Health behaviour interventions to improve mental health outcomes for students in the university setting: a systematic review of randomised controlled trials.

Publisher: BioMed Central Country of Publication: England NLM ID: 101217089 Publication Model: Electronic Cited Medium: Internet ISSN: 1479-5868 (Electronic) Linking ISSN: 14795868 NLM ISO Abbreviation: Int J Behav Nutr Phys Act Subsets: MEDLINE

Original Publication: [London] : BioMed Central, c2004-

Health Behavior* ; Health Promotion*/methods ; Mental Health* ; Students*/psychology; Humans ; Young Adult ; Exercise ; Randomized Controlled Trials as Topic ; Sedentary Behavior ; Universities

Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: Author Melinda Hutchesson is a member of the Editorial Board of International Journal of Behavioral Nutrition and Physical Activity. Melinda Hutchesson was not involved in the journal’s peer review process of, or decisions related to, this manuscript.
Background: University students incur significantly elevated levels of stress compared to the general population and their non-student counterparts. Health risk behaviours are important modifiable determinants for the onset and aggravation of various mental health disorders, in which, university students generally exhibit poor engagement. Thus, this study aims to determine the efficacy of health behaviour interventions in relation to change in health behaviour and mental health outcomes, the impact of interventions (i.e., penetration, fidelity, and implementation), intervention characteristics associated with improved outcomes (efficacy) and the economic evaluation of interventions.
Methods: Six electronic databases were searched for randomised controlled trials (RCT) published from the 1st January 2012 to 11th July 2023. Eligible RCTs included university students, evaluated behavioural interventions targeting health behaviours (i.e. dietary intake, physical activity, sedentary behaviour, alcohol use, substance use, smoking, and sleep) and reported a change in both health behaviour and mental health outcomes.
Results: Twenty-two RCTs met the study inclusion criteria. Overall, only seven studies were effective in improving both health behaviour and mental health outcomes, with most (n = 4) focused on improving sleep behaviours. Insufficient evidence was found regarding intervention impact, intervention characteristics associated with improved outcomes and the economic evaluation of interventions to guide future implementation of health behaviour interventions in universities due to inadequate reporting of outcomes.
Conclusions: There is limited evidence regarding the efficacy of health behaviour interventions in improving both health behaviour and mental health outcomes. There is also insufficient evidence regarding intervention impact, intervention characteristics associated with improved outcomes and economic evaluation to guide the implementation of these interventions in the university setting.
(© 2025. The Author(s).)

Implement Sci. 2022 Feb 8;17(1):16. (PMID: 35135566)
Ann Behav Med. 2010 Aug;40(1):49-64. (PMID: 20652464)
JMIR Mhealth Uhealth. 2019 Jun 25;7(6):e14273. (PMID: 31237569)
Int J Behav Nutr Phys Act. 2025 Mar 11;22(1):32. (PMID: 40069770)
BMC Fam Pract. 2016 Aug 04;17:104. (PMID: 27488823)
Transl Psychiatry. 2020 Jan 22;10(1):26. (PMID: 32066686)
Health Educ Res. 2002 Oct;17(5):670-9. (PMID: 12408211)
J Clin Sleep Med. 2018 Mar 15;14(3):337-347. (PMID: 29510791)
World Psychiatry. 2020 Oct;19(3):360-380. (PMID: 32931092)
J Consult Clin Psychol. 2019 Jul;87(7):657-669. (PMID: 31070386)
Front Public Health. 2018 May 07;6:120. (PMID: 29868535)
J Am Coll Health. 2025 Jan;73(1):111-123. (PMID: 37105759)
Nutrients. 2019 Apr 23;11(4):. (PMID: 31018565)
Nutrients. 2021 Jan 28;13(2):. (PMID: 33525585)
World J Biol Psychiatry. 2023 Jun;24(5):333-386. (PMID: 36202135)
Int J Environ Res Public Health. 2021 Dec 24;19(1):. (PMID: 35010445)
Pilot Feasibility Stud. 2020 Oct 31;6(1):167. (PMID: 33292770)
Int J Environ Res Public Health. 2013 May 21;10(5):2043-57. (PMID: 23698697)
Health Policy. 2009 Dec;93(2-3):85-92. (PMID: 19709773)
J Acad Nutr Diet. 2021 Dec;121(12):2377-2388. (PMID: 34427188)
Sleep Med Rev. 2018 Aug;40:160-169. (PMID: 29397329)
Proc Natl Acad Sci U S A. 2005 Dec 20;102(51):18757-62. (PMID: 16339311)
Exp Clin Psychopharmacol. 2020 Apr;28(2):143-149. (PMID: 31204824)
BMJ. 2021 Mar 29;372:n71. (PMID: 33782057)
J Med Internet Res. 2022 Jan 26;24(1):e30566. (PMID: 35080497)
JMIR Mhealth Uhealth. 2020 Mar 18;8(3):e17046. (PMID: 32186518)
Public Health Nutr. 2021 Dec;24(17):5686-5703. (PMID: 33722332)
J Consult Clin Psychol. 2012 Oct;80(5):876-86. (PMID: 22663899)
Int J Behav Med. 2022 Jun;29(3):346-356. (PMID: 34432263)
J Am Coll Health. 2020 Aug-Sep;68(6):587-592. (PMID: 30849021)
J Abnorm Psychol. 2018 Oct;127(7):623-638. (PMID: 30211576)
Behav Res Ther. 2021 Jun;141:103847. (PMID: 33813352)
J Nutr Educ Behav. 2014 Nov-Dec;46(6):S27-41. (PMID: 25457733)
Prev Med Rep. 2018 Jul 30;11:274-281. (PMID: 30116698)
BMJ. 2022 Jul 20;378:o1557. (PMID: 35858703)
J Med Internet Res. 2017 Apr 10;19(4):e106. (PMID: 28396306)
Appl Health Econ Health Policy. 2024 Mar;22(2):165-179. (PMID: 38190019)
Am Psychol. 1999 Oct;54(10):817-20. (PMID: 10540594)
BMJ. 2014 Mar 07;348:g1687. (PMID: 24609605)
Prev Med. 2014 Jul;64:121-5. (PMID: 24704131)
Public Health. 2019 Apr;169:101-113. (PMID: 30877961)
Lancet Psychiatry. 2017 Oct;4(10):749-758. (PMID: 28888927)
Curr Opin Psychiatry. 2007 Jul;20(4):359-64. (PMID: 17551351)
Nutrients. 2023 Mar 04;15(5):. (PMID: 36904282)
Obes Rev. 2021 Apr;22(4):e13150. (PMID: 33103340)
Obes Rev. 2019 Jul;20(7):1045-1056. (PMID: 30942550)
BMJ. 2011 Oct 18;343:d5928. (PMID: 22008217)
Behav Ther. 2014 May;45(3):376-89. (PMID: 24680232)
Health Promot Chronic Dis Prev Can. 2016 Aug;36(8):163-70. (PMID: 27556920)
JMIR Mhealth Uhealth. 2017 May 17;5(5):e67. (PMID: 28526664)
Int J Environ Res Public Health. 2020 Mar 09;17(5):. (PMID: 32182922)
Am J Health Promot. 2012 Nov-Dec;27(2):e47-58. (PMID: 23113786)
Prev Med. 2015 Jul;76 Suppl:S68-75. (PMID: 25511466)
J Sleep Res. 2022 Apr;31(2):e13493. (PMID: 34549852)
Clin Psychol Rev. 2001 Feb;21(1):33-61. (PMID: 11148895)
J Am Coll Health. 2016 Nov-Dec;64(8):630-638. (PMID: 27471879)
Aust N Z J Psychiatry. 2021 Jan;55(1):7-117. (PMID: 33353391)
Prev Sci. 2009 Dec;10(4):376-86. (PMID: 19499339)

Faculty of Health and Medicine, University of Newcastle Australia Faculty of Health and Medicine, University of Newcastle Australia

Keywords: Diet; Exercise (MeSH); Health behaviour (MeSH); Mental health; Sedentary behaviour (MeSH); Sleep (MeSH); Systematic review; University student

Date Created: 20250312 Date Completed: 20250312 Latest Revision: 20250529

20250530

PMC11900387

10.1186/s12966-025-01718-7

40069770