Commensurate measures of alcohol-related consequences across countries and cultures are critical for addressing the global burden of hazardous alcohol use. The Rutgers Alcohol Problem Index (RAPI), developed and validated in the United States, is a popular measure of alcohol problems. This study examined measurement invariance of the RAPI across samples of U.S. and Swedish high school seniors. Latent mean differences in alcohol problems across countries and differences in associations between alcohol problems with alcohol use and protective behavioral strategies (PBS) were also examined. The RAPI was scalar invariant. Swedish students reported fewer problems than U.S. students (latent mean difference = −0.19, p = .047). In both samples, the RAPI was positively correlated with alcohol use frequency and quantity (ps < .001), and negatively correlated with PBS use (ps < .05). Overall, the RAPI demonstrated measurement invariance, and we found evidence for its validity across samples of U.S. and Swedish high school seniors.

OBJECTIVE: This study used causal inference to estimate the longitudinal effects of contagion in cohabitants and family members on university students' mental health and academic self-efficacy during the COVID-19 pandemic.

DESIGN: A prospective longitudinal study including a baseline online measurement in May 2020, and online follow-ups after 5 months and 10 months. Participants were recruited through open-access online advertising.

SETTING: Public universities and university colleges in Sweden.

PARTICIPANTS: The analytical sample included 2796 students.

OUTCOME MEASURES: Contagion in cohabitants and in family members was assessed at baseline and at the 5-month follow-up. Mental health and academic self-efficacy were assessed at the 5-month and 10-month follow-ups.

RESULTS: Mild symptoms reported in cohabitants at baseline resulted in negative mental health effects at follow-up 5 months later, and mild baseline symptoms in family members resulted in negative effects on academic self-efficacy at follow-ups both 5 and 10 months later.

CONCLUSIONS: Notwithstanding the lack of precision in estimated effects, the findings emphasise the importance of social relationships and the challenges of providing students with sufficient support in times of crisis.

Research topic/aim

Students’ degree project could if involving research on people, risk infringing on individual´s privacy, processing sensitivepersonal data and encompassing difficult ethical issues, not least regarding informed consent. If these projects would havebeen performed by researchers, the projects would have required prior approval by the Swedish Ethical Review Authority inaccordance with the Swedish Act (2003:460) concerning the ethical review of research involving humans. However, since theprojects are performed by students, who are not obliged to undergo this review, it is unclear how an ethically acceptableapproach is to be guaranteed. It is well known that such student projects are carried out, but the extent to which this happens has not previously been investigated, neither in Sweden nor in other countries. We thereby present our experiences of a formalized ethical review process at a Higher Institution site in Sweden.

Theoretical framework

Establishing such formalized ethical review can lead to a greater consensus on which materials and methods are suitable forthe students, which in turn leads to increased equal treatment. Also serve as a pedagogical support resource for supervisors, who may experience ambiguities regarding research ethics issues and student projects. By gathering and building up ethics expertise at the university, a specialised support function is also developed that can offer advice and guidance, perspectives, and training. Through interaction and cooperation, the support function can contribute to an active learning environment, where students and supervisors are stimulated to reflect on their own decision-making (Fosnot, 2005). Experimental and experiential learning emphasizes that didactics is best achieved through active participation where participants deal with realproblems (Kolb, 1984). Ethically reflective learning specifically emphasizes the development of the student's ability to reflecton their own values, ethical dilemmas, and decision-making on ethical issues (Gill & Thomson, 2020). Common to these theories is the perspective that a formalized assessment offers students and teachers the opportunity to exchangeperspectives and to deal with ethical issues in a more concrete way.

Methodological design

Essays that have passed examination during the years 2014-2017 were included. A total of 1215 essays were read through,and the presence of ethically sensitive content was coded in a pre-established protocol.Expected conclusions/findings Out of a total of 1215 reviewed essays, 277 (22.8%) contained ethically sensitive content; the most common was sensitivepersonal data relating to health 165 (13.6%). In accordance, one in five undergraduate students completed studies that would have required the approval of the Ethical Review Authority, had they been researchers. Ethically sensitive content was proportionally more common in essays at the advanced level (32.9%) than at the first level (20.4%). Only 191 of the 277 essays (68.9%) that should have undergone a formalized ethical review process did so. The implementation of formalized ethical review of thesis projects seems to work best when the student's supervisor has their own experience of ethical review. Different institutional/disciplinary cultures also seem to have a large impact.

Relevance to Nordic educational research

The implementation of ethically acceptable approaches in student projects is an under-researched area, nationally andinternationally. The relevance is thereby urged. 

Hur vanligt är det att studenter bedriver projekt som inbegriper etiskt känsligt innehåll? I denna artikel redogörs för en undersökning rörande ett högskolepedagogiskt utvecklingsarbete som avser formaliserad etikprövning av studentuppsatser. Undersökningen inbegriper uppsatser som examinerats och godkänts vid fakulteten för hälsa och samhälle vid Malmö universitet under åren 2014–2017. Med etiskt känsligt innehåll avses här känsliga personuppgifter samt intervenerande metoder, som vid forskning kräver etikprövning enligt lag (2003:460) om etikprövning av forskning som avser människor. Av totalt 1215 granskade uppsatser hade 277 (22,8 %) etiskt känsligt innehåll; vanligast var känsliga personuppgifter avseende hälsa. 165 (13.6 %) uppsatser innehöll sådana uppgifter. Etiskt känsligt innehåll var mer vanligt förekommande i uppsatser på avancerad nivå (32,9 %) än på grundnivå (20,4 %). Var femte student på grundnivå genomförde alltså studier som skulle ha krävt Etikprövningsmyndighetens godkännande om de hade varit forskare.

Enligt fakultetens riktlinjer ska samtliga studentarbeten med ett innehåll som skulle ha krävt förhandsprövning vid forskning förhandsprövas av fakultetens etikråd för studentarbeten. Men endast 191 av de 277 uppsatser (68,9%) som borde ha genomgått sådan handläggning passerade etikrådet. Implementeringen av formaliserad etikprövning av uppsatsprojekt tycks fungera bäst då studentens handledare är forskarutbildad och kan antas ha egen erfarenhet av etikprövning. Vår undersökning visade också att etikprövningen implementerats i olika grad vid olika institutioner. I artikeln diskuteras möjliga förklaringar till denna skillnad.

Ethical Review of Student Projects: The Responsibility of Higher Education Institutions

How common is it for students to undertake projects involving ethically sensitive content? This article presents a study on higher education pedagogical development project concerning the formalized ethical review of student essays. The survey included essays that were examined and approved at the Faculty of Health and Society, Malmö university during 2014–2017. Ethically sensitive content refers here to sensitive personal data and intervention methods that, in research, require ethical review according to the Act (2003:460) on ethical review of research involving humans. Out of a total of 1215 examined thesis, 277 (22.8%) contained ethically sensitive content; the most common being personal health-related data. 165 (13.6%) essays contained such information. Advanced level theses had a higher prevalence of ethically sensitive content (32.9%) compared to undergraduate theses (20.4%). This indicates that a significant proportion of undergraduate students undertook projects involving content that would require ethical review if they were researchers.

The faculty’s guidelines stipulate that all student works containing content requiring prior ethical review in research, should be reviewed by the faculty’s ethics council. However, only 68.9% of the essays that necessitated such review passed the ethics council, indicating a gap in compliance with ethical review processes. The study suggests that the effectiveness of formalized ethical review of thesis projects is enhanced when the student’s supervisor holds a doctoral degree, likely due to their familiarity and experience with ethical review procedures. Furthermore, the research highlights variations in the implementation of ethical review across different departments within the faculty. The article delves into possible reasons for these discrepancies.

BACKGROUND: Emerging adulthood is often associated with mental health problems. About one in three university students report symptoms of depression and anxiety that can negatively affect their developmental trajectory concerning work, intimate relationships, and health. This can interfere with academic performance, as mood and anxiety disorders are key predictors of dropout from higher education. A treatment gap exists, where a considerable proportion of students do not seek help for mood and anxiety symptoms. Offering internet interventions to students with mental health problems could reduce the treatment gap, increase mental health, and improve academic performance. A meta-analysis on internet interventions for university students showed small effects for depression and none for anxiety. Larger trials are recommended to further explore effects of guidance, transdiagnostic approaches, and individual treatment components.

METHODS: This study will offer 1200 university students in Sweden participation in a three-armed randomized controlled trial (RCT) evaluating a guided or unguided transdiagnostic internet intervention for mild to moderate depression and anxiety, where the waitlist control group accesses the intervention at 6-month follow-up. Students reporting suicidal ideation/behaviors will be excluded and referred to treatment within the existing healthcare system. An embedded study within the trial (SWAT) will assess at week 3 of 8 whether participants in the guided and unguided groups are at higher risk of failing to benefit from treatment. Those at risk will be randomized to an adaptive treatment strategy, or to continue the treatment as originally randomized. Primary outcomes are symptoms of depression and anxiety. Follow-ups will occur at post-treatment and at 6-, 12-, and 24-month post-randomization. Between-group outcome analyses will be reported, and qualitative interviews about treatment experiences are planned.

DISCUSSION: This study investigates the effects of a transdiagnostic internet intervention among university students in Sweden, with an adaptive treatment strategy employed during the course of treatment to minimize the risk of treatment failure. The study will contribute knowledge about longitudinal trajectories of mental health and well-being following treatment, taking into account possible gender differences in responsiveness to treatment. With time, effective internet interventions could make treatment for mental health issues more widely accessible to the student group.

In higher education, students' trust in the university management may affect both mental health and academic self-efficacy. This longitudinal study, conducted during the most challenging course of the COVID-19 pandemic, uses multinomial regression and causal inference to estimate the effects of students' trust in their universities' strategies for managing the pandemic, on students' self-reported changes in mental health and academic self-efficacy. The analyzed sample (N = 2796) was recruited through online advertising and responded to a baseline online survey in the late spring of 2020, with two follow-up surveys five and ten months later. Results show that positive trust in university management of the pandemic protected against experiencing one's mental health and academic self-efficacy as worse rather than unchanged, both five and ten months after the baseline assessment. The findings emphasize the importance of developing and maintaining trust-building measures between academia and students to support students' mental health and academic self-efficacy in times of uncertainty.

Background and objectives: Internet gaming disorder (IGD) is associated with health, social, and academic problems but whether these are consequences of the disorder rather than precursors or correlates is unclear. We aimed to evaluate whether IGD in the 1st year of university predicts health, academic and social problems 1 year later, controlling for baseline health, academic and social problems, demographics, and mental health symptoms.

Methods: In a prospective cohort study, 1741 university students completed both a baseline online survey in their 1st year and a follow-up survey 1 year later. Log-binomial models examined the strength of prospective associations between baseline predictor variables (IGD, baseline health, academic and social problems, sex, age, and mental health symptoms) and occurrence of health, academic and social problems at follow-up.

Results: When extensively adjusted by the corresponding outcome at baseline, any mental disorder symptoms, sex, and age, baseline IGD was associated only with severe school impairment and poor social life (risk ratio [RR] = 1.77; 95% confidence interval [CI] = 1.14-2.75, p = .011; RR = 1.22; 95% CI = 1.07-1.38, p = .002, respectively).

Conclusions and scientific significance: University authorities and counselors should consider that incoming 1st-year students that meet criteria for IGD are likely to have increased academic and social impairments during their 1st year for which they may want to intervene. This study adds to the existing literature by longitudinally examining a greater array of negative outcomes of IGD than previously documented.

Objective: Mental wellbeing is a fundamental aspect of the broader notion of quality of life. Little is known about the mental wellbeing of university students in general and Swedish university students in particular. As emerging adults, university students typically experience substantial changes to their living conditions, relationships, and academic stress, and depression and anxiety are prospectively associated with lower academic achievement at the end of the first year.

Methods: Data from five cross-sectional cohorts (n = 7423), collected between spring 2020 and spring 2022, were compared descriptively, regarding sociodemographic factors, lifetime and past 30-day symptoms of mental health problems, experiences of bullying, feeling loved and measures of well-being. Linear regression identified protective factors for wellbeing according to the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), and risk factors for lower wellbeing.

Results: Participants were > 70% women, 24–27 years old, 75–83% born in Sweden. About one-third had experienced physical bullying at school and about 70% felt loved and cared for. About two-thirds had medium levels of wellbeing, with one-third having low levels and about 5% having high levels. Protective factors for wellbeing included older age, male gender, feeling loved most of the time, and the grit construct. Risk factors included being an international student, non-heterosexual sexual orientation, having symptoms of depression or anxiety most of the time, and experiencing effort/reward imbalance.

Conclusions: A large proportion of students experience less than optimal wellbeing. Interventions to enhance positive, nurturing relationships and reinforce grit-related factors could support students in this challenging period of life.

Background:

During the COVID-19-pandemic, Sweden introduced voluntary public health recommendations. In addition, Swedish higher education institutions shifted to remote teaching to reduce contagion. For the majority of students, this led to changes relating to several daily behaviors, and study routines, which might impact mental health.

Purpose:

This study investigates compliance with recommendations, COVID-19 symptoms, academic self-efficacy, and mental health in students in higher education in Sweden

Method:

Self-reports were collected through online questionnaires from students at higher education institutions across Sweden (N: 4495; 71% women; mean-age: 26.5 years). These were analyzed using multinomial regressions taking a Bayesian approach.

Results:

Compliance with recommendations ranged from about 70 to 96 percent, with women and older students reporting higher compliance. Most of those with COVID-19 symptoms reported having mild to moderate symptoms (30%). Mild to moderate COVID-19 symptoms in significant others were associated with symptoms of contagion but not with study capacity or mental health. In contrast, over 80% reported effects, mainly negative, on both academic self-efficacy and mental health.

Conclusions:

Students largely followed voluntary recommendations, indicating no need of coercive measures. Still, many reported negative effects on academic self-efficacy and mental health thus raising concerns for enduring effects. Digital interventions boosting study skills and mental health could be a key for providing accessible support to all at reasonable costs.

Background: Improving relationship dynamics positively impacts both partners’ health among couples. However, few studies have investigated sexual and gender minority (SGM) couples’ relationship goals and their experiences toward achieving them.

Purpose: The present study investigated SGM couples’ experiences that centered on them working toward or maintaining their relationship goals over time.

Method: From a cohort study with SGM couples, a purposive sample of 40 couples was selected and interviewed over Zoom. Interviews were individual-level, semi-structured, and recorded. Thematic analysis was used to analyze the transcripts.

Results: Approximately half of the 40 couples identified as gay male couples, a third as lesbian couples, and about one-fifth as queer or gender minority couples. Top three reported relationship goals were 1) improving communication, 2) working on finances, and 3) enhancing intimacy. Feeling emotionally connected, career-related decisions, and improving sexual satisfaction were other commonly reported goals. Overall, most partners felt they made progress toward at least 1 of their 3 relationship goals within the prior 6 months. However, perceived relationship goal progress varied extensively between partners across couple groups. Facilitator-related themes about relationship goal progress included dyadic efforts, having a support system including professional help, and planning. Barrier-related themes included nonexistent or minimal effort, different communication styles, employment and economical struggles, and competing life and health priorities.

Conclusion(s): Dyadic efforts and support systems were key toward someone working toward or maintaining their relationships goals. Findings suggest key relationship functioning areas to target in a future multiple health behavior change intervention for SGM couples.