Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Health and Rehabilitation Sciences


Dr. Angela Mandich

2nd Supervisor

Dr. Anita Cramp



The purpose of this integrated-article dissertation was to examine stress and health in Canadian post-secondary students. Data from the spring 2013 National College Health Assessment (NCHA) was utilized in study one and two. This dataset is comprised of 34,039 students from 34 self-selected Canadian postsecondary institutions who took part in the NCHA survey. Study one examined the impact of stress, identified stressors and predicted which students were more likely to experience stress. Stress was the most commonly identified impediment to academic performance and 57.6% of students reported more than average stress. Most frequently reported stressors include; academics, finances, and sleep difficulties. Female students, graduate students, Caucasian students, non-international students, or students in a relationship were most likely to have elevated stress levels, as are those with a mental health diagnosis, learning disability, disability, or chronic illness. In study two, NCHA data was analyzed descriptively and structural equation modeling was used to examine the relationship between health behaviours (e.g., physical activity, sleep, and nutrition), stress, and academic performance. A total of 13.2 % of students reached Canada’s Food Guide Nutrition Guidelines, while 17.2% met Canadian Society of Exercise Physiology’s Guidelines for Physical Activity, and 44.8% identified that sleep was not a problem. Overall, 3.3% of students met recommendations for all three health behaviours. Sleep, exercise, and nutrition had a direct effect on stress and academic performance respectively. Stress also had a direct effect on academic performance. All health behaviours demonstrated significant indirect effects, influenced through stress, on academics. Lastly, via focus groups, study three investigated Canadian university students’ perceptions of individual and institutional factors that impact health and well-being. Students suggested that stress, health behaviours, accountability, and social capital affected their individual health. At an institutional level, a supportive campus culture mediates health; leading to engagement, cohesion, and empowerment. A lack of integration related to student health can result in; disconnection, disempowerment, and decreased motivation adversely impact health. Findings from all three studies support a comprehensive approach to addressing stress and overall health of students at post-secondary institutions.