Social Media and Self-Concept Among Postsecondary Students: A Scoping Review.

The vast majority of college-aged students use social networking sites (SNS) to foster connectedness and enable networking. In addition, SNS allow individuals to control their online self-presentation. This may lead to incongruence between students' actual selves and their curated online selves, thereby damaging one's self-perception by increasing social comparison orientation. The goal of this article was to investigate the relationship between SNS use and self-concept that has not yet been explored in depth among the postsecondary population. Utilizing Arksey and O'Malley's methodological framework, a scoping review of the published literature was conducted. A total of 41 articles were included in the review. Three overarching themes were extracted from the findings. The first theme found that consistent exposure to the thin ideal and fitspiration posts across various SNS were linked to increased body dissatisfaction. The second theme found that engaging in online academic or ability-based comparisons resulted in a worsened mental state among postsecondary students. The third theme found that one's SNS followers or the number of "likes" received have mixed effects on student self-concept. Through gaining an improved understanding of the SNS stressors that contribute to students' mental health from this review, postsecondary institutions can implement more targeted interventions to bolster student wellbeing.

Preliminary evidence for the validity of the Brief Post-Secondary Student Stressors Index (Brief-PSSI): A cross-sectional psychometric assessment.

The brief version of the Post-Secondary Student Stressors Index (Brief-PSSI) was developed in order to improve the usability of the instrument as a method for evaluating the severity and frequency of stressors faced by post-secondary students. While the original 46-item instrument has been thoroughly psychometrically validated and successfully used among student populations, the length of the instrument limits its utility. Providing a valid, shortened version of the PSSI will enable institutions to include the tool on existing online surveys currently being deployed to surveil the mental health and wellbeing of their students. This study reports preliminary evidence in support of the validity and reliability of the Brief-PSSI using a cross-sectional pilot sample of students attending an Ontario university in 2022. A total of 349 participants (average age 25 (SD = 7.7), range 19-60) completed the first survey, while 149 completed the follow-up survey (average age of 26 (SD = 7.7), range 17-60). Evidence of internal structure, relations to other variables, and of test-retest reliability was assessed according to established index validation guidelines, including the specification of multiple-indicator, multiple-cause models, and Spearman's rho correlation coefficients. Results provide preliminary support for the validity and reliability of the tool, which demonstrated acceptable goodness-of-fit statistics, statistically significant relationships with like constructs in the hypothesized directions, and good test-retest reliability correlation coefficients. The Brief-PSSI is a useful tool for evaluating the sources of stress among post-secondary students, assessing both the severity of stress experienced and frequency with which each stressor occurred. Future research should explore the practical utility of adding the Brief-PSSI to existing survey assessments as well as pursue the continued collection of validation evidence for the tool among varied student populations.

Canada's Student Mental Health Network: Protocol for a Comprehensive Program Evaluation.

BACKGROUND: Prevalence estimates for mental health-related problems, including above-average stress, psychological distress, and symptoms of mental illnesses have increased significantly among Canadian postsecondary students. As demand for downstream mental treatment has surpassed many institutions' abilities to deliver timely care, there is a need for innovative upstream supports that foster mental health promotion and mental illness prevention among this population. OBJECTIVE: Supported by an extensive network of student volunteers, Canada's Student Mental Health Network is a virtual, one-stop shop for centralized mental health education and evidence-based resources tailored to postsecondary students. This article describes a protocol for the comprehensive evaluation of the Network. METHODS: Development of the Network was developed using a participatory action research framework. Network content is created and curated by students and reviewed by subject matter experts. The proposed program evaluation will include both a formative process evaluation and a summative impact assessment to determine the feasibility, acceptability, and utility of the Network in addition to assessing change in the 3 primary outcomes of interest: mental health literacy, perceived social support, and help-seeking behavior. Participants will be recruited directly from the Network website using a "rolling" recruitment approach to allow for continuous data collection and evaluation. A combination of qualitative (ie, interviews) and quantitative (ie, surveys) methods of data collection will be used. RESULTS: The process of evaluation of the Network will begin in September 2022, collecting data for 1 year. In September 2023, the impact evaluation will begin using the same follow-up schedule. Data collection will then remain ongoing to facilitate the continued evaluation of the Network. Reports detailing evaluation data will be released annually. CONCLUSIONS: The Network is a novel and innovative method of delivering universal mental health promotion to Canadian postsecondary students by providing centralized and freely accessible mental health education and resources, created by students and validated by subject matter experts. The continued creation and curation of resources for the Network will be ongoing to meet the evolving needs of the target population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/41521.

Trends in Post-Secondary Student Stress: A Pan-Canadian Study.

OBJECTIVE: Previous research has evaluated the sources of post-secondary student stress, but has failed to explore whether stressors fluctuate over time. The purpose of this research was to use the Post-Secondary Student Stressors Index to examine whether stressors changed significantly and meaningfully over the course of an academic year. Due to the timing of data collection, results also provide context around students' experiences of stress during the COVID-19 pandemic. METHOD: Cross-sectional data was collected at 3 time points via online surveys over the course of the 2020-2021 academic year from >10,000 students. Participants attended 15 post-secondary institutions across Canada, representing 9 provinces and 1 territory. Validated instruments were used to assess levels of stress, distress and the severity of student-specific stressors. Kruskal-Wallis ranked tests and multiple pairwise comparison analyses were conducted to assess whether the mean severity of stressors changed over time. Standard effect sizes were calculated using Cohen's d. RESULTS: Mean levels of stress and psychological distress were high at the start of the study and remained high across time points. A similarly high level of stress was observed on average for student-specific stressors. While significant differences in mean severity were observed over time for some stressors, standardized effect sizes were negligible, suggesting little meaningful change and consistent levels of chronic stress over the course of the academic year. CONCLUSIONS: This is the first paper to examine trends in student-specific stress using a nationwide sample of Canadian post-secondary students during the first year of the COVID-19 pandemic. Patterns observed in student-specific stressors reflected changes likely to be indicative of the pandemic, including the most severe stress associated with academics, finances and concerns for the future. Implications for future research are discussed, in particular, the importance of examining stressors related to COVID-19 and their impact on student mental health.

Further evidence in support of the validity of the post-secondary student stressors index using a nationwide, cross-sectional sample of Canadian university students.

The Post-Secondary Student Stressors Index (PSSI) was created to facilitate improved evaluation of the sources of post-secondary student stress. This study reports evidence in support of the validity of the tool using a large, nationwide cross-sectional sample of students attending universities across Canada during the 2020-2021 academic year. We provide additional evidence for the construct validation of the PSSI, including internal structure evidence and relations to other variables by estimating multiple-indicator, multiple-cause models and investigating Spearman's rho correlation coefficients between the PSSI and like constructs. Based on index validation guidelines, results provide further support for the internal structure of the PSSI, demonstrating hypothesized relationships with like constructs and manifest variables, as well as acceptable goodness-of-fit statistics. Similarly, correlation coefficients were statistically significant and in line with directionality hypotheses. The results of this research provide further evidence for the validity of the PSSI among varied university student populations in Canada and addresses several of the limitations identified in earlier preliminary psychometric work on the instrument.

A scoping review and evaluation of instruments used to measure resilience among post-secondary students.

As mental health problems continue to increase among post-secondary populations, the need to develop effective initiatives designed to bolster students' resilience has increasingly been identified as a priority. Therefore, access to valid tools with which to measure the efficacy of these interventions is imperative. To date, a comprehensive assessment of existing instruments used to evaluate the construct of resilience among post-secondary student populations has not been conducted. The purpose of this study was to fill this gap by conducting a scoping review of literature detailing the use of resilience instruments and evaluating their quality based on suitability for use in the post-secondary setting and associated psychometric evidence. We identified a total of 78 records published between 2010 and 2022, extracting a total of 12 instruments. Using detailed criteria frameworks, each instrument was assessed in terms of suitability and quality of associated psychometric evidence for validity and reliability. The results of our study suggest that many of the instruments currently being used to assess resilience among post-secondary students may not be appropriate. The majority of the instruments included in our review were developed for use among general adult populations and not specifically designed for use in the post-secondary setting. Most instruments did not assess resilience in a comprehensive, holistic matter that addressed the ability to bounce back from adversity by drawing upon psychological, social, cultural, and environmental resources, as defined by recent research. Further, no instruments included in our review had published evidence in support of a complete psychometric analysis. The results of our evaluation suggest that the Connor-Davidson Resilience Scale (CD-RISC) is the most suitable instrument for measuring resilience among post-secondary populations due to its suitability, comprehensive assessment of the construct of resilience, and demonstrably strong psychometric properties for both the 25- and 10-item versions of the tool.

The Post-Secondary Student Stressors Index: Proof of concept and implications for use.

Objective This study demonstrates the utility of the Post-Secondary Student Stressors Index (PSSI), an instrument designed to identify and evaluate the sources of student stress. The PSSI is comprised of 46 stressors, rated by severity and frequency, across five domains: academics, learning environment, campus culture, interpersonal, and personal. Participants: Pilot testing of the tool was conducted among n = 535 post-secondary students enrolled at an Ontario university. Methods: Mean severity and frequency ratings were calculated for each stressor on the instrument. Results were plotted, and stratified by sex. T-tests for differences in means across sexes were calculated for each stressor. Results: Female students in this sample consistently rated nearly all stressors on the instrument as more severe than their male counterparts. Females also reported higher frequency ratings on average, indicating that they worried about stressors more often than did males. Domain-specific stressors are discussed. Conclusions: The PSSI can provide post-secondary institutions with the ability to improve the targeting of their mental health promotion and mental illness prevention efforts.

Cross-Canada Release of the Post-Secondary Student Stressors Index (PSSI): Protocol for a Cross-sectional, Repeated Measures Study.

BACKGROUND: The prevalence of mental health-related problems, including stress, psychological distress, and symptoms of mental illnesses, continues to increase among Canadian postsecondary student populations. Excessive stress in this population has been linked to a number of negative academic and health outcomes. Despite attempts to improve mental health at postsecondary institutions, a persistent gap exists in the evaluation of the specific sources of stress for students within the postsecondary setting. OBJECTIVE: The purpose of this paper is to report the study protocol for a cross-Canada, multisite launch of the Post-Secondary Student Stressors Index (PSSI), which will engage postsecondary institutions across the country as partners and facilitate improved measurement of the sources of student stress, in addition to contributing toward improved tailoring of upstream mental health services and support. METHODS: Created in collaboration with students, the PSSI is a validated 46-item tool assessing stressors across five domains: academics, learning environment, campus culture, interpersonal, and personal stressors. The tool is designed to be applicable to students at all years, levels, and areas of study. Data will be collected longitudinally at multiple time points over the course of each academic year. RESULTS: We recruited 15 postsecondary institutions across Canada for the first year, inviting students to participate in an online survey including questions concerning sociodemographic characteristics, stress, mental health, and resiliency. Analyses, including appropriate data visualization, will be conducted to determine the impact of specific stressors on mental health, linking responses over time to allow for the observation of changes in trends. CONCLUSIONS: The PSSI is an intuitive and evidence-informed tool that can aid postsecondary institutions in evaluating the sources of student stress on their campuses. This multisite project will make a substantial contribution to the current literature regarding postsecondary student stress and allow institutions across the country to improve the tailoring of upstream mental health services in order to directly support the unique needs of their student body. Opportunities for knowledge translation and exchange are discussed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/27713.

Cross-sectional trend analysis of the NCHA II survey data on Canadian post-secondary student mental health and wellbeing from 2013 to 2019.

BACKGROUND: Canadian post-secondary students are considered to be at risk for chronic stress and languishing mental health, but there has been no longitudinal analysis of the available population-level data. The purpose of this study was to examine trends in the overall and sex-specific prevalence of self-reported stress, distress, mental illness, and help seeking behaviours among Canadian post-secondary students over the past several years. METHODS: Using the 2013, 2016, and 2019 iterations of the National College Health Assessment II Canadian Reference data, we conducted a trend analysis for each variable of interest, stratified by sex. The significance and magnitude of the changes were modelled using cumulative linked ordinal regression models and log binomial regression models. RESULTS: With few exceptions, we observed significant increases over time in the proportion of students reporting symptoms of psychological distress, mental illness diagnoses, and help seeking for mental health related challenges. Female students reported a higher level of stress than male students, with a statistically significant increase in the stress level reported by female students observed over time. In all cases, larger proportions of female students were observed compared to male students, with the proportion of female students who self-reported mental illness diagnoses nearly doubling that of males. CONCLUSIONS: Our analysis indicated that the proportion of students self-reporting mental health related challenges, including stress, psychological distress, and diagnosed mental illnesses increased between the 2013, 2016 and 2019 iterations of the NCHA II conducted among Canadian post-secondary students.

Postsecondary Mental Health Policy in Canada: A Scoping Review of the Grey Literature: Politique de santé mentale post-secondaire au Canada: un examen de la portée de la littérature grise.

OBJECTIVE: Concerns surrounding the mental health and well-being of Canadian postsecondary students have increased in recent years, with data suggesting increases in the prevalence of self-reported stress and psychological distress. Strategies to address postsecondary mental health have emerged at the national, provincial, and institutional levels. While reviews of the academic literature on the subject have been conducted, a detailed review of the grey literature has not. The objective of this study was to map the current state of grey literature related to current or recommended action supporting postsecondary mental health and well-being in Canada, with a focus on policy documents and guiding frameworks. METHODS: We conducted a review following Arksey and O'Malley's 5-step framework for scoping reviews, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Our search was restricted to documents with a primary focus on postsecondary mental health, a national or provincial scope, and publication date between 2000 and 2019. RESULTS: While a national policy or guiding framework applicable to all postsecondary institutions across Canada does not yet exist, recommendations for policy at both the national and provincial levels were well aligned, emphasizing the need for a comprehensive approach to addressing mental health services through the use of a whole-campus approach that encompasses both upstream and downstream services. CONCLUSION: Postsecondary sector stakeholders should consider how existing policy documents and guiding frameworks can be used to inform evidence-based, institutionally specific action on postsecondary mental health. More work is required to align the fragmented action occurring across Canada and incentivize postsecondary institutions to create a sustainable, effective strategy to address the increasingly complex and unique mental health needs of their students, staff, and faculty.

Adherence of the #Here4U App - Military Version to Criteria for the Development of Rigorous Mental Health Apps.

BACKGROUND: Over the past several years, the emergence of mobile mental health apps has increased as a potential solution for populations who may face logistical and social barriers to traditional service delivery, including individuals connected to the military. OBJECTIVE: The goal of the #Here4U App - Military Version is to provide evidence-informed mental health support to members of Canada's military community, leveraging artificial intelligence in the form of IBM Canada's Watson Assistant to carry on unique text-based conversations with users, identify presenting mental health concerns, and refer users to self-help resources or recommend professional health care where appropriate. METHODS: As the availability and use of mental health apps has increased, so too has the list of recommendations and guidelines for efficacious development. We describe the development and testing conducted between 2018 and 2020 and assess the quality of the #Here4U App against 16 criteria for rigorous mental health app development, as identified by Bakker and colleagues in 2016. RESULTS: The #Here4U App - Military Version met the majority of Bakker and colleagues' criteria, with those unmet considered not applicable to this particular product or out of scope for research conducted to date. Notably, a formal evaluation of the efficacy of the app is a major priority moving forward. CONCLUSIONS: The #Here4U App - Military Version is a promising new mental health e-solution for members of the Canadian Armed Forces community, filling many of the gaps left by traditional service delivery.

Psychometric assessment of the Post- Secondary Student Stressors Index (PSSI).

BACKGROUND: Previous research has linked excessive stress among post-secondary students to poor academic performance and poor mental health. Despite attempts to ameliorate mental health challenges at post-secondary institutions, there exists a gap in the evaluation of the specific sources of stress for students within the post-secondary setting. METHODS: The goal of this study was to develop a new instrument to better assess the sources of post-secondary student stress. Over the course of two years, the Post-Secondary Student Stressors Index (PSSI) was created in collaboration with post-secondary students as co-developers and subject matter experts. In this study, we used a combination of individual cognitive interviews (n = 11), an online consensus survey modeled after a traditional Delphi method (n = 65), and an online pre- (n = 535) and post-test (n = 350) survey to psychometrically evaluate the PSSI using samples of students from Ontario, Canada. We collected four types of evidence for validity, including: content evidence, response processes evidence, internal structure evidence, and relations to other variables. The test-retest reliability of the instrument was also evaluated. RESULTS: The PSSI demonstrated strong psychometric properties. Content validation and response processes evidence was derived from active student involvement throughout the development and refinement of the tool. Exploratory factor analysis suggested that the structure of the PSSI reflects the internal structure of an index, rather than a scale, as expected. Test-retest reliability of the instrument was comparable to existing, established instruments. Finally, the PSSI demonstrated good relationships with like measures of stress, distress, and resilience, in the hypothesized directions. CONCLUSIONS: The PSSI is a 46-item inventory that will allow post-secondary institutions to pinpoint the most severe and frequently occurring stressors on their campus. This knowledge will facilitate appropriate targeting of priority areas, and help institutions to better align their mental health promotion and mental illness prevention programming with the needs of their campus.

Preliminary analysis of validation evidence for two new scales assessing teachers' confidence and worries related to delivering mental health content in the classroom.

BACKGROUND: While mental health challenges in the classroom have increased over the past several years, existing research suggests that many educators feel unprepared to broach the topics of mental health and mental illness with their students. This paper outlines the development and gathering of preliminary evidence of validity for two new scales designed to assess teachers' confidence and worries related to delivering mental health content in the classroom. METHODS: Content evidence was collected through the use of two methods: a focus group held with members of the Elementary Teachers' Federation of Ontario, and a consensus survey conducted among a sample of educational experts recruited from an Ontario university. Internal structure evidence was derived from the initial intake survey of an evaluation of a new online guide designed to give elementary school teachers the tools and knowledge to develop lesson plans related to mental health. Internal consistency reliability of test scores was estimated with Cronbach's alpha. RESULTS: Both scales loaded on a single dimension with all items loading strongly (factor loadings greater than .60). Cronbach's alpha coefficients of .96 for scores on the Teacher Confidence Scale and .93 for scores on the What Worries Me Scale estimated strong internal consistency reliability. CONCLUSIONS: We identified two unidimensional scales measuring concerns educators may have about discussing the topic of mental health in a classroom setting. The Teacher Confidence Scale for Delivering Mental Health Content contains 12 items measuring educators' confidence in delivering mental health related materials in the classroom. The What Worries Me Scale contains 11 items. These scales may be useful for evaluating programs, educational workshops, and other initiatives aimed at improving teachers' abilities to provide mental health content in the classroom.

A scoping review of mental health mobile apps for use by the military community.

Advancements in technology have opened doors to new directions in mental health care, including the emergence of mobile health applications. Such apps are helping to make mental health care more accessible to those who face barriers to care, such as military personnel. We conducted a scoping review to map the existing literature on mental health-related apps intended for use by military personnel/veterans. As a result, we identified several themes from the literature. We also discuss how apps are being developed and tested for use by the military community and provide suggestions for future research directions.

Gender-specific associations between involvement in team sport culture and canadian adolescents' substance-use behavior.

Canadian adolescents have some of the highest rates of substance use in the world. The etiology of this phenomenon has not been fully explored, and one possible contextual determinant is involvement in sport activities that foster risk-taking behaviors through physical and social mechanisms. Using the 2013-14 Health Behaviour in School Aged Children (HBSC) study we therefore examined this hypothesis in a contemporary national sample of Canadian adolescents. The strength and direction of the relationship between sport and substance use varied by gender and substance, with team sport participation associated with increased binge drinking (RR 1.33 [95% CI 1.13-1.56] for boys, RR 1.21 [1.06-1.38] for girls) and use of smokeless tobacco (RR 1.68 [1.34-2.10] for boys, RR 1.32 [1.01-1.72] for girls), but with lower prevalence levels of cannabis use (RR 0.73 [95% CI 0.61-0.88]) and cigarette smoking (RR 0.79 [95% CI 0.70-0.89]) in girls alone. We also compared team sport athletes with high social involvement (sports team as primary peer group) and physical involvement (higher number of days/week physically active) to those with low involvement. For boys, the combination of high physical and high social involvement was associated with the highest risk, while high social involvement alone was associated with the greatest risk for girls. While team sport participation confers only a small increased risk for substance use, the prevalence of sport participation results in a large population impact. Given this fact, interventions such as education for parents and coaches and policies encouraging engagement in a variety of extracurricular activities should be explored.