ABSTRACT
Objective: The purpose of this study was to examine the associations between mental health concerns, positive and negative feelings, and engagement in unhealthy behaviors among US college students during the pandemic. A secondary purpose was to explore positive changes in health and well-being. Methods: College students completed a 45-item online survey in the fall of 2020 that examined demographics, health literacy, health behaviors, overall health and well-being, and academic and financial impacts. Median-unbiased estimation for odds ratio and exact mid-p method inference methods were conducted using R version 4.0.3. We conducted content analysis for qualitative open-ended survey responses. Results: Gender, degree program, and religiosity were associated with having mental concerns. These socio-demographic variables, along with age and ethnicity, were linked to positive and negative feelings. Participants who felt threatened, afraid, stressed, and sad were likely to report mental concerns. Participants who felt cheerful, calm, rested, and full of interests were likely to report no mental concerns. Students who felt sadder, less calm, and less full of interests were likely to engage in unhealthy behaviors. Conclusions: Findings contribute to an increased understanding of mental health and engagement of unhealthy and healthy behaviors among students informing recommendations for services across campuses and communities.