Challenge Accepted! a Critical Reflection on How to Perform a Health Survey Among University Students-An Example of the Healthy Campus Mainz Project

Conditional reciprocal stressor-strain effects in university students: a cross-lagged panel study in Germany

University students worldwide are facing increasing mental health challenges. Traditional stress models, like the Job/Study Demand-Resources Model, link stressors directly to strain. Yet, recent studies suggest the influence of strain on stressors may be even stronger. Our research explored these reciprocal dynamics among university students, considering social support and mindfulness as potential moderators. We conducted a two-wave panel study with 264 university students. We ran separate cross-lagged panel structural equation analyses for three key health outcomes-emotional exhaustion, depression, and well-being-each paired with perceived study stressors, specifically workload and work complexity. Findings revealed significant stressor and strain effects, with social support notably moderating the impact of emotional exhaustion on workload. These insights challenge traditional stress theories and underscore the importance of mental health support and effective stress management strategies for students, emphasizing the need for proactive mental health initiatives in academic environments.

Cigarette Smoking, Risky Alcohol Consumption, and Marijuana Smoking among University Students in Germany: Identification of Potential Sociodemographic and Study-Related Risk Groups and Predictors of Consumption

(1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are the most common behaviors related to legal and illicit drug use worldwide, including among university students. To plan effective evidence-based programs to prevent the risky consumption of these substances among university students, the present study aimed to identify potential sociodemographic and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online health survey with approximately 270 health-related items was conducted among students at the University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female ≥ 4, male ≥ 5), and marijuana smoking were chosen as dependent variables. Of the 270 health-related items, 56 were chosen as independent variables and collated into five groups (sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using established and validated instruments. Pearson's chi-square test was used to analyze the differences in prevalence between the sociodemographic and study-related groups, and binary logistic regression was used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university students who entered the analyses, 14.9% reported smoking cigarettes, 38.6% reported risky alcohol consumption, and 10.9% reported smoking marijuana. The prevalence of these differed between genders, fields of study, and aspired degree level, among other factors. Binary logistic regression analyses revealed nine significant predictors (p ≤ 0.05) of cigarette smoking (Nagelkerke R2 = 0.314), 18 significant predictors of risky alcohol consumption (Nagelkerke R2 = 0.270), and 16 significant predictors of marijuana smoking (Nagelkerke R2 = 0.239). (4) Conclusions: This study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany to be associated with multiple factors, especially health behaviors. Furthermore, each of the substances was highly associated with each of the two other substances we examined. Other variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role. Therefore, our recommendation for future prevention programs is that substance use among university students should be addressed as a whole, not just in terms of specific substances.

Videos using different message strategies to promote the interruption of sedentary behavior in university students during online lectures - A pilot study

Background

Sedentary behavior (SB) is highly prevalent among university students and has increased during COVID-19 pandemic. As SB is associated with negative health outcomes, appropriate prevention measures in the university setting are needed.

Objective

This pilot study aimed at investigating the effects of videos using different message strategies to interrupt SB in the collective of university students during online lectures.

Methods

During online lectures, university students (N = 96) were shown one of three videos on the interruption of SB. The videos differed in their message strategies with regard to evidence type (statistical vs. narrative) and vividness (static vs. animated images). Demographics, health variables (SB intentions, SB attitudes) and selected media reception variables (identification, homophily, counterarguing) were examined as possible influence factors on the interruption of SB evoked by watching the video.

Results

Approximately half of the students interrupted sedentary behavior during watching the videos and students of the older age group (cut-off: median = 22 years) interrupted SB significantly more often (p = 0.046). The interruption of SB was predicted by SB intentions (p < 0.05). Identification with characters significantly predicted the intentions to reduce SB (p < 0.001), with a large effect of the overall regression model (R2corr = 0.47).

Conclusion

Considering the increased digitalization in general and restrictions due to COVID-19 pandemic, videos seem to be a useful tool to interrupt SB among university students during online lectures. Narrative formats could facilitate the intention to reduce SB, which in turn could have a positive impact on the interruption of SB. However, further research on effective communication and message strategies is needed.

Mental health state and its determinants in German university students across the COVID-19 pandemic: findings from three repeated cross-sectional surveys between 2019 and 2021

Background

Students were at an increased risk for elevated mental symptoms during the first year of the COVID-19 pandemic compared to pre-pandemic levels. As universities remained closed much longer than anticipated, the mental burden was expected to persist through the second year of the pandemic. The current study aimed to investigate the prevalence of mental distress from 2019 through 2021 and identify risk factors for elevated mental burden, focusing on gender.

Methods

We analyzed three cross-sectional online surveys among students at the University of Mainz, conducted in 2019 (n = 4,351), 2020 (n = 3,066), and 2021 (n = 1,438). Changes in the prevalence of depressive symptoms, anxiety, suicidal ideation, and loneliness were calculated using Pearson's chi-square tests and analyses of variance. Multiple linear regressions yielded associated risk factors.

Results

The proportion of students with clinically relevant depressive symptoms was significantly higher during the pandemic (38.9% in 2020, and 40.7% in 2021), compared to pre-pandemic (29.0% in 2019). Similarly, more students reported suicidal ideation and generalized anxiety during the pandemic with a peak in the second pandemic year (2021). The level of loneliness was significantly higher in 2020, compared to 2019, and remained at a high level in 2021 (p < 0.001, η p 2 = 0.142). Female and diverse/open gender, being single, living alone, and being a first-year student were identified as risk factors associated with mental burden during the pandemic.

Discussion

Mental burdens remained elevated among students through the second year of the pandemic and were associated with socio-demographic risk factors and pandemic-related concerns. Future research should monitor recovery and evaluate the need for psychosocial support.

Informiert = Geimpft? Das Informationsverhalten und die COVID-19-Impfentscheidung bei Studierenden

Eine zu geringe Impfbereitschaft zählt zu den größten globalen Gesundheitsgefahren und war in der COVID-19-Pandemie auch in Deutschland eine der großen Herausforderungen der öffentlichen Gesundheit. Die Identifikation potenzieller Einflussfaktoren auf das Impfverhalten ist deshalb für eine zielgruppengerechte Gesundheitskommunikation von großer Bedeutung. Studierende sind eine besonders wichtige Zielgruppe der Prävention und Gesundheitsförderung. Der Beitrag geht mit Hilfe einer Online-Befragung der Studierenden einer westdeutschen Universität (n = 1398) im Sommersemester 2021 den Fragen nach, inwieweit sich geimpfte und ungeimpfte Studierende mit hoher bzw. niedrigerer Impfintention hinsichtlich a) ihrer Medien- und Informationsnutzung und b) ihres Vertrauens in Medien und Informationsquellen in der COVID-19-Pandemie unterschieden. Die Ergebnisse zeigen z. T. deutliche Differenzen. Während geimpfte Studierende sich intensiver informierten und hierfür auch stärker auf klassische Medienangebote zurückgriifen, vertrauten insbesondere ungeimpfte Studierende mit niedrigerer Impfintention u. a. mehr auf alternative Nachrichtenseiten und Blogs.

Sedentary time of university students before and during the COVID-19 pandemic: Risk groups and pre-pandemic predictors using cross-sectional and longitudinal data

Background

The present study aimed to (1) assess and compare sedentary time (ST) of university students before and during the COVID-19 pandemic, (2) examine risk groups with regard to ST and the "extent of change" in ST (from before to during the pandemic) in association with sociodemographic (gender, age), study-related (degree aspired to, field of study, semester), and pre-pandemic physical health-related [pre-pandemic physical activity (PA) and ST levels, pre-pandemic BMI class] variables, and (3) investigate whether the change in ST was predicted by these variables.

Methods

Two online surveys were conducted among students at the University of Mainz, Germany-the first in 2019 (before the pandemic) and the second in 2020 (during the pandemic). Participants of both surveys were included in a longitudinal sample. With the longitudinal sample's data, paired t-tests, single factor, and mixed analyses of variances were used to examine group differences in ST and the "extent of change" in ST. A linear regression analysis was computed to investigate the influence of the abovementioned sociodemographic, study-related, and pre-pandemic physical health-related variables on the change in ST.

Results

Of the N = 4,351 (pre-pandemic) and N = 3,066 (in-pandemic) participants of the online surveys, N = 443 entered the longitudinal sample. ST increased by 1.4 h/day to critical levels (≥8 h/day) in all subgroups analyzed-even among students who were highly physically active before the pandemic. Students with a low pre-pandemic ST had the largest increase in ST. Pre-pandemic PA level negatively predicted the change in ST.

Conclusion

Even during a global pandemic lockdown, individuals who were previously more physically active and had less ST showed more health-promoting behavior in terms of ST. Therefore, it can be stated that efforts to promote PA and reduce ST are always valuable. Since ST increased and was worryingly high in all subgroups analyzed, all university students should be targeted by multidimensional approaches to tackle ST and promote their health.

Physical Activity and Sedentary Behavior in University Students–The Role of Gender, Age, Field of Study, Targeted Degree, and Study Semester

Background

Physical inactivity and sedentary behavior are modifiable risk factors for an unhealthy lifestyle in university students. The aim of this study was to identify subgroups among German university students with an increased risk for unhealthy behavior. For this purpose, differences in physical activity and sedentary behavior with respect to sociodemographic and study related factors were examined.

Methods

A total of 4,351 students participated in an online survey. The amount of physical activity (metabolic equivalent of task-min/week) and the sitting time (h/day) were assessed using the German short form of the International Physical Activity Questionnaire. Differences in gender and age as well as field of study, targeted degree and study semester were analyzed using a single factorial ANOVA with Tukey correction or a Welch-ANOVA with Games-Howell correction.

Results

For physical activity, significant differences were found for gender (F_{(2, 80.46)} = 17.79, p < 0.001, ηp2 = 0.009), for field of study (F_{(5, 1738.09)} = 7.41, p < 0.001, ηp2 = 0.01), and for study semester (F_{(1, 948.12)} = 5.53, p < 0.05, ηp2 =0.001), but not for age and targeted degree (p > 0.05). For sedentary behavior, significant differences were found for field of study (F_{(5, 3816)} = 5.69, p < 0.001, ηp2 = 0.01) and targeted degree (F_{(3, 3868)} = 3.94, p < 0.01, ηp2 = 0.003), but not for gender, age and study semester (p > 0.05).

Conclusion

Female students, students enrolled in “natural sciences, mathematics and informatics” and first year students appear to have an increased risk of an unhealthy lifestyle. Future research should identify barriers to and incentives of physical activity as well as reasons for high amounts of SB in sub-populations of university students. Suitable prevention and intervention programs are necessary.

The Prevalence of Pharmacological Neuroenhancement Among University Students Before and During the COVID-19-Pandemic: Results of Three Consecutive Cross-Sectional Survey Studies in Germany

Background

According to the literature, the conditions of studying and living as well as the psychological, social and health behavior-related variables, which were strongly related to pharmacological neuroenhancement (PN) before the pandemic, significantly changed during the pandemic. For this reason, it is expected that the prevalence of PN among university students is higher during the pandemic compared to before the pandemic. Therefore, the present study aimed to investigate and compare the prevalence of PN among university students before and during the COVID-19-pandemic.

Methods

Three online surveys assessing the 12-month prevalence of PN were conducted among university students at the University of Mainz, Germany. The first survey took place in summer term 2019 (before the pandemic), the second in summer term 2020 (during the first German lockdown), and the third in summer term 2021 (after the second German lockdown). Pearson's chi-square test was used to test whether the 12-month prevalence of PN differed significantly between the three surveys.

Results

The 12-month prevalence of PN was 10.4% in 2019, 11.3% in 2020, and 8.0% in 2021. Chi-square tests revealed no statistical difference in the prevalence of PN between 2019 and 2020. Overall, the use of PN was lower in 2021 compared to 2019 (p < 0.0001) as well as in comparison to 2020 (p = 0.001). Only the use of cannabis slightly increased from 2019 to 2020 (7.1 vs. 8.3%) and decreased in 2021 (5.4%). At all three time points, cannabis was the most commonly used substance for the purpose of PN. Consequently, the results suggest that the prevalence of PN was highly intertwined with the prevalence of cannabis use for PN.

Discussion

The decrease in the prevalence of PN of around three percentage points in 2021 compared to the previous years was a surprising finding. It may be mainly due to the decrease in the prevalence of cannabis for the purpose of PN. However, the fairly high prevalence of PN of around 8% in 2021 is still an important finding that demonstrates that there is still an urgent need for prevention initiatives among university students to combat the use of PN.

Potential risk groups and psychological, psychosocial, and health behavioral predictors of pharmacological neuroenhancement among university students in Germany

Aiming to develop and implement intervention strategies targeting pharmacological neuroenhancement (PN) among university students more specifically, we (1) assessed the prevalence of PN among German university students, (2) identified potential sociodemographic and study-related risk groups, and (3) investigated sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior related factors predicting the 12-month prevalence of PN. Therefore, a cross-sectional online survey was administered to students of the University of Mainz, Germany. A binary logistic regression with stepwise inclusion of the five variable groups was performed to predict PN. A total number of 4351 students out of 31,213 registered students (13.9%) participated in the survey, of which N = 3984 answered the question concerning PN. Of these, 10.4% had used one substance for PN at least once in the past 12 months. The regression analysis revealed 13 variables that were significantly related to the 12-month prevalence of PN. Specifically, the group of health behavior related variables showed the strongest relationship with PN. Therefore, an approach to the prevention of PN should be multifactorial so that it addresses social conditions, as well as education on substance use and healthy behaviors in terms of non-pharmacological strategies as alternatives of PN.

The impact of lockdown stress and loneliness during the COVID-19 pandemic on mental health among university students in Germany

The COVID-19 pandemic led to a shutdown of universities in Germany. In a longitudinal design, we compared mental health (depression, anxiety, somatic complaints) of university students in Germany before (June to August 2019) and in the course of the COVID-19 pandemic (June 2020) and determined the impact of pandemic-related stress and loneliness on students' mental health in self-report online surveys. We investigated 443 participants (mean age 22.8 years), among them 77% female, and 10.4% medical students. A small increase of depression mean scores was observed (F(1,420) = 5.21; p = .023), anxiety and somatic complaints have not significantly changed. There was a medium increase in loneliness from pre-pandemic scores to the pandemic situation (F(1,423) = 30.56; p < .001). Analyzed with regression analyses, current loneliness and pre-pandemic distress represented the strongest associations with mental health during the pandemic. Additionally, health-related concerns during the pandemic were associated with symptoms of depression [b = 0.21; 95%CI(0.08; 0.34); t = 3.12; p = .002], anxiety [b = 0.07; 95%CI(0.01; 0.12); t = 2.50; p = .013], somatic complaints [b = 0.33; 95%CI(0.18; 0.47); t = 4.49; p < .001], and loneliness [b = 0.10; 95%CI(0.03; 0.17); t = 2.74; p = .006]. Social stress due to the pandemic situation was associated with loneliness [b = 0.38; 95%CI(0.32; 0.45); t = 11.75; p < .001]. The results imply that university students represent a risk group for psychosocial long-term ramifications of the pandemic.

Prävalenz von Internetsucht vor und während der COVID-19 Pandemie unter Studierenden der Johannes Gutenberg-Universität Mainz

Ziel der Studie Internetsucht ist eine Verhaltensstörung, von welcher v. a. Jugendliche und junge Erwachsene, unter ihnen auch Studierende an Hochschulen betroffen sind. Die COVID-19 Pandemie führte aufgrund der Maßnahmen zu ihrer Eindämmung zu starken Einbußen sozialer Beziehungen, Studium und Freizeitaktivitäten der Studierenden. Diese Studie untersuchte, wie hoch die Prävalenz der Internetsucht unter Studierenden vor und während der COVID-19 Pandemie ausfällt und welche soziodemografischen (Geschlecht, Fachgruppe) und Gesundheitsfaktoren (Depressionssymptome, Einsamkeit, Ängste, Impulsivität) mit Internetsuchtsymptomen assoziiert sind.

Methodik In der vorliegenden Studie nahmen 2 Stichproben der Studierenden der Johannes Gutenberg-Universität Mainz im Sommer 2019 (N=4351) vor und im Sommer 2020 (N=3066) während der COVID-19 Pandemie im Rahmen des Modellvorhabens „Healthy Campus Mainz-gesund studieren“ zur Prävention und Gesundheitsförderung zu verschiedenen Gesundheitsthemen und Studienbedingungen an Online-Umfragen teil. Es wurde die Prävalenz von Internetsucht erhoben und mittels logistischer Regression Zusammenhänge mit Geschlecht, Depressionssymptomen, Einsamkeit, Ängsten und Impulsivität analysiert.

Ergebnisse Die Prävalenz der Internetsucht lag 2019 bei 3,9% und lag 2020 signifikant höher bei 7,8%. Während 2019 männliches Geschlecht noch mit Internetsucht assoziiert war (OR2019=0,685, p<0,05), konnten 2020 keine Geschlechtsunterschiede mehr festgestellt werden. Sowohl vor als auch während der Pandemie gingen Depressionssymptome (OR2019=1,121, p<0,001; OR2020=1,175, p<0,001) und Einsamkeit (OR2019=1,121, p<0,001; OR2020=1,071, p<0,05) mit Internetsucht einher, während der Pandemie auch Angstgefühle (OR2020=1,156, p<0,05).

Schlussfolgerung Studierende stellen eine gefährdete Gruppe für Internetsucht dar. Während der COVID-19 Pandemie trat die Symptomatik deutlich häufiger auf als noch ein Jahr zuvor. Es müssen unbedingt geeignete Präventions- und Interventionsangebote für Studierende implementiert werden, die sowohl Internetsucht, aber auch damit einhergehende Probleme wie Depression und Einsamkeit in den Blick nehmen.