Mental Health and Healthy Lifestyle Behaviors in First-Year Health Sciences Graduate Students

Purpose: Mental health disorders account for nearly one half of the disease burden for young adults in the United States and the prevalence of depression among college students has increased from 10% in 2000 to a current rate of 15%. The college years are frequently a transition period when students are gaining independence from their parents and developing healthy lifestyle behaviors. However, during this critical phase in development, college students tend to have poor dietary habits and low physical activity levels that may contribute to obesity and related health conditions in later life. The American College Health Association National College Health Assessment-II identified the leading impediments to academic success reported by college students as being stress (30%), anxiety (21%), sleep problems (20%), and depression (14%.) With poor healthy lifestyle habits and a high degree of burden from mental health disorders, there is an urgent need to develop and test interventions to improve the healthy lifestyle behaviors, mental health and academic outcomes in college youth.

Methods:  This is a descriptive study of the baseline variables and correlates of healthy lifestyle behaviors of first year graduate students participating in a wellness onboarding study. First year graduate students from 7 health sciences colleges (Dentistry, Health and Rehabilitation Medicine, Nursing, Optometry, Pharmacy, and Veterinary Medicine) were invited to participate in the study. Consent was obtained online. The study consisted of the completion of a personalized wellness assessment, biometric screen, completion of a personalized wellness plan, and then random assignment to either wellness coaching by a Family Nurse Practitioner (FNP) student trained in COPE (Creating Opportunities for Personal Empowerment), a cognitive behavioral skill building program and wellness coaching or counseling about healthy lifestyle resources available and encouragement follow their individual wellness plan. Analysis: Descriptive statistics were used to summarize sample characteristics and baseline measures. Pearson correlation coefficients were used to test the pair-wise correlations between healthy lifestyle beliefs, healthy lifestyle behaviors, depression, anxiety, and stress. Chi-square statistics were used to compare the healthy lifestyle behavior risks factors across groups.

Results:  107students participated in this study. Fifty-nine percent of participants were < 25 years of age, 31% participants were between the ages of 25 and 34, and 10% of the participants were > 35 years of age. The majority of the sample was White, not of Hispanic origin (70%), followed by Asian/Pacific Islander at 10%, Hispanic (7.5%), and Black, not of Hispanic origin (5.6%). The majority of the students were never married (80%) and did not have children (92%). Participants were from Nursing (39%), Veterinary Medicine (23%), Medicine (22%), Pharmacy (6%), Health and Rehabilitation (4%) and Dentistry and Optometry (2% each). Nineteen percent of the sample described their health as excellent, followed by very good 18%, good 49%, fair 12% and poor 1%. More than half of the participants saw a consistent healthcare provider (60%). Overall, 44% of the total students had elevated symptoms of depression and 43% had elevated symptoms of anxiety. In addition, 88% of the total first year graduate students had elevated stress levels. In addition, lower healthy lifestyle beliefs were significantly associated with higher depression (r =-0.37, P < 0.001), higher anxiety (r = -0.36, P < 0.001), and higher stress (r = -0.36, P < 0.001). A significant negative correlations also existed between healthy lifestyle behaviors and depression (r = -0.36, P < 0.001), healthy lifestyle behaviors and anxiety (r = -0.30, P < 0.001), and healthy lifestyle behaviors and stress (r = -0.22, P = 0.02). Positive and significant correlations existed between healthy lifestyle behaviors and healthy lifestyle beliefs (r=0.52, P < 0.001). Additionally, depression, anxiety, and stress were highly correlated with each other (pair-wise correlation coefficients of 0.60-0.81).

Conclusion: Understanding similarities in baseline correlations among mental health and healthy lifestyle behaviors among first year graduate students can guide interventions to improve mental health and healthy lifestyle behaviors in this at-risk population.