Background Health questionnaires and health checks are an established part of preventive health care services in Finland. However, only very limited research of these has been conducted. The Finnish Student Health Service (FSHS) provides primary health care services to all bachelor’s and master’s degree university students (approximately 134,500 students) in Finland. FSHS’s statutory health examination process of university entrants includes an electronic health questionnaire (eHQ) and, based on the students’ eHQ responses, a subsequent health check if necessary. To our knowledge, no previous studies have been published on the use of questionnaires for screening students for general health checks. Objective The general aim of the study is to evaluate the health examination process of university entrants. The objectives are to determine how students’ self-reported health in the eHQ and participation in the health examination process are associated with graduation, mental health problems, and the use of student health care services. Methods This is an ongoing, nationwide, retrospective, register-based cohort study with a 6-year follow-up. The study population is the cohort of university entrants (N=15,723) from the 2011-2012 academic year. These students were sent the eHQ, which consisted of 26 questions about health, health habits, social relations, and studying. Based on the eHQ responses, students were referred to one of the following interventions: (1) a health check, (2) an appointment other than a health check (eg, physiotherapy), or (3) electronic feedback to support a healthy lifestyle, when the other interventions were not necessary. Multiple comparisons will be made within these groups using logistic regression. The primary outcome variables are graduation, having a mental health problem, and attending a health check. The use of FSHS health care services will be studied with the cluster analysis method. The data have been obtained from three nationwide registers: the eHQ register, the medical records of FSHS, and the Higher education achievement register. The data have been linked using personal identity codes. Results As of August 2019, the data collection and processing are complete and the statistical analyses are in progress. Preliminary results are expected in autumn 2019. Further publications are expected in 2020, and two PhD theses are expected to be completed by the end of 2022. Conclusions Studying practical procedures in primary health care is highly important for resource allocation and the development of evidence-based processes. This study will be the first to assess the usage of a health questionnaire in screening students for health checks. The findings of this study will contribute to the field of preventive health care. The main practical implication is the development of the FSHS’s health examination process. We hypothesize that participation in the health examination process enhances academic achievement and the detection of university students’ mental health problems early on in their studies. International Registered Report Identifier (IRRID) DERR1-10.2196/14535

ObjectiveTo evaluate the association between health and study-related factors measured by an Electronic Health Questionnaire (eHQ), participation in a health examination process and graduation in a university student population.DesignNationwide, retrospective, register-based cohort study with a 6-year follow-up.SettingStudent health care in Finland. Finnish Student Health Service (FSHS) provides statutory student health services to university students in Finland. The health examination process of FSHS includes the eHQ provided annually to university entrants and a subsequent health check when necessary based on students’ eHQ response.ParticipantsA national cohort of university entrants from the 2011–2012 academic year (n=14 329, n (female)=8075, n (male)=6254).Outcome measuresThe primary outcome measure was graduation, measured based on whether a student had completed a bachelor’s, licentiate or master’s degree during the 6-year follow-up.ResultsSome 72% of the women and 60% of the men had graduated during the follow-up. The predictors in the eHQ associated with non-graduation differed by sex. Among the women’s low enthusiasm about studies (OR 2.6, 95% CI 1.9 to 3.6), low engagement with studies (OR 2.5, 95% CI 1.8 to 3.4) and daily smoking (OR 1.9, 95% CI 1.4 to 2.6) were the strongest predictors to non-graduation. Among the men, low engagement with studies (OR 3.7, 95% CI 2.5 to 5.5) and obesity (body mass index≥35) (OR 4.0, 95% CI 1.9 to 8.8) were the strongest predictors to non-graduation. Not attending the health check when referred was associated with non-graduation in both sexes: the OR for not graduating was 1.6 (95% CI 1.3 to 1.9) in women and 1.3 (95% CI 1.0 to 1.6) in men.ConclusionsEngagement and enthusiasm about studying in the first year are important predictors of graduation and therefore a potential intervention target. Health promotion initiatives conducted early in the studies may have a positive effect on students’ academic achievement.

Background General health checks are an established component of preventive health care in many countries. Declining participation rates have raised concerns in health care providers. Understanding the reasons for attendance and non-attendance is necessary to improve the preventive health care system. The aim of this study was to examine health- and study-related factors associated with university entrants’ health check attendance. Methods Since 2009, an electronic health questionnaire (eHQ) has been conducted yearly to all Finnish university entrants by the Finnish Student Health Service (FSHS) to screen students for a general health check. The questionnaire comprises 26 questions about health, health habits and studying. The study population consisted of the 3346 entrants from the 2011–2012 academic year who were referred to a health check based on their eHQ responses. The eHQ data were linked with health check attendance information. Multivariable logistic regression was used to study the associations between the questionnaire responses and non-attendance of the health check. Results Male sex (OR 1.6, 95% CI % 1.4–1.9) and low engagement with studies (OR 1.5, 95% CI 1.2–2.0) were the variables most strongly associated with non-attendance. Having low state of mind was negatively associated with health check non-attendance thus enhanced the health-check attendance (OR 0.6, 95% CI 0.5–0.8). Conclusions The results suggest that providing health checks in student health care may serve as a way of reaching students with health concerns. However, motivating males and smokers to attend general health checks continue to be a challenge also in a university student population. That low engagement with studies associates with health check non-attendance points to need to improve collaboration between universities and student health care. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00032 .

Ylioppilaiden terveydenhoitosäätiö (YTHS) lähettää ensimmäisen vuoden yliopisto-opiskelijoille sähköisen terveyskyselyn. Tämän tutkimuksen tarkoituksena oli selvittää, miten sähköiseen terveyskyselyyn vastaamatta jättäneet yliopisto-opiskelijat eroavat kyselyyn vastanneista terveydentilan, terveystottumusten ja sosiaalisten tilanteiden kokemisen suhteen. Lisäksi tarkoituksena oli saada tietoa opiskelijoiden syistä jättää vastaamatta sähköiseen kyselyyn.  Kohdejoukkona oli lukuvuonna 2011–2012 sähköiseen terveyskyselyyn vastaamatta jättäneet opiskelijat, joista 498 satunnaisesti valitulle opiskelijalle tehtiin puhelinhaastattelu. Puhelinhaastattelussa opiskelijoille esitettiin sähköisessä terveyskyselyssä olleita kysymyksiä terveydentilasta, terveystottumuksista ja sosiaalisten tilanteiden kokemisesta. Vastauksia verrattiin niiden opiskelijoiden vastauksiin, jotka olivat vastanneet sähköiseen kyselyyn samana lukuvuotena (N=8750). Määrällinen aineisto analysoitiin tilastollisin menetelmin ja avoin kysymys laadullisella sisällön analyysillä. Sähköiseen terveyskyselyyn vastaamatta jättäneet opiskelijat kokivat terveydentilansa ja mielialansa paremmaksi sekä sosiaaliset tilanteet positiivisemmin kuin terveyskyselyyn vastanneet opiskelijat. He kokivat myös vähemmän yksinäisyyttä. Vastaamatta jättäneissä opiskelijoissa oli vastanneita enemmän ylipainoisia. Yleisimmät syyt jättää vastaamatta kyselyyn olivat, että opiskelija ei muistanut saaneensa kutsua vastata kyselyyn, ei ehtinyt vastata, ei pitäneet vastaamista tärkeänä tai koki terveydentilansa riittävän hyväksi. Tutkimuksen tulosten perusteella vaikuttaa siltä, että katoon ei jää enemmän terveydentilansa heikommaksi kokevia tai psyykkisesti oireilevia.

BACKGROUND Health questionnaires and health checks are an established part of preventive health care services in Finland. However, only very limited research of these has been conducted. The Finnish Student Health Service (FSHS) provides primary health care services to all bachelor’s and master’s degree university students (approximately 134,500 students) in Finland. FSHS’s statutory health examination process of university entrants includes an electronic health questionnaire (eHQ) and, based on the students’ eHQ responses, a subsequent health check if necessary. To our knowledge, no previous studies have been published on the use of questionnaires for screening students for general health checks. OBJECTIVE The general aim of the study is to evaluate the health examination process of university entrants. The objectives are to determine how students’ self-reported health in the eHQ and participation in the health examination process are associated with graduation, mental health problems, and the use of student health care services. METHODS This is an ongoing, nationwide, retrospective, register-based cohort study with a 6-year follow-up. The study population is the cohort of university entrants (N=15,723) from the 2011-2012 academic year. These students were sent the eHQ, which consisted of 26 questions about health, health habits, social relations, and studying. Based on the eHQ responses, students were referred to one of the following interventions: (1) a health check, (2) an appointment other than a health check (eg, physiotherapy), or (3) electronic feedback to support a healthy lifestyle, when the other interventions were not necessary. Multiple comparisons will be made within these groups using logistic regression. The primary outcome variables are graduation, having a mental health problem, and attending a health check. The use of FSHS health care services will be studied with the cluster analysis method. The data have been obtained from three nationwide registers: the eHQ register, the medical records of FSHS, and the Higher education achievement register. The data have been linked using personal identity codes. RESULTS As of August 2019, the data collection and processing are complete and the statistical analyses are in progress. Preliminary results are expected in autumn 2019. Further publications are expected in 2020, and two PhD theses are expected to be completed by the end of 2022. CONCLUSIONS Studying practical procedures in primary health care is highly important for resource allocation and the development of evidence-based processes. This study will be the first to assess the usage of a health questionnaire in screening students for health checks. The findings of this study will contribute to the field of preventive health care. The main practical implication is the development of the FSHS’s health examination process. We hypothesize that participation in the health examination process enhances academic achievement and the detection of university students’ mental health problems early on in their studies. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14535