Physical and mental health perspectives of first year undergraduate rural university students

Adverse Childhood Experiences, maladaptive coping behaviours and protective factors in undergraduate students: A cross-sectional study

Objectives: The purpose is to examine the relationship between Adverse Childhood Experiences (ACEs), protective factors, and select maladaptive coping behaviors in postsecondary students. Participants: Undergraduate students attending Dalhousie University. Methods: An online anonymous survey was conducted. Zero order one-tailed correlations were computed to measure relationships between ACEs, levels of maladaptive coping behaviors and protective factors. A structural equation mediation model examined direct and indirect pathways between measures. Results: 42.5% of respondents (n = 327) reported ≥3ACEs. Higher ACEs were associated with higher expression of maladaptive coping behaviors. Respondents with high ACEs and low levels of protective factors reported lower levels of hope and forgiveness and higher levels of stress and rumination. Conclusion: Higher levels of protective factors were associated with lower levels of maladaptive coping behaviors in students with high ACEs.

Exploring the Interplay between Stress Perception and Approach-Avoidance Achievement Goal Orientation among Rural Students in College: A Longitudinal Study in China

The objective of this study was to examine the relationship between stress perception and achievement goals among rural college students in China. Using a two-wave random intercept cross-lagged model, this study analyzed data from a longitudinal survey conducted at 15 public universities in Beijing. First, there was a significant decline in stress levels among Chinese rural students from their junior to senior years. Second, the achievement goal orientations of these students remained relatively stable during the period. Third, while no significant association was found between approach goals and stress perception, a clear positive reciprocal relationship emerged between avoidance goals and stress perception. These results suggest that educators should focus on alleviating the stress experienced by rural college students through academic, employment, and interpersonal support to break the vicious cycle of stress perception and avoidance goal orientation. Future research should further explore the influence of diverse group characteristics and emotional states on these outcomes.

Unveiling the Moderating Factors in the Relationship between Physical Activity and Health-Related Quality of Life among University Students during COVID-19: A Mixed Study Design

This study examines the moderating effects of various factors on the relationship between physical activity (PA) and health-related quality of life (HRQoL) among 287 female college students during the COVID-19 pandemic. Data were collected through an online questionnaire covering health issues, PA, self-esteem, HRQoL, and sociodemographic information, supplemented by semi-structured interviews and focus groups with six participants. Results showed that 46% of respondents had good HRQoL, and 38% were physically active. The interactions of age, socioeconomic status (SES), and academic performance with PA on HRQoL were insignificant. However, physical and mental health problems significantly moderated the PA-HRQoL relationship, accounting for 1% and 4% of the variance, respectively. The qualitative analysis highlighted the need for student activity clubs and mental health support to enhance coping strategies and overall HRQoL. In conclusion, age and SES did not moderate the PA-HRQoL relationship, while physical and mental health issues did. Programs targeting students with health problems are crucial to improving their physical and mental health, thereby enhancing their well-being.

Healthcare-seeking of medical students: the effect of socio-demographic factors, health behaviour and health status - a cross-sectional study in Hungary

BACKGROUND

Medical students are more likely to have various physical and psychological issues, but less information is available about the healthcare-seeking behaviour for physical and mental health issues. The aim of this study is to determine the factors affecting medical students' healthcare-seeking when visiting a general practitioner (GP) and/or psychologist.

METHODS

688 medical students (326 International and 362 Hungarian,) participated in a cross-sectional study. The information was gathered using a self-administered online questionnaire and covered socio-demographic background, health behaviour, general and mental health status and healthcare-seeking. For analysing adjusted associations, multivariable logistic regression models were used.

RESULTS

Overall, 56.8% of medical students visit the GP; and 17.2%, the psychologist. Hungarian medical students visited the GP with chronic diseases, International medical students were more likely to visit a GP when they encountered sexual activity and had chronic diseases. Moreover, there was a significant correlation between sex, alcohol consumption, and perceived stress in the total sample of psychologist visits. When Hungarian medical students were in their clinical years and had a poor self-rated mental health, they were more likely to visit a psychologist. Whereas female international medical students and those who had poor self-rated mental health were more likely to seek psychological help.

CONCLUSION

Students visit a GP and/or psychologist is associated with a variety of factors, including socio-demographic background, health behaviours, and health issues. Medical schools should encourage help-seeking behaviours and early disclosure of medical students. Their ability to grasp healthcare attitudes and designing treatments will be important for both their academic success and future profession.

A scoping review of the barriers and facilitators to accessing and utilising mental health services across regional, rural, and remote Australia

BACKGROUND

Inadequate healthcare access and utilisation are implicated in the mental health burden experienced by those living in regional, rural, and remote Australia. Facilitators that better enable access and utilisation are also reported in the literature. To date, a synthesis on both the barriers and facilitators to accessing and utilising mental health services within the rural Australian context has not been undertaken. This scoping review aims to (1) synthesise the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia, as identified using the Modified Monash Model; and (2) better understand the relationship between barriers and facilitators and their geographical context.

METHODS

A systematic search of Medline Complete, EMBASE, PsycINFO, Scopus, and CINAHL was undertaken to identify peer-reviewed literature. Grey literature was collated from relevant websites. Study characteristics, including barriers and facilitators, and location were extracted. A descriptive synthesis of results was conducted.

RESULTS

Fifty-three articles were included in this scoping review. Prominent barriers to access and utilisation included: limited resources; system complexity and navigation; attitudinal and social matters; technological limitations; distance to services; insufficient culturally-sensitive practice; and lack of awareness. Facilitators included person-centred and collaborative care; technological facilitation; environment and ease of access; community supports; mental health literacy and culturally-sensitive practice. The variability of the included studies precluded the geographical analysis from being completed.

CONCLUSION

Both healthcare providers and service users considered a number of barriers and facilitators to mental health service access and utilisation in the regional, rural, and remote Australian context. Barriers and facilitators should be considered when re-designing services, particularly in light of the findings and recommendations from the Royal Commission into Victoria's Mental Health System, which may be relevant to other areas of Australia. Additional research generated from rural Australia is needed to better understand the geographical context in which specific barriers and facilitators occur.

Rural origin student representation in health courses at the University of Tasmania: 2011-2020

OBJECTIVE

To describe longitudinal trends in the admission and completion of domestic Tasmanian rural origin students in health courses at the University of Tasmania (UTAS).

METHODS

A retrospective audit of records for all domestic Tasmanian students admitted to, or who completed a health course offered by UTAS between 2011 and 2020 was conducted. Data extracted from student records included gender, age, Indigenous background, rural origin (based on residential address outside of Launceston or Hobart at the time of application), health discipline, year of admission and/or completion. Data were analysed in STATA.

RESULTS

Between 2011 and 2020, 7516 domestic Tasmanian students were admitted to health courses at UTAS, of which 22.6% were rural origin (vs. a rural population of 36.7%). Students admitted were mostly female (77.0%) and studying nursing (51.1%). Rural origin students were more likely to study at the regional campus in Launceston than in Hobart, the capital city (OR, 3.79 [3.4-4.3, p < 0.00]). Over this same period, 5086 students completed a health course. There was little difference in completion rates among regional vs. rural origin students (OR, 1.04 [1.0-1.1, p < 0.00]); however, completion rates decreased with increasing remoteness. Indigenous and male students were less likely to complete than non-Indigenous (OR, 0.73 [0.7-0.8, p < 0.05]) and female students (OR, 0.97 [1.0-1.0, p < 0.05]) respectively.

CONCLUSIONS

Tasmanian rural origin students are admitted to a range of health courses at UTAS and many complete. However, additional measures are needed to attract a greater number of local rural origin students to study health courses and to support them through to course completion.

The Role of Social Support and Socioeconomic Factors in the Prediction of Depression among First-Year Undergraduate Students

Aim

This study was devoted to determining the role of social support and socioeconomic factors in predicting students' depression.

Methods

In this cross-sectional study, all first-year undergraduate students in the Shahrekord University of Medical Sciences, Iran, during the 2019-2020 academic year were included via the census method. Data collection tools include a researcher-made checklist about demographic and socioeconomic status, a standard questionnaire of perceived social support, and Beck's depression questionnaire. Smoothly clipped absolute deviation (SCAD) linear regression was used to model the role of social support and socioeconomic factors in predicting depression.

Results

Out of the 220 first-year undergraduate students, 174 (79.1%) were female, and 176 (80.0%) were single. The mean ± SD of depression score among the first-year undergraduate students was 10.56 ± 5.19, and the mean ± SD of social support score was 48.86 ± 5.46. The mean score of depression was significantly higher in female students than in males (11.09 versus 8.59, P = 0.001) but was not statistically significant in different categories of age (P = 0.70), marital status (P = 0.37), ethnicity (P = 0.10), parents' education, and the other demographic variables. Pearson's correlation showed an inverse and significant correlation between depression and social support (R = -0.20, P = 0.003). The mean score of depression was at the highest level for students of public health and environmental health majors and was the lowest for students of laboratory sciences, which was statistically significant (P < 0.001). After adjusting the other variables, SCAD regression showed that social support plays a key role in depression prediction, and increasing social support leads to a decrease in depression score.

Conclusion

Considering the existence of an inverse and significant correlation between depression and social support, any intervention to promote social support for first-year undergraduate students may decrease depression.

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.

Prevalence Rates of Depression and Anxiety among Young Rural and Urban Australians: A Systematic Review and Meta-Analysis

Globally, depression and anxiety are major public health concerns with onset during adolescence. While rural Australia experiences overall lower health outcomes, variation in mental health prevalence rates between rural and urban Australia is unclear. The aim of this paper was to estimate the pooled prevalence rates for depression and anxiety among young Australians aged between 10 and 24 years. Selected studies from a systematic literature search were assessed for risk of bias. Random effects model using DerSimonian and Laird method with Freeman-Tukey Double Arcsine Transformation was fitted. Sensitivity analyses were performed. Prevalence estimates were stratified by region and disorder. The overall pooled prevalence of depression and anxiety was 25.3% (95% CI, 19.9-31.0%). In subgroup analysis, anxiety prevalence was 29.9% (95% CI, 21.6-39.0%); depression: 21.3% (95% CI, 14.9-28.5%); and depression or anxiety: 27.2% (95% CI, 20.3-34.6%). Depression and anxiety prevalence were higher in urban 26.1% (95% CI, 17.3-35.9%) compared to rural areas 24.9% (95% CI, 17.5-33%), although the difference was not statistically significant. The heterogeneity was high with an I2 score of 95.8%. There is need for further research on healthcare access, mental health literacy and help-seeking attitude in Australia.

Community-Based Participatory Research: Partnering with College Students to Develop a Tailored, Wellness-Focused Intervention for University Campuses

College students face unique challenges with leading healthful lifestyles. Using a community-based participatory research approach, college student research partners at two land-grant universities collected data and developed a tailored intervention to improve the well-being of college students. To inform the design of the program, college students were trained to conduct a needs assessment that included a campus-wide survey on the health behaviors of college students, environmental audits of health policies and food pantries on campus, and stakeholder interviews with campus health professionals. Outcomes of the needs assessment data highlighted university students ranked their health as "good" but nutrition health as "fair/poor." Low or very low food security was self-reported by 36.9% of participants and had an overall diet quality score of 47.6 ± 10.1 out of 100. Health professional interview data indicated campuses provide healthful resources to students, but students are not aware those resources exist. Utilizing the needs assessment data previously mentioned, the nominal group technique was then used for student research partners to collaboratively determine the best intervention approaches and develop a wellness program. Student partners identified (1) education, (2) sharing of campus resources, and (3) incentives as important areas of intervention. Using the data collected, the student research partners developed a program titled, The College Cooking Connection, to address health-related quality of life in college students. Using a community-based participatory research approach to program planning, educators and researchers have a greater likelihood of addressing the current needs of the population they are targeting and developing a successful intervention to meet those health concerns. This study aims to partner with young adult university students to understand the college environment and allow the target community to be involved with the development of intervention programs for their campus.

Mental health of Brazilian students during the COVID-19 pandemic: the role of gratitude, optimism, and hope in reducing anxiety

OBJECTIVE

To investigate the role of optimism, hope, and gratitude as psychosocial factors for healthy development, especially with regard to anxiety in college students in the context of coronavirus disease 2019 (COVID-19).

METHODS

This is a quantitative, descriptive cross-sectional study. A sociodemographic questionnaire, the Brazilian Gratitude Scale (Escala Brasileira de Gratidão [B-GRAT]), and the Brazilian versions of an anxiety subscale, the Revised Life Orientation Test (LOT-R), Hope Index Scale, and BIG-FIVE were administered. Data were analyzed using the Mann-Whitney U test, the Kruskal-Wallis test, Spearman correlations, and hierarchical linear regression.

RESULTS

A total of 297 students were assessed. The relationship between gratitude and anxiety became positive in the hierarchical linear analysis, contradicting the initial negative association between these variables according to the Spearman coefficients. This contradiction may be a result of the suppression effect. When gratitude was added to the model, these three variables together accounted for 38% of the variance in anxiety. This indicates that optimism, hope, and gratitude together are significant predictors, although optimism alone accounts for the greater part of the variance in decreased anxiety.

CONCLUSION

The data confirm that family and religiosity are protective factors against mental illness, specifically non-adaptive anxiety. Furthermore, developing optimism as a protective factor makes it possible to experience less anxiety while hope has the potential to provide the individual with multiple pathways to healthy development. This study highlights that gratitude plays a dual role in these relationships as it has the potential to be associated with anxious feelings with likely negative outcomes while at the same time it can drive positive psychosocial factors of optimism and hope, decreasing anxiety.

Psychological distress among first-year health science students in Taiwan

Background

Objective

Methods

Results

Conclusion

•

Some first-year health science students are at risk of psychological distress.

•

Anxiety and self-harm are common among first-year health science students.

•

Students in four-year programs are more likely to experience mental health challenges.

Trajectories of Resilience in University Inductees following Outdoor Adventure (OA) Residential Programmes

Even before COVID-19, university inductees were vulnerable to transitional stressors, which impact upon their psychological well-being and ability to complete their studies. Resilience, as a psychological construct, may be analogous to holding the functioning that supports higher-level academic performance in twenty-first century higher education (HE). Given the significant investment HE requires, coupled with students’ capacity to develop their resilience, universities may be expected to promote psychological resilience in new students. Linking HE to resilience, outdoor adventure (OA) residential programmes have enabled inductees to build components of resilience (i.e., increased self-perception, feelings of control, and intrapersonal relationships) that may heighten their immediate and longer-term academic performance. Yet, few studies have examined the sustainability of these effects. Across five annual cohorts, the self-perceived resilience of 2500 inductees was profiled across three time-point trajectories: (i) pre-OA programme, (ii) post-OA programme, and (iii) three months post-OA programme. Further, the functionality of inductees’ enduring resilience was evaluated for predicting their prospective academic performance at the end of their first year of study. Students’ self-perceived resilience, well-being, and positive recollection of OA experiences reflected their bounce-back ability and a healthy trajectory of productive functioning. Students reporting higher levels of resilience after three months of following the programme were more likely to achieve better prospective academic outcomes. The large sample size ensured that a powerful detection of change was established across time. However, given the absence of a comparison condition across all time points, any lasting improvements in students’ resilience was unable to be attributed to the OA programme. Nonetheless, the results give significant grounds for further research in this direction, including the study of more distinct narrative enquiries at follow-up. In this way, pedagogical practices, supporting effective interventions, may be deployed with incoming students, with the aim of building and maintaining students’ on-going resilience across different learning contexts.

HEARTSMAP-U: Adapting a Psychosocial Self-Screening and Resource Navigation Support Tool for Use by Post-secondary Students

BACKGROUND

Mental health challenges are highly prevalent in the post-secondary educational setting. Screening instruments have been shown to improve early detection and intervention. However, these tools often focus on specific diagnosable conditions, are not always designed with students in mind, and lack resource navigational support.

OBJECTIVE

The aim of this study was to describe the adaptation of existing psychosocial assessment (HEARTSMAP) tools into a version that is fit-for-purpose for post-secondary students, called HEARTSMAP-U.

METHODS

We underwent a three-phase, multi-method tool adaptation process. First, a diverse study team proposed a preliminary version of HEARTSMAP-U and its conceptual framework. Second, we conducted a cross-sectional expert review study with Canadian mental health professionals (N = 28), to evaluate the clinical validity of tool content. Third, we conducted an iterative series of six focus groups with diverse post-secondary students (N = 54), to refine tool content and language, and ensure comprehensibility and relevance to end-users.

RESULTS

The adaptation process resulted in the HEARTSMAP-U self-assessment and resource navigational support tool, which evaluates psychosocial challenges across 10 sections. In Phase two, clinician experts expressed that HEARTSMAP-U's content aligned with their own professional experiences working with students. In Phase three, students identified multiple opportunities to improve the tool's end-user relevance by calling for more "common language," such as including examples, definitions, and avoiding technical jargon.

CONCLUSIONS

The HEARTSMAP-U tool is well-positioned for further studies of its quantitative psychometric properties and clinical utility in the post-secondary educational setting.

The Resilience Journal: Exploring the Potential of Journal Interventions to Promote Resilience in University Students

Given the prevalence of mental health issues among university students, they must be regarded as a vulnerable population. Resilience interventions offer one potential means of strengthening students' capacity to overcome academic challenges and external threats. This is all the more urgent in light of the additional difficulties caused by the current COVID-19 pandemic, such as the demands of remote learning. The present study is a first step toward designing and evaluating an appropriate dynamic resilience intervention for students. The design of the Resilience Journal intervention draws on insights from expressive writing and positive writing research and focuses on reflection on daily challenges. In this online intervention, 100 business school students (66% female, M age = 23.74) at a German university were randomly assigned to two groups and completed two different versions of the Resilience Journal for 5 days. The two versions focused, respectively on broadening attention to challenges and priming attention to mastered challenges. In a pre-post design, two resilience measures and one measure of life satisfaction were used to assess intervention outcomes. Additionally, a newly developed rating scale was used for daily monitoring of dynamic resilience. While both groups showed a significant increase in resilience as measured by the Brief Resilience Scale, that increase could not be attributed directly to the intervention, as there were no group differences, and the design did not include a control group. The other resilience and life satisfaction measures showed no significant change. This first implementation confirms the potential of the Resilience Journal and indicates directions for the development of dynamic resilience interventions and measures in future studies. To further study the potential of such a positive psychology intervention, future research necessitates the inclusion of control groups.

Meaning in life as a predictor of the general health among medical sciences students: A cross-sectional study

AIM

To investigate the predictive role of meaning in life on the general health among medical sciences students.

DESIGN

A cross-sectional study.

METHODS

Four-hundred medical sciences students were selected by proportional to size sampling. The general health questionnaire and the personal meaning profile were administrated to identify the predictive role of meaning in life on the student's general health. Descriptive statistics and linear regression were administrated.

RESULTS

The mean ± SD of the total score of general health and meaning in life among students was 16.34 ± 6.73 and 71.50 ± 9.78, respectively. In the multiple linear regression model, factors such as father's educational level, and meaning in life can predict a 20% variance of general health among university students. As meaning in life thus emerges as a variable worth further in the health of university students, implementing interventional studies to assess the effect of meaning in life on students' general health is recommended.

Developing Resilience During the COVID-19 Pandemic: Yoga and Mindfulness for the Well-Being of Student Musicians in Spain

Here, we report on a quasi-experimental study to explore the applicability and perceived benefits of the CRAFT program, which is based on mindfulness, yoga, positive psychology, and emotional intelligence, to improve higher education student musicians' health and well-being during the lockdown. A subset of student musicians at a Higher Conservatory of Music in Spain followed the CRAFT program during the academic year 2019/2020, 1 h per week as part of their curriculum. Students enrolled in CRAFT-based elective subjects formed the CRAFT program group (n = 40), while other students represented the control group (n = 53). The onset of the national lockdown elicited by the COVID-19 pandemic occurred halfway through the program, which was subsequently delivered in an online format. We administered an online survey to explore the effect that the exposure to the CRAFT program had in terms of how participants dealt with various health and well-being concerns arising from the COVID-19 lockdown. There was a significantly higher proportion of proactive participants in the CRAFT program group, 92%, than in the control group, 58%, in terms of implementing practices to improve their health and well-being during the lockdown. Additionally, significantly more participants acknowledged perceived benefits from their practices in the CRAFT program group, 78%, than in the control group, 52%. Among proactive participants, yoga/meditation was the most implemented in the CRAFT program group, followed by exercise, and other yoga/meditation practices, whereas in the control group, exercise and Alexander technique-based practices were the most applied. In the CRAFT program group, the highest rate of perceived benefits was from yoga/meditation CRAFT-based practices, 51%, followed by exercise, 32%, and other yoga/meditation practices, 27%, whereas in the control group, benefits were reported by 29% of exercising participants and 16% for those having practiced the Alexander technique. A similar pattern was observed when excluding participants with previous yoga/meditation experience. This study revealed how participants can independently apply learned skills from the CRAFT program in response to a naturally occurring life event of unprecedented global impact, suggesting that previous exposure to mindfulness and yoga is likely to have a beneficial effect on how young adults react towards exceptionally stressful conditions.

Health Care Utilization, Transition Readiness, and Quality of Life: A Latent Class Analysis

OBJECTIVE

To identify possible subgroups of health care utilization (HCU) patterns among adolescents and young adults (AYAs) with a chronic medical condition (CMC), and examine how these patterns relate to transition readiness and health-related quality of life (HRQoL).

METHODS

Undergraduates (N = 359; Mage=19.51 years, SD = 1.31) with a self-reported CMC (e.g., asthma, allergies, irritable bowel syndrome) completed measures of demographics, HCU (e.g., presence of specialty or adult providers, recent medical visits), transition readiness, and mental HRQoL (MHC) and physical HRQoL (PHC). Latent class analysis identified four distinct patterns of HCU. The BCH procedure evaluated how these patterns related to transition readiness and HRQoL outcomes.

RESULTS

Based on seven indicators of HCU, a four-class model was found to have optimal fit. Classes were termed High Utilization (n = 95), Adult Primary Care Physician (PCP)-Moderate Utilization (n = 107), Family PCP-Moderate Utilization (n = 81), and Low Utilization (n = 76). Age, family income, and illness controllability predicted class membership. Class membership predicted transition readiness and PHC, but not MHC. The High Utilization group reported the highest transition readiness and the lowest HRQoL, while the Low Utilization group reported the lowest transition readiness and highest HRQoL.

CONCLUSIONS

The present study characterizes the varying degrees to which AYAs with CMCs utilize health care. Our findings suggest poorer PHC may result in higher HCU, and that greater skills and health care engagement may not be sufficient for optimizing HRQoL. Future research should examine the High Utilization subgroup and their risk for poorer HRQoL.

Comparison of physical fitness and mental health status among school-age children with different sport-specific training frequencies

This cross-sectional study compared the physical fitness and mental health status of 140 school-age children who participated in sport-specific training with 180 age-matched peers. All the participants were grouped by sport-specific training frequencies in extracurricular time into the following: (i) high sports training frequency group (HFG): training three to five times per week (n = 77, mean [SD] age: 9.60 [0.12] years); (ii) low sports training frequency group (LFG): training once per week (n = 63, mean [SD] age: 9.88 [0.14] years); and (iii) control group (CG): maintaining routine life (n = 180, mean (SD) age: 9.77(0.09) years). Physical fitness status, including body composition (body mass index), endurance (vital capacity; 50 × 8 round trip), speed and agility (50 m sprint), flexibility (sit-and-reach), coordination (1-min rope skipping), and core strength (1-min sit-ups) as well as mental health status was measured. Overall, the results showed that Grade 3 to 4 HFG students showed better total physical fitness scores than the LFG and CG students. Grade 2 and 5 participants in the three groups showed no significant difference in the total physical fitness score. Children in HFG performed better in several PF indicators (i.e., cardiopulmonary function, flexibility, core strength, and coordination) than those in LFG and CG, and children in LFG got a higher score than those in CG on a testing item of 1-min rope skipping. The mental health test results showed that HFG performed better than LFG and CG. The results indicated that participating in sport-specific training 3–5 times per week was beneficial for children’s physical and mental health. Additionally, there was a weak and negative correlation between physical fitness and mental health in LFG and CG, while no correlation was found between physical fitness and mental health in HFG.

University Student Health and Wellbeing Study: A test-retest reliability study of a web-based survey investigating undergraduate student health and wellbeing

ISSUE ADDRESSED

Understanding the health behaviours of Australian university students and their impact on wellbeing and academic success is important; however, there are limited reliable, population level survey tools to measure student health across a range of domains. The purpose of the research was to determine the reliability of the web-based University Student Health and Wellbeing Study (USHWS) survey via a test-retest reliability study within a large Australian university student population.

METHODS

A test-retest of the measurement instrument was completed by a sample of university students (n = 195) over a two-week period. The instrument assessed alcohol and tobacco use, mental health, sexual health, physical activity, nutrition and sun protective behaviours. Test-retest reliability was analysed using two-way random effects model of intraclass correlations (ICC) and AC₁ coefficient for individual measurements with 95% confidence intervals (95% CI).

RESULTS

Questions on demographics, general health, nutrition, sun protection, alcohol and tobacco use, mental health and sexual health had fair to high reliability (ICCs range from 0.32 to 1.00). Reliability of some physical activity items were poor with large variability (ICC = 0.15, 95% CI 0.01-0.28 to 0.86, 95% CI 0.82-0.89).

CONCLUSIONS

A majority of the USHWS survey items represented a moderate to high test-retest reliability. Variability and poor reliability of physical activity questions may be due to survey implementation time and usual behaviour changes. SO WHAT?: The USHWS survey is reliable instrument to assess Australian university student health at a population level with the aim of informing effective programming, policy and initiatives.

SUMMARY

The University Student Health and Wellbeing Study (USHWS) survey is a foundational tool to understand university student's health in Australia. The USHWS reported fair to high reliability with few physical activity items showing lower reliability. Greater variability may be due to usual day-to-day fluctuations in behaviour.

The Mediating Role of Visual Stimuli From Media Use at Bedtime on Psychological Distress and Fatigue in College Students: Cross-Sectional Study

BACKGROUND

Empirical research has linked psychological distress with fatigue. However, few studies have analyzed the factors (eg, stimuli from bedtime media use) that affect the relationship between psychological distress and fatigue.

OBJECTIVE

The aim of this study was to examine whether visual stimuli from bedtime media use mediate the relationship between psychological distress and fatigue among college students.

METHODS

The sample included 394 participants (92 males, 302 females) with a mean age of 19.98 years (SD 1.43 years), all of whom were Chinese college students at an occupational university in Sichuan Province, China. Data were collected using a paper-based questionnaire that addressed psychological distress, stimuli from bedtime media use, and fatigue. Mediation analysis was conducted using the PROCESS macro version 2.16.2 for SPSS 22, which provided the 95% CIs.

RESULTS

Both psychological distress (r=.43, P<.001) and visual stimuli from bedtime media use (r=.16, P<.001) were positively related to fatigue. The association between auditory stimuli from bedtime media use and fatigue was not significant (r=.09, P=.08). The relationship between psychological distress and fatigue was partially mediated by visual stimuli from bedtime media use (beta=.01, SE 0.01, 95% CI 0.0023-0.0253).

CONCLUSIONS

The findings imply that psychological distress has an indirect effect on fatigue via visual stimuli from bedtime media use. In contrast, auditory stimuli from bedtime media use did not have the same effect. We suggest that college students should reduce bedtime media use, and this could be achieved as part of an overall strategy to improve health. Mobile health apps could be an option to improving young students' health in daily life.

The challenges and mental health issues of academic trainees

In the last decade, mental health issues have come to the foreground in academia. Literature surrounding student mental health continues to grow as universities try to implement wellness services and study the mental health of their students. Studies vary greatly in terms of measurement tools, timeframe, sample demographics, as well as the chosen threshold of symptom severity for diagnosis. This review attempts to summarize, contextualize and synthesize papers that pertain to the challenges faced by academic trainees at the undergraduate, graduate and post-graduate level. The evidence for, and against, the common claim of increasing prevalence of mental health issues among students in recent years is discussed. While some studies support this claim, it is difficult to reach a definitive conclusion due to numerous confounding factors such as increased help-seeking behaviour, greater awareness of mental health issues and weak methodology. The prevalence of depression, anxiety, suicidal and self-injurious behaviour, distress and general mental illness diagnoses are discussed. Other issues known to influence mental health, such as sexual assault and bullying, are briefly addressed. Finally, select studies on a few wellness strategies that may improve mental health of trainees, such as mindfulness, are summarised, along with diverse recommendations for individual students, universities, and academia as a whole.

Outdoor Adventure Builds Resilient Learners for Higher Education: A Quantitative Analysis of the Active Components of Positive Change

The inability of young adults to adapt to university life has been attributed to their declining resilience. Resilience refers to any individuals’ capacity to change or modify behaviour in response to environmental hazards, so they thrive. Outdoor Adventure (OA) residential programmes have helped higher education inductees to acquire skills associated with resilience such as increased self-perception, better interpersonal relationships. However, this study addresses important gaps in existing literature by deploying a high-quality research design to examine the short-term impact of OA experiences on inductees’ resilience and to identify the active components of those experiences that best cultivate inductees’ adaptive capabilities. Multivariate analyses evaluated the efficacy of OA programming to build the resilience of over 2500 inductees. Significant positive gains were reported in the resilience of inductees attending 1-week residential OA programmes measured by an Effect size (ES) = 0.38 and 6.29% increase. Compared to students inducted at university, this represented an 8.35% greater increase in resilience (ES difference = –0.526). Camp-based experiences such as mastering new skills, developing new relationships and being female predicted heightened resilience. A defined blend of embodied, adventure-based meaningful challenges provides a template for helping university inductees to re-adjust, grow and persevere.

The effect of Imaginary Working Qigong on the psychological well-being of college students: Study protocol for a randomized controlled trial

INTRODUCTION

College students are special populations that are particularly prone to have significantly high level of psychological distress than their community peers. Apparently, the best way to manage stress and mental state is through self-care. The characteristic of Qigong is self-directed and self-healing, which is a traditional Chinese mind-body exercise, which has the potential as a stress management intervention. Imaginary Working Qigong, as a kind of static Qigong, is more perception-oriented and can bring about benign sensations of mind and body so as to eliminate stress completely and induce physiological and mental relaxation. In this study protocol, we will systematically examine the feasibility and acceptability of Imaginary Working Qigong on psychological outcomes of the college students and deeply explore molecular biological mechanisms underlying the effects of mind adjustment induced Imaginary Working Qigong.

METHODS/DESIGNS

We will conduct a randomized, assessor and statistician-blinded, parallel-controlled trial exploring the beneficial mind adjustment of Imaginary Working Qigong in college students.A total of 80 eligible college students from Beijing University of Chinese Medicine will be recruited and randomly allocated into Imaginary Working Qigong training or unaltered lifestyle control group according 1:1 allocation ratio with allocation concealment. Imaginary Working Qigong training will last 8 weeks. The study period is 12 weeks including a 4-week supervised training, 4-week independence training, and a 4-week follow-up. Relevant psychological outcomes measurement will take place at baseline, 5 weeks (at the end of supervised training), 9 weeks (at the end of independence training), and 13 weeks (after the 4-week follow-up period) by blinded independent outcome assessors.

CONCLUSION

This is the first randomized controlled trial protocol from the perspective of Qigong connotation to systematically evaluate the effects and relevant molecular mechanism of Imaginary Working Qigong for the mental health of a college student population. If our study demonstrates a significant intervention effect, this would provide preliminary higher-quality evidence and establish a further guidance for the application of Imaginary Working Qigong program among a college student population.

ETHICS AND DISSEMINATION

The study protocol and consent forms have been approved by the medical and animal experiment ethic committee of BUCM (approval number: BJZYYDX-LL2014005).

The effect of Three-Circle Post Standing (Zhanzhuang) Qigong on the physical and psychological well-being of college students: Study protocol for a randomized controlled trial

BACKGROUND

The physical and mental health of college students tends to continuously decline around the world due to lifestyle or behavior habits changes, and pervasive presence of the Internet. Thus it is urgent to improve their health in college life. As a traditional Qigong form is practiced mainly in a standing posture. Three-Circle Post Standing Qigong (TCPSQ) is suitable for regular practicing and has beneficial effects on improving the physiological function and psychological emotion by adjusting body, breathing, and mind. The aim of the 3 adjustments is to achieve a state of harmonious unity-integrating these adjustments into "one." In this study protocol article, we will systematically explore the effectiveness and safety, feasibility of TCPSQ on physical and psychological outcomes of the college students and deeply understand the state of harmonious unity-integrating adjustments of body, breath, and mind into "one."

METHOD/DESIGN

We will conduct a randomized, assessor, and statistician blinded, parallel-controlled trial comparing the beneficial effect of TCPSQ in college students. A total of 80 eligible college students from the Beijing University of Chinese Medicine (BUCM) will be recruited and randomly allocated into TCPSQ training or unaltered lifestyle control group according 1:1 allocation ratio with allocation concealment. TCPSQ intervention will last 10 weeks. The study period is 18 weeks including a 10-week supervised intervention and a 8-week follow-up. The relevant physical and psychological outcomes, adverse events, and safety will be evaluated at baseline, 6 weeks (at the mid-point of intervention), 11 weeks (at the end of intervention), and 19 weeks (after the 8-week follow-up period) by blinded independent outcome assessors.

DISCUSSION

This is the first randomized controlled trial protocol from the perspective of Qigong connotation to systematically investigate the effect of TCPSQ for the physical and mental health of a college student population. If the results in our study prove a significant intervention effect, this would provide preliminary higher-quality evidence and establish an optimal guidance for the application of TCPSQ exercise program among a college student population.

ETHICS AND DISSEMINATION

The study was approved by the ethics committee of the Beijing University of Chinese Medicine (approval number: 2018BZHYLL0109). A SPIRIT checklist is available for this protocol. The trial was registered in Chinese Clinical Trial Registry (WHO ICTRP member). Registration number: ChiCTR-BON-17010840.

Prediction of course completion by students of a university in Brazil

Abstract The conclusion of the undergraduate course by university students in the time predicted by the curriculum is desirable for young people and for society. The aim was to verify the reliability, sensitivity and specificity of a broad set of predictors for academic performance of university students, who completed the undergraduate course within the time predicted by the curricula, through data mining methodology, provided by the Support Vector Machines algorithm. A simple approach is proposed for the prediction of course completion by students in a university in Brazil. The dataset has 170 students who finished the course and 117 who did not finish. With the proposed methodology, it was possible to predict the course completion by students with an accuracy of 79.5% when using the 19 original variables. An accuracy of 75% was found using only 05 variables: Course, year of the course, gender, initial and final academic performance.

Are US degree-granting institutions associated with better community health determinants and outcomes?

OBJECTIVES

The impact of individual education level on health outcomes is well-established, but the effect of degree-granting institutions on county health rankings (CHRs) is unknown. The objective of this study is to determine if there is an association between the presence of degree-granting institutions and CHRs.

STUDY DESIGN

This is an ecologic study.

METHODS

Data for 3062 counties were derived from the Robert Wood Johnson County Health Rankings and the Integrated Postsecondary Education Data System for year 2016. Ordinal logistic regression was utilized to determine the association between presence of a degree-granting institution and county rankings for health behaviors, health outcomes, clinical care, social and economic factors, and physical environment. All models were adjusted for potential confounding factors including age, sex, race/ethnicity, English language proficiency, and urban/rural location.

RESULTS

The presence of a degree-granting institution was positively associated with CHRs for length of life (odds ratio [OR] = 1.28; 95% confidence interval [CI]: 1.05, 1.58), health behaviors (OR = 1.46; 95% CI: 1.19, 1.79), and clinical care (OR = 1.36; 95% CI: 1.11, 1.67). Counties with the highest rankings in one health category were more likely to score in the highest rankings for other health categories.

CONCLUSIONS

These findings suggest that degree-granting institutions are associated with CHRs. Partnerships between public health agencies and degree-granting institutions are recommended to improve population health.

The Effects of Stigma on Determinants of Mental Health Help-Seeking Behaviors Among Male College Students: An Application of the Information-Motivation-Behavioral Skills Model

Considered a public health issue, the prevalence and severity of poor mental well-being on college campuses has continued to rise. While many college campuses offer mental health counseling services, and utilization rates are increasing, their proportional usage is low especially among males, who often deal with poor mental well-being by adopting unhealthy coping strategies. The purpose of this study was to use the Information-Motivation-Behavioral Skills (IMB) model to assess the relationship between the determinants as factors that may impact help-seeking behaviors in a large sample (n = 1,242) of male college students. Employing a cross-sectional study design, a 71-item online survey assessed information via total mental health literacy (MHL), motivation via attitudes toward mental health and subjective norms regarding mental health, and behavioral skills via intentions regarding help-seeking behaviors, and stigma. Results revealed correlations between information and motivation (r = .363, p < .01), information and behavioral skills (r = .166, p < .01), and motivation and behavioral skills (r = .399, p < .01). Multiple regression was used to determine stigma is a mediator for all relationships. These findings represent an opportunity to take a public health approach to male mental health through developing multilayered interventions that address information, motivation, behavioral skills, and stigma.

Mental Health Services for Students at Postsecondary Institutions: A National Survey

OBJECTIVE

Although the high prevalence of mental health issues among postsecondary students is well documented, comparatively little is known about the adequacy, accessibility, and adherence to best practices of mental health services (MHSs)/initiatives on postsecondary campuses. We evaluated existing mental health promotion, identification, and intervention initiatives at postsecondary institutions across Canada, expanding on our previous work in one Canadian province.

METHODS

A 54-question online survey was sent to potential respondents (mainly front-line workers dealing directly with students [e.g., psychologists/counsellors, medical professionals]) at Canada's publicly funded postsecondary institutions. Data were analyzed overall and according to institutional size (small [<2000 students], medium [2000-10 000 students], large [>10 000 students]).

RESULTS

In total, 168 out of 180 institutions were represented, and the response rate was high (96%; 274 respondents). Most institutions have some form of mental health promotion and outreach programs, although most respondents felt that these were not a good use of resources. Various social supports exist at most institutions, with large ones offering the greatest variety. Most institutions do not require incoming students to disclose mental health issues. While counselling services are typically available, staff do not reliably have a diverse complement (e.g., gender or race diversity). Counselling sessions are generally limited, and follow-up procedures are uncommon. Complete diagnostic assessments and the use of standardized diagnostic systems are rare.

CONCLUSIONS

While integral MHSs are offered at most Canadian postsecondary institutions, the range and depth of available services are variable. These data can guide policy makers and stakeholders in developing comprehensive campus mental health strategies.

Internet use for mental health information and support among European university students: The e-MentH project

The aim of the present study was to describe the socio-demographic variables associated with the use of the Internet for mental health information-seeking by European university students, including participants’ trust in the Internet, and their use of the Internet in comparison to traditional formal mental health care. A cross-sectional anonymous 25-item survey was conducted with 2466 students in three courses (Computer Science, Law, Nursing) from four European universities (France, Ireland, Italy, Spain). Participants were equally distributed in all four countries; they were mostly females (57.5%), with a mean age of 21.6 years. Overall, female, French and Nursing students were more likely to look for mental health information. The majority (69.7%) of students reported that information about mental health on the Internet was unreliable. Among all participants, Spanish students reported a higher trust in web content. The findings suggest that university students frequently use the Internet for mental health information-seeking but not for mental health support. Furthermore, they do not entirely trust the Internet for mental health-related issues. This should be considered in planning Internet-based programmes for mental health promotion and prevention in university students.

Social Kills of Undergraduates Without Mental Disorders: Academic and Socio-Demographic Variables

Abstract Literature shows a lack of studies regarding the influence of academic and socio-demographic characteristics in social skills of students without mental disorders. The aim of this work was to characterize and compare the social skills of university students without indicators of mental disorder, according to the academic and socio-demographic variables. The participants were 461 students from both genders and various areas, without mental disorders, based on the criteria of a structured clinical interview. Social skills were evaluated through the QHC-Universitários. Data was compared using statistical procedures. The students of full-time human science courses, those in the intermediate/final years and females were more skillful. The employed students from evening courses reported more skills in speaking in public, while living with other students seemed to promote more confrontation skills.

Technology-based interventions for tobacco and other drug use in university and college students: a systematic review and meta-analysis

Background

University students have high levels of tobacco and other drug use, yet they are unlikely to seek traditional care. Technology-based interventions are highly relevant to this population. This paper comprises a systematic review and meta-analysis of published randomized trials of technology-based interventions evaluated in a tertiary (university/college) setting for tobacco and other drug use (excluding alcohol). It extends previous reviews by using a broad definition of technology.

Methods

PubMed, PsycInfo, and the Cochrane databases were searched using keywords, phrases, and MeSH terms. Retrieved abstracts (n = 627) were double screened and coded. Included studies met the following criteria: (1) the study was a randomized trial or a randomized controlled trial (RCT); (2) the sample was composed of students attending a tertiary (e.g., university, college) institution; (3) the intervention was either delivered by or accessed using a technological device or process (e.g., computer/internet, telephone, mobile short message services [SMS]); (4) the age range or mean of the sample was between 18 and 25 years; and (5) the intervention was designed to alter a drug use outcome relating to tobacco or other drugs (excluding alcohol).

Results

A total of 12 papers met inclusion criteria for the current review. The majority of included papers examined tobacco use (n = 9; 75%), two studies targeted marijuana use (17%); and one targeted stress, marijuana, alcohol, and tobacco use. A quantitative meta-analysis was conducted on the tobacco use studies using an abstinence outcome measure (n = 6), demonstrating that the interventions increased the rate of abstinence by 1.5 times that of controls (Risk Ratio [RR] = 1.54; 95% Confidence Interval [CI] = 1.20–1.98). Across all 12 studies, a total of 20 technology-based interventions were reviewed. A range of technology was employed in the interventions, including stand-alone computer programs (n = 10), internet (n = 5), telephone (n = 3), and mobile SMS (n = 2).

Conclusions

Although technological interventions have the potential to reduce drug use in tertiary students, very few trials have been conducted, particularly for substances other than tobacco. However, the improvement shown in abstinence from tobacco use has the potential to impact substantially on morbidity and mortality.

Electronic supplementary material

The online version of this article (doi:10.1186/s13722-015-0027-4) contains supplementary material, which is available to authorized users.

Privacy Issues in the Development of a Virtual Mental Health Clinic for University Students: A Qualitative Study

BACKGROUND

There is a growing need to develop online services for university students with the capacity to complement existing services and efficiently address student mental health problems. Previous research examining the development and acceptability of online interventions has revealed that issues such as privacy critically impact user willingness to engage with these services.

OBJECTIVE

To explore university student perspectives on privacy issues related to using an online mental health service within the context of the development of an online, university-based virtual mental health clinic.

METHODS

There were two stages of data collection. The first stage consisted of four 1.5-hour focus groups conducted with university students (n=19; 10 female, 9 male, mean age = 21.6 years) to determine their ideas about the virtual clinic including privacy issues. The second stage comprised three 1-hour prototype testing sessions conducted with university students (n=6; 3 male, 3 female, mean age = 21.2 years) using participatory design methods to develop and refine a service model for the virtual clinic and determine student views on privacy within this context.

RESULTS

The students raised a number of issues related to privacy in relation to the development of the university virtual clinic. Major topics included the types of personal information they would be willing to provide (minimal information and optional mental health data), concern about potential access to their personal data by the university, the perceived stigma associated with registering for the service, and privacy and anonymity concerns related to online forums contained within the virtual clinic.

CONCLUSIONS

Students would be more comfortable providing personal information and engaging with the virtual clinic if they trust the privacy and security of the service. Implications of this study include building the clinic in a flexible way to accommodate user preferences.

Self-reported contacts for mental health problems by rural residents: predicted service needs, facilitators and barriers

BACKGROUND

Rural and remote Australians face a range of barriers to mental health care, potentially limiting the extent to which current services and support networks may provide assistance. This paper examines self-reported mental health problems and contacts during the last 12 months, and explores cross-sectional associations between potential facilitators/barriers and professional and non-professional help-seeking, while taking into account expected associations with socio-demographic and health-related factors.

METHODS

During the 3-year follow-up of the Australian Rural Mental Health Study (ARMHS) a self-report survey was completed by adult rural residents (N = 1,231; 61% female; 77% married; 22% remote location; mean age = 59 years), which examined socio-demographic characteristics, current health status factors, predicted service needs, self-reported professional and non-professional contacts for mental health problems in the last 12 months, other aspects of help-seeking, and perceived barriers.

RESULTS

Professional contacts for mental health problems were reported by 18% of the sample (including 14% reporting General Practitioner contacts), while non-professional contacts were reported by 16% (including 14% reporting discussions with family/friends). Perceived barriers to health care fell under the domains of structural (e.g., costs, distance), attitudinal (e.g., stigma concerns, confidentiality), and time commitments. Participants with 12-month mental health problems who reported their needs as met had the highest levels of service use. Hierarchical logistic regressions revealed a dose-response relationship between the level of predicted need and the likelihood of reporting professional and non-professional contacts, together with associations with socio-demographic characteristics (e.g., gender, relationships, and financial circumstances), suicidal ideation, and attitudinal factors, but not geographical remoteness.

CONCLUSIONS

Rates of self-reported mental health problems were consistent with baseline findings, including higher rural contact rates with General Practitioners. Structural barriers displayed mixed associations with help-seeking, while attitudinal barriers were consistently associated with lower service contacts. Developing appropriate interventions that address perceptions of mental illness and attitudes towards help-seeking is likely to be vital in optimising treatment access and mental health outcomes in rural areas.

Investigation of health anxiety and its related factors in nursing students

OBJECTIVE

To explore health anxiety in a sample of nursing students to determine the relationships between health anxiety and life satisfaction, personality, and alexithymia.

METHODS

Two thousand and eighty-six nursing students in junior college, which were divided into five groups, were evaluated by questionnaires, including the Life Satisfaction Scales Applicable to College Students, the Chinese version of the Short Health Anxiety Inventory, the Toronto Alexithymia Scale (TAS-20), and the Eysenck Personality Questionnaire.

RESULTS

The mean age, whether the individual was an only child, residence (urban or rural), and were significantly different between the groups. The self-assessment scores were also significantly different between the groups. The Short Health Anxiety Inventory total score and the factor of fearing the likelihood of becoming ill were significantly negatively correlated with the Life Satisfaction Scales Applicable to College Students total score and its two factors, but were significantly positively correlated with psychoticism, neuroticism, and TAS-20 total scores and its scores of the three TAS-20 factors. The negative consequence scale of Short Health Anxiety Inventory was not significantly correlated with externally oriented thinking, but was significantly negatively correlated with extraversion. A hierarchical multiple regression analysis indicted that objective satisfaction, subjective satisfaction, neuroticism, and the three factors of TAS-20 were predictors of health anxiety.

CONCLUSION

Health anxiety was correlated with life satisfaction, personality, and alexithymia in junior college nursing students. Subjective and objective satisfaction, neuroticism, and the identification and expression of emotions may be predictors of health anxiety in nursing students.

The relationship between mental health and health-related physical fitness of university students

The purpose of this study was to examine the relationship between mental health and health-related physical fitness of university students. For this study, 228 university students were participated in this experiment (male 91, female 137). We tested health-related physical fitness and mental health with questionnaire. Data were analyzed using independent t-test and liner regression. In the present results, there was significant difference according to gender in mental health and health-related physical fitness. The correlation between physical fitness and mental health was also observed.