Dataset Information

A theory-based online health behaviour intervention for new university students (U@Uni): results from a randomised controlled trial.

ABSTRACT:

Background

Too few young people engage in behaviours that reduce the risk of morbidity and premature mortality, such as eating healthily, being physically active, drinking sensibly and not smoking. This study sought to assess the efficacy and cost-effectiveness of a theory-based online health behaviour intervention (based on self-affirmation theory, the Theory of Planned Behaviour and implementation intentions) targeting these behaviours in new university students, in comparison to a measurement-only control.

Methods

Two-weeks before starting university all incoming undergraduates at the University of Sheffield were invited to take part in a study of new students' health behaviour. A randomised controlled design, with a baseline questionnaire, and two follow-ups (1 and 6 months after starting university), was used to evaluate the intervention. Primary outcomes were measures of the four health behaviours targeted by the intervention at 6-month follow-up, i.e., portions of fruit and vegetables, metabolic equivalent of tasks (physical activity), units of alcohol, and smoking status.

Results

The study recruited 1,445 students (intervention n = 736, control n = 709, 58% female, Mean age = 18.9 years), of whom 1,107 completed at least one follow-up (23% attrition). The intervention had a statistically significant effect on one primary outcome, smoking status at 6-month follow-up, with fewer smokers in the intervention arm (8.7%) than in the control arm (13.0%; Odds ratio = 1.92, p = .010). There were no significant intervention effects on the other primary outcomes (physical activity, alcohol or fruit and vegetable consumption) at 6-month follow-up.

Conclusions

The results of the RCT indicate that the online health behaviour intervention reduced smoking rates, but it had little effect on fruit and vegetable intake, physical activity or alcohol consumption, during the first six months at university. However, engagement with the intervention was low. Further research is needed before strong conclusions can be made regarding the likely effectiveness of the intervention to promote health lifestyle habits in new university students.

Trial registration

Current Controlled Trials, ISRCTN67684181.

SUBMITTER: Epton T

PROVIDER: S-EPMC4067627 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

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Publications

A theory-based online health behaviour intervention for new university students (U@Uni): results from a randomised controlled trial.

Epton Tracy T Norman Paul P Dadzie Aba-Sah AS Harris Peter R PR Webb Thomas L TL Sheeran Paschal P Julious Steven A SA Ciravegna Fabio F Brennan Alan A Meier Petra S PS Naughton Declan D Petroczi Andrea A Kruger Jen J Shah Iltaf I

BMC public health 20140605

<h4>Background</h4>Too few young people engage in behaviours that reduce the risk of morbidity and premature mortality, such as eating healthily, being physically active, drinking sensibly and not smoking. This study sought to assess the efficacy and cost-effectiveness of a theory-based online health behaviour intervention (based on self-affirmation theory, the Theory of Planned Behaviour and implementation intentions) targeting these behaviours in new university students, in comparison to a mea ...[more]

PMID: 24903620

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Project description:BackgroundToo many young people engage in unhealthy behaviours such as eating unhealthily, being physically inactive, binge drinking and smoking. This study aimed to estimate the short-term and long-term cost-effectiveness of a theory-based online health behaviour intervention ("U@Uni") in comparison with control in young people starting university.MethodsA costing analysis was conducted to estimate the full cost of U@Uni and the cost of U@Uni roll-out. The short-term cost-effectiveness of U@Uni was estimated using statistical analysis of 6-month cost and health-related quality of life data from the U@Uni randomised controlled trial. An economic modelling analysis combined evidence from the trial with published evidence of the effect of health behaviours on mortality risk and general population data on health behaviours, to estimate the lifetime cost-effectiveness of U@Uni in terms of incremental cost per QALY. Costs and effects were discounted at 1.5% per annum. A full probabilistic sensitivity analysis was conducted to account for uncertainty in model inputs and provide an estimate of the value of information for groups of important parameters.ResultsTo implement U@Uni for the randomised controlled trial was estimated to cost £292 per participant, whereas roll-out to another university was estimated to cost £19.71, both giving a QALY gain of 0.0128 per participant. The short-term (6-month) analysis suggested that U@Uni would not be cost-effective at a willingness-to-pay threshold of £20,000 per QALY (incremental cost per QALY gained = £243,926). When a lifetime horizon was adopted the results suggest that the full implementation of U@Uni is unlikely to be cost-effective, whereas the roll-out of U@Uni to another university is extremely likely to be cost-effective. The value of information analysis suggests that the most important drivers of decision uncertainty are uncertainties in the effect of U@Uni on health behaviours.ConclusionsThe study provides the first estimate of the costs and cost-effectiveness of an online health behaviour intervention targeted at new university students. The results suggest that the roll-out, but not the full implementation, of U@Uni would be a cost-effective decision for the UK Department of Health, given a lifetime perspective and a willingness-to pay threshold of £20,000 per QALY.Trial registrationCurrent Controlled Trials ISRCTN67684181.

Project description:BackgroundNumerous studies have demonstrated the effectiveness of digital interventions for improving the mental health of university students. However, low rates of engagement with these interventions are an ongoing challenge and can compromise effectiveness. Brief, transdiagnostic, web-based video interventions are capable of targeting key mental health and related issues affecting university students and may be more engaging and accessible for this population.ObjectiveThis study used a 2-arm randomized controlled trial to evaluate the effectiveness of Uni Virtual Clinic-Lite (UVC-Lite), a fully automated, transdiagnostic, web-based video intervention, relative to an attention-control condition. The primary outcomes were symptoms of depression and generalized anxiety disorder. The secondary outcomes included psychological distress, social anxiety symptoms, body appreciation, quality of life, well-being, functioning, general self-efficacy, academic self-efficacy, and help seeking. Program use (intervention uptake and engagement) and satisfaction were also assessed.MethodsUniversity students (n=487) with mild to moderate symptoms of distress were recruited from universities across Australia and randomly allocated to receive access to the UVC-Lite intervention or an attention-control condition targeting general health for a period of 6 weeks. UVC-Lite includes 12 modules, each comprising a brief animated video and an accompanying exercise. Of the 12 modules, 7 also included a brief symptom screening quiz. Outcomes were assessed at baseline, postintervention, and 3- and 6-months postintervention.ResultsThe primary and secondary outcomes were analyzed on an intention-to-treat basis using mixed models repeated measures ANOVA. The intervention was not found to be effective relative to the control condition on any of the primary or secondary outcomes. While 67.9% (114/168) of participants accessed at least 1 module of the intervention, module completion was extremely low. Subgroup analyses among those who engaged with the program (completed at least 1 video) and those with higher baseline distress (Distress Questionnaire-5 score ≥15) did not reveal any differences between the conditions over time. However, uptake (accessing at least 1 video) and engagement (completing at least 1 video) were higher among those with higher baseline symptoms. Satisfaction with the intervention was high.ConclusionsThe UVC-Lite intervention was not effective relative to a control program, although it was associated with high satisfaction among students and was not associated with symptom deterioration. Given the challenges faced by universities in meeting demand for mental health services, flexible and accessible interventions such as UVC-Lite have the potential to assist students to manage symptoms of mental health problems. However, low uptake and engagement (particularly among students with lower levels of symptomatology) are significant challenges that require further attention. Future studies should examine the effectiveness of the intervention in a more highly symptomatic sample, as well as implementation pathways to optimize effective engagement with the intervention.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12621000375853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380146.

Project description:Depression is highly prevalent among university students. Internet-based interventions have been found to be effective in addressing depressive symptoms, but it is open if this also applies to interventions directed at academic stress. It is also largely unclear if the techniques employed in such programs provide significant additional benefits when controlling for non-specific intervention effects. A sample of N = 200 students with elevated levels of depression (CES-D ? 16) of a large distance-learning university were randomly assigned to either an Internet- and App-based stress intervention group (IG; n = 100) or an active control group (CG; n = 100) receiving an Internet-based psychoeducational program of equal length. Self-report data was assessed at baseline, post-treatment (7 weeks) and three-month follow-up. The primary outcome was depression (CES-D) post-treatment. Secondary outcomes included mental health outcomes, modifiable risk factors, and academic outcomes. We found significant between-group effects on depressive symptom severity (d = 0.36; 95% CI: 0.08-0.64), as well as behavioral activation (d = 0.61; 95% CI: 0.30-0.91), perceived stress (d = 0.45; 95% CI: 0.18-0.73), anxiety (d = 0.35; 95% CI: 0.03-0.67) and other secondary outcomes post-treatment. Effects on depression were sustained at three-month follow-up. Response rates for depressive symptoms were significantly higher in the IG (26%) than the CG (14%) at post-test (? 2=4.5, p = 0.04), but not at three-month follow-up (p = 0.454). We also found significant effects on relevant academic outcomes, including work impairment (follow-up; d = 0.36), work output (post-treatment; d = 0.27) and work cutback (follow-up; d = 0.36). The intervention was more effective for depressive symptoms compared to the CG, and so controlling for unspecific intervention effects. This suggests that specific techniques of the intervention may provide significant additional benefits on depressive symptoms. Trial registration: German Clinical Trial Registration (DRKS): DRKS00011800 (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011800).

Project description:IntroductionFood waste (FW) represents a significant social and environmental problem, with 1.3 billion tons of food wasted yearly worldwide. Even if consumers are increasingly aware of the phenomenon, it remains relevant, and understanding the behaviors of specific target audience segments appears instrumental to the planning of effective interventions. To this end, we designed an observational study to investigate, throughout an online questionnaire, FW-related habits of university students in a Southern Italian region.MethodsA representative sample of 431 students from the University of Catanzaro Magna Graecia completed an online survey aimed at investigate FW related behaviors. A descriptive analysis was performed on the whole cohort, and a formal statistical analysis was carried out after excluding responders who had not correctly followed the survey instructions (n = 85). Differences were assessed by chi square (χ 2) tests. A food wasting score was generated, and differences in the score values were analyzed by Student T-test. Linear and multiple regression analyses were performed to identify factors contributing to the score.ResultsOverall, the results of our survey show a high prevalence of virtuous behaviors in the food purchasing phase; while, at home, less than 50% of respondents apply easy-to-implement waste prevention rules. The statistical analysis showed that the major determinants of FW were: no direct involvement in grocery shopping and male gender. Indeed, even if we observed several significant differences comparing subgroups based on established or putative determinants of FW behaviors, none survived matching for group size, gender and relevant food managing (shopping, storing, cooking) habits. The only exception was the more appropriate handling of "use by" products by respondents who received structured nutrition teaching, as opposed to students whose academic courses do not include this subject (adjusted p = 0.008).ConclusionOur data suggest that young adults are trying to implement strategies to reduce FW, even if there is room for improvement, particularly in the storage phase. Extending nutrition education to all university programs may be helpful in reaching this goal.

Project description:BackgroundPast studies have associated gratitude interventions with a host of positive outcomes. However, there is a dearth of research regarding the impact such interventions have on the academic motivation of university students, thought to be a primary determinant of academic achievement and overall satisfaction with school activities. Here, we examined the effects of a 2-week online gratitude journal intervention on the academic motivation of university students.MethodsEighty-four students were randomly assigned to either an active manipulation group (gratitude group) or a neutral control group. In the first 6 days of each week, participants in the gratitude group were asked to log in to the online system once a day and list up to five things they had felt grateful for. They were also requested to evaluate various aspects of their daily lives. Participants in the control group were only requested to perform the daily self-evaluations. Academic motivation was assessed using the Academic Motivation Scale (AMS), which conceptualizes motivation in academic settings as being composed by three different components, i.e., intrinsic motivation, extrinsic motivation and amotivation, the latter being associated with the perceived lack of contingency between actions and outcomes. Responses were collected 5 times: before group assignment (baseline), 1 week after the start of the intervention, immediately after the intervention, and at two follow-ups, 1 and 3 months after the intervention.ResultsAnalysis using a self-determination index derived from the AMS components showed that participants who regularly engaged with the gratitude journal task displayed significant enhancements in academic motivation. Additional analysis revealed that the enhancements were driven by decreases in the levels of amotivation. Furthermore, follow-up data showed that there were no signs that such enhancements had receded 3 months after the end of the intervention. Improvements in academic motivation were not observed among participants in the control group.ConclusionsThe current results provide evidence that gratitude interventions can positively impact the academic motivation of university students. More broadly, they show that the effects extend well beyond the realm of typically assessed measures of individual well-being, and can effectively regulate a fundamental component of goal-directed behavior such as motivation.

Project description:IntroductionSchool canteens represent an opportune setting in which to deliver public health nutrition strategies given their wide reach, and frequent use by children. Online school canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer behaviour strategies that impact on purchasing decisions. The aim of this study is to assess the efficacy of a consumer behaviour intervention implemented in an online school canteen ordering system in reducing the kilojoule, saturated fat, sugar and sodium content of primary student lunch orders.Methods and analysisThe study will employ a cluster randomised controlled trial design. Approximately 1040 students (aged 5-12 years) from 10 primary schools in New South Wales, Australia, currently using an online canteen ordering system will be invited to participate. Schools will be randomised in a 1:1 ratio to receive either the intervention (enhanced system) or control (standard online ordering only). The intervention will include evidence-based strategies shown to influence healthy food purchasing (strategies targeting availability, menu labelling, placement and prompting). The primary outcomes of the trial will be the mean content per student online lunch order of (1) energy (kJ), (2) saturated fat (g), (3) sugar (g) and (4) sodium (mg). The impact of the intervention will be determined by between-group assessment of the nutritional content of lunch purchases over a 2-month period postintervention initiation.Ethics and disseminationThe study was approved by the Hunter New England Human Research Ethics Committee, University of Newcastle Human Research Ethics Committee and New South Wales Department of Education and School Communities. Study findings will be disseminated widely through peer-reviewed publications and relevant presentations in international conferences and to stakeholders.Trial registration numberACTRN12616000499482.

Dataset Information

A theory-based online health behaviour intervention for new university students (U@Uni): results from a randomised controlled trial.

Background

Methods

Results

Conclusions

Trial registration

Publications

A theory-based online health behaviour intervention for new university students (U@Uni): results from a randomised controlled trial.

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