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

Abstract

BACKGROUND The COVID-19 pandemic is a public health emergency that poses challenges for 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. Due 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 research is to use a mobile surveillance system to identify risk and protective factors for undergraduate mental health. Factors will be identified from weekly self-report data (e.g., affect, living accommodation) and device sensor data (e.g., physical activity, device usage) to prospectively predict self-reported mental health and service utilization. METHODS Undergraduate students at Western University, Canada, will be recruited via e-mail to complete an internet baseline questionnaire with the option to participate in the study on a weekly basis using the Student Pandemic Experience (SPE) mobile application (app) for Android/iOS. The app collects sensor samples (e.g., GPS coordinates, 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 by 1) cross-sectional associations between student characteristics (e.g., demographics) and key psychosocial factors (e.g., affect, stress, social connection) and behaviors (e.g., physical activity, device usage) and 2) longitudinal associations between psychosocial and behavioral factors and campus-based health service utilization. RESULTS Data collection began November 9th, 2020 and will be ongoing through to at least August 31st, 2021. Retention from the baseline survey (N=427) to app sign-up was 315/427 (74%), with approximately 175-215 (55-68%) of app participants actively responding to weekly surveys. From November 9th, 2020 to May 1st, 2021, 3363 responses to the app surveys and 18914 sensor samples (consisting of up to 68 individual data items each, e.g., GPS coordinates, steps) were collected from the 315 participants that signed up for the app. CONCLUSIONS Identifying risk and resilience factors for student mental health during this public health crisis is critical for informing optimal campus-based strategies and program development during the pandemic and beyond.