The association between health behaviours and academic performance moderated by trait mindfulness amongst university students: an observational study.

Objectives: To target health communication at less health-conscious groups, evidence on health behaviours' effects on non-health-related outcomes - such as academic performance - is necessary. Recent research has highlighted the associations of various health behaviours on academic performance of university students. However, there is a lack of research investigating the most predominant health behaviours simultaneously and their association with academic performance, as well as the factors that potentially influence the direction or strength of these associations. Therefore, this study investigated (I) which of the predominant health behaviours (physical activity, healthy diet, sleep, sedentary behaviour, alcohol consumption, smoking, drug use) are most associated with academic performance and (II) whether the personal resource of trait mindfulness moderates these associations. Methods: An online survey was conducted amongst university students during the 2021 summer semester. Group differences in academic performance regarding health behaviours were analysed using ANOVA (N = 1,049). A first linear regression model (N = 571), considering all selected health behaviours simultaneously, assessed their association with academic performance. A second model (N = 540) assessed interaction effects of health behaviours and trait mindfulness. Separate regressions assessed each interaction's association with academic performance. Results: Sleep, fruit and vegetable consumption, and gender were significantly associated with academic performance. The second model showed no significant interaction effects. Conclusion: Targeting sleep and fruit and vegetable consumption might be the most promising strategies for elevating students' academic performance, thereby enabling health communication strategies to reach groups driven by performance improvements rather than health benefits.

Conditional reciprocal stressor-strain effects in university students: a cross-lagged panel study in Germany.

University students worldwide are facing increasing mental health challenges. Traditional stress models, like the Job/Study Demand-Resources Model, link stressors directly to strain. Yet, recent studies suggest the influence of strain on stressors may be even stronger. Our research explored these reciprocal dynamics among university students, considering social support and mindfulness as potential moderators. We conducted a two-wave panel study with 264 university students. We ran separate cross-lagged panel structural equation analyses for three key health outcomes-emotional exhaustion, depression, and well-being-each paired with perceived study stressors, specifically workload and work complexity. Findings revealed significant stressor and strain effects, with social support notably moderating the impact of emotional exhaustion on workload. These insights challenge traditional stress theories and underscore the importance of mental health support and effective stress management strategies for students, emphasizing the need for proactive mental health initiatives in academic environments.

A blended learning approach for teaching thoracic radiology to medical students: a proof-of-concept study.

Introduction: The best way to impart knowledge to medical students is still unclear. Therefore, we designed a blended learning course in thoracic radiology including both "traditional" in-class time as well as online learning modules. The aims were (1) to investigate students' attitudes toward this blended learning approach; and (2) to test whether it improved their knowledge about thoracic radiology. Methods: A prospective study was conducted at the local medical center; 156 fourth-year medical students completed this study. Before and after the course, students had to complete (1) questionnaires to investigate their attitudes (7-point Likert scale); and (2) an objective test to assess their knowledge (multiple-choice/free text questions; results as % of correct answers). Results: Regarding (1), the course led to an improvement in all items compared to baseline, exemplary: interest in thoracic radiology (precourse 4.2 vs. 5.4 postcourse) and the fulfillment of students' expressed requirements regarding the teaching content (4.5 precourse vs. 6.2 postcourse). Furthermore, the great majority (88%) of our participants wished for more online learning offerings in the future. Regarding (2), the course led to improved knowledge on the objective test (precourse: 40% vs. postcourse: 63% correct answers). Conclusion: This feasibility study showed the successful design and implementation of a blended learning approach in thoracic radiology. Furthermore, it revealed medical students' positive attitudes toward this approach and showed an increased knowledge in thoracic radiology. Thus, such approaches might be used to enrich the teaching armamentarium in medical education and to further enhance interest and knowledge in thoracic diseases among medical students.

Cigarette Smoking, Risky Alcohol Consumption, and Marijuana Smoking among University Students in Germany: Identification of Potential Sociodemographic and Study-Related Risk Groups and Predictors of Consumption.

(1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are the most common behaviors related to legal and illicit drug use worldwide, including among university students. To plan effective evidence-based programs to prevent the risky consumption of these substances among university students, the present study aimed to identify potential sociodemographic and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online health survey with approximately 270 health-related items was conducted among students at the University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female ≥ 4, male ≥ 5), and marijuana smoking were chosen as dependent variables. Of the 270 health-related items, 56 were chosen as independent variables and collated into five groups (sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using established and validated instruments. Pearson's chi-square test was used to analyze the differences in prevalence between the sociodemographic and study-related groups, and binary logistic regression was used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university students who entered the analyses, 14.9% reported smoking cigarettes, 38.6% reported risky alcohol consumption, and 10.9% reported smoking marijuana. The prevalence of these differed between genders, fields of study, and aspired degree level, among other factors. Binary logistic regression analyses revealed nine significant predictors (p ≤ 0.05) of cigarette smoking (Nagelkerke R2 = 0.314), 18 significant predictors of risky alcohol consumption (Nagelkerke R2 = 0.270), and 16 significant predictors of marijuana smoking (Nagelkerke R2 = 0.239). (4) Conclusions: This study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany to be associated with multiple factors, especially health behaviors. Furthermore, each of the substances was highly associated with each of the two other substances we examined. Other variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role. Therefore, our recommendation for future prevention programs is that substance use among university students should be addressed as a whole, not just in terms of specific substances.

Sociodemographic and work-related differences in teachers' attitude towards and perceived stress from emergency remote teaching during the COVID-19 pandemic.

The aim was to investigate the attitude towards and perceived stress from emergency remote teaching (ERT) among teachers during the COVID-19 pandemic. A Germany-wide online survey was conducted among teachers from all school types in March 2021. Data from 31,089 teachers entered analysis. ANOVAs or Welch's t-tests with post-hoc analyses were performed to determine sociodemographic and work-related group differences in teachers' attitude towards and perceived stress from ERT. The mean attitude towards ERT was 3.47 (± .84) out of 5 and the mean perceived stress was 5.03 (± .62) out of 6. Regarding the attitude towards ERT, we revealed significant differences for gender, age groups, number of children, occupational group, school management membership, and employment status (p < .05). Regarding perceived stress, significant differences were obtained for gender, age groups, and employment status (p < .05). A more positive attitude towards ERT seems to be associated with lower stress levels. Being female, a higher age, a higher number of children living in the own household as well as working full-time might hinder an effective implementation of remote teaching in school settings in Germany. Policy-makers and schools should think of strategies to improve the attitude towards and decrease perceived stress from remote teaching. This could include subgroup-specific training on the use of digital media, adapted to the work environment.

Videos using different message strategies to promote the interruption of sedentary behavior in university students during online lectures - A pilot study.

Background: Sedentary behavior (SB) is highly prevalent among university students and has increased during COVID-19 pandemic. As SB is associated with negative health outcomes, appropriate prevention measures in the university setting are needed. Objective: This pilot study aimed at investigating the effects of videos using different message strategies to interrupt SB in the collective of university students during online lectures. Methods: During online lectures, university students (N = 96) were shown one of three videos on the interruption of SB. The videos differed in their message strategies with regard to evidence type (statistical vs. narrative) and vividness (static vs. animated images). Demographics, health variables (SB intentions, SB attitudes) and selected media reception variables (identification, homophily, counterarguing) were examined as possible influence factors on the interruption of SB evoked by watching the video. Results: Approximately half of the students interrupted sedentary behavior during watching the videos and students of the older age group (cut-off: median = 22 years) interrupted SB significantly more often (p = 0.046). The interruption of SB was predicted by SB intentions (p < 0.05). Identification with characters significantly predicted the intentions to reduce SB (p < 0.001), with a large effect of the overall regression model (R2corr = 0.47). Conclusion: Considering the increased digitalization in general and restrictions due to COVID-19 pandemic, videos seem to be a useful tool to interrupt SB among university students during online lectures. Narrative formats could facilitate the intention to reduce SB, which in turn could have a positive impact on the interruption of SB. However, further research on effective communication and message strategies is needed.

Predictors of job satisfaction among teachers in Germany during the SARS-CoV-2 pandemic: cross-sectional results of a nationwide online questionnaire.

Introduction: During the SARS-CoV-2 pandemic teaching was changed several times to distance learning. To consider the associated stresses and challenges for teachers a nationwide cross-sectional study was performed in March 2021 in which N = 31,089 teachers from Germany participated. Methods: A multiple linear regression model with stepwise inclusion of thematically sorted variables (sociodemographic, SARS-CoV-2- and work-related variables) was used to identify relevant predictors of job satisfaction. Results: The analysis revealed that work-related variables were significant predictors of job satisfaction. In the third regression model, when all variables are included the adjusted R2 was 0.364. Overall, the results showed that, e.g., work predictability (b = 0.097), influence at work (b = 0.118), and meaning of work (b = 0.212) increased job satisfaction. In contrast, increased emotional exhaustion (b = -0.016), feelings of unfair treatment (b = -0.048), and work family conflicts (b = -0.154) deteriorated job satisfaction. Discussion: The results indicate that future research should focus especially the work-related topics in more detail and that job satisfaction is a useful concept for analyzing working conditions from a public health point of view.

Mental health state and its determinants in German university students across the COVID-19 pandemic: findings from three repeated cross-sectional surveys between 2019 and 2021.

Background: Students were at an increased risk for elevated mental symptoms during the first year of the COVID-19 pandemic compared to pre-pandemic levels. As universities remained closed much longer than anticipated, the mental burden was expected to persist through the second year of the pandemic. The current study aimed to investigate the prevalence of mental distress from 2019 through 2021 and identify risk factors for elevated mental burden, focusing on gender. Methods: We analyzed three cross-sectional online surveys among students at the University of Mainz, conducted in 2019 (n = 4,351), 2020 (n = 3,066), and 2021 (n = 1,438). Changes in the prevalence of depressive symptoms, anxiety, suicidal ideation, and loneliness were calculated using Pearson's chi-square tests and analyses of variance. Multiple linear regressions yielded associated risk factors. Results: The proportion of students with clinically relevant depressive symptoms was significantly higher during the pandemic (38.9% in 2020, and 40.7% in 2021), compared to pre-pandemic (29.0% in 2019). Similarly, more students reported suicidal ideation and generalized anxiety during the pandemic with a peak in the second pandemic year (2021). The level of loneliness was significantly higher in 2020, compared to 2019, and remained at a high level in 2021 (p < 0.001, ηp2 = 0.142). Female and diverse/open gender, being single, living alone, and being a first-year student were identified as risk factors associated with mental burden during the pandemic. Discussion: Mental burdens remained elevated among students through the second year of the pandemic and were associated with socio-demographic risk factors and pandemic-related concerns. Future research should monitor recovery and evaluate the need for psychosocial support.

Sedentary time of university students before and during the COVID-19 pandemic: Risk groups and pre-pandemic predictors using cross-sectional and longitudinal data.

Background: The present study aimed to (1) assess and compare sedentary time (ST) of university students before and during the COVID-19 pandemic, (2) examine risk groups with regard to ST and the "extent of change" in ST (from before to during the pandemic) in association with sociodemographic (gender, age), study-related (degree aspired to, field of study, semester), and pre-pandemic physical health-related [pre-pandemic physical activity (PA) and ST levels, pre-pandemic BMI class] variables, and (3) investigate whether the change in ST was predicted by these variables. Methods: Two online surveys were conducted among students at the University of Mainz, Germany-the first in 2019 (before the pandemic) and the second in 2020 (during the pandemic). Participants of both surveys were included in a longitudinal sample. With the longitudinal sample's data, paired t-tests, single factor, and mixed analyses of variances were used to examine group differences in ST and the "extent of change" in ST. A linear regression analysis was computed to investigate the influence of the abovementioned sociodemographic, study-related, and pre-pandemic physical health-related variables on the change in ST. Results: Of the N = 4,351 (pre-pandemic) and N = 3,066 (in-pandemic) participants of the online surveys, N = 443 entered the longitudinal sample. ST increased by 1.4 h/day to critical levels (≥8 h/day) in all subgroups analyzed-even among students who were highly physically active before the pandemic. Students with a low pre-pandemic ST had the largest increase in ST. Pre-pandemic PA level negatively predicted the change in ST. Conclusion: Even during a global pandemic lockdown, individuals who were previously more physically active and had less ST showed more health-promoting behavior in terms of ST. Therefore, it can be stated that efforts to promote PA and reduce ST are always valuable. Since ST increased and was worryingly high in all subgroups analyzed, all university students should be targeted by multidimensional approaches to tackle ST and promote their health.

Implementation of occupational safety and health measures at German schools during the SARS-CoV-2 pandemic-cross-sectional results from 31,089 teachers.

Background: The SARS-CoV-2 pandemic exacerbated existing health-related challenges in schools and created new ones. Under pandemic conditions, health risks increased, and with them the requirements for occupational safety and health (OSH) measures. The aim of the study was (a) to examine the status quo of OSH measures in German schools, (b) to analyze whether the implementation of OSH measures was associated with preferable outcomes and (c) to identify predictors for the implementation of OSH measures. Methods: A nationwide cross-sectional online survey was conducted among teachers at all school types in Germany in March 2021. Data on the implementation of OSH measures (risk assessments, infection protection instructions and instructions on occupational safety), associated health-related parameters (e.g., somatic symptoms, PHQ-15) and predictor variables (e.g., gender, age or federal states) were assessed using descriptive statistics, analysis of variance and multiple linear regression analysis. Results: Less than 10% of surveyed teachers (N = 31,089) reported that their schools met legal requirements for occupational safety and health measures. Beneficial associations became apparent where more measures were implemented, e.g., significantly better somatic and mental health. Predictors for the implementation of OSH measures were found, especially on a systemic level (e.g., federal states schools were located in). Conclusions: Our study can serve as a basis for future studies. It provides a status quo regarding the implementation of, associations with and predictors for OSH measures in German schools. Our results are best understood as evidence-based arguments to encourage political decision makers to improve the implementation of OSH measures in German schools and thereby foster teachers' health.

Differences in Work and Commuting Accidents between Employees and Students at Higher Education Institutions in Rhineland-Palatinate, Germany, from December 2014 to December 2019.

Accidents are one of the most important public health concerns because of their high prevalence and considerable health outcomes. Although higher education institutions (HEIs) play an important role in health promotion and disease prevention, accidents are rarely investigated in this setting. Therefore, the aim of the present study was to address this gap by analyzing the frequency and characteristics of employee and student accidents at HEIs in Rhineland-Palatinate, Germany. A dataset of all accidents that happened to employees and students at HEIs in Rhineland-Palatinate from December 2014 to December 2019 and the characteristics of these accidents was provided by the responsible statutory accident insurance (Accident Insurance Fund of Rhineland-Palatinate). Modified thousand-men quotas (the rate of injuries per 1000 people) were calculated to investigate the differences in frequencies and characteristics of accidents between employees and students, as well as between institutions. A total of 3810 accidents (n = 1326; 34.8% work and n = 2484; 65.2% commuting) were reported, of which 426 involved employees and 3384 involved students. The frequency and characteristics of the accidents varied between employees and students, as well as between institutions. Sports programs at HEIs for example imply high risks for unintentional injuries especially for students (as they make up the majority of participants). Other main findings are that medical students, as well as students of subjects including laboratory work, are at a higher risk to experience study-related accidents whereas employees seem to be at a higher risk when working in a technical field. The results call for the development of accident prevention concepts at HEIs and the implementation of interventions in respective institutions and target groups.

Is mental health literacy for depression associated with the intention toward preventive actions? A cross-sectional study among university students.

Objective: Mental Health Literacy (MHL) might play an important role in preventing depression. This study assessed the MHL level for depression of university students and its association with intentions toward preventive actions against depression. Participants: University students (n = 315) were surveyed online. Methods: MHL level and group differences were analyzed using t-tests and one-way ANOVA. To investigate the relation between MHL and the intention for preventive actions against depression, correlation and regression analyses were performed. Results: The mean MHL level of the participants was reasonably high (42.65 of 75 points). MHL levels differed significantly between different groups. MHL was slightly associated with intention for preventive actions (beta = 0.274, p < 0.001). The explained variance was low (7.5%). Conclusions: MHL levels of university students have potential for improvement, especially among males and non-health related students. Promotion of MHL could be one of the targets points in interventions aimed at depression prevention.

Depression and anxiety in female refugees from East Africa and the Middle East displaced to Germany: cross-sectional results of the female refugee study, taking sociodemographic and migration-related factors into account.

At the end of 2022, 108.4 million people around the world were forcibly displaced, the highest number ever recorded. Of these, 50% were women. Despite this situation, little is known about the mental health of female refugees. The first aim of this study was to examine the prevalence of depression and anxiety symptoms among female refugees in Germany. The second aim was to examine which sociodemographic and migration-related variables have an impact on refugees' mental health, and the third aim was to assess the potential predictors of their mental health. A sample of 92 female refugees from East Africa and the Middle East living in Germany were interviewed. Symptoms of depression and anxiety were assessed using the Hopkins Symptom Checklist (HSCL-25). The experience of potentially traumatic events (PTEs) was assessed using the Posttraumatic Diagnostic Scale (PDS) and the Harvard Trauma Questionnaire (HTQ). In our sample of female refugees, 65.2% reported symptoms of depression, and 60.9% reported symptoms of anxiety. Symptoms of depression or anxiety were associated with being from the Middle East, having a higher level of education, and reporting more PTEs. The multiple regression model for anxiety was able to explain 32.4% of the variance in anxiety symptoms. The findings highlight the high burden of mental health problems that female refugees bear. The identified predictors of depressive and anxiety symptoms should sensitize medical and refugee professionals to identify vulnerable individuals and groups, refer them to appropriate psychological treatment, and, where possible, modify the identified predictors.

Determinants of university students' COVID-19 vaccination intentions and behavior.

Vaccination hesitancy has been a major challenge for health authorities and societies during the COVID-19 pandemic. The general determinants of vaccination intentions and behavior include sociodemographic and health-related, psychological, and communication-related factors, with varying relevance for different types of vaccinations, countries, and target groups. The predictors of university students' COVID-19 vaccination behavior have not been sufficiently studied. Using a German university as an example and based on an online survey of 1398 university students, we investigated factors related to (a) the likelihood of vaccination against COVID-19 and (b) vaccination intention among those who had not been vaccinated by summer of 2021. Psychological factors showed high relevance. Field of study, trust in, and use of certain media and information channels were found to be important determinants of students' vaccination decision. Our findings can help better understand university students' vaccination behavior to develop and implement tailored strategies and campaigns.

Psychological Burdens among Teachers in Germany during the SARS-CoV-2 Pandemic-Subgroup Analysis from a Nationwide Cross-Sectional Online Survey.

BACKGROUND: Schools underwent massive changes during the SARS-CoV-2 pandemic worldwide. Besides existing occupational health challenges, teachers had to deal with biological and psychological burdens that had the potential to impact their psychological well-being. The aim of the present study was to (i) assess the current state of psychological burdens in German teachers and (ii) identify highly burdened subgroups to derive and address interventions. METHODS: A nationwide cross-sectional online survey was conducted among teachers at all school types in Germany in March 2021. Data on psychological strains were assessed using established (e.g., PHQ-4) and new-pandemic-specific-(e.g., COVID-19-associated anxieties) instruments. ANOVAs and Tukey's post hoc tests were used to identify highly burdened subgroups (e.g., gender, age, and number of risk factors for severe courses of COVID-19) of teachers. RESULTS: Psychological burdens in German teachers (N = 31.089) exceeded the level of the general population, for example, regarding symptoms of depression (PHQ-2, M = 1.93 vs. 1.24) or generalized anxiety (GAD-2, M = 1.72 vs. 1.03). Subgroup analysis revealed that psychological burdens were unevenly distributed among different groups of teachers; for example, younger teachers (18-30 years) showed more depression symptoms compared with their older colleagues (56-67 years) (PHQ-2, M = 2.01 vs. 1.78). CONCLUSIONS: The online survey was conducted during the "third wave" of SARS-CoV-2 in Germany, which might have influenced risk perception and psychological strains. Future studies at different times, ideally longitudinal monitoring of the mental health of teachers, are recommended. Based on our results, evidence-based subgroup-specific interventions should be implemented to sustain teachers' mental health; for example, younger teachers or teachers with risk factors for a severe course of COVID-19 should receive special attention and support. Teachers from special needs schools whose mental health is, on average, good could also be a starting point for identifying the health promotion structural elements of this school type (e.g., fewer students per teacher). However, beyond the specific pandemic-related psychological burdens, the classic occupational health challenges of physical, biological, and chemical stress and their resulting strains should not be disregarded.

Triple careers of athletes: exploring the challenges of planning a pregnancy among female elite athletes using semi-structured interviews.

BACKGROUND: The challenging factors that elite athletes perceive for combining their sportive career with planning a pregnancy and motherhood need to be identified in order to develop supportive measures. Therefore, this phenomenological qualitative study aimed to explore challenges associated with planning a pregnancy among female, non-pregnant elite athletes. METHODS: Semi-structured skype-interviews were performed among female elite athletes (athletes competing on national or international level) aged 28 years or older. Using Mayring's qualitative content analysis approach, anchor examples served to identify potential challenges of planning a pregnancy which were categorized independently by two researchers. RESULTS: Interviews of 16 elite athletes (mean age 30.7 years) entered analysis. Eleven challenges of planning a pregnancy were identified, categorized into organizational / environmental, financial, personal, and physical factors. CONCLUSIONS: With regard to financial challenges, we propose mandatory maternity leave and continuation of the contracts and salary. Furthermore, mentoring programs may help to provide support and advice to new generations of female elite athletes and help to reduce concerns regarding the wish of becoming pregnant during a sportive career. In order to reduce physical concerns regarding pregnancy and exercise, we see a need for scientific studies investigating the association of sport discipline specific characteristics on sportive performance and the mother´s, fetus' and child´s health. Finally, the results of the current study may be used in future quantitative studies to test specific hypotheses.

Physical Activity and Sedentary Behavior in University Students-The Role of Gender, Age, Field of Study, Targeted Degree, and Study Semester.

Background: Physical inactivity and sedentary behavior are modifiable risk factors for an unhealthy lifestyle in university students. The aim of this study was to identify subgroups among German university students with an increased risk for unhealthy behavior. For this purpose, differences in physical activity and sedentary behavior with respect to sociodemographic and study related factors were examined. Methods: A total of 4,351 students participated in an online survey. The amount of physical activity (metabolic equivalent of task-min/week) and the sitting time (h/day) were assessed using the German short form of the International Physical Activity Questionnaire. Differences in gender and age as well as field of study, targeted degree and study semester were analyzed using a single factorial ANOVA with Tukey correction or a Welch-ANOVA with Games-Howell correction. Results: For physical activity, significant differences were found for gender (F(2, 80.46) = 17.79, p < 0.001, ηp2 = 0.009), for field of study (F(5, 1738.09) = 7.41, p < 0.001, ηp2 = 0.01), and for study semester (F(1, 948.12) = 5.53, p < 0.05, ηp2 =0.001), but not for age and targeted degree (p > 0.05). For sedentary behavior, significant differences were found for field of study (F(5, 3816) = 5.69, p < 0.001, ηp2 = 0.01) and targeted degree (F(3, 3868) = 3.94, p < 0.01, ηp2 = 0.003), but not for gender, age and study semester (p > 0.05). Conclusion: Female students, students enrolled in "natural sciences, mathematics and informatics" and first year students appear to have an increased risk of an unhealthy lifestyle. Future research should identify barriers to and incentives of physical activity as well as reasons for high amounts of SB in sub-populations of university students. Suitable prevention and intervention programs are necessary.

Distinct Patterns of University Students Study Crafting and the Relationships to Exhaustion, Well-Being, and Engagement.

Job crafting has been established as a bottom-up work design instrument for promoting health and well-being in the workplace. In recent years, the concepts of job crafting have been applied to the university student context, proving to be positively related to student well-being. Building on person-centered analyses from the employment context, we assessed approach study crafting strategy combinations and the relationships to students' exhaustion, study engagement, and general well-being. Data from 2,882 German university students were examined, collected online during the summer term in 2020. Using latent profile analysis, we found five distinct crafting groups, which showed discriminate validity with regard to emotional exhaustion, engagement, and well-being. The results underscore the positive role of study crafting for students' health and well-being. They further indicate a less important role of increasing social resources for emotional exhaustion when combined with a moderate increase in structural resources and a moderate increase in challenging demands. Our findings imply that interventions to promote study crafting should be considered to promote student health and well-being.