Prospective examination of mental health in university students during the COVID-19 pandemic

BackgroundThe impact of changing social restrictions on the mental health of students during the COVID-19 pandemic warrants exploration. AimsTo prospectively examine changes to university students mental health during the pandemic. MethodsStudents completed repeated online surveys at three time points (October 2020 (baseline), February 2021, March 2021) to explore relationships between demographic and psychological factors (loneliness and positive mood) and mental health outcomes (depression, anxiety, and stress). ResultsA total of 893 students participated. Depression and anxiety levels were higher at all timepoints than pre-pandemic normative data (p<.001). Scores on all mental health measures were highest in February, with depression and anxiety remaining significantly higher in March than baseline. Female students and those with previous mental health disorders were at greatest risk of poor mental health outcomes. Lower positive mood and greater loneliness at baseline were associated with greater depression and anxiety at follow-ups. Baseline positive mood predicted improvement of depression and anxiety at follow-ups. ConclusionDepression and anxiety were significantly higher than pre-pandemic norms, with female students and those with previous mental health difficulties being at greatest risk. Given these elevated rates, universities should ensure adequate support is available to meet potentially increased demand for services.

Understanding and Addressing Vaccine Hesitancy in the Context of COVID-19: Development of a Digital intervention

BackgroundSevere Acute Respiratory Coronavirus 2 (SARS-CoV-2) was identified in late 2019, spreading to over 200 countries and resulting in almost two million deaths worldwide. The emergence of safe and effective vaccines provides a route out of the pandemic, with vaccination uptake of 75-90% needed to achieve population protection. Vaccine hesitancy is problematic for vaccine rollout; global reports suggest only 73% of the population may agree to being vaccinated. As a result, there is an urgent need to develop equitable and accessible interventions to address vaccine hesitancy at the population level. MethodWe report the development of a scalable digital intervention seeking to address COVID-19 vaccine hesitancy and enhance uptake of COVID-19 vaccines. Guided by motivational interviewing (MI) principles, the intervention includes a series of therapeutic dialogues addressing 10 key concerns of vaccine hesitant individuals. Development of the intervention occurred linearly across four stages. During stage 1, we identified common reasons for COVID-19 vaccine hesitancy through analysis of existing survey data, a rapid systematic literature review, and public engagement workshops. Stage 2 comprised qualitative interviews with medical, immunological, and public health experts. Rapid content and thematic analysis of the data provided evidence-based responses to common vaccine concerns. Stage 3 involved the development of therapeutic dialogues through workshops with psychological and digital behaviour change experts. Dialogues were developed to address concerns using MI principles, including embracing resistance and supporting self-efficacy. Finally, stage 4 involved digitisation of the dialogues and pilot testing with members of the public. DiscussionThe digital intervention provides an evidence-based approach to addressing vaccine hesitancy through MI principles. The dialogues are user-selected, allowing exploration of relevant issues associated with hesitancy in a non-judgmental context. The text-based content and digital format allow for rapid modification to changing information and scalability for wider dissemination.

Experiences of the COVID-19 pandemic: cross-sectional analysis of risk perceptions and mental health in a student cohort

ObjectiveThis study examined the COVID-19 risk perceptions and mental health of university students on returning to campus in the midst of the COVID-19 pandemic. MethodsAn online survey was completed during the first four weeks of the academic year (October 2020) by 897 university students. The survey included demographics and measures of experiences of COVID-19 testing, self-isolation, shielding, perceived risk, mental health and indices capturing related psychological responses to the pandemic. ResultsWe observed higher levels of depression and anxiety, but not stress, in students compared with pre- pandemic normative data, but lower than levels reported earlier in the pandemic in other similar cohorts. Depression, anxiety and stress were independently associated with greater loneliness and reduced positive mood. Greater worry about COVID-19 was also independently associated with anxiety and stress. Female students and those with pre-existing mental health disorders were at greatest risk of poor mental health outcomes. ConclusionAlthough students perceived themselves at only moderate risk of COVID-19, the prevalence of depression and anxiety among university students should remain a concern. Universities should provide adequate support for students mental health during term-time. Interventions to reduced loneliness and worry, and improve mood, may benefit students overall mental well-being.