An App-Based Surveillance System for Undergraduate Students’ Mental Health During the COVID-19 Pandemic: Protocol for a Prospective Cohort Study

Abstract

Background The COVID-19 pandemic is a public health emergency that poses challenges to the mental health of approximately 1.4 million university students in Canada. Preliminary evidence has shown that the COVID-19 pandemic had a detrimental impact on undergraduate student mental health and well-being; however, existing data are predominantly limited to cross-sectional survey-based studies. Owing to the evolving nature of the pandemic, longer-term prospective surveillance efforts are needed to better anticipate risk and protective factors during a pandemic. Objective The overarching aim of this study is to use a mobile (primarily smartphone-based) surveillance system to identify risk and protective factors for undergraduate students’ mental health. Factors will be identified from weekly self-report data (eg, affect and living accommodation) and device sensor data (eg, physical activity and device usage) to prospectively predict self-reported mental health and service utilization. Methods Undergraduate students at Western University (London, Ontario, Canada), will be recruited via email to complete an internet-based baseline questionnaire with the option to participate in the study on a weekly basis, using the Student Pandemic Experience (SPE) mobile app for Android/iOS. The app collects sensor samples (eg, GPS coordinates and steps) and self-reported weekly mental health and wellness surveys. Student participants can opt in to link their mobile data with campus-based administrative data capturing health service utilization. Risk and protective factors that predict mental health outcomes are expected to be estimated from (1) cross-sectional associations among students’ characteristics (eg, demographics) and key psychosocial factors (eg, affect, stress, and social connection), and behaviors (eg, physical activity and device usage) and (2) longitudinal associations between psychosocial and behavioral factors and campus-based health service utilization. Results Data collection began November 9, 2020, and will be ongoing through to at least October 31, 2021. Retention from the baseline survey (N=427) to app sign-up was 74% (315/427), with 175-215 (55%-68%) app participants actively responding to weekly surveys. From November 9, 2020, to August 8, 2021, a total of 4851 responses to the app surveys and 25,985 sensor samples (consisting of up to 68 individual data items each; eg, GPS coordinates and steps) were collected from the 315 participants who signed up for the app. Conclusions The results of this real-world longitudinal cohort study of undergraduate students’ mental health based on questionnaires and mobile sensor metrics is expected to show psychosocial and behavioral patterns associated with both positive and negative mental health–related states during pandemic conditions at a relatively large, public, and residential Canadian university campus. The results can be used to support decision-makers and students during the ongoing COVID-19 pandemic and similar future events. For comparable settings, new interventions (digital or otherwise) might be designed using these findings as an evidence base. International Registered Report Identifier (IRRID) DERR1-10.2196/30504

An app-based ecological momentary assessment of undergraduate student mental Health during the COVID-19 pandemic in Canada (Smart Healthy Campus Version 2.0): Longitudinal study

“…Additionally, to the best of our knowledge, there are no directly comparable works to SHC 2.0, but there are related ones. The most closely related Canadian work would be our COVID-specific study Student Pandemic Experience (SPE) [ 18 , 34 ] which had a larger sample size (315 participants), but the mental health questionnaires were tied to the pandemic, longer, and only done once per week. Globally, there is related work to SHC 2.0, but again, these studies do not appear to directly investigate associations between mental health measures and digital measures from hardware; the focus is elsewhere.…”

“…However, this SHC 2.0 study ended up being launched and run during a significant portion of the COVID-19 pandemic. We also launched a separate, strongly-pandemic focused study/app called Student Pandemic Experience (SPE) [ 18 ], which collected more data than the SHC 2.0 study, but was not suitable for use past the pandemic due to the specialized questionnaires used. For SHC 2.0, general objectives of the study were to 1) address the lack of longitudinal data in Canada on overviews of student mental health and any potential related measures of lifestyle, and 2) to identify associations between these self-reported overviews of mental health (from questionnaires) and lifestyle-related smartphone digital measures.…”

Body‐related self‐conscious emotions, self‐compassion, and dietary restraint in Canadian undergraduate university students: A multilevel mediation and moderation analysis

“…Data for this study was collected as part of a larger study, which aimed to examine university students' mental health and coping responses during the COVID‐19 pandemic (Brogly, Bauer, et al, 2021). Undergraduate students were recruited from a single university in southwest Ontario, Canada, between November 2020 and February 2021.…”

An App-Based Ecological Momentary Assessment of Undergraduate Mental Health During the COVID-19 pandemic in Canada (Smart Healthy Campus Version 2.0): Longitudinal Study

“…However, the SHC 2.0 study ended up being launched and run during a significant portion of the COVID-19 pandemic, as it was still relevant. We also launched a separate, strongly-pandemic focused study/app called Student Pandemic Experience (SPE) 14 , which collected more data than the SHC 2.0 study, but was not suitable for use past the pandemic due to the specialized questionnaires used. For SHC 2.0, objectives of the study were to 1) address the lack of longitudinal data in Canada on overviews of student mental health and any potentially related measures of lifestyle, and 2) to identify associations between these self-reported overviews of mental health (from questionnaires) and lifestyle-related measures (from smartphone digital measures).…”