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Gilley KN, Baroudi L, Yu M, Gainsburg I, Reddy N, Bradley C, Cislo C, Rozwadowski ML, Clingan CA, DeMoss MS, Churay T, Birditt K, Colabianchi N, Chowdhury M, Forger D, Gagnier J, Zernicke RF, Cunningham JL, Cain SM, Tewari M, Choi SW. Risk Factors for COVID-19 in College Students Identified by Physical, Mental, and Social Health Reported During the Fall 2020 Semester: Observational Study Using the Roadmap App and Fitbit Wearable Sensors. JMIR Ment Health 2022; 9:e34645. [PMID: 34992051 PMCID: PMC8834863 DOI: 10.2196/34645] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/14/2021] [Accepted: 01/06/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic triggered a seismic shift in education to web-based learning. With nearly 20 million students enrolled in colleges across the United States, the long-simmering mental health crisis in college students was likely further exacerbated by the pandemic. OBJECTIVE This study leveraged mobile health (mHealth) technology and sought to (1) characterize self-reported outcomes of physical, mental, and social health by COVID-19 status; (2) assess physical activity through consumer-grade wearable sensors (Fitbit); and (3) identify risk factors associated with COVID-19 positivity in a population of college students prior to release of the vaccine. METHODS After completing a baseline assessment (ie, at Time 0 [T0]) of demographics, mental, and social health constructs through the Roadmap 2.0 app, participants were instructed to use the app freely, wear the Fitbit, and complete subsequent assessments at T1, T2, and T3, followed by a COVID-19 assessment of history and timing of COVID-19 testing and diagnosis (T4: ~14 days after T3). Continuous measures were described using mean (SD) values, while categorical measures were summarized as n (%) values. Formal comparisons were made on the basis of COVID-19 status. The multivariate model was determined by entering all statistically significant variables (P<.05) in univariable associations at once and then removing one variable at a time through backward selection until the optimal model was obtained. RESULTS During the fall 2020 semester, 1997 participants consented, enrolled, and met criteria for data analyses. There was a high prevalence of anxiety, as assessed by the State Trait Anxiety Index, with moderate and severe levels in 465 (24%) and 970 (49%) students, respectively. Approximately one-third of students reported having a mental health disorder (n=656, 33%). The average daily steps recorded in this student population was approximately 6500 (mean 6474, SD 3371). Neither reported mental health nor step count were significant based on COVID-19 status (P=.52). Our analyses revealed significant associations of COVID-19 positivity with the use of marijuana and alcohol (P=.02 and P=.046, respectively) and with lower belief in public health measures (P=.003). In addition, graduate students were less likely and those with ≥20 roommates were more likely to report a COVID-19 diagnosis (P=.009). CONCLUSIONS Mental health problems were common in this student population. Several factors, including substance use, were associated with the risk of COVID-19. These data highlight important areas for further attention, such as prioritizing innovative strategies that address health and well-being, considering the potential long-term effects of COVID-19 on college students. TRIAL REGISTRATION ClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/29561.
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Affiliation(s)
- Kristen N Gilley
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Loubna Baroudi
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Miao Yu
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Izzy Gainsburg
- Stephen M. Ross School of Business, University of Michigan, Ann Arbor, MI, United States
| | - Niyanth Reddy
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Christina Bradley
- Stephen M. Ross School of Business, University of Michigan, Ann Arbor, MI, United States
| | - Christine Cislo
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | | | - Caroline Ashley Clingan
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Matthew Stephen DeMoss
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Tracey Churay
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Kira Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | | | - Mosharaf Chowdhury
- Department of Computer Science Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Daniel Forger
- Department of Mathematics, University of Michigan, Ann Arbor, MI, United States
| | - Joel Gagnier
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, United States.,Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Ronald F Zernicke
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, United States.,Exercise & Sport Science Initiative, University of Michigan, Ann Arbor, MI, United States
| | - Julia Lee Cunningham
- Stephen M. Ross School of Business, University of Michigan, Ann Arbor, MI, United States
| | - Stephen M Cain
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV, United States
| | - Muneesh Tewari
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States.,Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States.,Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Sung Won Choi
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
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