Background The COVID-19 pandemic has significantly impacted lives and greatly affected the mental health and public safety of an already vulnerable population—college students. Social distancing and isolation measures have presented challenges to students’ mental health. mHealth apps and wearable sensors may help monitor students at risk of COVID-19 and support their mental well-being. Objective This study aimed to monitor students at risk of COVID-19 by using a wearable sensor and a smartphone-based survey. Methods We conducted a prospective study on undergraduate and graduate students at a public university in the Midwest United States. Students were instructed to download the Fitbit, Social Rhythms, and Roadmap 2.0 apps onto their personal smartphone devices (Android or iOS). Subjects consented to provide up to 10 saliva samples during the study period. Surveys were administered through the Roadmap 2.0 app at five timepoints: at baseline, 1 month later, 2 months later, 3 months later, and at study completion. The surveys gathered information regarding demographics, COVID-19 diagnoses and symptoms, and mental health resilience, with the aim of documenting the impact of COVID-19 on the college student population. Results This study enrolled 2158 college students between September 2020 and January 2021. Subjects are currently being followed-up for 1 academic year. Data collection and analysis are currently underway. Conclusions This study examined student health and well-being during the COVID-19 pandemic and assessed the feasibility of using a wearable sensor and a survey in a college student population, which may inform the role of our mHealth tools in assessing student health and well-being. Finally, using data derived from a wearable sensor, biospecimen collection, and self-reported COVID-19 diagnosis, our results may provide key data toward the development of a model for the early prediction and detection of COVID-19. Trial Registration ClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788 International Registered Report Identifier (IRRID) DERR1-10.2196/29561
Background The Roadmap mobile health (mHealth) app was developed to provide health-related quality of life (HRQOL) support for family caregivers of patients with cancer. Methods Eligibility included: family caregivers (age ≥18 years) who self-reported as the primary caregiver of their pediatric patient with cancer; patients (age ≥5 years) who were receiving cancer care at the University of Michigan. Feasibility was calculated as the percentage of caregivers who logged into ONC Roadmap and engaged with it at least twice weekly for at least 50% of the 120-day study duration. Feasibility and acceptability was also assessed through a Feasibility and Acceptability questionnaire and the Mobile App Rating Scale to specifically assess app-quality. Exploratory analyses were also conducted to assess HRQOL self- or parent proxy assessments and physiological data capture. Results Between September 2020–September 2021, 100 participants (or 50 caregiver-patient dyads) consented and enrolled in the ONC Roadmap study for 120-days. Feasibility of the study was met, wherein the majority of caregivers (N=32; 65%) logged into ONC Roadmap and engaged with it at least twice weekly for at least 50% of the study duration (defined a priori in the Protocol). The Feasibility and Acceptability questionnaire responses indicated that the study was feasible and acceptable with the majority (>50%) reporting Agree or Strongly Agree with positive Net Favorability [( Agree + Strongly Agree ) – ( Disagree + Totally Disagree )] in each of the domains (e.g., Fitbit use, ONC Roadmap use, completing longitudinal assessments, engaging in similar future study, study expectations). Improvements were seen across the majority of the mental HRQOL domains across all groups; even though underpowered, there were significant improvements in caregiver-specific aspects of HRQOL and anxiety and in depression and fatigue for children (ages 8–17 years), and a trend toward improvement in depression for children ages 8–17 years and in fatigue for adult patients. Conclusions This study supports that mHealth technology may be a promising platform to provide HRQOL support for caregivers of pediatric patients with cancer. Importantly, the findings suggest that the study protocol was feasible, and participants were favorable to participate in future studies of this intervention alongside routine cancer care delivery.
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic triggered a seismic shift in education, to online learning. With nearly 20 million students enrolled in colleges across the U.S., the long-simmering mental health crisis in college students was likely further exacerbated by the pandemic. OBJECTIVE This study leveraged mobile health (mHealth) technology and sought to: i) characterize self-reported outcomes of physical, mental, and social health by COVID-19 status; ii) assess physical activity through consumer-grade wearable sensors (Fitbit®); and iii) identify risk factors associated with COVID-19 positivity in a population of college students prior to release of the vaccine. METHODS Detailed methods were previously published in JMIR Res Protocols (Cislo et al). After completing a baseline assessment (i.e., Time 0 [T0]) of demographics, mental, and social health constructs through the Roadmap 2.0 app, participants were instructed to use the app freely, to wear the Fitbit®, and complete subsequent assessments at T1, T2 and T3, followed by a COVID-19 assessment of history and timing of COVID-19 testing and diagnosis (T4: ~14 days after T3). Continuous measures were described using means (M) and standard deviations (SD), while categorical measures were summarized using frequencies and proportions. Formal comparisons were made based on COVID-19 status. The multivariate model was determined by entering all statistically significant variables (P<0.05) in univariable associations at once and then removing one variable at a time by backward selection until the optimal model was obtained. RESULTS During the fall 2020 semester, 1,997 participants consented, enrolled, and met criteria for data analyses. There was a high prevalence of anxiety, as assessed by the State Trait Anxiety Index (STAI), with moderate and severe levels in N=465 (24%) and N=970 (49%) students, respectively. Approximately, one-third of students reported having a mental health disorder (N=656, 33%). The average daily steps recorded in this student population was approximately 6500 (M=6474, SD=3371). Neither reported mental health nor step count were significant based on COVID-19 status (P=0.52). Our analyses revealed significant associations of COVID-positivity with use of marijuana and alcohol (p=0.020 and 0.046, respectively) and lower belief in public health measures (P=0.003). In addition, graduate students were less likely and those with ≥20 roommates were more likely to report a COVID-19 diagnosis (P=0.009). CONCLUSIONS Mental health problems were common in this student population. Several factors, including substance use, were associated with risk of COVID-19. These data highlight important areas for further attention, such as prioritizing innovative strategies that address health and well-being, considering the potential long-term effects of COVID-19 on college students. CLINICALTRIAL ClinicalTrials.gov (NCT04766788) INTERNATIONAL REGISTERED REPORT RR2-10.2196/29561
BACKGROUND The COVID-19 pandemic has impacted lives significantly and greatly affected an already vulnerable population, college students, in relation to mental health and public safety. Social distancing and isolation have brought about challenges to student’s mental health. Mobile health apps and wearable sensors may help to monitor students at risk for COVID-19 and support their mental well-being. OBJECTIVE Through the use of a wearable sensor and smartphone-based survey completion, this study aimed to monitor students at risk for COVID-19. METHODS We conducted a prospective study of students, undergraduate and graduate, at a public university in the Midwest. Students were instructed to download the Fitbit, Social Rhythms, and Roadmap 2.0 apps onto their personal mobile devices (Android or iOS). Subjects consented to provide up to 10 saliva samples during the study period. Surveys were administered through the Roadmap 2.0 app at five timepoints - at baseline, 1-month later, 2-months later, 3-months later, and at study completion. The surveys gathered information regarding demographics, COVID-19 diagnoses and symptoms, and mental health resilience, with the aim of documenting the impact of COVID-19 on the college student population. RESULTS This study enrolled 2158 college students between September 2020 and January 2021. Subjects are currently being followed on-study for one academic year. Data collection and analysis are ongoing. CONCLUSIONS This study examined student health and well-being during the COVID-19 pandemic. While data collection and analyses are ongoing, the study will assess the feasibility of wearable sensor use and survey completion in a college student population, which may inform the role of our mobile health tools on student health and well-being. Finally, using wearable sensor data, biospecimen collection, and self-reported COVID-19 diagnosis, our results may provide key data towards the development of a model for the early prediction and detection of COVID-19. CLINICALTRIAL ClinicalTrials.gov NCT04766788
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