Self-regulation for the promotion of student health Traffic lights: the development of a tailored web-based instrument providing immediate personalized feedback

Background and objective: University students report more health complaints and a poorer quality of life than their working peers. The majority of these students do not seek contact with health professionals. Health problems result not only from risk behaviors (e.g. drugs use) but also from various stress-related factors, necessitating the investigation of several factors of students’ lives. The Internet provides a suitable environment for developing an accessible screening and self-regulation instrument for student health promotion.

Design and methods: A web questionnaire was created that included reliable measurement scales (e.g. health, health (risk) behavior, quality of life, satisfaction with study), calculation modules with cut-off points and personalized feedback. The instrument included traffic lights, personal scores for comparison with peer scores, advice and referral. The validity, reliability, feasibility and effectiveness of the instrument were demonstrated using three studies (n = 334; n = 267; n = 4009).

Results: The hypothesized research model, including the direct and indirect effects of the self-regulation of health via quality of life and health (risk) behaviors was an appropriate fit to the data (Structural Equation Modeling), explaining a substantial amount of variance (67%) and thus demonstrating predictive validity. Students reported intentions to change their behavior, actual behavioral changes and quality of life improvements up to a year after initially participating in a study.

Conclusions: This instrument: (1) detects health complaints at an individual level and group level (e.g. study program); (2) encourages students to change their health (risk) behavior via personalized feedback; (3) provides students with a fairly complete and elaborate overview of their health-related quality of life and (4) is the first instrument providing a very high level of tailoring. Self-regulation (both self-assessment and personalized feedback) can fulfill an important role in addressing health problems and risks at an early stage and without the immediate need for professional intervention.