (22/37, 60%). The sample sizes ranged from 14 to 1584 young adults. Physical activity was measured more frequently (28/37, 76%) than sleep (16/37, 43%) or sedentary behavior (4/37, 11%). Of the 37 studies, 11 (30%) reports included 2 movement behaviors and no reports included 3 movement behaviors. eEMA was frequently used to measure potential correlates of movement behaviors, such as emotional states or feelings (25/37, 68%), cognitive processes (7/37, 19%), and contextual factors (9/37, 24%). There was wide variability in the implementation and reporting of eEMA procedures, measures, missing data, analysis, and compliance.

CONCLUSIONS

The use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults has greatly increased in recent years; however, reports continue to lack standardized reporting of features unique to the eEMA methodology. Additional areas in need of future research include the use of eEMA with more diverse populations and the incorporation of all 3 movement behaviors within a 24-hour period. The findings are intended to assist investigators in the design, implementation, and reporting of physical activity, sedentary behavior, and sleep research using eEMA in young adults.

TRIAL REGISTRATION

PROSPERO CRD42021279156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021279156.

A comparison of the effects of remote coaching HIIT training and combined exercise training on the physical and mental health of university students

Aim

To compare the differences in the effects of based on remote coached high intensity interval training and combined exercise training on the physical and mental health of university students.

Method

Sixty university students were recruited from Shandong Normal University and randomly divided into HIIT group (n = 30) and AR group (n = 30), with the HIIT group using high-intensity interval training intervention and the AR group using combined exercise (aerobic combined with resistance) training intervention for 8 weeks. Mental health indicators, fitness indicators and body composition indicators were measured at the beginning and end of the intervention.

Results

After 8 weeks, among the mental health indicators, the results of the Symptom Self-Rating Scale (SCL-90) test showed a significant improvement in the HIIT group in terms of total score, somatization, obsessive-compulsive, interpersonal sensitivity, depression, hostility, and psychoticism (p < 0.05); the AR group showed significant improvements in psychoticism (P < 0.05). There were no significant differences between the two groups. The results of the Pittsburgh Sleep Quality Index scale (PSQI) showed a significant difference in sleep efficiency in the HIIT group with an inverse improvement in scores; the AR group showed no significant improvement in each test item. The results of the between-group covariance showed significant differences in sleep efficiency and hypnotic drugs in the HIIT group (p < 0.05). Among the fitness indicators, the HIIT group showed significant improvements in maximum oxygen uptake, grip strength and flexibility (P < 0.05); the AR group showed significant improvements in back muscle strength and flexibility (P < 0.05). The results of the between-group covariance showed significant improvements in maximum oxygen uptake in the HIIT group (P < 0.01). Regarding body composition indicators, there was a significant improvement in Body weight, BMI, Body fat percentage and Waist-to-hip ratio in both the HIIT and AR groups (P < 0.01). There were no significant differences between the two groups.

Conclusion

HIIT and combined exercise training based on remote coaching had some improvement on fitness level and body composition of university students, HIIT was more advantageous in improving aerobic endurance, and HIIT based on remote coaching may have better effect than combined exercise in mental health.

Trial registration

Chinese Clinical Trial Register, ChiECRCT20220149. Registered on 16 May 2022.

Transition readiness and quality of life in emerging adult college students

OBJECTIVE

To examine the relative contribution of transition readiness (i.e., healthcare self-management) to health-related quality of life (HRQoL) among emerging adult (EA) college students without a chronic medical condition (CMC).Participants: College students (n = 2372; Mage = 19.32, SD = 1.26) from a Midwestern university.Methods: Participants completed online measures of demographics, HRQoL, and transition readiness.Results: Hierarchical regression analyses found transition readiness accounted an additional 3-4% of the variability in mental and physical HRQoL (p < .001), beyond demographic factors. 11.3% of EAs reported overall mastery of transition readiness, with navigating health insurance being the weakest area.Conclusions: Findings support the consensus that transition readiness is relevant to HRQoL for all EAs, including those without a CMC. EAs without a CMC demonstrate relatively weak transition readiness skills. Primary and university-based healthcare might consider programs supporting transition readiness and HRQoL among underresourced EAs.

Health literacy and mental well-being among university students in the United States

Objective: Exploration of the relationship between mental health constructs and physical health constructs can help practitioners better understand the mental health of vulnerable populations, such as college students in the United States. The purpose of this exploratory study was to investigate the connection between mental well-being and health literacy of US college students. Participants: The sample included 410 undergraduate students (63% white; 71% female) attending universities across the United States. Methods: Participants completed the All Aspects of Health Literacy Scale and the Warwick-Edinburgh Mental Well-being Scale. Univariate and bivariate statistics were observed for all study variables, and three linear regression models were run to see whether functional, communicative, and/or critical health literacy scores predicted mental well-being. Conclusions: Findings suggest that health literacy was associated with improved mental well-being among US college students, which has implications for health programming at US universities, such as the coordination of physical and mental healthcare.

What seems to explain suicidality in Yucatan Mexican young adults? Findings from an app-based mental health screening test using the SMART-SCREEN protocol

The relationship between suicidality, depression, anxiety, and well-being was explored in young adults (median age 20.7 years) from the State of Yucatan (Mexico), which has a suicide rate double that of other Mexican states. A cross-sectional study was carried out in 20 universities in Yucatan and 9,366 students were surveyed using validated questionnaires built into a smartphone app, applying partial least squares structural equation models. High suicide risk was assessed in 10.8% of the sample. Clinically relevant depression and anxiety levels were found in 6.6% and 10.5% of the sample, respectively, and 67.8% reported high well-being. Comparably higher levels of suicide risk, depression and anxiety, and lower well-being were found in women, who were also somewhat older than men in our study. Furthermore, path analysis in the structural equation model revealed that depression was the main predictor of suicidal behaviour as well as of higher anxiety levels and lower self-perceived well-being in the total sample and in both genders. Our findings draw attention to the association between suicidality, depression, anxiety, and well-being in Yucatan young adults and gender differences with this regard. Mental health screening via smartphone might be a useful tool to reach large populations and contribute to mental health policies, including regional suicide prevention efforts.

Improving university students' mental health using multi-component and single-component sleep interventions: A systematic review and meta-analysis

University is a time of significant transitions during a young adult's life, with delayed and shortened sleep and poor mental health a common occurrence. This systematic review and meta-analysis examined the effect of both multi-component and single-component sleep interventions on improving university students' sleep and mental health. Five databases (MEDLINE, PsycINFO, Embase, CINAHL and Cochrane Library) were searched for relevant literature published until April 2022. Treatment studies including university students aged 18-24 years, participating in a sleep intervention (multi-component, e.g., CBT-I, or single-component, e.g., sleep hygiene) were eligible. Comparator groups were either active, i.e., alternative intervention, or passive, i.e., waitlist control or treatment-as-usual, with study outcomes to include measures of sleep and mental health. Of 3435 references screened, 11 studies involving 5267 participants, with and without insomnia symptoms, were included for a narrative synthesis on intervention designs and methodology. Six studies eligible for meta-analyses showed a moderate effect of sleep interventions in reducing sleep disturbance (SMD = -0.548 [CI: -0.837, -0.258]) at post-treatment, alongside a small effect in improving anxiety (SMD = -0.226 [CI: -0.421, -0.031]) and depression (SMD = -0.295 [CI: -0.513, -0.077]). Meta-regression examining study and intervention characteristics identified subpopulation (experiencing insomnia or not) as a significant moderator for effects on sleep (p = 0.0003) and depression (p = 0.0063), with larger effects in studies with participants experiencing insomnia. Comparison group type (active or passive) was also a significant moderator (p = 0.0474), with larger effects on sleep in studies using passive comparison groups. Study type, delivery format, and intervention duration were not identified as significant moderators. At follow-ups, small but significant effects were sustained for anxiety and depression. Protecting and promoting sleep amongst university students may help safeguard and advance mental health.

Shedding Light on the Lifestyle and Participation of Portuguese Adolescents with Chronic Conditions—Data from the HBSC 2018 Study

Variables associated with lifestyle can constitute either risk or protective factors for the development and progression of chronic conditions (CC). This study intends to explore the differences between adolescents with and without CC and between adolescents whose school participation is affected/not affected by the existing CC with regard to variables related to lifestyle (i.e., sleep, physical activity, BMI, and leisure). In addition, it also intends to analyze the influence of these variables (i.e., CC and lifestyle) regarding the adolescents’ quality of life (QoL). This work is part of the Portuguese HBSC 2018 study. A total of 8215 adolescents participated (52.7% female), with an average age of 14.36 years (SD = 2.28). The results showed that the adolescents with CC and whose school attendance and participation are affected by their CC exhibit more sleep difficulties (i.e., they experience lower sleep quality and have a higher degree of sleepiness), higher BMI levels (i.e., higher values of overweight and obesity), less participation in leisure activities, and a lower perception of QoL. A higher perception of QoL is associated with school participation unaffected by the existing CC, sleeping well, a low level of sleepiness, a more frequent practice of physical activity, a lower BMI, and a greater involvement in leisure activities. Adolescent health and well-being are a prominent issue in terms of public policies, with behavior and lifestyle playing a significant role in this domain. This message needs to be reinforced in regard to families, educators, healthcare professionals, and public sector policies, particularly concerning students with CC.

Differences in physical activity and perceived benefits and barriers to physical activity between LGBTQ + and non-LGBTQ + college students

ObjectiveTo compare physical activity (PA) behaviors and perceived benefits and barriers among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) and non-LGBTQ + college students. Participants: Participants were 406 college students. Methods: Surveys assessed PA behaviors and perceptions of PA among college students. Multivariate ANOVA assessed differences in PA behaviors and perceptions of PA. Results: LGBTQ + students (n = 71) engaged in 17% less aerobic PA and 42% less resistance training than their counterparts (n = 335; both p < .05). LGBTQ + students reported 6.5% lower total Exercise Benefits and Barriers Scale scores and 13.3% higher Barriers Scale scores (both p < .05). Conclusions: LGBTQ + college students are at higher risk of not meeting PA guidelines than non-LGBTQ + students. More perceived barriers and fewer perceived benefits to PA may contribute to this disparity. Identification of LGBTQ+-specific barriers to PA among college students is needed to inform programming to increase PA among this at-risk community.

Students' Perceived Well-Being and Online Preference: Evidence from Two Universities in Vietnam during COVID-19

University education is still being impacted two years after the COVID-19 outbreak. We performed a rapid survey in February 2022 at two public universities in Vietnam to examine the effects of the pandemic on well-being and the factors that may associate with online class preference among university students as well as to investigate the need for support to improve resilience. A web-based survey included 1589 undergraduate students in total. Both quantitative and qualitative data analysis was carried out. Overall, approximately a quarter of respondents said that they perceived an influence on their health, 42.9% expressed stress, and more than 70% reported worrying about the future. In total, 61.9% of the respondents reported having satisfaction with online classes, while over half of them preferred a program of 50% online classes. Students who live in an urban area, are female, have had pre-COVID-19 campus life experience, have decreased income, and/or experience low online satisfaction and over-information may be in need of more support. The results show implications for universities to consider policies addressing well-being and post-pandemic online education. Providing support to university students to improve their resilience against the impact on their studying, campus life, health, and well-being should be prioritized during and post-pandemic.

Daily wellness behaviors in college students across a school year

Objective: To establish the prevalence of mood and wellness behaviors in college students across a school year. Methods: 1,554 college students (69.4% female; average age 18.8 years) were followed with daily surveys on wellness behaviors for the school year. 1,207 participants completed at least 50% of daily surveys on mood, exercise, sleep, nutrition, mindfulness practice and singing/playing musical instrument. Results: Over 88.7% of college students reported at least one wellness behavior each day with 17.7% reporting 4 or more. Each of the wellness behaviors, however, displayed distinct prevalence patterns, varied significantly across the school year, and often across a given school week. Almost every individual wellness behavior was associated with a positive mood, and the cumulative number of daily wellness behaviors was a strongly associated with mood state. Conclusions: Daily wellness behaviors are collectively common, vary significantly within individuals, and are strongly associated with positive mood, both individual and cumulatively.

Psychometric validation and cultural adaptation of the Italian medical student stressor questionnaire

Medical students encounter specific stressors that can lead to higher levels of psychological distress compared to their similar aged counterparts who study other subjects. The Medical Student Stressor Questionnaire (MSSQ) was developed to specifically identify stressors among medical students as well as measure the intensity of stress caused by the stressors. However, no Italian version has been validated to date. The aim of this study was to develop an Italian version of the MSSQ (MSSQ-I) and to assess its psychometric properties. The MSSQ has been translated and culturally validated into Italian. All medical students from the University of Brescia were asked to participate in a web-survey in which they were asked to complete the MSSQ-I. For the analysis of the stability over time, participating students were asked to complete again the MSSQ-I after about one month. Among 1754 medical students, 964 completed the MSSQ-I for the validation analyses. A first Confirmatory Factor Analysis and a subsequent Explanatory Factor Analysis outlined a slightly modified factor structure of the scale with five factors instead of six as in the original scale. The internal consistency on the overall scale was high (α = 0.94), as well as the internal consistency of each of the new factors: (α > 0.83 for the first four factors and α = 0.67 for the fifth). External validity analysis confirmed moderate/high concurrent validity. These results suggest that the MSSQ-I can be used as a tool to identify stressors among Italian medical students, although further research is needed to confirm its individual test-retest reliability.

The relationship between physical activity intensity and subjective well-being in college students

ObjectiveThe aim of this study was to examine the associations between physical activity (PA) and subjective well-being (SWB) by focusing on the intensity of PA and different components of SWB. Participants: The sample included 723 undergraduate students (mean age = 19.3 years). Methods: Participants responded to questionnaires measuring life satisfaction, happiness, positive affect, negative affect, vigorous-intensity PA, moderate-intensity PA, and walking. Multiple regression models were performed with the SWB variables as the outcomes and PA variables as the predictors while controlling for age and sex. Results: While vigorous-intensity PA was the only significant predictor for life satisfaction, both moderate-intensity PA and vigorous-intensity PA were positively associated with happiness and positive affect and negatively associated with negative affect. Walking was not associated with any component of SWB. Conclusion: PA has a positive relationship with SWB in college students and this relationship differs by the intensity of PA and the component of SWB.

Communication effectiveness: examining interactions between college health professionals and students on university campuses

ObjectiveTo examine how students would describe their communication exchanges with college health professionals on a university campus and also how students perceived those exchanges to be effective health communication. Participants: 48 participants completed the online survey. Methods: An open-ended questionnaire was utilized to collect data. Thematic analysis technique was used to analyze the data. Results: The analysis yielded six themes that emerged from participants' responses: clear communication, instruction, listening, friendliness, immediate feedback, and professionalism. Conclusions: The findings show that students' understanding of efffective health communication differs. Therefore, college health professionals should be cognizant of these differences when communicating with students who access health services on university campuses.

COVID-19 pandemic stresses and relationships in college students

OBJECTIVE

The goal of this study was to understand how intergenerational intimacy and individuation associate with COVID-19 pandemic-related stresses and changes to relationship qualities, and consequentially, with substance use indicators, happiness, and life satisfaction.

BACKGROUND

Intergenerational family systems theory suggests that dysfunctional relationship patterns in one's family of origin contribute to greater stress, and consequentially, to poorer health outcomes. We examined how these patterns emerge for young adults during a pandemic.

METHOD

A sample (N = 501) of young adults at a large university in Texas completed an online questionnaire about health and happiness.

RESULTS

More intergenerational intimacy was associated with more positive COVID-19 pandemic-related changes in relationship quality with family and friends, and with more happiness and life satisfaction. More intergenerational individuation was associated with less COVID-19 pandemic-related stress, fewer coping motives for alcohol use, and with more happiness and life satisfaction. Less COVID-19 pandemic-related stress and more positive COVID-19 pandemic-related changes in relationship qualities with family and friends were associated with more positive outcomes.

CONCLUSION

More positive intergenerational relationships are associated with more positive outcomes in regards to COVID-19 pandemic-related stress and relationship changes.

IMPLICATIONS

Promoting positive intergenerational relational qualities between young adults and their parents can buffer against pandemic-related consequences in health and happiness. Family health practitioners should promote these intergenerational qualities in families, which in turn should increase positive psychosocial and health outcomes in the context of a pandemic.

The Post-Secondary Student Stressors Index: Proof of concept and implications for use

Objective This study demonstrates the utility of the Post-Secondary Student Stressors Index (PSSI), an instrument designed to identify and evaluate the sources of student stress. The PSSI is comprised of 46 stressors, rated by severity and frequency, across five domains: academics, learning environment, campus culture, interpersonal, and personal. Participants: Pilot testing of the tool was conducted among n = 535 post-secondary students enrolled at an Ontario university. Methods: Mean severity and frequency ratings were calculated for each stressor on the instrument. Results were plotted, and stratified by sex. T-tests for differences in means across sexes were calculated for each stressor. Results: Female students in this sample consistently rated nearly all stressors on the instrument as more severe than their male counterparts. Females also reported higher frequency ratings on average, indicating that they worried about stressors more often than did males. Domain-specific stressors are discussed. Conclusions: The PSSI can provide post-secondary institutions with the ability to improve the targeting of their mental health promotion and mental illness prevention efforts.

Do Academic Stress, Burnout and Problematic Internet Use Affect Perceived Learning? Evidence from India during the COVID-19 Pandemic

Distress in online classrooms and problematic internet use are two issues that have caused student burnout and affect perceived learning during the COVID-19 pandemic. Given the high pressure placed on students throughout COVID-19, it is critical to understand the influence of problematic internet use (PIU), psychological stress, academic burnout, and resilience on perceived learning (PL). A cross-sectional analytical study was chosen to collect data from 350 learners pursuing undergraduate and postgraduate business/management degrees in Karnataka, India. The data were analyzed using SPSS (Statistical Package for Social Science) and Smart PLS 3. The present study reports a non-significant negative total effect of stress on PL, while there was a significant positive direct effect but a significant indirect negative effect of multiple mediators, namely PIU, burnout, and resilience. In the relationship between stress and PL, burnout has full competitive mediation, and the suppressive effect of burnout and resilience wipes out the beneficial benefit of stress on PL, resulting in reduced PL. As a societal problem, a change in educational policy and prevention strategies for students and organizations (reducing the number of courses, number of exams, and handling parental expectations) would be effective. Emotional intelligence to improve resilience, which assists students in sailing through a current challenging situation and using IT for reducing negative and unexpected emotional outbursts should be encouraged.

Occupational alienation and the mental health of university students

Abstract Mental health, especially in the youth, has been a prevailing concern in recent years. University students are a particularly high-risk population for mental health problems. Changing perspectives in the field of mental health present the opportunity to explore this concept through an occupational justice lens – specifically that of occupational alienation. Through a brief review of relevant literature, this critical essay will explore the relationship among the concepts of alienation from both a sociology and occupational science perspective, and consider the insights that may be obtained through application of this concept to understanding the mental health of university students. The use of an occupational justice lens provides an opportunity for an alternative perspective when considering factors potentially contributing to the mental health problems in this population.

Client-Therapist Convergence on Sleep Difficulty and its Impact on Treatment Outcomes

While agreement between clients and their clinicians on therapy goals has frequently been investigated as a process-level variable (i.e., working alliance), dyadic convergence on presenting concerns is also important for initial case formulation. Transdiagnostic presenting problems, like sleep difficulty, pose a particular challenge for client-therapist convergence. The current study describes sleep difficulty in a treatment-seeking college population and investigates the impact of client and therapist baseline sleep problem reports on therapy outcomes.

Data were collected through a large practice research network, with the sample comprising 47,023 clients from 99 university counseling centers across the United States.

A larger proportion of clients (49.3%) had self-reported high baseline sleep difficulty than those with a clinician-identified sleep concern (16.0%). Clients with baseline sleep difficulty were more likely to end treatment with greater self-reported sleep difficulty and psychological symptom distress, although they may experience larger gross symptom change than clients without baseline sleep difficulty. Clinician-identified sleep concerns were significantly associated with client outcomes, particularly when clients did not report baseline sleep difficulty themselves.

Findings from this study suggest that it may be efficacious and efficient with limited time for treatment to address sleep concerns in a college setting.

Clinicians' attendance to their clients' transdiagnostic presenting concerns, like sleep difficulty, may increase clients' own awareness of problematic patterns of behavior. When time for therapy is short, as is often the case in college counseling, it may be efficient to prioritize these concerns with the potential to impact a broad range of symptoms.

Mental Health in Times of the COVID-19 Pandemic: Exploring the Impact on Well-Being Across the Athlete-Collegiate Career

In reaction to the COVID-19 pandemic, restrictive policies altered student-athletes’ academic and athletic life. Sparse research has investigated the pandemic’s effect on student-athlete mental health in terms of both negative (e.g., depression, anxiety) and positive (e.g., well-being, quality of life) dimensions. This study explored the effect of the COVID-19 pandemic on well-being and quality of life among National Collegiate Athletic Association Division I student-athletes at different stages of their collegiate career. Ninety-nine student-athletes (Mage = 19.7 years, SD = 1.5) completed assessments on their mental health. Regression analysis revealed experiences directly related to COVID-19 did not affect general well-being or quality of life, but anxiety, depression, and significant insomnia did. Social well-being was lower for student-athletes closer to graduation (e.g., juniors, seniors), independent of reported anxiety and depression levels. These findings highlight the importance of psychosocial support, particularly in times of crisis, and indicate that tailored support might be beneficial at later stages of the collegiate years.

The value of Bayesian predictive projection for variable selection: an example of selecting lifestyle predictors of young adult well-being

BACKGROUND

Variable selection is an important issue in many fields such as public health and psychology. Researchers often gather data on many variables of interest and then are faced with two challenging goals: building an accurate model with few predictors, and making probabilistic statements (inference) about this model. Unfortunately, it is currently difficult to attain these goals with the two most popular methods for variable selection methods: stepwise selection and LASSO. The aim of the present study was to demonstrate the use predictive projection feature selection - a novel Bayesian variable selection method that delivers both predictive power and inference. We apply predictive projection to a sample of New Zealand young adults, use it to build a compact model for predicting well-being, and compare it to other variable selection methods.

METHODS

The sample consisted of 791 young adults (ages 18 to 25, 71.7% female) living in Dunedin, New Zealand who had taken part in the Daily Life Study in 2013-2014. Participants completed a 13-day online daily diary assessment of their well-being and a range of lifestyle variables (e.g., sleep, physical activity, diet variables). The participants' diary data was averaged across days and analyzed cross-sectionally to identify predictors of average flourishing. Predictive projection was used to select as few predictors as necessary to approximate the predictive accuracy of a reference model with all 28 predictors. Predictive projection was also compared to other variable selection methods, including stepwise selection and LASSO.

RESULTS

Three predictors were sufficient to approximate the predictions of the reference model: higher sleep quality, less trouble concentrating, and more servings of fruit. The performance of the projected submodel generalized well. Compared to other variable selection methods, predictive projection produced models with either matching or slightly worse performance; however, this performance was achieved with much fewer predictors.

CONCLUSION

Predictive projection was used to efficiently arrive at a compact model with good predictive accuracy. The predictors selected into the submodel - felt refreshed after waking up, had less trouble concentrating, and ate more servings of fruit - were all theoretically meaningful. Our findings showcase the utility of predictive projection in a practical variable selection problem.

Regulation/Non-Regulation/Dys-Regulation of Health Behavior, Psychological Reactance, and Health of University Undergraduate Students

The Self-Regulation vs. External-Regulation Theory (2017) has postulated a continuum of regulation/non-regulation/dys-regulation that is present both in the individual and in the individual’s context. This gives rise to a behavioral heuristic that can predict and explain other health-related variables, such as psychological reactance and student health. On a voluntary basis, 269 university students completed validated questionnaires on variables of regulation, reactance and health. Using an ex post facto design, we performed correlational analysis and structural linear regression to build a structural equations model (SEM) with acceptable statistical values. The results showed various predicted relationships: self-regulation was associated with and positively predicted self-regulated health behavior; external health-regulating contexts were associated with and positively predicted self-regulated health behavior; non-regulatory and dysregulatory contexts negatively predicted self-regulated health behavior and students’ health itself, as well as positively predicting psychological reactance behavior. Implications are established for explaining variability in general and health-related self-regulation, as well as for intervening in these variables in health programs.

Substance Use, Family Functionality, and Mental Health among College Students in Spain

Mental health symptoms are overrepresented among college students worldwide. The current research investigates the associations among substance use, family functionality, and mental health (depression, anxiety, and stress) among college students in Spain. A total of 828 (59.2% female and 40.8% male) college students from two public universities completed a self-reported online survey that included items on demographic information, substance use (alcohol, tobacco, cannabis, cocaine, prescription sedatives, and recreational sedatives), mental health symptoms (using the DASS-21 questionnaire) and family functionality (using the APGAR questionnaire). College students reporting substance use (especially recreational sedatives) and family dysfunctionality were more likely to exhibit symptoms of depression, anxiety and stress. These findings provide support for the underlying role of substance use and family functionality on mental health symptoms. Treatments targeting depression, anxiety, and stress among college students in Spain should aim to reduce substance use by and increase family support of students.

Association of eHealth Literacy With Lifestyle Behaviors in University Students: Questionnaire-Based Cross-Sectional Study

Background

Maintenance of good health and a healthy lifestyle have significant impacts on the lives of university students. However, university students are prone to engage in risky health behaviors, resulting in impaired health status. Electronic health (eHealth) literacy is an important factor in maintaining a healthy lifestyle. However, no studies have assessed the eHealth literacy levels and the associated lifestyle behaviors among university students in Japan.

Objective

The purposes of this study were to clarify the eHealth literacy level, the participant characteristics associated with eHealth literacy, and the association of eHealth literacy with lifestyle behaviors of students in a Japanese university.

Methods

A questionnaire-based cross-sectional study of 3183 students at a national university in Japan was conducted. eHealth literacy was quantified using the Japanese version of the eHealth Literacy Scale (eHEALS). The association between participant characteristics (gender, school year, department of study, and living status) and eHEALS score was assessed using t tests. Additionally, the associations of eHealth literacy with lifestyle behaviors (exercise, smoking, alcohol consumption, etc.) were evaluated using logistic regression analyses.

Results

The mean eHEALS score was 23.6/40 points. The mean eHEALS score for students in medical departments was 27.0/40 points, which was 2.9 points higher than that of nonmedical students (P<.001). Similarly, the graduate school participants had higher scores than the undergraduate students. The proportion of participants who exercised regularly was higher in the high eHEALS score group than in the low score group, with an adjusted odds ratio of 1.39 (P<.001).

Conclusions

The eHealth literacy level of university students in Japan was comparable to that of the general Japanese population. Graduate students, as well as those in medical departments, had higher eHealth literacy. Furthermore, students with higher eHealth literacy had better exercise routines.

Bipolar disorder and the college student: A review and implications for universities

Objective: This brief report provides a review of the prevalence and expression of bipolar disorder in the college student population. Implications for college teachers and universities working with students with bipolar disorder are presented. Methods: Responses from the National College Health Assessment (2009-2017) reference groups were collated to estimate whether the prevalence of students with bipolar disorder has been increasing over time. Results: Data indicate that although overall prevalence is low, the presence of students with bipolar disorder has increased over the past decade. Conclusions: To help students with serious mental illness, including bipolar disorder, succeed in higher education, practices consistent with the philosophy of supported education should be adopted. Special attention will need to be paid to students' financial and academic challenges.

Post-Secondary Stress and Mental Well-Being: A Scoping Review of the Academic Literature

Post-secondary students have been identified as an at-risk population for chronic stress and poor mental health. We conducted a scoping review of the academic literature surrounding student stress and mental well-being as the first phase of research in the development of Canada’s National Standard for the Psychological Health and Safety of Post-Secondary Students. Major thematic findings included student stress, resilience through effective coping and help-seeking, and programs or strategies to improve campus mental health. Recommendations include a call for increased mental health promotion and mental illness prevention activities that are sensitive to diverse cultures, ethnicities, religions, and sexualities.

Trends in college students' mental health diagnoses and utilization of services, 2009-2015

Objective: To examine changes in diagnoses/treatment for 12 mental health (MH) conditions, previous use of campus MH services, and willingness to seek MH services in the future. Participants: ACHA-NCHA II participants from 2009 to 2015 (n = 454,029). Methods: Hierarchical binary logistic regression with step 1 controlling for demographics and step 2 considering time. Results: Time was significant except for bipolar disorder, bulimia, and schizophrenia with increases for all conditions except substance abuse. Anxiety (OR = 1.68), panic attacks (OR = 1.61), and ADHD (OR = 1.40) had the highest odd ratios. Use of MH services at current institution (OR = 1.30) and willingness to utilize services in the future (OR = 1.37) also increased over time. Conclusions: Based on a national sample, self-reported diagnoses/treatment of several MH conditions are increasing among college students. This examination of a variety of MH issues can aid college health professionals to engage institutional stakeholders regarding the resources needed to support college students' MH.

The Relationships Between Physical Health and Chronic Disease, Stress, and Resource Strain in Head Start Employees

Background: Emerging research indicates that Head Start employees often struggle with health issues and may not be able to model the healthy behaviors that they hope to instill in young children. The purpose of this study was to examine the relationships between perceived physical health and chronic disease, stress, financial-resource strain, and job type. Method: This study was conducted in a large, multi-site Head Start agency located across five counties in the American Midwest. Employees (N = 550) were invited to complete a 58-item questionnaire that assessed overall health and health behaviors, demographics, workplace environment, and interest in well-being programs. Bivariate analysis and multinomial logistic regressions were used to analyze the relationships between variables of interest and physical health. Findings: More than half (n = 295; 53.64%) responded, and one quarter of the employees (25.42%) reported poor or fair health. Poor and fair physical health was associated with the number of chronic conditions, difficulty paying for basic necessities, and perceived stress, but not job type. A high percentage of responding employees (83.34%) reported interest in well-being programs, yet interests varied significantly by health status. Employees with poor and fair health expressed interest in stress and emotional-coping programs, in contrast to the fitness interests of employees who reported good, very good, or excellent health. Conclusion/Application to Practice: To meet the needs of employees with poor or fair physical health, employers should offer health behavior modification programs that address the sources of employee stress, including financial-resource strain and mental health challenges.

Knowledge of physical activity guidelines and mental health benefits among Emirati university students

AIMS

The purpose of this study was to assess Emirati university students' knowledge of physical activity guidelines and perceptions of the benefits of physical activity for mental health.

METHODS

A random sample (n = 628) completed an online questionnaire assessing the recommended amount of physical activity for good health (min/week) and to what extent exercise can help improve wellbeing, and manage depression and anxiety/stress (5-point Likert-type scale).

RESULTS

Only 3% of respondents identified 150 min/week and less than half (39%) of the respondents reported an amount within the range of 150-300 min/week. Most respondents believed that physical activity could improve wellbeing (69%), and manage depression (71%) and anxiety/stress (74%). Females were more likely than males to view physical activity as a way to manage depression (p = .003), and anxiety/stress (p = .002).

CONCLUSIONS

More work may be required to promote awareness of physical activity guidelines in this population, and males' awareness of mental health benefits of physical activity.

Sport and Physical Activity Level Impacts Health-Related Quality of Life Among Collegiate Students

PURPOSE

To examine and compare the role of self-assessed sport and physical activity involvement on the health-related quality of life among undergraduate student-athletes and general undergraduate college students.

DESIGN

Cross-sectional survey. Data set was examined for differences in physical and mental health by self-assessed sport and physical activity level.

SETTING

Large Midwestern University in the fall of 2016.

PARTICIPANTS

A combined data set representing undergraduate Division I student athletes (n = 842) and general undergraduate students (n = 1322).

MEASURES

Veterans RAND 12 Item Health Survey (VR-12), as measure of health-related quality of life, comprised of physical component score (PCS) and mental component score (MCS). Self-assessed sport and physical activity level categorized as Division I athlete, club athlete, intramural player, student who works out regularly, or student who is physically inactive.

ANALYSIS

Standard univariable statistics described the study population. Two-sample t tests and χ² tests were conducted, as appropriate, to compare Division I student-athletes to the general undergraduate group. Multivariable linear regression models were then built to assess associations between physical activity level and year in school with VR-12 outcomes, after adjusting for sex. All pairwise interactions were considered for inclusion in the final models. Adjusted least-square means were calculated for all variables in the model; pairwise comparisons were adjusted for multiple comparisons via Tukey-Kramer adjustment criteria. A linear test for trend was also conducted for the association between VR-12 MCS and increasing physical activity.

RESULTS

Significant differences in MCS were noted between levels of sport and physical activity; however, such differences were not detected in PCS. After controlling for sex, a positive relationship between increased sport and physical activity level and greater MCS was found.

CONCLUSIONS

This study represents the first prospective assessment of health-related quality of life among undergraduate athletes and general college students. Higher levels of sport and physical activity were associated with more positive mental health in these populations.

Differences in quality of life among college student electronic cigarette users

PURPOSE

The purpose of this study was to explore an association between e-cigarette use and Quality of Life (QOL) among college students.

METHODS

During February 2016, 1,132 students completed an online survey that included measures of tobacco use and the WHOQOL-BREF instrument. Differences were tested using Chi-square, Fisher's exact test, and ANOVA, and regression was used to assess possible relationships.

RESULTS

E-cigarettes were used by 6.97% of the participants, either solo or along with traditional cigarettes. Bivariate analyses suggest that male college students are more likely than females to use e-cigarettes, either solo or in combination with traditional cigarettes (χ2 =19.4, P < .01). Lesbian, gay, and bisexual students are more likely than heterosexual students to use traditional cigarettes, either solo or in combination with e-cigarettes (χ2 = 32.9, P < .01). Multivariate models suggest that for every 10-unit increase in overall QOL, psychological well-being, social relations or environmental health the adjusted odds of being a sole cigarette user were significantly lower (all, P < .01), respectively. For every 10-unit increase in psychological well-being the adjusted odds of being a dual user was significantly lower (OR = .83, P = .026).

CONCLUSIONS

Findings indicate that lower quality of life appears to be connected to tobacco use.

Multilevel analysis exploring the links between stress, depression, and sleep problems among two-year college students

OBJECTIVE

This study explored the association of stress and depression with a multidimensional sleep problems construct in a sample of 2-year college students.

PARTICIPANTS

The sample consisted of 440 students enrolled in 2-year study from Fall 2011 to Fall 2013.

METHODS

Participants in an obesity prevention study completed surveys assessing sleep, stress, and depression at baseline, 4, 12, and 24 months. Multilevel models predicting sleep problems were conducted to distinguish episodic from chronic reports of stress and depression.

RESULTS

Participants were primarily women (68%), white (73%), young adults (M age = 22.8), with an average of 8.4 hours of sleep per night. Neither stress nor depression was predictive of sleep quantity; however, they were predictive of sleep quality.

CONCLUSIONS

Results show that sleep quality rather than sleep quantity may be the greater health concern for young adults, suggesting that intervention programs targeting depression, stress management, and healthy sleep patterns are warranted.