@article{ref1,
title="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",
journal="JMIR mental health",
year="2022",
author="Gilley, Kristen and Baroudi, Loubna and Yu, Miao and Gainsburg, Izzy and Reddy, Niyanth and Bradley, Christina and Cislo, Christine and Rozwadowski, Michelle Lois and Clingan, Caroline Ashley and DeMoss, Matthew Stephen and Churay, Tracey and Birditt, Kira and Colabianchi, Natalie and Chowdhury, Mosharaf and Forger, Daniel and Gagnier, Joel and Zernicke, Ronald F. and Cunningham, Julia Lee and Cain, Stephen M. and Tewari, Muneesh and Choi, Sung Won",
volume="ePub",
number="ePub",
pages="ePub-ePub",
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. <br><br>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. <br><br>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. <br><br>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). <br><br>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. INTERNATIONAL REGISTERED REPORT: RR2-10.2196/29561.<p /> <p>Language: en</p>",
language="en",
issn="2368-7959",
doi="10.2196/34645",
url="http://dx.doi.org/10.2196/34645"
}