Student Health and Lifestyle Survey

Student Health and Lifestyle Survey 2015 Healthy University Project University of Edinburgh 1 Contents 1 Abstract 3 2 Introduction 2.1 About the University of Edinburgh 2.2 Aim of the Healthy University project 2.3 Aim of the student Health and Lifestyle Survey 2.4 Methodology 2.4.1 Sample and data collection 2.4.2 Questionnaire design 3 3 4 5 6 6 6 3 Results 3.1 Demographics 3.2 Physical activity 3.3 Diet 3.4 Sleep 3.5 Sexual health 3.6 Alcohol 3.7 Tobacco 3.8 Drugs 3.9 Mental health 7 8 13 16 19 20 22 26 28 30 4 Discussion 32 5 Comparative study 35 6 Recommendations and Future Research 39 7 Limitations of the study 41 8 Appendix: Student Health and Lifestyle Questionnaire 42 9 References 53 2 Healthy University Research Project ABSTRACT: This report presents findings on a small-scale evaluation of the health and lifestyle of students at the University of Edinburgh. The purpose of the study was to assess a range of self-reported health behaviours and lifestyle characteristics of undergraduate and postgraduate research students. In addition, data extracted from the survey were compared with those of the general adult population in Scotland in accordance with the latest Scottish Health Survey (2014). An online questionnaire provided demographic information as well as patterns and behaviours in regards to the physical activity, diet, sleep, sexual health, alcohol consumption, smoking, drug usage and mental health of the students. Results appeared overall encouraging, however areas where interventions and further areas of research were required, were revealed by the study. The most encouraging results on students choices and habits were reported in regard to sleep, smoking and mental health, while interventions are proposed for the areas of physical activity, diet, sexual health, alcohol consumption and drugs. Keywords: university students, health and lifestyle, health survey, physical activity, alcohol, smoking. 2.0 Introduction 2.1 The University of Edinburgh The University of Edinburgh was founded in 1582 and is one of the oldest Scottish Universities. The University employs over 12,000 staff in a variety of academic and support roles across the institution. The University of Edinburgh's academic structure is based on three Colleges (Humanities & Social Science; Medicine & Veterinary Medicine; Science and Engineering) containing a total of 22 Schools that provide taught and research programmes to approximately 30,000 students each year. 3 The sixth Equality and Diversity Monitoring and Research Committee (EDMARC) report provides yearly analyses of student and staff of the University. According to the report, 61.7% of undergraduate (UG) entrants were female in 2013/14. There remain gender differences between Colleges (linked to subject differences) with both the College of Humanities and Social Sciences and the College of Medicine and Veterinary Medicine consistently having more female UG entrants and the College of Science and Engineering having more male. The large majority (81%) of UG entrants continue to be 21 or under on entry. The proportion of undergraduate students with a registered disability continues to rise and is 10.0%. According to the mid-year student factsheet produced January 2015, by Governance and Strategic Planning, 90% of UG students were full-time and 10% part-time, while 40% came from Scotland, 30% from the UK, 10% from the EU and 20% from Overseas. Regarding postgraduate taught (PGT) students, female entrants outnumber men with 62.3% being female in 2013/14. This is the highest level recorded by EDMARC. Subject differences remain at postgraduate taught level, with the College of Humanities and Social Science attracting the highest proportion of female entrants. According to the mid-year student factsheet, 60% of PGT students in 2015 studied full-time and 40% part-time. At the same time 25% of students were from Scotland, 15% from the rest of the UK, 10% from the EU and 50% from Overseas. For postgraduate research (PGR) entrants the proportion of male student outnumbers female ones, with 50.4% of entrants in 2013/2014 being male, while the College of Science and Engineering attracts more male entrants than the other two Schools. According to the mid-year student factsheet, 60% of PGR students studied full-time in 2015, while 40% studies part time. Furthermore, 30% of postgraduate research students came from Scotland, 20% from the UK, 20% from the EU and 30% from Overseas. 2.2 About the Healthy University Project The research described in this report was conducted as part of the Healthy University Project (HUP), which was funded for 14 months (May 2014 – July 2015) by the Student Experience Project and hosted by Sport & Exercise. The project aims to actively promote and deliver tangible health and wellbeing benefits for the University community with a particular focus on students’ health. With such a short period of funding, it was clear that there was a need to 4 identify what the health issues for students are, to identify what services, facilities, support mechanisms and opportunities to improve heath are already in place, and to identify and begin to address some of the gaps. 2.3 Aim of the Health and Lifestyle Survey A number of opportunities were created by the Healthy University Project team over the course of the 14 months to actively engage with students to hear their views of what the health issues are and to listen to their vision of what a healthy university could look and feel like to be part of. The aim of this particular study was to get a representative sample of University of Edinburgh students to anonymously self-report on their lifestyle behaviours across a range of topics. Data extracted and analysed from the study provided parameters that, in addition to ongoing engagement with students, would inform priorities for the future work of the Healthy University Project. A PHD Student intern was recruited to carry out this research. The main responsibility of this post was to undertake a time-limited piece of research that will provide the HUP and key stakeholders with a baseline measure of students' current health and lifestyle. The brief was to: 1. propose a methodology for the research that will ensure a good sample of students from diverse backgrounds is achieved. 2. ensure that the selection of existing measurement questionnaires are adapted and therefore fit for use and appropriate for Edinburgh. 3. undertake the research with an agreed number of students (both undergraduate and postgraduate). 4. analyse the results of the questionnaire and provide recommendations. 5. provide a written report with findings from the research. The outcomes of the Lifestyle Survey, as well as the design and data gathering and analysis methodologies employed for the study, are discussed further in the following sections of this report. 5 2.4 Methodology 2.4.1 Sample and Data Collection Survey participants were recruited using stratified sampling, with the total number of students being invited to participate being 8187. The participation invitation method was via e-mail, sent to the student population. The e-mail invitation included a clickable link, redirecting to the survey questionnaire. The survey was developed using SurveyMonkey, an online cloudbased survey development tool. SurveyMonkey is the official tool used by the Student Experience team to develop surveys targeted at Edinburgh University students. A total of 1189 University students participated in the study (15% response rate) during the spring semester of the academic year 2014/2015 (end of April to end of May 2015). The population invited to take part in the survey was 1:3 undergraduate students (inclusive of final year) and 1:3 postgraduate research students of the University of Edinburgh. Postgraduate taught students were not surveyed on this occasion due to clashes with other surveys running during the same time period (see Limitations of the Study). 2.4.2 Questionnaire Design Edinburgh University students were asked to complete an online questionnaire designed to assess their health and lifestyle habits. The final questionnaire was adapted from other student health and lifestyle surveys conducted in Higher Education institutions in the UK and was also informed by the Scottish Health Survey. Existing measurement questionnaires were therefore adapted to be made fit for purpose for Edinburgh University. Furthermore, NHS Health Scotland subject experts undertook a review of the final version of the questionnaire for accuracy and clarity. Feedback on the questionnaire was also requested from representatives of the key stakeholders of the HUP including the Student Counselling Service, Student Accommodation Services (Residence Life), EUSA and the Sports Union. Once the questions had been finalised, the questionnaire passed through the University’s ethics committee to get approval for the protection of human subjects. Approval was granted and the survey was developed as an on-line questionnaire and distributed to students. 6 The final survey featured 48 questions divided into nine sections. The first section (nine questions), asked for demographic data. The second section (five questions), asked participants about their physical activity. The third section (four questions), asked about dietary habits. The fourth section (two questions), was targeted on sleeping habits. The fifth section (five questions), asked participants about their sexual health and sexual behaviour. The sixth section (ten questions), was targeted on alcohol consumption. The seventh section (six questions), asked participants about their smoking habits. The eighth section (four questions), asked about drug usage. Finally the ninth section (three questions), was focused on mental health and wellbeing. The survey took approximately 15 minutes to complete. Incentives were provided as motivators for student participation. At the end of the survey questionnaire, each student was able to provide his/her student number to participate in a random prize draw if they so wished. Student numbers provided were however not in any way linked to previously provided answers, thus the identity of the student could not be tracked. This way anonymity was ensured. Prizes provided for students included fifty, £25 vouchers and two gym memberships. Fifty-two winners were thus selected from the students participating in the prize draw. 3.0 Results Considering the number of students who participated in the study against the overall student population, the results of the study appear to be overall representative. Respondent rates between undergraduate and postgraduate students, schools and age ranges are representative of the student population. Part-time students responding are however underrepresented in the sample, since the participation percentage was 16% instead of the optimum 25%. It is also important to note that due to the nature of the questions, students were given the option to opt out of answering each of the survey sections. Overall the results of the study were encouraging; however, there are areas which suggest a need for interventions. Most students self-evaluated their physical health as good or very good. The majority indicated that they were active for the recommended amount of minutes, but not days per week. At the same time they self-evaluated their diet as healthy or average, with a 7 small percentage indicating an unhealthy or very unhealthy diet. The vast majority had breakfast most days of the week, however approximately one fourth of all respondents consumed the recommended ‘5 a day’ portions of fruit and vegetables per day. Finally the majority of students slept an average of 7-8 hours per night. Most students were sexually active, and the majority practised safe sex. The vast majority of respondents consumed alcoholic drinks. The average amongst participating students was 8 units per week, however 50% of students drank more than the recommended amount on a typical day when they are drinking. Pre-loading appeared common among students with a considerable percentage indicating that they always drink alcohol at home, before going out. When asked about their smoking habits, the majority of students said that they never smoked, while of those who smoked more than half said that they would like to quit. Similarly, the majority of students said that they never used drugs. Finally, most of the respondents selfevaluated their mental health as good or very good. Detailed percentages and graphs regarding the above-identified trends are presented below. Results have been extracted and compiled from the statistical analysis of the collected survey responses. 3.1 Demographics The first section of the survey asked about demographic information. A total of 1189 University students participated in the study. 993 of them were undergraduate representing 84% of respondents, while 196 were postgraduate research students, representing 16%. Based on data from the University Student Factsheet 2013-2014, produced by Governance and Strategic Planning, a minimum of 240 UG students and 160 PGR students was required for a representative sample, thus students are represented for both groups. 8 Q1: Are you an undergraduate or postgraduate student? Undergraduate Postgraduate Research 84% 16% Figure 1: Rates of undergraduate and postgraduate research students. Out of the three Colleges of the University, the College of Humanities and Social Sciences was the most represented at 54%, followed by the College of Science and Engineering at 30% and the College of medicine and Veterinary Medicine at 30%. Based on data from the University Student Factsheet 2013-2014, produced by Governance and Strategic Planning, a percentage of 55% of respondents from the School of Humanities and Social Sciences, 16% from the School of Medicine and Veterinary Medicine and 29% from the School of Science and Engineering was required for an accurate sampling. It therefore appears that results are representative in relation to Schools’ representation. Q2: Which University of Edinburgh College do you study in? Science & Engineering Medicine & Veterinary Medicine 30% 16% Humanities and Social Sciences 54% Figure 2: School representation among participants. The vast majority of respondents were full-time students, while part time students were slightly underrepresented in the study. 1168 respondents were full time students (98%), while 21 were 9 part time students (2%). In regard to sampling an optimum ration of 75:25 was required for accurate representation. It therefore appears that part-time students were underrepresented in the study. Q3: What is your mode of study? Full-time Part-time 98% 2% Figure 3: Characteristics of participants regarding mode of study. Out of the total number of respondents, 809 were female representing a majority of 68%, while 374 were male representing 31% of participating students, while a small number of 6 selfidentified as transgender, representing 1%. Based on data from the University Student Factsheet 2013-2014, produced by Governance and Strategic Planning, 56% of female students and 44% of male was required for accurate representation. It therefore appears that male students are slightly underrepresented in the results. Q4: What is your gender? Male 31% Female Transgender 68% 1% Figure 4: Characteristics of participants regarding gender. 10 In regard to age ranges, the majority of respondents were between 18-20 years old (47%), followed by the 21-24 age group (36%) and the 25 or over group (17%). A very small percentage of the 17 or under age group was represented (0,2%). Q5: What is your age? 17 or under 0.2% 18-20 47% 21-24 36% 25 or over 17% Figure 5: Characteristics of participants regarding age. 1118 of respondents self-identified as not being disabled, representing 94% of respondents, while 50 self-identified as a disabled person, representing 4%. An additional 2% indicated they preferred not to say. According to the Equality and Diversity Monitoring and Research Committee (EDMARC) report for 2014/2015, 8% of the total student population self-identifies as a disabled person. It therefore appears that disabled students are slightly underrepresented in the survey results. Q6: Would you describe yourself as a disabled person? Yes 4% No Prefer not to say 94% 2% Figure 6: Characteristics of participants regarding disability. 11 In regard to sexuality, 83% of students responded they self-identified as heterosexual, 6% bisexual, 3% gay and 1% lesbian, while 3% indicated they were not sure and 4% preferred not to say. Data on the sexuality of the student population were not available. Similarly, there are currently no national statistics at population level in Scotland or the UK, so it is impossible to say whether the population is representative of the student population in this respect. Q7: How would you identify your sexuality? Heterosexual 83% Bisexual 6% Prefer not to say 4% Not sure 3% Gay 3% Lesbian 1% Figure 7: Characteristics of participants regarding sexuality. In regard to domicile on entry, 37% of respondents came from Scotland, 29% from another UK location, 17% from the European Union, 16% from overseas and 1% from the Channel Islands and Isle of Man. Based on data from the University Student Factsheet 2013-2014, produced by Governance and Strategic Planning, a minimum of 152 students from Scotland, 92 students from the UK, 52 students from the EU and 104 students from Overseas were required for a representative sample. Students are represented for all domiciles on entry, since the numbers of students participating were 435 (Scotland), 348 (UK), 207 (EU), 193 (Overseas) and 6 (Channel Island and Isle of Man). Q8: What is your domicile on entry? Scotland 37% Other UK 29% EU 17% Overseas Channel Islands and… 16% 1% 12 Figure 8: Characteristics of participants regarding domicile on entry. The majority of respondents lived outside student accommodation (73%), in comparison to those living in student accommodation (27%). Q9: Do you live in University Accommodation? Yes No 27% 73% Figure 9: Characteristics of participants regarding accommodation. 3.2 Physical Activity The next section of the survey examined students’ physical activity. Students were allowed to opt out from completing this section. 97% chose to complete the section, while 3% opted out. Results on respondents’ general physical health were encouraging. 84% of students self-rated their physical health as good (43%), very good (31%), or excellent (10%) while 13% rated it as fair (13%) or poor (3%). 13 Q10: How would you rate your general physical health? Excellent 10% Very Good 31% Good 43% Fair Poor 13% 3% Figure 10: Response to physical health self-evaluation question. Guidelines published by the four UK chief medical officers (2011) recommend that adults should aim to be active daily. Over a week, activity should add up to at least 150 minutes of moderate intensity activity in bouts of 10 minutes or more – one way to approach this is to do 30 minutes on at least 5 days a week. When asked how many days over the past week they had been active for a total of 30 minutes of more, 42% of students responded for 3-4 days, 29% for 0-2 days and 29% for 5 or more days. Q11: In the past week, on how many days have you been physically active for a total of 30 minutes or more? 0-2 days 29% 3-4 days 5 or more 42% 29% Figure 11: Response to physical activity frequency over the past week question. For those who reported being physically active for 4 days or less, a question followed asking whether they had been active for at least two and a half hours (150 minutes) over the past week. 62% responded positively, and 38% negatively. 14 Q12: If 4 days or less, have you been physically active for at least two and a half hours (150 minutes) over the course of the past week? Yes No 62% 38% Figure 12: Response to physical activity time over the past week question. Encouraging was the fact that the majority of students indicated being more physically active since attending the University of Edinburgh. 43% said they were more physically active, 36% said they were less physically active and 21% reported no change. Q13: Have you been more physically active since you started attending University of Edinburgh? More active 43% Less active No change 36% 21% Figure 13: Response to willingness to be more physically active question. Also encouraging was the fact that 89% of students indicated they would like to be more physically active, in contrast to 11% who would not. 15 Q14: Would you like to be more physically active? Yes No 89% 11% Figure 14: Response to physical activity time over the past week question. Whilst only 29% of students are meeting the health recommendation of 30 minutes of physical activity most days of the week, it is encouraging that a further 62% are active for 150 minutes. It therefore appears that the majority of students are meeting the recommended activity time for adults but not the frequency. 3.3 Diet The next section of the survey was focused on dietary habits. In total, 97% of students chose to complete the section, while 3% opted out. When students were asked to assess how healthy they thought their diet was, only 7% of students considered their diet to be unhealthy (6%) or very unhealthy (1%) with the vast majority of students perceiving their diet to be average (42%), healthy (45%) or very healthy (6%). 16 Q15: How healthy do you consider your diet to be? Very Healthy 6% Healthy 45% Average 42% Unhealthy Very unhealthy 6% 1% Figure 15: Response to healthy diet self-evaluation question. Breakfast is considered a good indicator of a healthy diet. A majority of 84% of students indicated that they had breakfast most days of the week in comparison to 16% who did not. Q16: Do you have breakfast most days of the week? Yes No 84% 16% Figure 16: Response to breakfast intake frequency question. The World Health Organisation recommends ‘5 a day’ in regard to fruit and vegetables intake, which is equivalent to eating a minimum of 400g of fruit and vegetables a day to lower the risks of serious problems such as heart disease, stroke, type 2 diabetes and obesity. When asked how many portions of fruit and vegetables they eat in a typical day, 28% of students responded three portions, 20% four portions, 16% two portions, 15% five portions, 11% six or more, 8% one and 1% zero portions. Only 26% of students thus met the ‘5 a day’ recommendation. 17 Q17: How many portions of fruit and vegetables do you eat in a typical day? 0 1% 1 9% 2 16% 3 28% 4 20% 5 15% 6 or more 11% Figure 17: Response to daily portions of fruit and vegetables intake question. Finally, students were asked to indicate how many 200ml glasses of fluids such as water, milk, fruit juices, tea and coffee they consumed on an average day. 30% answered 5-6, 23% answered 7-8, 21% answered 3-4, 11% answered 9-10, 10% answered more than 10 and 5% answered 1-2. The European Food Safety Authority recommends that women should drink about 1.6 litres of fluid and men should drink about 2.0 litres of fluid per day. This translates to about eight glasses of 200ml each for women and 10 glasses of 200ml each for a man. Results therefore show that 44% of students comply with this recommendation. Q18: How many 200ml glasses of fluids do you drink on an average day? 1 to 2 5% 3 to 4 21% 5 to 6 30% 7 to 8 9 to 10 More than 10 23% 11% 10% Figure 18: Response to the number of glasses of fluid intake question. 18 3.4 Sleep The next section of the survey focused on sleeping habits. In total, 99% of students chose to complete the section, while 1% did not. The majority of respondents indicated that they slept well (42%), followed by those who indicated average (27%), very well (18%), badly (11%) and very badly (2%). Q19: How well do you sleep? Very well 18% Well 42% Average 27% Badly Very badly 11% 2% Figure 19: Response to sleep quality self-evaluation question. Furthermore, 66% slept for 7-8 hours, 17% slept for 4-6, 14% slept 9-10 hours, 2% slept for more than 10 and 1% less than 4 hours. According to the Director of the Clinical Sleep Research Unit at Loughborough University: ‘Most adults need between 6 and 9 hours of sleep each night. Simply put, you need enough to make you refreshed and able to function efficiently the next day’. It therefore appears as though the majority of Edinburgh University students sleep the recommended number of hours per night. 19 Q20: How many hours of sleep do you get on an average night? Less than 4 1% 4 to 6 17% 7 to 8 66% 9 to 10 More than 10 14% 2% Figure 21: Response to average number of hours of sleep question. 3.5 Sexual Health The next section of the survey examined sexual health. In total, 92% of students chose to complete the section, while 8% opted out. Initially students were asked whether they were or had ever been sexually active. 81% responded positively and 19% negatively. Q22: Are you (or have you ever been) sexually active? Yes No 81% 19% Figure 22: Response to sexual activity question. Furthermore, from those who had previously been sexually active only 67% indicated that they practised safe sex, 14% did not and 19% did occasionally. Safe sex means taking steps to reduce the risk of unwanted pregnancy or sexually transmitted infections (STI’s). 20 Q23: Do you practice safe sex to avoid sexually transmitted infections (e.g. condoms)? Yes No Sometimes 67% 14% 19% Figure 23: Response to safe sex practice question. The two most popular contraception methods used by students, were the combined pill at 41% and the condom at 39%, followed by the less popular long acting method (e.g. injection, implant, coil) at 12% and not using any method at 7%, while other methods such as Femidom, emergency contraception and permanent methods shared the final 1% of respondents. Students were also asked whether they had ever been tested for a sexually transmitted infection (STI). 49% of students reported having being tested, while 51% responded they had never been tested. Q24: Have you ever been tested for a Sexually Transmitted Infection (STI)/HIV? Yes No 51% 49% Figure 24: Response to STI/HIV testing question. Finally, amongst those who had been tested 93% had not been diagnosed with an STI. From those who had, the most common was Chlamydia at 4%, followed by Genital Warts 1.5% and Genital Herpes at 1%. 21 3.6 Alcohol Consumption The next section of the survey looked into alcohol consumption amongst students. In total, 98% of students chose to complete the section, while 2% opted out. The majority of students indicated that they did drink alcohol (87%), in comparison to those who did not (13%). Q25: Do you consume alcoholic drinks? Yes No 87% 13% Figure 25: Response to alcoholic drinks consumption question. Students who did drink alcohol were then asked to indicate the average number of alcohol units they thought they consumed per week. The average amongst those who responded was 8 units per week. Then they were asked about the number of alcohol units they consumed on a typical day when they were drinking. The majority indicated 3-4 units (28%), followed by those who said 5-6 (24%) and 1-2 (22%), while less common responses were 7-8 (12%), more than 10 (8%) and 9-10 (6%). Chief Medical Officers in the UK agree that men should drink no more than 21 units of alcohol a week and that women should have no more than 14 units. Additionally, to protect against the risks of alcohol, drinking should be spaced over the week, so men should drink no more than 3 to 4 units a day and women 2 to 3 units. 50% of students therefore drink more than the recommended amount on a typical day when they are drinking. 22 Q26: How many units of alcohol do you drink on a typical day when you are drinking? 1 to 2 22% 3 to 4 28% 5 to 6 24% 7 to 8 12% 9 to 10 6% More than 10 8% Figure 26: Response to number of drinks on typical drinking day question. The following question asked respondents how often they have had more than 6 (if female) or more than 8 (if male), alcohol units on a single occasion. The majority responded less than monthly (37%), then monthly (32%), weekly (20%) and never (10%), while only 1% responded daily or almost daily. Q27: How often have you had 6 (if female) / 8 (if male) or more alcohol units on a single occasion? Never 10% Less than monthly 37% Monthly 32% Weekly Daily or almost daily 20% 1% Figure 27: Response to number of alcohol units per single occasion question. Interestingly, the majority of students said that they always drink alcohol at home (pre-load) before going out (40%), in comparison to those who said they sometimes did (43%) and those who never did (17%). 23 Q28: Would you say you drink alcohol at home (pre-load) before going out? Always 40% Sometimes 43% Never 17% Figure 28: Response to pre-loading question. When asked to indicate how many alcohol units they consumed on a typical occasion of preloading before going out, most students said 3-4 (25%), followed by those who said 5-6 (23%), 1-2 (19%), 0 (14%), 7-9 (11%), and more than 10 (6%). The questionnaire moved on to ask how often respondents have had a feeling of regret of guilt after drinking, while being students at Edinburgh University. Most responded less than monthly (45%), never (33%) or monthly (17%), followed by those who responded weekly (4.5%) or daily/almost daily (0.5%). Worryingly, this means that 22% of students who drink are having feelings of regret or guilt monthly or more frequently. Q29: How often whilst being a student at University of Edinburgh, have you had a feeling of regret or guilt after drinking? Daily or almost daily Weekly Monthly 0.5% 4.5% 17% Less than monthly Never 45% 33% Figure 29: Response to feeling of regret after drinking question. 24 Following from the previous question, students were asked how often, while a student at Edinburgh University, they had been unable to remember what happened the night before because they had been drinking. 49.5% responded never, 37% less than monthly, 11% monthly, 2% weekly and 0.5% daily or almost daily. Q30: How often whilst being a student at University of Edinburgh, have you been unable to remember what happened the night before because you had been drinking? Daily or almost daily 0.5% Weekly 2% Monthly 11% Less than monthly 37% Never 49.5% Figure 30: Response to inability to remember because of drinking question. Furthermore, students were asked how often, while a student at Edinburgh University, they had failed to do what was normally expected of them because they had been drinking. 56% responded never, 32% less than monthly, 10% monthly, 2% weekly and 0.2% daily or almost daily. Q31: How often whilst being a student at University of Edinburgh, have you failed to do what was normally expected of you because you had been drinking? Daily or almost daily 0.2% Weekly 2% Monthly Less than monthly Never 10% 32% 56% Figure 31: Response to inability to cope because of drinking question. 25 Finally students were asked whether they would like to drink less alcohol. 19% responded yes, while 81% responded no. 3.7 Tobacco The following section of the survey examined the smoking habits of Edinburgh University students. In total, 95% of students chose to complete the section, while 5% opted out. Respondents’ smoking behaviour appeared to be largely positive. The majority indicated that they had never smoked (71%), while some of them said that they used to smoke but they have now given up (12%), that they smoke but not every day (11%) or that they smoked every day (6%). Q32: Which of the following best describes you? I have never smoked 71% I used to smoke but I have now given up 12% I smoke but not everyday 11% I smoke everyday 6% Figure 32: Response to general smoking habits question. Of the 17% of students who said they smoked, 40% said that smoked every day or nearly every day, 27% once a month, 14% three times a week, 10% once a fortnight, 6% once a week and 3% twice a week. 26 Q33: How often do you smoke? Once a month 27% Once a fortnight 10% Once a week 6% Twice a week 3% Three times a week 14% Everyday or nearly everyday 40% Figure 33: Response to frequency of smoking question. Furthermore, 32% had smoked more than 10 cigarettes over the past week, 11% had smoked 1-2 cigarettes, 9% 5-6 cigarettes, 6% 9-10 cigarettes, 6% 3-4 cigarettes, 3% 7-8 cigarettes and 32% indicated they had smoked zero cigarettes over the past week. Q34: How many cigarettes have you smoked over the past week? O 33% 1 to 2 3 to 4 11% 6% 5 to 6 7 to 8 9 to 10 More than 10 9% 3% 6% 32% Figure 34: Response to number of cigarettes smoked over the past week question. When asked what they smoked, most respondents said cigarettes (51%) and roll-ups (42%), followed by those who said pipe tobacco (3%), shisha (narghile) (3%), cigars (0.5%) and ecigarettes (0.5%). Respondents were then asked whether they had started smoking or had been smoking more since attending Edinburgh University. 52% responded no, while 48% responded yes. The final 27 question of the section, asked whether respondents would like to give up smoking. Results were encouraging, since 54% responded positively and 46% negatively. Q35: Would you like to give up smoking? Yes No 54% 46% Figure 35: Response to aspiration to give up smoking question. 3.8 Drugs The next section of the survey examined drug usage amongst students. In total, 94% of students chose to complete the section, while 6% opted out. Positive was the fact that the majority of respondents indicated that they had never used drugs (74%), followed by those who said that use drugs but not every day (15%) and those who used to use drugs but they have now given up (11%). Only 2 respondents said that they use drugs every day (0.18%). Q36: Which of the following best describes you? I use drugs everyday I use drugs but not everyday I used to use drugs but I have now given up 0.18% 15% 11% I have never used drugs 74% Figure 36: Response to general drug usage habits question. 28 Of the 15% of students who said that they used drugs, they were then asked to indicate the types of drugs they used. A detailed report on the types of drugs students used and the frequency of usage can be seen on the following table. The most commonly used drug in the last year appeared to be MDMA and Marijuana/Cannabis, followed by Ecstasy and Caffeine Tablets. On the other hand, none of the students responding had ever used Heroin or Crystal Meth. Ever Used 76% 90% 56% 34% 41% 28% 16% 30% 0% 34% 2% 65% 0% 2% 2% 17% 52% 12% 30% MDMA Marijuana/Cannabis Cocaine Ketamine Magic Mushrooms LSD Benzodiazepines Poppers Heroin Amphetamines Crack Cocaine Ecstasy Crystal Meth GHB Anabolic Steroids 2CB Caffeine Tablets Mephedrone Prescribed Medication Used in the Last Year 67% 65% 51% 31% 41% 28% 16% 28% 29% 58% 17% 38% 12% 26% Used in the Last Week 9% 25% 5% 3% 2% 5% 2% 7% 2% 2% 14% 4% Table 1: Types of drugs and frequency of usage. Students who said they used drugs were then asked to answer the next question on legal highs and/or new psychoactive substances (NPS) they thought they had taken. The most commonly used legal high used in the last year was Laughing Gas, followed by Sleeping Pills and Herbal Highs. Detailed results can be seen on the following table. Herbal Highs Party Pills Synthetic Cocaine Synthetic Cannabis Herbal Ecstasy NBOMes Bath Salts Plant Fertilizers Herbal Incense Special Teas Drug Analogues Research Chemicals Laughing Gas Sleeping pills/tranquillisers Ever Used 18% 13% 10% 15% 0% 2% 8% 2% 0% 4% 7% 4% 48% 28% Used in the Last Year 17% 13% 10% 13% 2% 8% 2% 4% 7% 4% 48% 28% Used in the Last Week 1% 2% 3% Table 2: Types of legal highs or NPS and frequency of use. 29 3.9 Mental Health The next section of the survey was focused on mental health. In total, 96% of students chose to complete the section, while 4% opted out. When asked to self-evaluate their general mental health, 35% of students indicated it was very good, 24% said it was good, 20% excellent, 16% fair and 5% poor. Q37: How would you rate your general mental health? Poor Fair Good 5% 16% 24% Very Good Excellent 35% 20% Figure 37: Response to self-evaluation on general mental health question. To further evaluate mental health, the WEMWBS scale was used for the following question. Researchers at the University of Warwick and the University of Edinburgh developed the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), which was used as a tested tool to allow the measurement of students’ mental health. The same tool was used for the same purpose in the Scottish Health Survey. This scale in made up of fourteen (14) positively worded sentences designed to assess positive effects and functioning with a five item scale ranging from ‘1 - None of the Time’ to ‘5 - All of the time’. A detailed report of the results can be seen on the following table: 30 I’ve been feeling optimistic about the future I’ve been feeling useful I’ve been feeling relaxed I’ve been feeling interested in other people I’ve had energy to spare I’ve been dealing with problems well I’ve been thinking clearly I’ve been feeling good about myself I’ve been feeling close to other people I’ve been feeling confident I’ve been able to make up my own mind about things I’ve been feeling loved I’ve been interested in new things I’ve been feeling cheerful None of the Time 2% 2% 3% 1% 4% 2% 2% 4% 2% 4% 2% 2% 3% 2% Rarely 8% 11% 20% 6% 18% 10% 8% 14% 12% 16% 8% 7% 9% 9% Some of the Time 29% 31% 37% 26% 36% 34% 28% 34% 27% 33% 24% 23% 24% 32% Often All of the Time 13% 10% 6% 19% 7% 9% 18% 9% 17% 9% 21% 28% 21% 11% 49% 46% 33% 48% 35% 44% 50% 39% 41% 38% 45% 39% 44% 46% Table 3: WEMWBS scale results. The final question, asked respondents whether since being a student at the University of Edinburgh they had ever had an emotional or mental health difficulty that had affected their lives or studies. The majority responded that they had not (57%), however a considerable amount of students responded that they had (43%). Q38: Since being at University of Edinburgh, have you ever had an emotional/mental health difficulty that has affected your life/studies? Yes No 43% 57% Figure 38: Response to possible emotional/mental difficulty affecting life/studies question. 31 4.0 Discussion The results of the study appeared encouraging, while some positive health and lifestyle choices were reported for the majority of the participating students. Results however also revealed areas where interventions are required as well as areas of future research. The majority of the students who took part on the research were female, aged between 18-24 years old and came from Scotland and the UK. Furthermore the most students who completed the survey were full-time, undergraduate students. The majority of students self-evaluated their physical health as good or very good (74%), while in comparison a small percentage indicated having fair or poor general physical health (16%). Students appeared to be overall physically active since the majority met the recommended guidelines for physical activity. 42% had been physically active for 30 minutes or more for 34 days, over the course of the past week, while 29% for 5 or more days. Furthermore, from those who had been physically active for 4 days or less, 62% indicated that they had been active for at least 150 minutes over the course of the past week. Guidelines published by the four UK chief medical officers (2011) recommend that adults should aim to be active daily. Over a week, activity should add up to at least 150 minutes of moderate intensity activity in bouts of 10 minutes or more – one way to approach this is to do 30 minutes on at least 5 days a week. Survey results thus revealed that whilst only 29% of students are meeting the health recommendation of 30 minutes of physical activity most days of the week, it is encouraging that a further 62% are active for 150 minutes. It therefore appears that the majority of students are meeting the time of recommended activity time for adults but not the frequency. There therefore appears to be a need to encourage students to be more active more often. When asked about diet the majority of respondents self-evaluated their dietary habits as healthy (45%) or average (42%), while a small percentage said that their diet was unhealthy or very unhealthy (7%). Furthermore, the vast majority of students had breakfast most days of the week (84%). The World Health Organisation recommends ‘5 a day’ in regard to fruit and vegetables intake, which is equivalent to eating a minimum of 400g of fruit and vegetables a day to lower the risks of serious problems such as heart disease, stroke, type 2 diabetes and obesity. 32 Regarding the ‘5 a day’ recommendation most students said that they consumed 3 portions of fruit and veg daily (28%), followed by those who consumed 4 (20%), 2 (16%) and 5 (15%). The European Food Safety Authority recommends that women should drink about 1.6 litres of fluid and men should drink about 2.0 litres of fluid per day. This translates to about eight glasses of 200ml each for women and 10 glasses of 200ml each for a man. Results from the survey show that the majority of respondents did not comply with this recommendation. Most students (30%) indicated drinking 5-6 200ml glasses of fluids including water and milk among others. Less indicated drinking 7-8 (23%) or 3-4 (21%). Positive was the fact that when asked to self-identify the quality of their sleep, the majority of students said that they slept well (42%), followed by those who slept average (27%). Furthermore, most students indicated they slept for 7-8 hours on an average night (66%). According to the director of the clinical sleep research unit at Loughborough University: ‘Most adults need between 6 and 9 hours of sleep each night. Simply put, you need enough to make you feel refreshed and able to function efficiently the next day’. It therefore appears as though the majority of Edinburgh University students sleep the recommended amount of hours per night. The majority of students said that they were sexually active (81%). Out of them most practise safe sex (67%), however there was still a significant amount who did not (14%) or who did sometimes (19%). The two most popular contraception methods used by students, were the combined pill and the condom. Furthermore, although most of the respondents had at some point been tested for an STI/HIV (51%), there was a considerable amount that had never been tested (49%). The most common STI among those who had been tested positive was Chlamydia, followed by Genital Warts and Genital Herpes. Regarding alcohol consumption the majority of students said that they consumed alcoholic drinks (87%). The average amount of alcohol units consumed per week, amongst those who responded was 8 units. On a typical day when they are drinking, most students consume 3-4 units of alcohol (28%), followed by those who consume 5-6 (24%) and 1-2 (22%). A smaller percentage consumes more than 9 units (14%). Chief medical officers in the UK agree that men should drink no more than 21 units of alcohol a week and that women should have no more than 14 units. Additionally, to protect against the risks of alcohol, drinking should be spaced over the week, so men should drink no more than 3 to 4 units a day and women 2 to 3 units. 33 50% of students therefore drink more than the recommended amount on a typical day when they are drinking. Pre-loading appeared popular among students. The majority indicated preloading sometimes (43%), however a considerable percentage indicated that they always drink alcohol at home, before going out (40%). Interesting was the fact that a considerable amount of students said that they had been feeling regret or guilt after drinking on a weekly (4.5%), or monthly (17%) basis. Similarly when asked whether they had been unable to remember what happened the night before because they had been drinking, 2% responded weekly and 11% monthly. Finally, when asked whether they had failed to do what was normally expected of them because they had been drinking, 2% responded weekly and 10% monthly. It therefore appears that there is a significant percentage of students that is consistently affected by the consumption of alcohol. When asked about their smoking habits, the majority of students said that they never smoked (71%). Among those who did smoke however, an interesting tendency was reported as the majority smoked either everyday (40%) or once a month (27%). From those, the majority said they had smoked either more than 10 cigarettes over the past week (32%) or no cigarettes (33%). Among smokers, cigarettes and roll-ups appeared to be the most popular. Encouraging was the fact that from the students who smoked, more than half said that they would like to quit (54%). In regard to drug usage, results were encouraging since the majority of students said that they never used drugs (74%). A small but considerable percentage however said that they used drugs, but not every day (15%). Among those who used drugs the most commonly used appeared to be Marijuana/Cannabis, followed by MDMA, Cocaine, Ecstasy and Caffeine Tablets. On the other hand, none of the students responding had ever used Heroin or Crystal Meth. Regarding legal highs and/or new psychoactive substances (NPS), the most commonly used legal high was Laughing Gas, followed by Sleeping Pills and Herbal Highs. Finally, most of the respondents self-evaluated their general mental health as good (24%) or very good (35%), which is encouraging considering the survey was released during the spring semester revision and examination period. At the same time however, a considerable percentage of 21%, self-evaluated their general mental health as fair or poor. When asked whether since being a student at the University of Edinburgh, they had ever had an emotional or mental health difficulty that had affected their life/studies, 57% responded negatively. On 34 the contrary a large percentage (43%) responded positively revealing that a considerable amount of students had experienced an emotional difficulty. 5.0 Comparative Study For the purposes of this research it was felt appropriate to conduct comparisons between the health and wellbeing habits of Edinburgh University students and the general adult population of Scotland. To conduct the comparative study, data were extracted from the latest Scottish Health Survey conducted in 2013, the results of which were published in the form of reports and publications in 2014. An overview of data generated by the Scottish Health Survey are presented below. The Scottish Health Survey is designed to provide data on the health of adults and children living in private households in Scotland. The adult population surveyed, which is here the one compared with Edinburgh student’s population, comprises of individuals who are aged 16 to 64 years old. In the 2013 survey, 4894 adults took part in the research across Scotland. Key topics included in the survey were: general health and mental wellbeing, dental health, alcohol consumption, smoking, diet, physical activity, obesity, long-terms conditions and multiple risks. Areas compared here however are limited to those shared with the student health and lifestyle survey and include: physical activity, alcohol consumption, smoking, diet and mental health. General Health Three quarters (74%) of adults responding to the Scottish Health Survey, assessed their general health as either ‘good’ or ‘very good’, while 8% described their heath as ‘bad’ or ‘very bad’. In comparison 74% of students responding to the Student Health and Lifestyle Survey questionnaire, self-rated their physical health as ‘good’ or ‘very good’, while 16% as ‘fair’ to ‘bad’. Balance therefore appears between the results of the two surveys, with Edinburgh University students rating higher in the ‘bad’ general health measure. 35 Alcohol Consumption Results of the Scottish Health Survey revealed that one in five women (20%) reported that they did not drink alcohol in comparison to 12% of men. The Student Health and Lifestyle Survey on the other hand, though it did not distinguish between male and female students, revealed that 13% of students did not drink alcohol, so less students were not drinking alcohol in comparison to the general Scottish adult population. Furthermore, the Scottish Health Survey showed that 22% of men and 16% of women drank at hazardous levels (which consist of more than 21 units per week for men and 14 for women). The average between men and women is 17.5 units per week, which is directly comparable to the Student Health and Lifestyle Survey where no distinction between male and female students was identified. Results coming from the Student Health and Lifestyle Survey indicated that the average number of alcohol units consumed per week, by both male and female students, were 8 units. However, when looking at individual responses from students, 10% of the respondents drink more than 17 units per week and 20% drink more than 10 units per week. It therefore appears that although the general average is relatively low, a considerable amount of students are still drinking at hazardous levels. In regard to heavy drinking, men drank an average of 5.2 units on their heaviest drinking day over the previous week in comparison to women who drank 2.8 units. However, the average unit consumption has declined over the years, the change has not been significant for either men or women. The average between men and women is therefore 4 units, which is directly comparable to the Student Health and Lifestyle Survey where no distinction between male and female students was identified. Most students responding on a similar question regarding the units of alcohol they consumed on a day they were drinking, were 3-4 (28%), 5-6 (24%) or 12 (22%) followed by 7-8 (12%), more than 10 (8%) and 9-10 (6%). The majority of students therefore, drank less than 7 units of alcohol on a drinking day, which is more than the average of the general Scottish drinking population. Overall Edinburgh University students therefore appeared to drink less alcohol units per week, but more on drinking days. 36 Smoking According to the Scottish Health Survey, smoking prevalence was higher among individuals between 25 and 54 (around 25%), while men were more likely to smoke cigarettes than women (23% of men in comparison to 20% of women). Positive however was the fact that there was a decline in cigarette smoking between 2012 (25%) and 2013 (21%). In comparison, Edinburgh University students appeared to smoke considerably less, since 17% indicated they were smokers (including those who did not smoke every day). The age range was however different to that of the Scottish Health Survey, since respondents were between 17 years old and 25 or over, with those over 25 making up 17% of respondents. Diet When it came to diet, the percentage of adults who met the 5-a-day recommendation had not changed significantly over the past few decades. Adults in Scotland consumed on average 3.2 portions of fruit and vegetables per day in 2013, with 9% reporting they consumed no portion in the day prior to the Scottish Health Survey interview. A key observation was that consumption was not majorly different between men and women and between different age groups. Results from the Student Health and Lifestyle Survey were similar, since the majority of Edinburgh University students consuming 3 (28%), 4 (20%) or 2 (16%) portions of fruit and vegetables per day. Quite positive was however the fact that 26% or respondents indicated they consumed 5 or more portions of fruit and vegetables per day. Physical Activity In regards to the levels of activity of adults, men are significantly more likely to meet the recommended guidelines on physical activity (62% of adults). However the results of the Scottish Health Survey over the past few years have revealed that age is also a factor, since 37 physical activity levels decline with age. Across Scotland, 75% of 16-24 year olds are active enough for their health. In comparison, Edinburgh University students appeared to be relatively active, with 29% responding that they are physically active for 30 min or more, on 5 or more days per week. The majority of 42% however indicated being physically active for 3-4 days per week. Mental Wellbeing Moderate to high severity was reported in regard to mental wellbeing according to the Scottish Health Survey since in 2012/2013, around one in ten (9%) adults had two or more symptoms of depression. Prevalence of two or more symptoms of anxiety was also 9%. Furthermore there has been a significant increase in the percentage of adults displaying one symptom of depression (from 5% in 2010/2011 to 8% in 2012/2013), coupled with a small drop in the percentage displaying no symptoms (from 86% in 2008/2009 to 83% in 2012/2013). A similar pattern was observed for symptoms of anxiety (11% of adults had one symptom in 2012/2013). Though not directly asking about depression and anxiety, the Student Health and Lifestyle Survey initially asked students to self-assess their general mental health. Results revealed that 80% of students self-identified their general mental health as excellent, very good or good. Furthermore the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) was used to assess the overall mental wellbeing of students. WEMWBS is based on Likert scale questions assessing overall mental wellbeing, specifically asking participant to rate descriptions of their experiences over the last 2 weeks. Results were again encouraging, since the majority of students rated relatively high in all questions of the scale. Statements that rated higher among participants were: ‘I’ve been feeling interested in other people’, ‘I’ve been able to make my own mind about things’ and ‘I’ve been interested in new things’. Very positive was the fact that the statement that rated higher than all others was: ‘I’ve been feeling loved’, which along with the previous high rated statements, could be perceived as an indicator of good overall mental wellbeing. On the contrary, statements that were rated lower were: ‘I’ve been feeling relaxed’ and ‘I’ve had energy to spare’, which could be justified since the survey was released during the spring semester revision and examination period (see Limitations of the Study). 38 6.0 Recommendations and Future Research The results of the study appeared encouraging since some positive health and lifestyle choices were reported for the majority of the participating students. Results however also revealed areas where interventions are required as well as areas of future research. The most encouraging areas of health and lifestyle appeared to be sleep and smoking, while in all other areas interventions are suggested. Regarding physical activity, survey results revealed that although 62% of students were active for 150 minutes, only 29% of students were meeting the health recommendation of 30 minutes of physical activity most days of the week. The majority of students therefore meet the time of recommended activity for adults but not the frequency. A need therefore appears for encouraging students to be more active, more often. Furthermore interventions regarding healthy diet are proposed, since students did not seem to meet recommendations for either daily fruit and vegetables consumption or intake of fluids. Only 15% of students participating in the study consumed the recommended ‘5 a day’ for fruit and vegetables, while 56% drunk 6 200ml glasses of fluids or less on an average day. It is therefore proposed that actions need to be taken to promote healthy diet to students. Since the percentage of students who do not drink the recommended amount of fluids per day are significant, it would be interesting to examine whether this is due to lack of awareness or a difficulty finding access to free water across the University campus. Worrying was the fact that a considerable 33% of students did not practice safe sex consistently to avoid sexually transmitted infections and pregnancy. Furthermore, 49% of them had never been tested for an STI/HIV. Interventions are therefore recommended to promote safe sex and raise awareness on the importance of frequent testing. Results on alcohol consumption revealed that 50% of students drink more than the recommended amount on a typical day when they are drinking. Furthermore a considerable percentage drink more than 17 units of alcohol per week (10%) or more than 10 units per week (20%). Pre-loading appeared popular among students, with the majority indicating pre-loading sometimes (43%), or always (40%) before going out. Interesting is also the fact that a 39 considerable amount of students (22%) have a feeling of regret or guilt after drinking on a monthly basis or more often. It therefore appears that a significant percentage of students are consistently affected by the consumption of alcohol. Interventions are therefore suggested to raise awareness on the risks of alcohol. Results in regard to drugs were encouraging since 74% of students said that they had never used drugs. A small but considerable percentage however said that they used drugs, but not every day (15%). Among those who used drugs the most commonly used in the last year appeared to be MDMA, Marijuana/Cannabis, Ecstasy and Caffeine Tablets. Furthermore, the most popular legal high appeared to be Laughing Gas, since 48% of students who used drugs had used it in the last year. Interestingly sleeping pills appeared to be the second most used legal high in the last year. Finally in regard to mental health, the results of the study were overall encouraging. A considerable 43% however, responded positively when asked whether they had experienced an emotional/mental health difficulty that had affected their life/studies since attending the University of Edinburgh. It would therefore be interesting to examine how many of them had used one of the University support groups to help them overcome their difficulty. It is also suggested that further awareness of the help outlets available for students should be promoted, including student counselling. Further study could be conducted to examine demographic variables. Comparisons between female and male students as well as between students of different ages and ethnicities would be an interesting future direction for this research. Socio-economic data, which are known to have an impact on health behaviours, could also be monitored in a future study. 40 7.0 Limitations of the Study It is important to acknowledge possible limitations that may have affected the results of the study. This study was originally scheduled to run at the beginning of the second semester of the academic year 2014/2015. However due to prolonged delays with ensuring ethical approval from the University’s Ethics committee, the survey was not released to undergraduate students until late April 2015 and research postgraduate students during May 2015. Students were therefore asked to participate in the study during the revision and examination period, which may have affected their normal health and lifestyle habits up to an extent. For example, feedback from one student indicated that students may have been less prone to drinking alcohol and using drugs during the examination period, but more prone to taking caffeine pills and smoking. Furthermore it is important to note that postgraduate taught students were not surveyed at this occasion due to clashes with other university surveys running during the same time period. Good practises of the University’s Student Survey team indicate that a number of surveys can be released at a given time to students, to avoid overload and opt out from participation. It is therefore suggested that if this survey was to be repeated in the future, that it should be released to students during February ahead of revision/ exam time, and this would also enable postgraduate taught students to be represented as well. Additional limitations include social desirability bias linked with self-report to survey questions. Self-report is considered advantageous in that data can be easily collected. However it comes with the disadvantage of possible social desirability bias, according to which survey respondents answer questions to what is the societal norm. They therefore are inclined to provide answers in a manner that will be viewed more favourably by others. This is a particular limitation of any self-report survey relating to health. Furthermore data were not analysed by demographic variables. Comparisons between students of different genders, age, ethnicities or other variables would be an interesting future research direction. Finally socio-economic data, which are known to have an impact on health behaviours, were not monitored in this study. 41 8.0 Appendix Student Lifestyle Questionnaire This survey is being conducted on behalf of the Healthy University Project, which seeks to gather data and information on Edinburgh University students’ lifestyle, health and wellbeing. The responses received, in addition to on-going engagement with students, will inform priorities for the future work of the project which is why it is important we hear from as many students as possible. If you wish to find out more about the project visit this link: www.ed.ac.uk/healthy_university Participation is anonymous and the identity of the participant is not disclosed at any point during the survey. If you feel you have been affected by any of the issues or themes in the questionnaire, various sources of support are available: your own GP or NHS24 http://www.nhs24.com (or tel: 111); EUSA Advice Place https://www.eusa.ed.ac.uk/adviceplace or the University of Edinburgh Student Counselling Service http://www.ed.ac.uk/schools-departments/studentcounselling/home If you would like to provide any feedback on this questionnaire, please contact Helen Ryall at the Healthy University Project, Centre for Sport and Exercise at Helen.Ryall@ed.ac.uk At the end of the survey you will have the opportunity to participate in a prize draw, for a chance to win a £25 cash prize (50 winners), or a yearly gym membership (2 winners). SECTION ONE: Demographics Q1. Are you an undergraduate or postgraduate student? * ~Multiple Choice / One Answer Undergraduate Postgraduate Taught Postgraduate Research Q2. Which Edinburgh University College do you study in? * ~Multiple Choice / One Answer Humanities & Social Sciences Medicine & Veterinary Medicine Science & Engineering Q3. What is your mode of study? * ~Multiple Choice / One Answer Full-time Part-time 42 Q4. What is your age? * ~Multiple Choice / One Answer 17 or under 18-20 21-24 25 or over Q5. What is your gender? * ~Multiple Choice / One Answer Male Female Transgender Q6. Would you describe yourself as a disabled person? * Note: The Equality Act 2010 defines a disabled person as anyone who has or has had a physical or mental impairment which has a substantial and long-term effect on their ability to carry out normal day-to-day activities. ~Multiple Choice / One Answer Yes No Prefer not to say Q7. What is your domicile on entry (area of permanent residence before commencing studies at Edinburgh University)? * ~Multiple Choice / One Answer Scotland Other UK EU Overseas Channel Islands and Isle of Man Q8. Do you live in University Accommodation? * ~Multiple Choice / One Answer Yes No Q9. How would you identify your sexuality? * ~Multiple Choice / One Answer Gay Lesbian Heterosexual Bisexual Not sure Prefer not to say SECTION TWO: Physical Activity Questions in this section deal with physical activity. If you would prefer to skip this section please tick here: 43 Q10. How would you rate your general physical health? * ~Multiple Choice / One Answer Excellent Very good Good Fair Poor Q11. In the past week, on how many days have you been physically active for a total of 30 minutes or more? * ~Multiple Choice / One Answer Note: Physical activity may include walking or cycling for recreation or to get to and from places; gardening; and exercise or sport, which lasts for at least 10 minutes. 0-2 days a week 3-4 days a week 5 or more days a week Q12. If 4 days or less, have you been physically active for at least two and a half hours (150 minutes) over the course of the past week? * ~Multiple Choice / One Answer Yes No Q13. Have you been more physically active since you started attending Edinburgh University? * ~Multiple Choice / One Answer More active Less active No change Q14. Would you like to be more physically active? * ~Multiple Choice / One Answer Yes No SECTION THREE: Diet Questions in this section deal with diet. If you would prefer to skip this section please tick here: Q15. How healthy do you consider your diet to be? * ~Multiple Choice / One Answer Very Healthy Healthy Average 44 Unhealthy Very unhealthy Q16. Do you have breakfast most days of the week? * ~Multiple Choice / One Answer Yes No Q17. How many portions of fruit and vegetables do you eat in a typical day? * Note: One portion is approximately one piece of medium-sized fruit or 80g of any one vegetable. ~Multiple Choice / One Answer 0 1 2 3 4 5 6 or more Q18. How many 200ml glasses of fluids do you drink on an average day? * Note: Drinks may include water, milk, fruit juices, tea and coffee but not alcoholic, sugary, soft and fizzy drinks. ~Multiple Choice / One Answer 1-2 3-4 5-6 7-8 9-10 More than 10 SECTION FOUR: Sleep Questions in this section deal with sleep habits. If you would prefer to skip this section please tick here: Q19. How well do you sleep? * ~Multiple Choice / One Answer Very well Well Average Badly Very Badly Q20. How many hours of sleep do you get on an average night? * ~Multiple Choice / One Answer Less than 4 4-6 7-8 45 9-10 More than 10 SECTION FIVE: Sexual Health Questions in this section deal with sexual health. If you would prefer to skip this section please tick here: Q21. Are you (or have you ever been) sexually active? * ~Multiple Choice / One Answer Yes No > Go to Question 26: Next section Q22. Do you practice safe sex to avoid sexually transmitted infections (e.g. condoms)? * ~Multiple Choice / One Answer Yes No Sometimes Q23. What contraception methods do you use to avoid your or your partner’s pregnancy? * ~Multiple Choice / Select all that apply I do not use any Permanent method (sterilisation, vasectomy) Long acting method (injection, implant, coil) Combined pill Femidom Condom Emergency contraception (morning after pill) Q24. Have you ever been tested for a Sexually Transmitted Infection (STI)/HIV? *~Multiple Choice / One Answer Yes No > Go to Question 26: Next section Q25. Have you ever been diagnosed with any of the following STI’s? Select all that apply * ~Multiple Choice / Select all that apply No, I have not Chlamydia Genital warts Genital herpes Gonorrhea Syphilis Pubic lice HIV Other (please specify) ~Include ‘Other’ Option 46 SECTION SIX: Alcohol Questions in this section deal with alcohol consumption. If you would prefer to skip this section please tick here: Q26. Do you consume alcoholic drinks? * ~Multiple Choice / One Answer Yes No > Go to Question 36: Next section Q27. What is the average number of alcohol units you consume per week? * Note: One unit is: Half pint of 3.6% beer, Half a small glass of 12% wine, one single measure of 40% spirits. ~Number Input field Alcohol units Q28. How many units of alcohol do you drink on a typical day when you are drinking? * ~Multiple Choice / One Answer 1-2 3-4 5-6 7-9 10+ Q29. How often have you had 6(if female)/8(if male) or more alcohol units on a single occasion? * ~Multiple Choice / One Answer Never Less than monthly Monthly Weekly Daily or almost daily Q30. Would you say you drink alcohol at home (pre-load) before going out? * ~Multiple Choice / One Answer Always Sometimes Never Q31. How many units of alcohol do you drink on a typical occasion when you are preloading before going out? * ~Multiple Choice / One Answer 0 1-2 3-4 5-6 7-9 10+ 47 Q32. How often whilst being a student at Edinburgh University, have you had a feeling of regret or guilt after drinking? * ~Multiple Choice / One Answer Daily or almost daily Weekly Monthly Less than monthly Never Q33. How often whilst being a student at Edinburgh University, have you been unable to remember what happened the night before because you had been drinking? * ~Multiple Choice / One Answer Daily or almost daily Weekly Monthly Less than monthly Never Q34. How often whilst being a student at Edinburgh University, have you failed to do what was normally expected of you because you had been drinking? * ~Multiple Choice / One Answer Daily or almost daily Weekly Monthly Less than monthly Never Q35. Would you like to drink less alcohol? * ~Multiple Choice / One Answer Yes No SECTION SEVEN: Smoking Questions in this section deal with smoking. If you would prefer to skip this section please tick here: Q36. Which of the following statements best describes you? * ~Multiple Choice / One Answer I have never smoked > Go to Question 42: Next section I used to smoke but I have now given up > Go to Question 42: Next section I smoke but not everyday I smoke everyday Q37. How often do you smoke? * ~Multiple Choice / One Answer Once a month 48 Once a fortnight Once a week Twice a week Three times a week Everyday or nearly everyday Q38. How many cigarettes have you smoked over the past week? * ~Multiple Choice / One Answer 0 1-2 3-4 5-6 7-9 10+ Q39. What do you smoke? Select all that apply. * ~Multiple Choice / Select all that apply Cigarettes Roll-ups Cigars Pipe tobacco Shisha (Narghile) Bidi/Beedi e-cigarettes Q40. Have you started smoking or smoke more since you started attending Edinburgh University? * ~Multiple Choice / One Answer Yes No Q41. Would you like to give up smoking? * ~Multiple Choice / One Answer Yes No SECTION EIGHT: Drugs Questions in this section deal with drugs. If you would prefer to skip this section please tick here: Q42. Do you use drugs? * ~Multiple Choice / One Answer No > Go to Question 46: Next section Yes Q43. How often do you use drugs? * 49 ~Multiple Choice / One Answer I have only taken drugs once I have taken drugs a few times in my life I take drugs a few times a year I take drugs once or twice a month I take drugs at least once a week I take drugs most days Q44. Tell us about the drugs you use: * ~Matrix Ever Used Used in last year Used in last week MDMA Marijuana/Cannabis Cocaine Ketamine Magic Mushroom LSD Benzodiazepines Poppers Heroin Amphetamines Crack Cocaine Ecstasy Crystal Meth GHB Anabolic Steroids 2CB Caffeine Tablets Mephedrone Prescribed Medication – Tramadol, Pregabalin Other (please specify) ~Include ‘Other’ Option Q45. Please indicate if any, which Legal Highs or New Psychoactive Substances (NPS) do you think you have taken: * Note: According to the NHS, legal highs are substances used like illegal drugs such as cocaine or cannabis, but not covered by current misuse of drugs laws. ~Matrix Ever Used Used in last year Used in last week Herbal Highs Party Pills Synthetic Cocaine Synthetic Cannabis Herbal Ecstasy NBOMes Bath Salts Plant Fertilisers Herbal Incense Special Teas 50 Drug Analogues Research Chemicals Laughing Gas Sleeping pills/tranquillisers Other (please specify) ~Include ‘Other’ Option SECTION NINE: Mental Health Questions in this section deal with mental health. If you would prefer to skip this section please tick here: Q46. How would you rate your general mental health? * Note: According to the World Health Organization, mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. ~Multiple Choice / One Answer Excellent Very good Good Fair Poor Q47. Please tick the box that best describes your experience of each over the last 2 weeks: * ~Five Point Likert Scale None of the Time I’ve been feeling optimistic about the future I’ve been feeling useful I’ve been feeling relaxed I’ve been feeling interested in other people I’ve had energy to spare I’ve been dealing with problems well I’ve been thinking clearly I’ve been feeling good about myself I’ve been feeling close to other people I’ve been feeling confident I’ve been able to make up my own mind about things I’ve been feeling loved I’ve been interested in new things I’ve been feeling cheerful 1 Rarely 2 Some of the Time 3 Often All of the Time 4 5 51 Q48. Since being at Edinburgh University, have you ever had an emotional/mental health difficulty that has affected your life/studies? * ~Multiple Choice / One Answer Yes No SECTION TEN: Prize Participation If you would like to be included in the prize draw, please provide your student ID (number) below: ~Free Text 52 9.0 References Bull, FC. and the Expert Working Groups. Physical Activity Guidelines in the U.K.: Review and Recommendations. School of Sport, Exercise and Health Sciences, Loughborough University, May 2010. CR166, College Report (2011). Mental health of students in higher education . London: Royal College of Psychiatrists . Dooris, M., & Doherty, S. (2010). Healthy Universities: current activity and future directions – findings and reflections from a national-level qualitative research study. Global Health Promotion , 17 (3), 06–16 . EDMARC. (2014). Student Report 2013/2014. GOVERNANCE AND STRATEGIC PLANNING (GASP). Edinburgh: The University of Edinburgh. GSR. (2015). 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