Effects of an Intervention on University Students' Mental Health and Learning During COVID-19

In March 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19)
as a global pandemic. In France, all universities have been closed on 16th March 2020. In
September 2020, face-to-face teaching restarted in French universities, but with new
constraints (e.g., reducing number of students in classrooms, wearing masks) and significant
changes in teachings (e.g., distance and/or hybrid education). In October 2020, several
French universities closed down again due to significant contamination among students.
Finally, on 30th October 2020, the French government imposed a second lockdown and all
universities have been closed. It is only in February 2021 that face-to-face teaching started
again in French universities (within the limit of 50% of the universities' capacity and 20%
of the teachings).

Since the beginning of the COVID-19, a deterioration in their mental health was observed,
particularly during lockdown, with very high levels of anxiety and depressive symptoms
(Essadek & Rabeyron, 2020; Husky et al., 2020; Le Vigouroux et al., 2021; Odriozola-González
et al., 2020). This may be explained in part by the fact that people who were experiencing
high levels of psychological distress prior to the pandemic are the most vulnerable (Druss,
2020; Yao et al., 2020), and before COVID-19, university students were already identified as
a vulnerable population (see literature review: Paula et al., 2020). Before COVID-19, a
central element of students' psychological distress was their difficulties coping with an
accumulation of hassles, such as university pressure, schedule changes or financial
difficulties (Réveillère et al., 2001). The pandemic confronts students with new and
unprecedented events (e.g., online learning, online examinations, regular and significant
changes to their schedule) that challenge their ability to adapt (Araújo et al., 2020; Zhai &
Du, 2020). Recent research has shown that the more university students used avoidance
strategies during lockdown, the more they had symptoms of anxiety and depression (Dawson &
Golijani-Moghaddam, 2020; Le Vigouroux et al., 2021). In addition, the inability to tolerate
uncertainty in the COVID-19 pandemic can trigger fear of virus (Schimmenti et al., 2020) and
impact negatively on psychological well-being (Satici et al., 2020).

COVID-19 has brought about a digital revolution in higher education (Strielkowski, 2020).
However, distance learning was not without consequences on student stress (IAU, 2020). This
confronts students with new obstacles (e.g., technological, personal, family; Baticulon et
al., 2020). The detrimental effects of distance education, in terms of stress and anxiety,
could also have important consequences for students' learning and academic success. Indeed,
the more depressive and anxiety symptoms learners have, the more their academic difficulties
are exacerbated (Mills & Blankstein, 2000), and the less successful their learning strategies
are (Warr & Downing, 2000). Furthermore, the fear of losing an academic year was the concern
that most exacerbated students' lockdown anxiety (Hasan & Bao, 2020).

The deleterious effects of the pandemic on students' health are now evident. However, some
areas of research are still under-explored.

1. Most of the research is largely descriptive and do not identify the factors involved in
the deterioration in mental health and learning

2. To date, no interventional studies have been conducted to prevent these deteriorations
during the pandemic.

To fill these gaps, our research proposes to evaluate the effects on mental health and
learning of a program focused on stress and learning. Our program has been pre-tested during
the 2019-2020 academic year. It included nine modules (that take place over 9 weeks) composed
of video capsules, with the following themes: stress information, learning information,
emotion and stress regulation strategies, cognitive and metacognitive learning strategies,
motivation for learning, physical activity, diet, sleep, and managing worry and uncertainty.
Particular attention will be paid to the communication tools in order to provide graphic
coherence, facilitating the understanding and appropriation of the different media. Our
program is based on modules from previous online student mental health intervention studies.
It presents, however, two innovative aspects: 1) elements and examples specific to the
COVID-19 pandemic and 2) the addition of modules focused on learning strategies. It is
therefore an original program, designed within the framework of this research, and adapted to
the context of the COVID-19 pandemic (notably concerning the themes of concern, the
stressors, or the distance learning courses). The different modules were designed by five
associate professors: two specialized in cognitive psychology, experts in learning, two
specialized in clinical psychology and cognitive and behavioral therapy, experts in stress
and emotion regulation, and one specialized in health psychology, expert in acceptance and
commitment therapy. Two Master students in clinical psychology and two undergraduate students
in psychology were involved in the process. All the modules are the result of a collaborative
effort between the associate professors who contributed their expertise and the students who
pre-tested the modules and help improve their design to make them attractive to other
students.

For the control group, the videos will be posted every week on a You Tube channel and
broadcast on a private discord group. After each video, an associate professor will invite
the students to share their feelings, comments, or questions, about the videos in this group.
In addition, this researcher will moderate the exchanges. For the hybrid group, student will
have to attend 10 lessons of 2 hours. These courses include the viewing of videos and a time
for discussion between students and the teacher.

Participants were repeatedly reminded that the program was not a substitute for medical
and/or psychotherapeutic care. They were also informed of the services offered by the
university (in particular, preventive medicine and health promotion services) which could
accompany should they need it. Each participant was identified by a code to aggregate the
data between the different measurement times and preserve anonymity. The recruitment was
based on voluntary participation and no compensation was offered to participants. The latter
signed a consent form and were informed that their information will remain anonymous and
their participation was voluntary and could be withdrawn at any time. Measurements are made
before and after the intervention, using an online questionnaire (made on qualtrics secure
software).