Published: June 25, 2024

The mental health of university students is a widely recognized global concern. transition to life marks crucial developmental phase characterized by individuation, the establishment new social connections, and increased autonomy responsibility. This period aligns with continued, rapid brain development at time when are exposed multiple risk factors known affect health, including psychosocial stressors, recreational drug use, alcohol binging, disruptions in sleep patterns. Mental disorders typically present before or during young adulthood, often going unrecognized for years, resulting significant delays receiving treatment. Failing adequately address issues timely fashion can lead progression more complex outcomes, such as school dropout, addiction, self-harm. Indeed, international prevalence estimates reveal higher rates among college compared general population. For example, multicenter study involving 13,984 from eight countries, led World Health Organization (WHO), demonstrated that one third met clinical criteria psychiatric disorder previous year (Auerbach et al., 2018). most frequently reported were depressive (18.5%) anxiety (16.7-18.6%), followed (6.8%) other substance use (3.0%). Moreover, approximately 22.6% experiencing suicidal thoughts. Tragically, suicide stands second leading cause death within this population (Sivertsen 2019). presence linked numerous detrimental consequences both short long term. In term, individuals may experience decline their quality life, poorer academic performance, absenteeism likelihood course dropout. endure lower unemployment rates, socioeconomic impairment (Duffy 2019); (Dyrbye 2012). Though alarming data presented above derived studies conducted countries diverse income levels, date, there disproportionately limited body evidence addressing adults attending universities low countries. Brazil, million enrolled 2714 education institutions (INEP, 2021; (Power BI Report, n.d.). few have been Brazil tended focus on medical students; also unveiling concerns about distress (Miguel 2021). 37% under treatment 4.5% had attempted suicide. prevalent diagnoses depression (39.1%) disorders/phobias (33.2%), while severe like psychotic (3.7%) bipolar (1.9%) less common (Campos 2017). Here we aim gaps current national literature. First, will university-aged country, namely Brazil. addition, given plagued selection biases owing challenge engaging otherwise healthy research surveys, utilize an web-based survey mitigate possibility. another largely unexplored facet issues, longitudinal college. To end, propose measure 8,028 undergraduate UniEduK group. private located two medium-sized cities southeast (Indaiatuba Jaguariúna), offering courses technical fields (e.g., administration, accounting, architecture, law, engineering) sciences medicine, nursing, psychology, biomedicine, veterinary medicine). achieve goal, carefully designed suitable Brazilian Students considering three main challenges: large number screen (n = 8,028), relatively budget resources available us, expected response kind survey. paper describe methods used design be administered University. 3.1 Overall based validated self-report questionnaires, structured electronic protocol repeated every year, evaluating trajectories over time, incoming account any trends specific cohorts students. analyzed cross-sectionally (with descriptive association analyses between different constructs measured) longitudinally trajectory level individual, area concentration, institution). 3.2 Participants/Recruitment All UniEduk 8,028) invited participate annually through email message briefly explaining encouraging participation via only exclusion related limitations accessing responding (i.e., no access devices internet connection; being illiterate [both considered negligible occurrence setting]). We devised several strategies aimed increasing participation. conduct wide media campaigns promote awareness concerning discuss importance study. Second, professors all disciplines encouraged remind engage Third, non-responders non-completers receive invitation reminders email, text (WhatsApp). Importantly, informed spent count equivalent complementary activity. these steps executed automatically anonymously ensure students' privacy. When invited, required read sign consent twice year. They declining not harm standing relationship University they invitations. 3.3 Instruments Research Requirements selected empirically psychometric Portuguese translation, electronically. A typical dilemma encountered type, tension having enough items assess phenotypes measure, impact consuming engagement rate participants. dilemma, two-step strategy (Figure 1). first step, addition collecting sociodemographic overall lifestyle/quality information (SHORT-SMILE) (De Boni 2023), array conditions using DSM-5 Cross-Sectional Adult Symptoms Scale Level 1 (DSM-5-TR Online Assessment Measures, n.d.) version Self Report Attention Deficit/Hyperactivity Disorder (ASRS-18) (Kessler 2005) (Table participants scoring indicated threshold domain detailed scales. These scales could relate depression, mania, generalized anxiety, sleeping disorders, borderline personality disorder, obsessive-compulsive attention-deficit/hyperactivity and/or 2). After administration relevant scales, participant option respond questionnaire traits (i.e, Big Five Inventory (Roiz Junior 2023)). Finally, total complete estimated 20 40 minutes, depending domains assessed. 3.4 Data Collection collection performed Electronic Capture (REDCap), it secure online platform management allows presentation generalizable instruments database storage. support capture protecting anonymity (Tamuhla 2022). provides convenient “Survey Queue” questionnaires “to-do list” so keep track progress. tracking initial participation, completeness status, REDCap feature best suited automation communication process and, furthermore, better Automated Invitations. individual link able choose how many sent well periodization. 3.5 Survey Distribution Tools upload student straight file containing emails (provided university's sector), order generate unique ID each student. allow us participants’ engagement/completion rate. 3.6 Reports Alerts “Reports alerts” tools built into certain events outcomes collected data. Our completion rates. establish which needed reports, apply logic filter our results. report then queries records returns those match criteria. same principle applied monitoring 2), security procedure answers PHQ-9 Scales. Specifically, set up answering affirmative either questions directly 1) ideation 2) plans, generates alert notifying team. team immediately notifies healthcare associated Upon notification, care contact offer them appropriate care. If does answer contact, call again day days. accepts offered care, evaluated psychiatry professionals necessary referrals. do agree, register non-agreement end. 3.7 Statistics As assessing (annually) journey, methodological designs statistical cross-sectional, accelerated cohorts, traditional cohorts. 3.7.1 Simple Analyses Descriptive statistics variables, reports divided categories interest enrolled, data, etc.). associations comparisons independent groups Student's t-test (for variables normal distribution), Mann-Whitney test non-normal ANOVA (depending studied). associate indices interest, dropout performance. Linear logistic regressions control confounding gender, age, status. anticipated include, but necessarily to, following: comparing traits, symptoms various university; exploring identify potential protective factors. 3.7.2 Accelerated Cohort Taking advantage sample size last semester course, cross-sectional compare (or year) student, inferring possible changes beginning end course. purpose, Generalized Estimation Equations (GEE) designed, variable semester/year substitute analyses, controlling confounds 3.7.3 Longitudinal Analyses/Cohort By following analyze Equations; detection nonlinear variations turn, evolution symptomatology individuals. 3.8 Ethical aspects was approved Ethics Committee UNIFAJ Center (no. 6.153.870, carried out accordance recommendations Resolution no. 466/2012 National Council (Conselho Nacional de Saúde, objectives methods. provided guarantee confidentiality anonymity. Informed Consent Form (ICF) form. Participants instructed ICF express agreement question: "Have you understood guidelines agree freely, knowledgeably spontaneously research?" asked enter full name attached acceptance take part directed thank note closed. Discussion: psychological well-being adult gaining attention. appropriate, major determinants success, personal development, future prospects. Meanwhile, existing literature suffers dearth describes proposal systematically plan upon decisions balance quality, precision, scalability, cost, engagement. Among challenges survey, highlighted need aiming maximum increase generalizability. considerations addressed here ensuring privacy interaction local services provide assistance cases emergency suicide). strived cost-efficient financial constraints. proposed portal improve engagement, integration reduce expense (Donohoe 2012)(Callegaro 2015). automated minimizes paid researchers run reducing entry errors (Alessi & Martin, 2010). since involves easier (Bernard, 2011). Limitations: Of disadvantages research. open-ended cannot explored immediate follow-up unable seek clarification ambiguous (Andrews 2003). issue, easily project have. Selection bias presents Internet affected myriad income, geographical location, status age. (Ball, 2019)(Gulliver anticipate serious accessibility. has free 181.8 users 2023, means 84.3% (Kemp, 2023); southeast, where is, even greater user concentration. WhatsApp finish sound, Brazilians, around 169 2023). Thus, though fully possibilities, maximizes accessibility way consequently, identifying participants, contains maximize probability continue a) piques b) helps understand research, c) increases confidence participating. hold meetings coordinators transmit reaches Furthermore, two-minute video team, reason its objectives, details (application confidentiality, freedom decline) opportunity ask email. intention demonstrate promoting ensured platform, trusted storage (Patridge Bardyn, 2018) throughout scientific community. long-term reduction costs, possibility utilization devices, entry, review analysis (Walther include Each aims summarize integrate think intervention strategies. noted Introduction, paucity Existing mainly (Pacheco 2017) – covering range degrees rare. represents hub critically impacts responsibilities, values (Aceijas methodology inform preventative measures. It established preventive actions feasible, cost effective efficient improving (Arango believe results guide implementation programs destined positive College high issues. developed described evaluate detect reasonable efforts near future, monitor efficiency programs. model scaled across communities. Study registration: registered Open Science Framework (OSF) https://doi.org/10.17605/OSF.IO/AM5WS

Language: Английский