203 - Exploratory Analysis of Sleep, Steps, and Mood in College Students Using Fitbit Data Across a Positive Psychology Digital App plus Human Coaching Randomized Controlled Trial

Publication Number: 4200.203

Xinyue Wu, University of Michigan Medical School, Ann Arbor, MI, United States; Xiao Cao, University of michigan, Ann Arbor, MI, United States; Simon Shavit, Children's Hospital of Michigan, Ann Arbor, MI, United States; Gavin C. Raab, University of Michigan Medical School, Ann Arbor, MI, United States; Michael Reifman, University of Michigan, Upper Saddle River, NJ, United States; Maxwell J. Kluge, University of Michigan Medical School, Ann Arbor, MI, United States; Jaeryeong Kim, University of Michigan Medical School, Ann Arbor, MI, United States; Michelle Rozwadowski, University of Michigan Medical School, Royal Oak, MI, United States; Erik Winnega, University of Michigan Medical School, Ann Arbor, MI, United States; Tracey Churay, University of Michigan Medical School, Ann Arbor, MI, United States; Skyla A. Shea, University of Michigan Medical School, Ann Arbor, MI, United States; Marsha L.. Benz, University of Michigan- Wolverine Wellness, Ann Arbor, MI, United States; Amanda M. Reis, University of Michigan Medical School, Ypsilanti, MI, United States; Joseph Durney, Steer for Student Athletes, Port Chester, NY, United States; Astrid Vargas, N/A, PORT CHESTER, NY, United States; Myles D. Durney, University of Michigan Medical School, Port Chester, NY, United States; Kerby A. Shedden, University of Michigan, Ann Arbor, MI, United States; Sung Won Choi, University of Michigan, Ann Arbor, MI, United States

Background: Wearable sensors and mHealth interventions offer scalable ways for college students to track and monitor their physical and mental health. Our team developed Roadmap, an mHealth platform created through iterative user-centered design, integrating positive psychology interventions (PPIs) that foster optimism and positive emotion while collecting wearable-based activity, sleep, and mood data (Figure 1).

Objective: This exploratory analysis examined the Fitbit®-tracked step count and sleep duration, along with app-reported daily mood, in college students randomized to intervention or control groups over 4-months.

Design/Methods: Eighty-three students (University of Michigan, Ann Arbor, MI; N=55 and STEER for Student Athletes, Port Chester, NY; N=28) were cluster-randomized to the intervention (Roadmap with PPIs and coaching; N=42) or control (limited app without PPIs; N=41). Participants used their assigned app and scheduled wellness-coaching sessions over 4-months. The app prompted daily mood ratings (1-10), and all participants received Fitbits® to continuously record steps and sleep. Fitbit® data were quality-checked; days with < 6 hours of heart-rate coverage or < 8 hours of step data and atypical sleep sessions were excluded. Valid daily data were aggregated to weekly and monthly averages and merged with mood ratings by study date.

Results: Fitbit® compliance was high, with an average wear time of 10 hours/day and valid data on ~70% of study days. Over 90% agreed that the Fitbit® was easy to use (Table 1). Both groups significantly increased daily steps over time (p=0.002), with the intervention group maintaining higher step counts. Although between-group sleep differences were not statistically significant, the intervention group showed greater interdaily stability and sleep regularity (Figure 2). In a mixed-effects model adjusting for site and study day, higher daily step counts were associated with better mood (β=0.45 per 1,000 steps, p< 0.001), while the intervention group showed a positive but non-significant trend toward higher mood.

Conclusion(s): This study supports the feasibility of integrating wearable tech with digital PPIs and coaching to support college student well-being. Students using the Roadmap intervention, which combined PPIs, Fitbit® metrics, and coaching, were more active and showed more stable sleep patterns than controls. Visualizing steps, sleep, and mood in the app, along with human coaching, was linked to increased activity and improved mood. These findings suggest mHealth interventions may help enhance daily behaviors and mental health in college students.

Figure 1. Overview and Key Features of the Roadmap mHealth Platform
The Roadmap mobile health platform was developed through iterative, user-centered design to promote emotional well-being and healthy daily behaviors. The app integrates positive psychology interventions-such as the Positive Piggy Bank, Gratitude Journal, and Pleasant Activity Scheduling-with self-monitoring of mood, sleep, and physical activity from Fitbit® Charge 5 wearable sensors. These features aim to foster optimism and engagement while supporting real-time visualization and human coaching to enhance college students' activity, sleep stability, and mental health.

Table 1. Feasibility and acceptability of the Fitbit® device worn for the study
Participants responded to this questionnaire at the end of the study (exit survey; N=70/83 respondents).

Figure 2. Fitbit®-Measured Steps and Sleep Patterns by Intervention Arm
Average daily steps (left) and sleep metrics (middle and right) among college students in the Roadmap intervention and control groups over four months. Participants in the intervention group showed consistently higher step counts across weeks and months, as well as slightly higher interdaily stability (IS) and sleep regularity index (SRI), suggesting more stable and synchronized sleep-wake patterns.