Evaluating the Effectiveness of a Brief, Prevention-Focused Wellness Intervention on Mental Health of First-Year College Students: A Randomized Controlled Trial

Background: High rates of mental health challenges among college students are well-documented and have increased dramatically during the last ten years. As of 2022, college age adults (ages 18-25) now have the highest rates of mental illness among any age group (30%). For college attendees, these challenges contribute to high risk of dropout, poor academic performance, and increased risk for disciplinary action in addition to the well-documented negative consequences of mental health problems in adulthood. Deploying prevention programs that help college students develop healthy lifestyle habits has significant potential to mitigate mental health risk amongst this population and generate positive effects in later life.

Methods: Participants (N = 122) were first-year college students, recruited from a large, Western university. Students met virtually via a web-based telehealth platform weekly for 60 minutes for six consecutive weeks in groups of between 10-12 participants. Each intervention session followed a manual, with a different wellness domain serving as a session theme (e.g. emotional, spiritual, intellectual, social, physical). Specific Solution-Focused Coaching (SFC) techniques (e.g. miracle question, finding exceptions, future-oriented questions, and goal setting) were applied throughout sessions by co-facilitators to aid participants in identifying meaningful healthy lifestyle habits for each wellness domain. Participants developed and implemented goals based on identified lifestyle habits. Control group participants were placed on a waitlist for participation after study completion but completed measures on the same schedule as intervention participants. Primary outcomes assessed included changes in depression and anxiety from baseline to post-test measured by the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder 7 (GAD-7), as well as stress (Perceived Stress Scale; PSS), resilience (Brief Resilience Scale; BRS), and well-being (World Health Organization Well-Being Index; WHO-5).

Results: Repeated Measures Analysis of Variance (RM-ANOVA) was conducted to assess for between-group differences across pre- and post-intervention assessment points. Results demonstrated significant between group differences over time for anxiety (GAD-7), F(1, 121) = 98.13, p<.01; depressive symptoms (PHQ-9), F(1, 121) – 88.56, p<.01, and well-being (WHO-5), F(1, 121) = 65.04, p<.01. Results for stress (p = .15), and resilience (p = .17) were not significant.

Implications: Given the alarming mental health and lifestyle trends among young adults, and in particular college students, there is a need for preventative approaches to enhancing well-being. Research has demonstrated a significant relationship between healthy lifestyle habits and mental health, with young adulthood being a critical developmental period for establishing lifestyle habits that are likely to continue throughout adulthood. Thus, utilizing a holistic approach, individuals can enhance multi-dimensional wellness (e.g. social, physical, emotional) through minor, intentional lifestyle changes, thereby mitigating mental health challenges. This study demonstrates the effectiveness of a brief, preventative intervention in improving perceived well-being, and decreasing anxiety and depressive symptoms among first-year college students.