ABSTRACT
Background: Sub-health status (SHS) is an intermediate status between health and disease. We aimed to investigate the prevalence of sub-health status among college students during the coronavirus disease (COVID-19) pandemic and analyze its influencing factors in order to provide basic information to increase the health level of college students. Methods: College students were selected as subjects from Guangzhou Baiyun Technician College Business using convenience sampling. The inclusion criteria was informed consent, current college students who voluntarily participated in this survey. Exclusion criteria were students with chronic diseases or mental disorders. General data questionnaire, daily lifestyle questionnaire, and SHS measurement scale were used to survey college students. The SHS measurement scale consists of three subscales covering the physiological (1-14 items), psychological (16-27 items), and social (29-37 items) dimensions, with 39 items in total. The items 15, 28, 38 and 39 were used for the overall evaluation of the health status within each dimension and would not be taken into account for the score rating. A commonly used 5-point Likert scale was developed to incorporate the positive items, including questions 1-3, 13-19, and 26-39 with a scaled score equal to the raw score at 1-5; while negative items including questions 4-12 and 20-25 with a scaled score equal to 6 minus the raw score. For each subscale, the sum of all item scores was the raw score. The total raw score was calculated as the sum of raw scores derived from all 3 sub-scales. For any individual dimension, a lower score indicated higher severity of SHS. For sub-scales and the whole scale, raw scores were converted into percentile scores for statistical analysis. Converted score = (raw score - minimum theoretical score) / (maximum theoretical score – minimum theoretical score) × 100. The highest and lowest converted scores of the three subscales were 0 and 100 respectively. In this study, analysis of sub-health was performed using converted scores for all subscales and the whole scale. Based on the sub-health measurement scale, the health condition of subjects would be assessed as disease status (scored < 54), SHS (scored 54 to 79) and health status. From March 6 to 16, 2020, an online survey was conducted via wjx.cn (an online platform available for questionnaire sources). A total of 16,163 students filled out the questionnaire. Results: During the COVID-19 pandemic, the detected prevalence of sub-health among college students was 64.4%.the total SHS score was 73.356 ± 11.115 points, the physiological SHS score was 81.284 ± 11.034 points, the psychological SHS score was 68.691 ± 12.559 points, and the social SHS score was 67.242 ± 17.112 points. Multiple linear regression analysis showed that eating irregular meals, exercising fewer times per week, sleeping fewer hours per night, sleeping after 11 PM more often, spending more time on electronic devices, exercising for fewer minutes each time, and skipping breakfast had the significant negative impact on the SHS scores of college students during the COVID-19 pandemic (P<0.05), while being the only child had a significant positive impact on the SHS scores of college students during the COVID-19 pandemic (P<0.05). Conclusions: During the COVID-19 pandemic, the detected prevalence of sub-health was high among college students. Society and schools should pay more attention to the health of college students during the COVID-19 pandemic and take pertinence action to solve the problem base on influencing factors.