tetano
Editor, Senior Moderator
JMIR Ment Health
. 2022 Jan 6.
doi: 10.2196/34645. Online ahead of print.
Risk Factors for COVID-19 in College Students Identified by Physical, Mental, and Social Health Reported During the Fall 2020 Semester: An Observational Study Using the Roadmap app and Fitbit Wearable Sensors
Kristen Gilley[SUP] 1 [/SUP], Loubna Baroudi[SUP] 2 [/SUP], Miao Yu[SUP] 1 [/SUP], Izzy Gainsburg[SUP] 3 [/SUP], Niyanth Reddy[SUP] 1 [/SUP], Christina Bradley[SUP] 3 [/SUP], Christine Cislo[SUP] 1 [/SUP], Michelle Lois Rozwadowski[SUP] 1 [/SUP], Caroline Ashley Clingan[SUP] 1 [/SUP], Matthew Stephen DeMoss[SUP] 1 [/SUP], Tracey Churay[SUP] 1 [/SUP], Kira Birditt[SUP] 4 [/SUP], Natalie Colabianchi[SUP] 5 [/SUP], Mosharaf Chowdhury[SUP] 6 [/SUP], Daniel Forger[SUP] 7 [/SUP], Joel Gagnier[SUP] 8 9 [/SUP], Ronald F Zernicke[SUP] 8 10 [/SUP], Julia Lee Cunningham[SUP] 3 [/SUP], Stephen M Cain[SUP] 11 [/SUP], Muneesh Tewari[SUP] 12 13 14 15 [/SUP], Sung Won Choi[SUP] 16 [/SUP]
Affiliations
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic triggered a seismic shift in education, to online learning. With nearly 20 million students enrolled in colleges across the U.S., 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: i) characterize self-reported outcomes of physical, mental, and social health by COVID-19 status; ii) assess physical activity through consumer-grade wearable sensors (Fitbit®); and iii) identify risk factors associated with COVID-19 positivity in a population of college students prior to release of the vaccine.
Methods: Detailed methods were previously published in JMIR Res Protocols (Cislo et al). After completing a baseline assessment (i.e., Time 0 [T0]) of demographics, mental, and social health constructs through the Roadmap 2.0 app, participants were instructed to use the app freely, to 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 means (M) and standard deviations (SD), while categorical measures were summarized using frequencies and proportions. Formal comparisons were made based on 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 by backward selection until the optimal model was obtained.
Results: During the fall 2020 semester, 1,997 participants consented, enrolled, and met criteria for data analyses. There was a high prevalence of anxiety, as assessed by the State Trait Anxiety Index (STAI), with moderate and severe levels in N=465 (24%) and N=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 (M=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-positivity with use of marijuana and alcohol (P =.020 and .046, respectively) and 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 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.
Clinicaltrial: ClinicalTrials.gov NCT04766788.
. 2022 Jan 6.
doi: 10.2196/34645. Online ahead of print.
Risk Factors for COVID-19 in College Students Identified by Physical, Mental, and Social Health Reported During the Fall 2020 Semester: An Observational Study Using the Roadmap app and Fitbit Wearable Sensors
Kristen Gilley[SUP] 1 [/SUP], Loubna Baroudi[SUP] 2 [/SUP], Miao Yu[SUP] 1 [/SUP], Izzy Gainsburg[SUP] 3 [/SUP], Niyanth Reddy[SUP] 1 [/SUP], Christina Bradley[SUP] 3 [/SUP], Christine Cislo[SUP] 1 [/SUP], Michelle Lois Rozwadowski[SUP] 1 [/SUP], Caroline Ashley Clingan[SUP] 1 [/SUP], Matthew Stephen DeMoss[SUP] 1 [/SUP], Tracey Churay[SUP] 1 [/SUP], Kira Birditt[SUP] 4 [/SUP], Natalie Colabianchi[SUP] 5 [/SUP], Mosharaf Chowdhury[SUP] 6 [/SUP], Daniel Forger[SUP] 7 [/SUP], Joel Gagnier[SUP] 8 9 [/SUP], Ronald F Zernicke[SUP] 8 10 [/SUP], Julia Lee Cunningham[SUP] 3 [/SUP], Stephen M Cain[SUP] 11 [/SUP], Muneesh Tewari[SUP] 12 13 14 15 [/SUP], Sung Won Choi[SUP] 16 [/SUP]
Affiliations
- PMID: 34992051
- DOI: 10.2196/34645
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic triggered a seismic shift in education, to online learning. With nearly 20 million students enrolled in colleges across the U.S., 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: i) characterize self-reported outcomes of physical, mental, and social health by COVID-19 status; ii) assess physical activity through consumer-grade wearable sensors (Fitbit®); and iii) identify risk factors associated with COVID-19 positivity in a population of college students prior to release of the vaccine.
Methods: Detailed methods were previously published in JMIR Res Protocols (Cislo et al). After completing a baseline assessment (i.e., Time 0 [T0]) of demographics, mental, and social health constructs through the Roadmap 2.0 app, participants were instructed to use the app freely, to 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 means (M) and standard deviations (SD), while categorical measures were summarized using frequencies and proportions. Formal comparisons were made based on 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 by backward selection until the optimal model was obtained.
Results: During the fall 2020 semester, 1,997 participants consented, enrolled, and met criteria for data analyses. There was a high prevalence of anxiety, as assessed by the State Trait Anxiety Index (STAI), with moderate and severe levels in N=465 (24%) and N=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 (M=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-positivity with use of marijuana and alcohol (P =.020 and .046, respectively) and 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 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.
Clinicaltrial: ClinicalTrials.gov NCT04766788.