275 - A Multi-Site, Randomized Controlled Trial of Integrated Human and Digital Support to Enhance College Student Mental Health: Positive Psychology App and Wellness Coaching

Publication Number: 3264.275

Gavin C. Raab, University of Michigan Medical School, Ann Arbor, MI, United States; Michael Reifman, University of Michigan, Upper Saddle River, NJ, 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; Xiao Cao, University of michigan, Ann Arbor, MI, United States; Jaeryeong Kim, University of Michigan Medical School, Ann Arbor, MI, United States; Maxwell J. Kluge, University of Michigan Medical School, Ann Arbor, MI, United States; Skyla A. Shea, University of Michigan Medical School, Ann Arbor, MI, United States; Xinyue Wu, University of Michigan Medical School, Ann Arbor, 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; 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; Tracey Churay, University of Michigan Medical School, Ann Arbor, MI, 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: College is a critical period marked by lifestyle changes and stressors that heighten mental health risk. Positive psychology interventions (PPIs), centered on goal setting, gratitude, and kindness, show promise in enhancing well-being. The Roadmap 2.0 (RM2.0) app incorporates PPIs, tracking mood, steps, and sleep. This multisite randomized controlled trial evaluated the effectiveness of a PPI-based digital app combined with human coaching in improving college students' mental health.

Objective: To assess mental health differences between intervention (RM2.0 + wellness coaching) and control (limited RM2.0 without PPI + wellness coaching) arms.

Design/Methods: In February 2025, students were recruited from the University of Michigan (Ann Arbor, MI ; N=55) and STEER for Student Athletes (Port Chester, NY; N=28). Participants (N=83) were cluster-randomized to intervention (PPI app + coaching; N=42) or control (limited app with no PPI + coaching; N=41) arms. All participants used the app freely, scheduled wellness coaching sessions throughout the 3-month study, and completed four monthly mental health surveys (e.g., PHQ-9, GAD-7, loneliness, flourishing). The app prompted daily mood ratings ("How has your mood been today?" 1=worst possible, 10=best possible).

Results: Mean age was 21 years (range 18-29); most were female (62%), white or Asian (36% each), and non-Hispanic (71%) (Table 1). App engagement remained steady (>60% of days/monthly) in both arms, with the intervention well-received (Table 2). In the intervention arm, the three most used PPIs were: Gratitude Journal, Savoring, and Engaging with Beauty (Figure 1). Across all participants, depression, anxiety, and loneliness scores improved at study exit compared to baseline. While arm-differences were not significant, flourishing scores in the intervention arm trended toward improvement. A linear mixed effects model of mood showed: 1) lower depression, anxiety, and loneliness correlated with higher mood scores (ß=0.22; P< 0.001); 2) younger age was associated with higher mood (ß=-0.08; P=0.02); 3) mood improved over the study duration (ß=0.003; P=0.02); and 4) the intervention arm trended toward higher mood scores (ß=0.38; P=0.07).

Conclusion(s): This pilot RCT demonstrated feasibility and acceptability of combining a digital PPI app with human wellness coaching among college students. Preliminary findings suggest potential mental health and flourishing benefits. Larger trials are needed to further explore intervention efficacy and optimize blended digital-human support models for college wellness.

Table 1. Participant Demographics Table
No significant baseline demographic differences between the intervention and control arms existed.

Table 2. Mobile App Rating Scale of Student Wellness 2.0
Summary of quantitative feedback collected from the exit survey (N=70) regarding the mobile application Roadmap 2.0.

Figure 1. RM 2.0 Activity Upset Plot
Each dot in the figure represents a unique combination of interactions with the positive psychology intervention activities in the Roadmap 2.0 app. For example, the right-most column in the figure shows that 3 participants completed every single activity in the app in contrast to the one participant who completed solely the gratitude journal activity. The bar graph on the left shows the total number of participants that used each activity. From top to bottom: 9, 9, 13, 20, 22, 26, 26, 27.