American Journal of Health Education
The American Journal of Health Education (AJHE) is the only refereed journal of its kind to cover today’s health education and health promotion issues head on with timely, substantive, and thought-provoking articles.
May / June 2026 (Volume 57, Issue 3)
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Free Access Article
Beyond COVID-19: Changes in Mental Health, Hopelessness, and Subjective Social Status Among College Students in Rural Settings
– Lei Xu, Shayla Sanders, Qiang Wu, Ryan Martin, Julianna Nieuwsma & Leslie E. Cofie
Background: Subjective social status (SSS) and hopelessness are linked to anxiety and depression, yet research among undergraduates – particularly considering the COVID-19 pandemic – is limited. This study examined associations among SSS, hopelessness, depression, and anxiety during and after the pandemic.
Methods: Cross-sectional surveys were conducted at a Southeastern U.S. university in 2021 (N = 1,602) and 2024 (N = 972). Measures included anxiety (GAD-7), depression (PHQ-9), SSS (MacArthur Scale), and hopelessness (Brief-H-Neg). Higher scores indicated greater distress, social status, or hopelessness. Linear regression models assessed associations.
Results: In 2021, 82.3% reported moderate to severe depression and 63.0% anxiety. By 2024, depression rose slightly (83.0%) and anxiety increased to 70.3%. Mean depression scores increased (p <.0001), anxiety remained stable (p = .7712), hopelessness declined (p <.0001), and SSS improved (p <.0001). Hopelessness correlated positively with anxiety (r = 0.60) and depression (r = 0.53), while SSS correlated negatively with both (p <.001). Regression analyses confirmed that lower SSS and higher hopelessness predicted greater distress. Female and lower-income students reported higher distress.
Translation to Health Education Practice: Despite improvements in hopelessness and SSS, mental health concerns remain widespread, highlighting the need for targeted prevention and treatment strategies in university settings.
Research Articles
Beyond COVID-19: Changes in Mental Health, Hopelessness, and Subjective Social Status Among College Students in Rural Settings
– Lei Xu, Shayla Sanders, Qiang Wu, Ryan Martin, Julianna Nieuwsma & Leslie E. Cofie
Personal and Communal Responsibility to Mitigate COVID-19 Spread on a University Campus
– Fredanna D. M. McGough, Paul E. Richardson, Lindsey R. Bell & Michelle M. Barthet
Higher Education Leaders’ Perspectives of Student Opioid Misuse and Opioid Overdose Prevention Programs at U.S. Colleges and Universities: An Exploration of Implementation Facilitators and Barriers
– Christina E. Freibott, Adison Hicks, Noel Vest, Michael D. Stein, Rachel C. Shelton & Sarah Ketchen Lipson
Distracted Driving Behaviors Among Young Drivers: A Study of Risk Perception and Effectiveness of Prevention Strategies
– Theresa M. Enyeart Smith & Catherine M. Foster
Mapping the Research Landscape: A Bibliometric Analysis of Yoga Interventions within Educational Contexts
– Kashinath Boral, Krishna Kanta Mondal & Himadri Borah
EduDiaCare for Individuals with Type 2 Diabetes: Development, Content Validation, and Acceptability Testing
– Nida Ul Hasanat, Martaria Rizky Rinaldi, Gilles van Luijtelaar & Kwartarini Wahyu
Yuniarti
Commentary: Leveraging AI Avatars for Safe Sleep Education: Combating SIDS Misinformation Through Interactive, Culturally Responsive Tools
– Aysha Jawed
