What matters most for undergraduates' psychological well-being? A structural equation model analysis of modifiable behaviors in the ACHA-NCHA.

Objective

Identify the strongest predictors of undergraduates' well-being and evaluate how these factors interact.

Participants

79,246 undergraduates from the Spring 2024 American College Health Association-National College Health Assessment IIIb. Mean age was 21.7 ± 4.8; the sample included diverse gender and racial/ethnic identities.

Methods

In this cross-sectional study, structural equation modeling (SEM) evaluated a latent well-being factor including flourishing, loneliness, psychological distress, and suicidality. Thirty predictors were identified through exploratory factor analysis and were modeled simultaneously to assess contributions and interactions.

Results

Time spent socializing and engaging in work and family obligations were the strongest positive predictors of well-being. Interpersonal problems, substance use, insomnia, and screen time were strongly associated with worsened well-being. Trends were consistent between students with and without diagnosed anxiety or depression.

Conclusions

Undergraduates' well-being reflects interacting social, behavioral, and environmental influences. Interventions should strengthen social connections, improve sleep, encourage healthier technology use, and reduce substance-related risks.