Characterize and Address Mental health Problems in University Students: the CAMPUS study (Preprint)

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BACKGROUND University students frequently face mental health challenges due to academic pressures, lifestyle changes, and developmental factors. Digital interventions, such as Doing What Matters in Times of Stress (DWM), a psychosocial e-mental health intervention developed by the World Health Organization, offer scalable approaches to address these issues. This study aimed to support students' mental health and well-being at the University of Verona by implementing the DWM intervention. OBJECTIVE This study aims to assess the effectiveness and implementability of DWM as a psychological strategy for effective mental health prevention and promotion, and for reducing psychological symptoms and distress and improving wellbeing in university students. METHODS During the study period (October 2023-June 2024), we conducted a prospective hybrid type-1 non-randomized follow-up study, with a pre-post design. The study population consisted of students attending the University of Verona, recruited through university communication channels and participated via online platforms. Data were collected at baseline (T1), before gaining access to the DWM intervention, and post-intervention (T2), one week after the end of the intervention, using an ad-hoc sociodemographic information page and self-reported tools assessing psychological distress as measured with the Kessler-10 (K-10), depressive symptoms as measured with the nine-item Patient Health Questionnaire depression scale (PHQ-9), anxiety symptoms with the seven-item Generalized Anxiety Disorder scale (GAD-7), and psychological well-being with the WHO-5 Wellbeing Index (WHO-5). In addition, at post-intervention, the implementability was assessed using the adapted versions of the Acceptability of Intervention Measure (AIM), the Intervention Appropriateness Measure (IAM), and the Feasibility of Intervention Measure (FIM). Statistical analyses included Wilcoxon matched-pairs signed-rank tests and logistic regression models to identify associated factors. RESULTS Out of 2.296 interested students, 1.498 completed all DWM sessions and assessments. At T1, students exhibited mild psychological distress, anxiety, and depressive symptoms with moderate well-being. Significant improvements were observed post-intervention: K-10 scores decreased from 22.41 (SD = 6.54) to 19.86 (SD = 5.96), GAD-7 scores from 8.27 (SD = 4.31) to 6.57 (SD = 3.76), and PHQ-9 scores from 8.28 (SD = 7.73) to 6.75 (SD = 4.37) (all P<.0001). WHO-5 well-being scores increased from 11.73 (SD = 4.65) to 13.26 (SD = 4.68). Satisfaction was high, with 90% of participants agreeing or strongly agreeing on satisfaction, 77.4% on appropriateness, and 95% finding the program easy to use. No significant differences in clinical outcomes were associated with sociodemographic or baseline mental health variables. CONCLUSIONS The DWM intervention demonstrated significant positive effects on students' mental health, showing reductions in distress, anxiety, and depressive symptoms, alongside improved well-being. The program's high levels of acceptability, appropriateness, and feasibility highlight its potential for broader application as a digital mental health strategy for university students. CLINICALTRIAL Open Sciences Framework: https://doi.org/10.17605/OSF.IO/KYV9F

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