JMIR Publications

ABSTRACT

Background:

There is evidence that anxiety and stress increased among college students during the COVID-19 pandemic. However, somewhat less is known about daily experiences of affect, worry, substance use behaviors, experiences of pleasure, concern over food security, experiences of bias/discrimination, feelings of belongingness, and other indicators of well-being and how they vary across days in this population.

Objective:

This study surveyed a wide range of indicators of health and well-being in daily life over 21 days in a sample of college students in a large university system in the United States during the pandemic. The relative proportion of variance in each daily measure due to between-person differences versus within-person day-to-day variability was estimated, indicating aspects of health and well-being that should be targeted to particular students versus may be more amenable to interventions that target day-level contextual factors.

Methods:

A sample of 2,068 young adult college students (ages 18-24; M age = 19.8, SD = 1.3; 66.6% women) completed a baseline survey; 97.3% (n=2012) then completed up to 21 consecutive daily surveys that assessed a comprehensive set of daily markers of health, behavior, and well-being. The daily diary study produced a total of 33,722 person-days.

Results:

Among all person-days, a minority were substance use days (e.g., 14.5% of days involved alcohol use, 5.6% vaping, 5.5% cannabis). Experiences of pleasure were reported on most (73.5%) days. Between-pevarson differences explained more than 50% of variance in numerous indicators of health and well-being, including daily vaping, cannabis use, other illicit substance use, experiences of bias/discrimination, positive affect, negative affect, worry, food insecurity, and feelings of belonging at the University. In contrast, within-person differences explained more than 50% of variance in daily alcohol use, cigarette use, stress, experiences of pleasure, where the student slept last night, and physical activity.

Conclusions:

College student health and well-being is multifaceted, with some aspects likely driven by person-level characteristics and experiences and other aspects by more dynamic, contextual risk factors that occur in daily life. These findings implicate services and interventions that should target individual students versus those that should target days on which students are at high risk for poor experiences or behaviors.