A longitudinal study of the impact of COVID-19 restrictions on students’ health behavior, mental health and emotional well-being

Background COVID-related restrictions impacted the lives of students on and off campus during Academic Year 2020/2021. Methods Our study collected data on student health behavior and habits as well as their mental and emotional health using anonymous surveys. We compared these data with data collected prior to COVID in the longitudinal part of our study (n = 721) and analyzed them for the cross-sectional part of the study (n = 506). Results The longitudinal data show a significant difference for some student behaviors and habits, such as sleeping habits, physical activity, breakfast consumption, time spent online or playing video games, vaping, and marijuana use, during the COVID pandemic compared with pre-COVID data. Respondents also reported a significant increase in difficulty concentrating, remembering, or making decisions, as well as being impacted by feelings of sadness or hopelessness. Yet, there was no increase in the proportion of respondents considering, planning or attempting suicide during COVID. The cross-sectional data illuminate the negative effect of the overall situation and the restrictions on students’ mental and emotional well-being. Three-quarters of respondents reported having craved human interaction during the past six months, more than half felt that their mental/emotional health had been impacted by the lack of social events or the switch to virtual (online) teaching. Two-thirds or more of respondents also expressed that they felt less connected to their peers and less motivated in their studies than in previous semesters. Fifty percent or more of respondents selected anxious, stressed, overwhelmed, disconnected, tired, and fatigued as words that best described their emotional state during the pandemic. Conclusions The impact of COVID-related restrictions on students’ behaviors and habits as well as their mental and emotional health was less severe than one would have expected based on studies during the early stage of the pandemic. While some behaviors and habits changed during the COVID pandemic compared with the pre-COVID period, the changes were not substantial overall. Our study did not find an increase in the proportion of respondents considering, planning or attempting suicide during COVID, although the cross-sectional data from our survey make the negative effect of the overall situation and the restrictions on students’ mental and emotional well-being evident. The impact of the pandemic will unquestionably be long-lasting and will necessitate further and future investigations.


Confidentiality
If you join the study, we will make every effort keep your information confidential and secure by taking the following steps: The data will be collected anonymously via a Checkbox survey.
Only the PI has access to the password-protected survey data.
The data will be downloaded and stored on the PI's personal folder on the FGCU server as recommended by BTS. IP address will be stripped off before exporting the data out of Checkbox.
However, despite these safeguards, there is the possibility of hacking or other security breaches that could compromise the confidentiality of the information you provide. Thus, it is important to remember that you are free to decline to answer any question that makes you uncomfortable for any reason.
We will not release information about you unless you authorize us to do so or unless we are required to do so by law. If results of this study are published or presented at a professional meeting, no information will be included that would make it possible to identify you as a study participant.
It is possible that organizations responsible for making sure the research is done safely and properly such as the university, and government offices may need to see the information you provide.

Storage and Future Use of Data
The data will be stored on the PI's personal folder on the FGCU server. They can be destroyed be deleting the folder they are in.
We do not collect any paper records. However, should we print out surveys they will be destroyed using a professional shredding service no sooner than three years after completion of the research.

Voluntary Nature of Study
Participating in this study is completely voluntary. Refusal to join the study will not affect any future services you may be eligible to receive from the University. You can choose to not answer an individual question or you may skip any section of the survey by clicking "Next" at the bottom of the survey page to move to the next section.
If you choose to join the study, you can leave it at any time with no penalty.

Contact Information for the Study Team
We do not foresee any problems from participating in this study. However, if you believe you experienced a research related injury, please contact Dr. Peter Reuter at 239-590-7512 or via email (preuter@fgcu.edu).
If you have any questions about this study, please contact Dr. Peter Reuter at 239-590-7512 or via email (preuter@fgcu.edu).

Contact Information for Questions about Your Rights as a Research Participant
If you have any questions about your rights as a subject/participant in this research, or if you feel you have been placed at risk, you can contact the Chair of the Human Subjects' Institutional Review Board via email (research@fgcu.edu).

Statement:
I have read the preceding information describing this study. All of my questions have been answered to my satisfaction. I am 18 years of age or older and freely consent to participate in the study. My decision to participate or to decline participating in this study is completely voluntary. I understand that I am free to withdraw from the study at any time. I am aware of my option to not answer to any questions I choose.
I understand that it is not possible to identify all potential risks I believe that reasonable steps have been taken to minimize both the known and potential but unknown risks. The submission of the completed survey is my informed consent to participate in the study.
If you would like a copy of the consent form, print a copy before continuing. By clicking on "next" at the bottom of this page you are consenting to participate in this research survey.
If you do not wish to participate, click the "x" in the top corner of the browser to exit.
Thank you very much for your time. Please note that this question asks about the highest grade level completed, not the highest grade level attended. If a parent has attended college but not obtained a Bachelor's degree, the "High school" option should be marked.

Yes No
Have you been diagnosed with/are you being treated for a mental health disordery?

Yes No
Have you been diagnosed with/are you being treated for a learning disability?

Yes No
Which disorder/disability are you being treated for? During the past 12 months, have you ever been bullied on campus including the dorms?
Bullying is when 1 or more students tease, threaten, spread rumors about, hit, shove, or hurt another student over and over again. It is not bullying when 2 students of about the same strength or power argue or fight or tease each other in a friendly way.

During the past 12 months, have you ever been cyber bullied?
Count being bullied through texting, Instagram, Facebook, or other social media.

Yes No
During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?

Yes No
The following question(s) ask about suicidal thoughts and suicide attempts. You are under no obligation to answer any of the questions but can skip over this part and continue the survey on the next page.
During the past 12 months, did you ever seriously consider attempting suicide?

Yes No
How many times did you consider attempting suicide? We understand that some participants may find it hard to answer certain questions or may get overwhelmed by emotions when describing events from the past.
If you are in immediate distress or crisis and need to speak to a clinician call the CAPS office and ask for an appointment or to speak with a clinician. Nights, weekends, and holidays, you may call the CAPS help line (239) 745-3277 and you will be connected to a clinician.
If you are imminent danger to harm yourself or others, call 911 if you are off campus and 590-1911 if you are on campus, or you may go to the emergency room at the nearest hospital.

How tall are you?
In height and inches During the past 7 days, how many times did you drink 100% fruit juices such as orange juice, apple juice, or grape juice?
Do not count punch, Kool-Aid, sports drinks, or other fruit-flavored drinks.