Mental Health, Health Experiences, and Health Perceptions of University Students Using E-learning in China During the COVID-19 Pandemic: Cross-Sectional Questionnaire (Preprint)
Authors: Nakamoto Ichiro , Zhuang Weiqing 
Published: August 2020

BACKGROUND

Digital health-the use of mobile health (mHealth) and electronic health (eHealth), has facilitated the widespread surveillance of health for young adults. Regardless of the increasing use of digital health as an instrument of health enhancement, limited research has explored the use of digital health, and how this has impacted the mental health, health experiences, and health perceptions of university students who are regularly accessing online education through digital technologies during the COVID-19 pandemic.

OBJECTIVE

The major aim of this study was to assess the frequency of digital health use among university students in China, the influence on their mental health, health considerations, and experiences of health-relative behaviors at a point when the shutdown of universities was in progress and e-learning (i.e., online education) was taken as the routine substitute for conventional face-to-face education during the COVID-19 epidemic.

METHODS

Full-time undergraduate or graduate students aged 18 to 26 from internet economics and business major of a technology university in China were recruited to participate in an anonymous and cross-sectional online survey to collect data on their utilization of digital health, the association with mental health, their perceptions and experiences of health. Of the 200 surveyed eligible university students who were guided to the online website, 165 (82.5%) students responded effectively to the questionnaire and thus were included in the analysis. Median values and frequency analyses were performed for major variables such as mental health and digital health use that were stratified into dichotomous observations. Chi-square test with p≤.05 was employed to determine the significant level of associations between the variables.

RESULTS

The average mental health score of the university students was 17.8 out of a total scale 40, which did not vary remarkably across gender, education, and other sociodemographic attributes. Statistically significant associations between digital health use and mental health (p=.003), the willingness of sharing health information with acquaintances (p=.017), control of health-relative behaviors (i.e., smoking, drinking and dieting, p=.001), communication with physicians (p=.029), and physical activity(p=.016) were identified for young students. During the COVID-19 pandemic, low digital health use among university students was significantly associated with good mental health and high digital health use the reverse. In contrast, digital health use was not associated significantly with components such as the concerns on health-relative topics, concerns on social media, and the decision-making on health treatment.

CONCLUSIONS

The average mental health score of the university students was 17.8 out of a total scale 40, which did not vary remarkably across gender, education, and other sociodemographic attributes. Statistically significant associations between digital health use and mental health (p=.003), the willingness of sharing health information with acquaintances (p=.017), control of health-relative behaviors (i.e., smoking, drinking and dieting, p=.001), communication with physicians (p=.029), and physical activity(p=.016) were identified for young students. During the COVID-19 pandemic, low digital health use among university students was significantly associated with good mental health and high digital health use the reverse. In contrast, digital health use was not associated significantly with components such as the concerns on health-relative topics, concerns on social media, and the decision-making on health treatment.

CLINICALTRIAL

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