Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project

College, health behaviours, questionnaires, recruitment, response rate, Administration, Community Health, Experimental Design, Health Education ALL Metrics - Views Downloads How to cite this article Keogh J, Rathbone E, Brown WJ et al. Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.12688/f1000research.168558.2) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente Select a format first ▬ ✚ Research Article Revised Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved] Justin Keogh https://orcid.org/0000-0001-9851-1068 1, Evelyne Rathbone1, Wendy J Brown1, [...] Beth Mozolic-Staunton1, Gregory Cox https://orcid.org/0000-0003-4334-608X 1, James Furness1*, Jaclyn Szkwara1*Justin Keogh https://orcid.org/0000-0001-9851-1068 1, Evelyne Rathbone1, [...] Wendy J Brown1, Beth Mozolic-Staunton1, Gregory Cox https://orcid.org/0000-0003-4334-608X 1, James Furness1*, Jaclyn Szkwara1* * Equal contributors PUBLISHED 22 Feb 2026 Author details Author details 1 Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, 4227, Australia Justin Keogh Roles: Conceptualization, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Evelyne Rathbone Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing Wendy J Brown Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Beth Mozolic-Staunton Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Gregory Cox Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing James Furness Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing Jaclyn Szkwara Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS First year university students may be at risk of poor health behaviours and outcomes. Unfortunately, online surveys assessing multiple aspects of the health and well-being of university students have poor response rates, meaning the representative of such data may be questionable. Therefore, the primary aim of this study was to document the development and implementation of an online health and well-being survey of medical and allied health students with substantially higher response rates than reported in the literature. A cross-sectional online survey was developed following recommendations to maximise the participation and response rates. All new students (defined as commencing a degree in May or September 2024) from undergraduate medical and postgraduate allied health programs from one Australian university were requested to participate. The survey included 136 items, most of which were validated questionnaires commonly used in national surveys. Participants were requested to complete the survey on their own device during scheduled class time within the first two weeks of their degree. Of 273 eligible students, 217 (79.5%) accessed the survey, with 201 (73.6%) completing it at least partially and 63.7% completing it fully. Median completion time was 14.4 (IQR: 12.3–16.8) minutes, and item-level response rates were high across disciplines. Differences in completion rates and survey duration were observed across disciplines, with occupational therapy students taking the longest to complete the survey. The BOOST-Well survey achieved markedly higher response rates than comparable studies, with this likely reflecting student-informed survey design, concise format, strategic timing, and evidence-based recruitment and implementation strategies. College, health behaviours, questionnaires, recruitment, response rate, Administration, Community Health, Experimental Design, Health Education Corresponding Author(s) Justin Keogh ([email protected]) Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2026 Keogh J et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Keogh J, Rathbone E, Brown WJ et al. Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.12688/f1000research.168558.2) First published: 20 Aug 2025, 14:808 (https://doi.org/10.12688/f1000research.168558.1) Latest published: 22 Feb 2026, 14:808 (https://doi.org/10.12688/f1000research.168558.2) We have tried to address the constructive criticisms of the two reviewers, such as; 1. Being more direct and introduction regarding the focus of the study; 2. Providing some updated methodological information which is now provided in the methods but also the results section (as we felt some of it fitted better there) 3. Updating some of the tables 4. Updating the discussion and some of the other final sections as required in this journal's submission guidelines We have tried to address the constructive criticisms of the two reviewers, such as; 1. Being more direct and introduction regarding the focus of the study; 2. Providing some updated methodological information which is now provided in the methods but also the results section (as we felt some of it fitted better there) 3. Updating some of the tables 4. Updating the discussion and some of the other final sections as required in this journal's submission guidelines 1. Being more direct and introduction regarding the focus of the study; 2. Providing some updated methodological information which is now provided in the methods but also the results section (as we felt some of it fitted better there) 3. Updating some of the tables 4. Updating the discussion and some of the other final sections as required in this journal's submission guidelines To read any peer review reports and author responses for this article, follow the "read" links in the Open Peer Review table. Lifestyles and health behaviours of students are important determinants of their ongoing health, as well as their academic achievement and future career success.1,2 However, many students face a variety of physical, emotional, social and academic challenges that may negatively impact their health behaviours and ongoing health and well-being.1,3,4 Such challenges may be greater in university than school-age students, as university students may perceive additional study, financial and graduate employability stress, which may be compounded by leaving home, the need for casual/part-time employment and loss of some social connections.5–8 There is also some evidence demonstrating that these challenges faced by university students may differ based on their country of study9 and their sex.10 Unfortunately, health and well-being information about university students is typically obtained through surveys. However, health survey research traditionally have limitations, including poor reporting of the survey or core questions, questionable validity and reliability of the survey items, poor reporting of the response rate, unclear representativeness of the sample and limited information about how missing data are handled.11 Moreover, response rates to online surveys which seek to assess multiple aspects of the health and well-being of university students are typically low, ranging from 9 to 14% in recent studies.3,8,12,13 A few exceptions report greater but potentially suboptimal response rates, for example 22% for an Australian university-wide survey1 and 31% for a USA-based nursing program.14 Such low response rates are problematic for universities who wish to accurately identify and better manage the health and well-being challenges faced by their students. By addressing the limitations of survey design,11 university educators, administrators and support service staff may gain a better understanding of the health and well-being challenges of their students. This understanding is an important step in ensuring appropriate resources and services are available and easily accessible by students when required. The primary aim of this study was therefore to develop and implement an online survey to examine the health and well-being behaviours of medical and allied health students, with higher participation and response rate than have been reported in previous surveys. The survey data will be used to inform the development of evidence-based and targeted strategies for improvement of students’ health and well-being, and to create a resource for students to develop research skills in data management and analysis in their research training. A cross-sectional online survey, BOnd Online Survey for Student Health and WELL-being Tracking (BOOST-Well) survey, was developed and then administered in May or September 2024 at the Faculty of Health Sciences and Medicine (FHSM) at a private Australian university (Bond University). The Consensus-based Checklist for Reporting of Survey Studies checklist (CROSS) was utilised as a framework for conducting and reporting on the survey15 and recruitment methods were informed by the work of Javidan et al.16 Baseline data were collected to inform a planned prospective cohort study of student health and behaviours. The BOOST-Well survey was developed over 18 months with initial input from 45 students who responded to a single question preliminary survey “What are the five most important issues that affect your health and well-being?” in June 2022. After review of the preliminary survey findings, the authors worked with faculty staff and with student representatives from each program to select and refine the survey questions with formatting to support clear response options. The BOOST-Well survey was reviewed by three student leaders for the FHSM, the FHSM Community Health and Well-being Officer, one academic from FHSM and all members of the research team, for critical content and layout. Minor changes were made to improve clarity, without altering any wording in previously validated scales. Based on this review, it was estimated it would take the participants 20-25 minutes to complete the survey. The survey is included in Appendix 1. During the development of the survey, the authors worked with elected student representatives and staff from each program (Medicine, Physiotherapy, Occupational Therapy and Nutrition and Dietetics) to develop recruitment strategies, based on a review of previous student surveys1,3,8,9,12–14 and the recommendations of Javidan et al.16 on ways to maximise response rates. The summary of how we looked to implement the recommendations are included in Appendix 2. All new and enrolled students (defined as commencing a degree that semester) from the undergraduate medical and postgraduate allied health programs were invited to participate. Students completed the online survey through Qualtrics (https://www.qualtrics.com/) on their own device (laptop or phone) during program specific class time in Orientation Week (O-Week), the week prior to formal classes commencing, or within the first two weeks of commencing their degree. Scheduling for each group was based on maximising the expected number of students who would attend the selected class. Physiotherapy and Nutrition and Dietetics students completed the survey in May 2024 and Occupational Therapy and Medical students in either May or September 2024. To minimise coercion, lead research academics, who were not directly involved in the specific program in which each group of students was enrolled, presented ‘in person’ PowerPoint slides alongside a video to explain the aims and rationale of the study. A QR code was provided for participants to access the survey and to enter a draw for an incentive on completion, with randomly selected students winning one of twenty $100 AUD gift cards. Descriptive statistics are presented as counts and percentages for categorical variables. For continuous variables, normality was assessed using histograms, normal Q-Q plots and the Shapiro-Wilk test. Skewed variables are reported as (medians with IQR). Differences in categorical variables between study programs were compared using the chi-square test, provided the assumption for expected counts was met. The non-parametric Kruskal-Wallis test was used to assess program differences in skewed continuous variables. Statistical significance was set at the 0.05 level. All analyses were conducted using Jamovi software version 2.3.28. The five most important issues identified by students in the preliminary survey in 2022 were stress (study and financial), time pressure, social support, general health (physical and mental health), and healthy lifestyle (nutrition, sleep, smoking and alcohol consumption). These issues were incorporated into the BOOST-Well survey, which included questions in six groups, with a total of 136 items. These included demographic characteristics (as used by the Australian Bureau of Statistics17) and wherever possible, validated questions or scales which have been used in national surveys in Australia, or in prior surveys of university students. When no suitable measures were found, the authors developed or modified questions, for example in relation to the students’ top three health concerns, swimming ability, training in life saving, first aid and resuscitation. Items included in each section of the survey, with sources and response rates, are shown in Table 1. | Survey section | Variable/measure or scale | Reference | Items (#) | Response rate (%) | |---|---|---|---|---| | Demographic characteristics | Age | Adapted from ABS census17 | 1 | 88.6 | | Gender | Adapted from ABS census17 | 1 | 100.0 | | | Country of birth | Adapted from ABS census17 | 1 | 100.0 | | | Language usually spoken at home | Adapted from ABS census17 | 1 | 99.5 | | | Student status | Internal university item | 1 | 100.0 | | | Indigenous origin | ABS census17 | 1 | 99.5 | | | Highest qualification | Adapted from ABS census17 | 1 | 100.0 | | | Program of study | Internal university item | 1 | 100.0 | | | Living arrangements | ABS census17 | 1 | 99.5 | | | Employment status | Adapted from ABS census17 | 1 | 99.5 | | | Income management | ALSWH18 | 1 | 99.5 | | | Postcode | Adapted from ABS census17 | 1 | 99.5 | | | Quality of Life (physical and mental health) | SF-12 version 1 (standard) for physical and mental health | Ware et al.19 | 12 | 94.0 | | Top 3 health concerns | Self-developed | 1 | 56.2a | | | Kessler K10 mental health scale | Kessler et al.20 | 10 | 93.5 – 94.0 | | | Time use, stress and social support | Time management, use of time, and amount of time that work/study affected physical and emotional well-being | ALSWH18 | 5 | 75.1 – 92.0 | | Stress | Bell and Lee21 | 11 | 92.0 | | | MOS social support | Sherbourne and Stewart22 | 19 | 91.0 – 92.0 | | | Health behaviours | Smoking, vaping and alcohol consumption | Based on or adapted from ALSWH18 | 13 | 53.3b – 100 | | Physical activity | Modified Active Australia survey23 | 8 | 85.6 | | | Muscle strengthening | Adapted from NHS24 | 2 | >86.0 | | | Transport | Modified from HABITAT25 | 2 | ~86.0 | | | Swimming ability | Self-developed | 3 | ~86.0 | | | Training in life saving, first aid and/or resuscitation | Self-developed | 6 | 67.0 – 78.6 | | | Sedentary behaviour | Chau et al.26 & Clark et al.27 | 2 | 77.6 | | | Fruit and vegetable consumption | NHS24 | 2 | ~86.0 | | | Diet and meals bought | Adapted from NHANES28 | 4 | ~86.0 | | | Height and weight | Adapted from NHS24 | 2 | 81.6 – 84.6 | | | Sun protection | ALSWH18 | 6 | ~86.0 | | | Health services and medications | Visits to health professionals | ALSWH18 | 13 | ~86.0c | | Medications and supplements | ALSWH18 | 2 | 22.9 – 32.3a | In consultation with our student representatives, and the recommendations of Javidan et al.,16 recruitment strategies adopted for the BOOST-Well survey included: Faculty and ‘in-kind’ support in terms of staff time, space, and IT resources, (Recommendation #1); student input throughout the survey development process (Recommendation #3); Faculty budget support for incentives (20 x $100 AUD gift cards for the student group) (Recommendation #5); and generation of student awareness in the form of a promotional video which was developed to ensure that consistent information was provided to each group of students before they completed the survey (Recommendation #6). These strategies are compared with those used in seven earlier student surveys are shown in Table 2. | Author date and place | Participants | Response numbers | Response rate (%) | Time to complete | Javidan et al.16 six recommendations | ||||| |---|---|---|---|---|---|---|---|---|---|---| | Faculty support | Assigned student reps | Incorporated participant input into survey design | Protected time in class to complete survey | Incentives offered | Generated student awareness | ||||| | Fruh et al.,14 2021 USA | Undergraduate Nursing, 570 students | 176 completed | 31% | NR | Faculty supported recruitment processes; provided access to Qualtrics survey and statistical software; provided financial incentives for survey completion | NR | NR | NR | $15 eligible for electronic gift card | Initial email for distribution; 7 automated email reminders | | Holt and Powell,29 2017 UK | University wide, available online to 32,000 students | 3683 commenced (3428 completed) | 11% | NR | Faculty supported recruitment processes; provided access to Qualtrics survey and statistical software | NR | Engaged student services to inform included questions | NR | NR | Initial email for distribution | | Reichel et al.,20 2021 Germany | University wide, available online to 31,213 students | 4714 commenced (4351 completed) | 14% | Estimated 35–45 minutes | Faculty supported recruitment emails; provided access to physical spaces for participant recruitment and survey completion, Unipark survey and statistical software; provided financial incentives for survey completion | NR | 12 students completed a pre-test, minor adjustments made thereafter | NR | Incentives provided, fresh fruit @ physical space; charitable donation if > 5000 students completed survey (1000€), individual gift cards (13 x 24-40€) for local restaurants and for online store (15 x 20-100€) | Initial email for distribution; 4 reminder emails; research team members attended lectures; lecturers included slides; promotional material – posters, leaflets, newspaper press release, social media | | Sanci et al.,1 2022 Australia | University wide, available online to 56,375 students | 14,880 commenced (12,347 completed) | 22% | Estimated 20 minutes | Faculty supported recruitment processes; provided access to Qualtrics survey and statistical software; provided financial incentives for survey completion | NR | The project team was Advised by a stakeholder advisory group including student association; pilot tested in a 4h workshop with 15 students. Students provided feedback on framing and comprehension of questions, survey length and item order | NR | Random draw >50 prizes (ipads, cycle vouchers, gift cards) | Initial email distribution; 2-weeks prior posters, flyers, digital slides for lecturers, online student social media channels, promotional video; reminder emails weekly – 8 weeks | | Skromanis et al.,3 2018 Australia | University wide, available online to 15,259 students | 1,013 AUS 382 INT | 9% 9% | Estimated 20 minutes | Faculty supported recruitment processes; provided access to survey and statistical software; provided financial incentives for survey completion | NR | Pilot study to elicit feedback | NR | Gift vouchers, value not reported | Initial email distribution; single reminder email & SMS; social media, flyers and postcards | | Whatnall et al.,8 2019 Australia | University wide, available online to 33,783 students | 3,529 commenced (3077 completed); Optional questions: 3025 drug use; 1786 sexual health; 2962 mental health | 9% | Estimated 15 minutes plus optional sensitive questions on drug use, sexual health and mental health | Faculty supported recruitment processes; provided access to Survey Monkey survey and statistical software; provided financial incentives for survey completion | NR | NR | NR | Gift vouchers (5 x $100 AUD) | Bulk email distribution; 2 reminder emails; university staff prompted to promote the survey; social media; digital signage; posters | | Yeh et al.,9 2023 Australia and Taiwan | Nursing, available via pen and paper to an unknown number of eligible students | 381 completed survey (201 Australian, 180 Taiwanese) | NR | Estimated 30 minutes | Faculty supported recruitment processes; provided students access to hardcopy questionnaires and pencils survey; financial incentives for survey completion | NR | NR | NR | $2 chocolate | Verbal explanation by researchers during class; written material provided to students in class | | Number of studies following Javidan’s Recom | 7 of 7 | 0 of 7 | 4 of 7 | 0 of 7 | 6 of 7 | 7 of 7 | Data on survey completion rates and time taken to complete the survey are shown in Table 3. | Total(N = 201) | Medicine (n = 114) | Physiotherapy (n = 48) | Occupational therapy (n = 27) | Nutrition & dietetics (n = 12) | Group differences (p-value) | | |---|---|---|---|---|---|---| | Survey completion | N % | n % | n % | n % | n % | NR | | Partial | 27 | 22 | 1 | 3 | 1 | | | 13.4 | 19.3 | 2.1 | 11.1 | 8.3 | || | Complete | 174 | 92 | 47 | 24 | 11 | | | 86.6 | 80.7 | 97.9 | 88.9 | 91.7 | || | Duration (mins) of fully completed survey | Median | Median | Median | Median | Median | | | IQR | IQR | IQR | IQR | IQR | || | 14.4 | 14.4 | 14.2 | 17.4 | 16.8 | .006* | | | 12.3–16.8 | 12.1–16.2 | 12.3–16.3 | 13.4–22.2a | 14.2–19.7 | Of 273 registered students, 217 (79.5%) viewed the initial section of the online questionnaire, which preceded the actual survey questions. Of these, 201 proceeded to either fill out the survey, (either partially (n = 27; or completely (n = 174)), for an overall response rate of 73.6% (201/273) at least partial completions and 63.7% full completions. Completion rates ranged from 80.7% to 97.9% for individual programs, with medical students having the lowest completion rate. The median (IQR) time taken for completion was 14.4 (12.3-16.8) minutes. The Occupational Therapy students took significantly longer to complete the survey than the medicine or physiotherapy students (see Table 3). Response rates to each section of the survey were high, but missing data were common in questions which did not apply to some individuals or required students to recall events that may have occurred more than two months before the survey (e.g., age when started smoking, year of completing resuscitation training). Response rates to open-ended questions, such as ‘top 3 health concerns’ and ‘medications and supplements’ were also low (see Table 1). A summary of participants’ demographic characteristics is provided in Table 4 for the total sample and for students in each of the four program groups. There were significant group differences in age and language spoken at home. Medical students were younger than students in the three allied health programs and the Occupational Therapy and Nutrition and Dietetics students were less likely to speak English at home than the other students. | Characteristics | Programs | |||| |---|---|---|---|---|---| | All (N = 201) | Medicine (n = 114) | Physiotherapy (n = 48) | Occupational Therapy (n = 27) | Nutrition and Dietetics (n = 12) | | | Age (years), median (IQR) | 20.5 (18–25) | 18 (18–19)a | 25 (24–27) | 24 (23–30) | 25 (21.8–26) | | Range | 18–48 | 18–31 | 21–48 | 19–39 | 20–48 | | Missing, n (%) | 23 (11.4) | 14 (12.3) | 8 (16.7) | 1 (3.7) | 0 (0.0) | | Gender, n (%) | ||||| | A woman | 130 (64.7) | 70 (61.4) | 27 (56.2) | 22 (81.5) | 11 (91.7) | | A man | 69 (34.3) | 43 (37.7) | 21 (43.8) | 4 (14.8) | 1 (8.3) | | Prefer not to say/Other | <5% | <5% | <5% | <5% | <5% | | Indigenous origin, n (%) | ||||| | No | 200 (100) | 113 (100) | 48 (100) | 27.0 (100) | 12 (100) | | Missing | 1 (0.5) | 1 (0.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) | | Country of birth, n (%) | ||||| | Australia | 83 (41.3) | 65 (57.0) | 10 (20.8) | 6 (22.2) | 2 (16.7) | | Other English-speaking country | 49 (24.4) | 18 (15.8) | 25 (52.1) | 4 (14.8) | 2 (16.7) | | Non-English-speaking country in Asia | 58 (28.9) | 26 (22.8) | 11 (22.9) | 17 (63.0) | 4 (33.3) | | Other | 11 (5.5) | 5 (4.4) | 2 (4.2) | 0 (0.0) | 4 (33.3) | | Language usually spoken at home, n (%) | ||||| | English | 129 (64.5) | 78 (69.0) | 38 (79.2) | 9 (33.3) | 4 (33.3) | | Other | 71 (35.5) | 35 (31.0) | 10 (20.8) | 18 (66.7) | 8 (66.7) | | Missing | 1 (0.5) | 1 (0.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) | | Living arrangements, n (%) | ||||| | Live alone | 39 (19.5) | 22 (19.3) | 7 (14.9) | 7 (25.9) | 3 (25.0) | | On campus – shared | 68 (34.0) | 60 (52.6) | 5 (10.6) | 3 (11.1) | 0 (0.0) | | Off campus – shared | 60 (30.0) | 19 (16.7) | 28 (59.6) | 9 (33.3) | 4 (33.3) | | Other | 33 (16.5) | 13 (11.4) | 7 (14.6) | 8 (29.6) | 5 (41.7) | | Missing | 1 (0.5) | 0 (0.0) | 1 (2.1) | 0 (0.0) | 0 (0.0) | | Income source, n (%) | ||||| | No paid work | 106 (53.0) | 54 (47.4) | 32 (68.1) | 15 (55.6) | 5 (41.7) | | Regular paid work | 55 (27.5) | 30 (26.3) | 8 (17.0) | 10 (37.0) | 7 (58.3) | | Irregular paid work | 39 (19.5) | 30 (26.3) | 7 (14.9) | 2 (7.4) | 0 (0.0) | | Missing | 1 (0.5) | 0 (0.0) | 1 (2.1) | 0 (0.0) | 0 (0.0) | | Highest qualification, n (%) | ||||| | School only | 96 (47.8) | 96 (84.2) | 0 (0.0) | 0 (0.0) | 0 (0.0) | | Bachelor’s degree | 86 (42.8) | 13 (11.4) | 44 (91.7) | 19 (70.4) | 10 (83.3) | | Other | 19 (9.5) | 5 (4.4) | 4 (8.3) | 8 (29.6) | 2 (16.7) | | Level of study, n (%) | ||||| | Undergraduate | 114 (56.7) | 114 (100.0) | ||| | Postgraduate | 87 (43.3) | 48 (100.0) | 27 (100.0) | 12 (100.0) | A summary of the data is available on the project’s Open Science Framework page.36 The primary aim of this study was to develop and implement an online survey to examine the health and well-being behaviours of medical and allied health students, with higher participation and response rates than have been reported in previous surveys. As the survey data will be used to inform the development of evidence-based and targeted health promotion strategies, and as a resource for students to develop research skills in data management and analysis within their research subjects, it was important to achieve a high response rate across all the health professional programs. The completion rates of 73.6% (at least partial completion) and 63.7% (full completion) were markedly higher than those reported in previous studies in Australia,3,8 Germany12 and the UK13 that typically had response rates of 9-14%. There are however a small number of recent studies with higher response rates, including one Australian university-wide study that had a response rate of 22%1 and a USA based study that recruited only nursing students with a response rate of 31%.14 The higher response rate for the BOOST-Well survey may be explained by several factors; many of which overlap with the six strategies recommended by Javidan et al.16 as being critical for maximising response rates to student surveys. We involved students throughout the survey development process to inform survey content, recruitment strategies and incentives. Reichel et al.12 and Sanci et al.1 (who obtained response rates of 14% and 22% respectively to university-wide surveys), also incorporated some student input into their survey development. Incentives have been widely used in previous studies, usually in the form of gift vouchers with value between $15 and $100.3,8,12,14 Two recent meta-analyses have concluded that appropriate incentives for maximising response rates to online surveys are unclear,29,30 so we cannot say whether our incentive approach affected our response rate. Our use of a video to explain the survey on the day of completion precluded the need for initial or follow-up reminder emails, or promotional materials such as posters, slides, or social media, as was the case in previous studies.1,3,8,12,14 A major difference between our approach and that used in previous studies is that we provided protected time in class for students to complete the survey. The only similar approach was by Yeh et al.,9 who provided hard copy surveys to their students during class-time but required them to complete the survey in their own time. Our students completed the survey in class time during Orientation week or within the first two weeks of commencing their degree. At this time, they were new to the university and were not overly encumbered with classes and assessments, nor other requests to complete formal feedback surveys for the university (i.e. teaching evaluations). The survey was also kept as short as possible, so that completion time would be minimised. The median completion time (14.4 minutes) was a little shorter than anticipated and substantially shorter than most previous surveys, which often took 20-45 minutes to complete.1,3,8,12 A review by Sammut et al.31 indicates that short surveys of ~10 minutes have substantially better response rates than longer surveys; the brevity of the survey may therefore have positively influenced our response rate. Others have shown that survey length and the complexity of individual questions, as well as the percentage of open-ended questions, may be related to reduced response rates and greater amounts of missing data.32 Overall, the combination of codesigned survey development and recruitment strategies, which align well with those proposed by Javidan et al.16 probably underpin the high response rates to the BOOST-Well survey. However, it is acknowledged that Bond University is a small institution with a strong culture of student engagement, small class sizes and personalised teaching.33 This, together with the focus on health professional students, may help to explain the strong response rate. The overall student-informed survey content is a strength of this study. The survey included questions on quality of life and well-being (including physical, mental and general health), as well as health behaviours and use of health services and medications. Inclusion of questions on time use, stress and social support was seen to be critical to the current generation of university students. However, survey development required a balance between comprehensiveness and conciseness, and the need to minimise completion time meant that some health issues were not included. While this is a limitation, new issues, such as alternative dietary patterns, sleep, social media and/or screen use and reproductive health may be included in follow-up surveys. As the entire population of newly registered students in these programs was only 273, we also need to acknowledge the small sample size and lack of power analysis. Partially due to the small sample size, another limitation of the BOOST-Well surveys is that the external validity of this study in that the health priorities identified by Bond students may not be applicable to students from larger public institutions. The BOOST-Well data will be used to develop targeted strategies for improving student health and well-being. The data will also be used as a resource for students to learn about data cleaning, coding and statistical analysis. This is important because it is challenging to access ‘real world’ data for development of research skills, because of time restrictions associated with obtaining ethical clearance for collection of data in a single trimester. Educators will now encourage students to work in interprofessional groups, to provide meaningful insights for discussion and reflection of student health issues from an interdisciplinary perspective.34 In future, it is planned to evaluate student perspectives on their involvement in this project and assess whether the project is useful for development of research interests, literacy and skills and interprofessional practice skills. By following a series of recommendations from the literature, we developed an online health and well-being survey that had a completion rate that is substantially higher than that typically reported for other studies involving university students. The data will inform the development of evidence-based and targeted strategies for improvement of students’ health and well-being, and as a resource for students to develop research skills. A data custodian team was created to establish secure data storage and processing protocols, with the faculty statistician as the lead data custodian. To ensure that data from individual respondents could not be identified in subsequent analyses, each participant created a self-generated identification code (SGIC) before completing the survey. SGICs were based on elements of personal information known only to the student, in order to enable effective longitudinal tracking, should the survey be completed again in the future by the same students.35 Data linked to the SGICs were initially extracted from Qualtrics and saved in a separate data store, accessible only to the lead data custodian, who then created a new identifier code to replace the SGIC created by individual students. The SGIC code elements were re-ordered and recoded according to a mapping system created by the lead data custodian, with details in a password protected file that is only accessible by the lead data custodian. Once all potentially identifying variables were removed, data were transferred to a separate data store for use by members of the research team. Participants provided informed consent electronically prior to completing the online survey through Qualtrics. The study adhered to the Declaration of Helsinki and was approved by the Bond University Human Research Ethics Committee (JK02927). Open Science Framework: BOOST-Well: BOnd Online Survey for Student Health and Well-being Tracking, https://doi.org/10.17605/OSF.IO/DHQBY36 This project contains the following underlying data: 2024_May_BOOST_data_201.xlsx Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Open Science Framework: BOOST-Well: BOnd Online Survey for Student Health and Well-being Tracking, https://doi.org/10.17605/OSF.IO/DHQBY36 This project contains the following underlying data: Multimedia Appendix 2.pdf Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). The authors would like to offer special thanks to Professor Kevin J Ashton whose guidance, mentorship and support greatly impacted this work. Though Professor Ashton is no longer with us, his dedication to the BOOST-Well Project and research team inspired and guided the research. The authors would also like to thank the Executive Dean of the Faculty of Health Sciences and Medicine, Professor Nick Zwar, as well as Assistant Professors Elisa Canetti and Paul Dunn and Mrs Tanya Forbes for their support and assistance with this project. The authors also thank the FHSM student leadership representatives for sharing their student perspectives and all the students who participated in this study. - 1. Sanci L, Williams I, Russell M, et al.: Towards a health promoting university: descriptive findings on health, wellbeing and academic performance amongst university students in Australia. BMC Public Health. 2022; 22(1): 2430. PubMed Abstract | Publisher Full Text | Free Full Text - 2. Bruffaerts R, Mortier P, Kiekens G, et al.: Mental health problems in college freshmen: Prevalence and academic functioning. J. Affect. 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Publisher Full Text Author details Author details 1 Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, 4227, Australia Justin Keogh Roles: Conceptualization, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Evelyne Rathbone Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing Wendy J Brown Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Beth Mozolic-Staunton Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Gregory Cox Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing James Furness Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing Jaclyn Szkwara Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Roles: Conceptualization, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) Copyright © 2026 Keogh J et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. metrics | Views | Downloads | | |---|---|---| | F1000Research | - | - | | PubMed Central Data from PMC are received and updated monthly. | - | - | Citations CITE how to cite this article Keogh J, Rathbone E, Brown WJ et al. Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.12688/f1000research.168558.2) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. track receive updates on this article Track an article to receive email alerts on any updates to this article. Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 22 Feb 2026 Revised Views 0 How to cite this report: Cagigal AM. Reviewer Report For: Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.5256/f1000research.193546.r465772) The direct URL for this report is: https://f1000research.com/articles/14-808/v2#referee-response-465772 https://f1000research.com/articles/14-808/v2#referee-response-465772 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Reviewer Report 28 Mar 2026 Approved with Reservations VIEWS 0 Thank you for the opportunity to review this manuscript describing the development and implementation of the BOOST-Well survey, an online instrument designed to assess health behaviours and well-being among medical and allied health students at an Australian university. The authors report ... Continue reading I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close Thank you for the opportunity to review this manuscript describing the development and implementation of the BOOST-Well survey, an online instrument designed to assess health behaviours and well-being among medical and allied health students at an Australian university. The authors report a response rate of 73.6% (partial completion) and 63.7% (full completion), which is substantially higher than rates reported in prior literature. Below, I highlight some issues for consideration to strengthen the manuscript: 1. Insifficient justification for the study and unclear novelty. While the introduction highlights limitations of existing surveys (e.g., low response rates), it does not clearly articulate why a new survey was required, and what specifically differentiates the BOOST-Well survey from existing approaches. Recommendation: The authors should explicity clarify what the novel contribution is, why existing surveys were insufficient for their context, and what gap this study fills beyong simply reporting higher response rates. 2. Limited justification for use of survey methodology: The manuscript assumes surveys are the appropriate method without justification. Recommendation: Include a brief rational for why a survey is appropriate for captiring multidimensional health and wellbeing data, and why alternative approaches (e.g., interviews) were not suitable. 3. Some methodological details are missing or unclear. In terms of the timing of data collection, why were surveys administered at two different time points (May and September)? were there differences between cohorts? No justification or rationale is provided for sample size; while a formal power calculation may not be required for a descriptive methodological study, this should be explicitly stated. 4. Potential participation bias. Although the authors state that steps were taken to minimise coercion, administering the survey during scheduled class time may introduce implicit pressure to participate. Recommendation: More explicitly acknowledge this as a limitation, and discuss how this may have influenced participation rates and the generalisability of findings. 5. Interpretation and clarity of response rate comparisons. The discussion contains unclear phrasing when comparing response rates with prior studies. The manuscript states that previous studies had “higher response rates” (22% and 31%), which are in fact lower than those reported here. 6. Limited discussion of survey findings. While the stated aim is methodological, the manuscript provides almost no discussion of the actual health and well-being data collected. This creates a disconnect, as readers are told the data will inform interventions, but no insight is provided into what was found. Recommendation: Include at least a brief summary of key findings, or a claer statement that these findings will be reported separately in another manuscript. 7. Minor issues: Minor wording issue: “Skewed variables are reported as (medians with IQR)”, parentheses unnecessary. Ensure consistency of terms such as "response rate", "completion rate", "participation rate"; these are currently used somewhat interchangeably. The manuscript claims the survey was kept “as short as possible,” yet includes 136 items. This tension should be acknowledged and justified more clearly. Below, I highlight some issues for consideration to strengthen the manuscript: 1. Insifficient justification for the study and unclear novelty. While the introduction highlights limitations of existing surveys (e.g., low response rates), it does not clearly articulate why a new survey was required, and what specifically differentiates the BOOST-Well survey from existing approaches. Recommendation: The authors should explicity clarify what the novel contribution is, why existing surveys were insufficient for their context, and what gap this study fills beyong simply reporting higher response rates. 2. Limited justification for use of survey methodology: The manuscript assumes surveys are the appropriate method without justification. Recommendation: Include a brief rational for why a survey is appropriate for captiring multidimensional health and wellbeing data, and why alternative approaches (e.g., interviews) were not suitable. 3. Some methodological details are missing or unclear. In terms of the timing of data collection, why were surveys administered at two different time points (May and September)? were there differences between cohorts? No justification or rationale is provided for sample size; while a formal power calculation may not be required for a descriptive methodological study, this should be explicitly stated. 4. Potential participation bias. Although the authors state that steps were taken to minimise coercion, administering the survey during scheduled class time may introduce implicit pressure to participate. Recommendation: More explicitly acknowledge this as a limitation, and discuss how this may have influenced participation rates and the generalisability of findings. 5. Interpretation and clarity of response rate comparisons. The discussion contains unclear phrasing when comparing response rates with prior studies. The manuscript states that previous studies had “higher response rates” (22% and 31%), which are in fact lower than those reported here. 6. Limited discussion of survey findings. While the stated aim is methodological, the manuscript provides almost no discussion of the actual health and well-being data collected. This creates a disconnect, as readers are told the data will inform interventions, but no insight is provided into what was found. Recommendation: Include at least a brief summary of key findings, or a claer statement that these findings will be reported separately in another manuscript. 7. Minor issues: Minor wording issue: “Skewed variables are reported as (medians with IQR)”, parentheses unnecessary. Ensure consistency of terms such as "response rate", "completion rate", "participation rate"; these are currently used somewhat interchangeably. The manuscript claims the survey was kept “as short as possible,” yet includes 136 items. This tension should be acknowledged and justified more clearly. - Is the work clearly and accurately presented and does it cite the current literature? Yes - Is the study design appropriate and is the work technically sound? Yes - Are sufficient details of methods and analysis provided to allow replication by others? Partly - If applicable, is the statistical analysis and its interpretation appropriate? Yes - Are all the source data underlying the results available to ensure full reproducibility? Partly - Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: University students mental health and digital mental health CITE HOW TO CITE THIS REPORT Cagigal AM. Reviewer Report For: Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.5256/f1000research.193546.r465772) The direct URL for this report is: https://f1000research.com/articles/14-808/v2#referee-response-465772 https://f1000research.com/articles/14-808/v2#referee-response-465772 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. Views 0 How to cite this report: Flinn C. Reviewer Report For: Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.5256/f1000research.193546.r461071) The direct URL for this report is: https://f1000research.com/articles/14-808/v2#referee-response-461071 https://f1000research.com/articles/14-808/v2#referee-response-461071 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Reviewer Report 05 Mar 2026 Clodagh Flinn, University College Dublin, Dublin, Ireland; Psychology, Carleton University (Ringgold ID: 6339), Ottawa, Ontario, Canada Approved with Reservations VIEWS 0 Thank you for your work revising this manuscript.

Point 1: Why did the authors choose to examine medical and allied health students specifically, as opposed to university students more broadly? Building this rationale into the ... Continue reading I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close

Point 1: Why did the authors choose to examine medical and allied health students specifically, as opposed to university students more broadly? Building this rationale into the ... Continue reading Thank you for your work revising this manuscript.

Point 1: Why did the authors choose to examine medical and allied health students specifically, as opposed to university students more broadly? Building this rationale into the introduction would be useful. Point 2: In the last paragraph it says, "The survey data will be used to inform the development of evidence-based and targeted strategies for improvement of students’ health and well-being..." Given that the actual survey data is not discussed or analysed in this manuscript, I think this should be removed. The aim of this manuscript vs. the survey itself is summed up well in the first sentence in the discussion but should be clearly distinguished in the introduction too.

Point 3: How exactly were potential participants invited to take part? During class time? Point 4: There were 273 students registered. Do you know how many were present on the data collection days? Were students who were absent on those days given the chance to complete the survey at a later date? (If participants completed the survey during class time only).

Point 5: "partial" survey completion in vague. Please be specific here - for example, did participants fill in 90% of the survey or stop after the demographics? Please also update the abstract if needed. Point 6: Thank you for updating the tables in response to my previous comment. Can you please review table 4 in full to ensure changes are made throughout? E.g., some very low frequencies remain in the gender and country of birth rows (although not all are technically <5%, there are very few - less than 5 - participants). You could consider combining the OT and N&D groups - although I understand this is not ideal, it would avoid very small frequencies and help to protect the identities of participants.

Point 7: Strengths and limitations. I think reframing the strength regarding the student-informed survey would be beneficial. As it stands, this section reads as though the actual content included in the survey is the strength, but the actual survey data isn't what this manuscript examined. I think that the student engagement in the study design could be reframed as a key methodological strength - PPI in research is so important and a major strength of this study - don't underplay it! Also discuss the integration of relevant faculty, etc. in the survey -this adds knowledge and feedback from a range of experts. Minor points: Introduction. Paragraph 2 begins with, "Unfortunately, health and well-being information about university students is typically obtained through surveys." Consider rephrasing this sentence - there is nothing fundamentally wrong with collecting data with surveys, although there are challenges limitations (like with any methodology) which are discussed. Methods. Add citation for statistical software, Jamovi. The link to appendix 2 does not appear to be active.

Point 1: Why did the authors choose to examine medical and allied health students specifically, as opposed to university students more broadly? Building this rationale into the introduction would be useful. Point 2: In the last paragraph it says, "The survey data will be used to inform the development of evidence-based and targeted strategies for improvement of students’ health and well-being..." Given that the actual survey data is not discussed or analysed in this manuscript, I think this should be removed. The aim of this manuscript vs. the survey itself is summed up well in the first sentence in the discussion but should be clearly distinguished in the introduction too.

Point 3: How exactly were potential participants invited to take part? During class time? Point 4: There were 273 students registered. Do you know how many were present on the data collection days? Were students who were absent on those days given the chance to complete the survey at a later date? (If participants completed the survey during class time only).

Point 5: "partial" survey completion in vague. Please be specific here - for example, did participants fill in 90% of the survey or stop after the demographics? Please also update the abstract if needed. Point 6: Thank you for updating the tables in response to my previous comment. Can you please review table 4 in full to ensure changes are made throughout? E.g., some very low frequencies remain in the gender and country of birth rows (although not all are technically <5%, there are very few - less than 5 - participants). You could consider combining the OT and N&D groups - although I understand this is not ideal, it would avoid very small frequencies and help to protect the identities of participants.

Point 7: Strengths and limitations. I think reframing the strength regarding the student-informed survey would be beneficial. As it stands, this section reads as though the actual content included in the survey is the strength, but the actual survey data isn't what this manuscript examined. I think that the student engagement in the study design could be reframed as a key methodological strength - PPI in research is so important and a major strength of this study - don't underplay it! Also discuss the integration of relevant faculty, etc. in the survey -this adds knowledge and feedback from a range of experts. Minor points: Introduction. Paragraph 2 begins with, "Unfortunately, health and well-being information about university students is typically obtained through surveys." Consider rephrasing this sentence - there is nothing fundamentally wrong with collecting data with surveys, although there are challenges limitations (like with any methodology) which are discussed. Methods. Add citation for statistical software, Jamovi. The link to appendix 2 does not appear to be active. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Psychological wellbeing and resilience. Chronic health conditions. Developmental transitions. CITE HOW TO CITE THIS REPORT Flinn C. Reviewer Report For: Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.5256/f1000research.193546.r461071) The direct URL for this report is: https://f1000research.com/articles/14-808/v2#referee-response-461071 https://f1000research.com/articles/14-808/v2#referee-response-461071 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. Version 1 VERSION 1 PUBLISHED 20 Aug 2025 Views 0 How to cite this report: Flinn C. Reviewer Report For: Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.5256/f1000research.185745.r416932) The direct URL for this report is: https://f1000research.com/articles/14-808/v1#referee-response-416932 https://f1000research.com/articles/14-808/v1#referee-response-416932 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Reviewer Report 10 Oct 2025 Clodagh Flinn, University College Dublin, Dublin, Ireland; Psychology, Carleton University (Ringgold ID: 6339), Ottawa, Ontario, Canada Approved with Reservations VIEWS 0 The study aimed to develop an online survey on health, health behaviours and wellbeing for university students, implementing Javidan et al.'s recommendations in order to maximise response/participation rates. The collaborative development of the survey with students is a ... Continue reading I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close The collaborative development of the survey with students is a ... Continue reading The study aimed to develop an online survey on health, health behaviours and wellbeing for university students, implementing Javidan et al.'s recommendations in order to maximise response/participation rates. The collaborative development of the survey with students is a clear strength of the study, it is great to see this being actively integrated into the work. Overall, I believe this is a good study which addresses an important area - dealing with low response rates for research on student wellbeing. As it stands, the introduction/methods suggest that the main aim is to explore health and wellbeing, not to design and implement a survey. Based on the intro/methods, I expected to see findings of the actual survey in the results, e.g., are students reporting depressive symptoms, high levels of smoking, etc. I believe the aims may be somewhat confusing to readers - is it to develop a survey and boost/report response rates, or to investigate health and wellbeing in students? I think that the implementation of recommendations and strategies to increase participation are very important and central to the study, and so this should be highlighted as the primary main aim. This is a paper on the development of a survey and how you increased participation, but I did not feel that this was clear until the results/discussion. Clearly stating your aims and structuring your results accordingly would be useful. You could also consider splitting results into the initial pilot study (in 2022) and the main study (2024). Lastly, although this study is focused on how the researchers developed a survey and implemented a range of measures in order to increase participation, there is little description of this process in the methods section.

-Given that this is a methodological/technical paper (survey development and implementation), the introduction focuses more on the general literature on student mental health. Because of this I expected to read about the actual health of the sample, and not only the response rates, etc.

-The paper is about the development and implementation of a survey - there should be more detailed information on how exactly this was done. -Add more detail into the method about which topics specifically the survey covered, why were they chosen (e.g., based on the pilot study). How exactly was the survey developed? -More information should be included regarding specific measures, and especially the development of questions by the researchers. Why were certain measures used? -Were questions developed by the researchers based on previous research or the pilot study? -More detail on recruitment is needed - e.g., how did authors work with student/staff representatives? How were the representatives selected? What recruitment ideas were used from previous research? How were students invited to take part? -What are Javidan's recommendations and how were they implemented? (Given the centrality of maximising participation to the research, I expected to see more about how this was done). -Add explicit ethical acknowledgement into the methods section unless there is a reason not to.

-Table 1 is very useful for showing exactly what was included in the survey. I think it should be moved up into the method section as it is helpful for contextualising the study. -There are some very small frequencies reported in the demographics (e.g., one participant responded "other" for gender within the occupational therapy group). I am concerned that some participants could be identified by this given the name of the research institution and area of study are available. Please check that this cannot occur, and consider changing smaller frequencies to <5% instead.

-There is more information about the survey development/recruitment in the discussion than the methods, but this is not where it should be encountered for the first time. Much of this should be moved to the methods section - e.g., procedures, incentives, etc. used in the present study. The discussion could consider why these initiatives worked, etc. -Could further develop the point about how the findings can be used for teaching purposes - you could also discuss how these implications go beyond the classroom, expanding them to broader researchers/policy makers too. This study is a great example of how response rates can be significantly increased, possibly yielding more representative samples, etc. Very minor points: - Some very minor grammatical error (e.g., abstract: "meaning the representative of such data") - please do a thorough proof read. - Please include full explanations for all abbreviations within the tables. The collaborative development of the survey with students is a clear strength of the study, it is great to see this being actively integrated into the work. Overall, I believe this is a good study which addresses an important area - dealing with low response rates for research on student wellbeing. As it stands, the introduction/methods suggest that the main aim is to explore health and wellbeing, not to design and implement a survey. Based on the intro/methods, I expected to see findings of the actual survey in the results, e.g., are students reporting depressive symptoms, high levels of smoking, etc. I believe the aims may be somewhat confusing to readers - is it to develop a survey and boost/report response rates, or to investigate health and wellbeing in students? I think that the implementation of recommendations and strategies to increase participation are very important and central to the study, and so this should be highlighted as the primary main aim. This is a paper on the development of a survey and how you increased participation, but I did not feel that this was clear until the results/discussion. Clearly stating your aims and structuring your results accordingly would be useful. You could also consider splitting results into the initial pilot study (in 2022) and the main study (2024). Lastly, although this study is focused on how the researchers developed a survey and implemented a range of measures in order to increase participation, there is little description of this process in the methods section.

-Given that this is a methodological/technical paper (survey development and implementation), the introduction focuses more on the general literature on student mental health. Because of this I expected to read about the actual health of the sample, and not only the response rates, etc.

-The paper is about the development and implementation of a survey - there should be more detailed information on how exactly this was done. -Add more detail into the method about which topics specifically the survey covered, why were they chosen (e.g., based on the pilot study). How exactly was the survey developed? -More information should be included regarding specific measures, and especially the development of questions by the researchers. Why were certain measures used? -Were questions developed by the researchers based on previous research or the pilot study? -More detail on recruitment is needed - e.g., how did authors work with student/staff representatives? How were the representatives selected? What recruitment ideas were used from previous research? How were students invited to take part? -What are Javidan's recommendations and how were they implemented? (Given the centrality of maximising participation to the research, I expected to see more about how this was done). -Add explicit ethical acknowledgement into the methods section unless there is a reason not to.

-Table 1 is very useful for showing exactly what was included in the survey. I think it should be moved up into the method section as it is helpful for contextualising the study. -There are some very small frequencies reported in the demographics (e.g., one participant responded "other" for gender within the occupational therapy group). I am concerned that some participants could be identified by this given the name of the research institution and area of study are available. Please check that this cannot occur, and consider changing smaller frequencies to <5% instead.

-There is more information about the survey development/recruitment in the discussion than the methods, but this is not where it should be encountered for the first time. Much of this should be moved to the methods section - e.g., procedures, incentives, etc. used in the present study. The discussion could consider why these initiatives worked, etc. -Could further develop the point about how the findings can be used for teaching purposes - you could also discuss how these implications go beyond the classroom, expanding them to broader researchers/policy makers too. This study is a great example of how response rates can be significantly increased, possibly yielding more representative samples, etc. Very minor points: - Some very minor grammatical error (e.g., abstract: "meaning the representative of such data") - please do a thorough proof read. - Please include full explanations for all abbreviations within the tables. - Is the work clearly and accurately presented and does it cite the current literature? Partly - Is the study design appropriate and is the work technically sound? Yes - Are sufficient details of methods and analysis provided to allow replication by others? No - If applicable, is the statistical analysis and its interpretation appropriate? Yes - Are all the source data underlying the results available to ensure full reproducibility? Yes - Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Psychological wellbeing and resilience. Chronic health conditions. Developmental transitions. CITE HOW TO CITE THIS REPORT Flinn C. Reviewer Report For: Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.5256/f1000research.185745.r416932) The direct URL for this report is: https://f1000research.com/articles/14-808/v1#referee-response-416932 https://f1000research.com/articles/14-808/v1#referee-response-416932 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. Views 0 How to cite this report: Al-Jumaili AA. Reviewer Report For: Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.5256/f1000research.185745.r407853) The direct URL for this report is: https://f1000research.com/articles/14-808/v1#referee-response-407853 https://f1000research.com/articles/14-808/v1#referee-response-407853 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Reviewer Report 16 Sep 2025 Not Approved VIEWS 0 Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project Reviewer Comments

– The abstract lacks clarity and should be rewritten to clearly reflect the study’s ... Continue reading I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close Reviewer Comments

– The abstract lacks clarity and should be rewritten to clearly reflect the study’s ... Continue reading Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project Reviewer Comments

– The abstract lacks clarity and should be rewritten to clearly reflect the study’s aim, methodology, key findings, and conclusions. – Please remove citations from the abstract, as referencing other studies is not appropriate in this section.

– The methodology section is currently vague. It should explicitly state the study design (e.g., cross-sectional survey), the setting (e.g., university faculty), the country of study (Australia), and the data collection period (month/year). – Clarify how participants were selected and provide justification for the sample size.

– Please specify the academic level of the student participants (e.g., undergraduate, postgraduate). – The results section lacks substantive findings. Include key outcomes supported by descriptive statistics or thematic summaries. – Participant demographics and characteristics should be clearly presented to contextualize the findings.

– The stated aim is overly detailed and should be streamlined. Consider summarizing the aim in one concise sentence. – Clarify whether the study has one primary aim or multiple objectives, and ensure these are aligned with the abstract and methods sections.

Could you provide a completed CROSS checklist as supplementary material or clarify which specific items were most influential in shaping your survey design and reporting? Were any psychometric properties (e.g., reliability, construct validity) assessed for the BOOST-Well survey items? Why were only three student leaders included in the pilot phase? Would broader pilot testing have helped capture more diverse feedback? How was the sample size determined to ensure adequate power for subgroup comparisons? Were any demographic groups underrepresented in the final sample, and if so, how might this affect the generalizability of your findings? How were missing or incomplete responses handled during analysis, particularly for questions with revised instructions (e.g., physical activity)? Which specific variables were marked as “NR” due to unmet assumptions, and how did this affect interpretation of group comparisons? Why was Jamovi selected for analysis, and were any limitations encountered compared to other platforms like SPSS or R?

Table 2-It is better to separate results those with NR from those with P-value (using different tables) Table 4 seems part of review article summarizing previous studies. Please justify why your research includes such a summary, given it is a research article.

“An online survey was developed to better understand the health behaviors and health and well-being for medical and allied health students, with a completion rate that is substantially higher than that typically reported.” This sentence is not supported by results (at least they are not shown in the abstract results). Reviewer Comments

– The abstract lacks clarity and should be rewritten to clearly reflect the study’s aim, methodology, key findings, and conclusions. – Please remove citations from the abstract, as referencing other studies is not appropriate in this section.

– The methodology section is currently vague. It should explicitly state the study design (e.g., cross-sectional survey), the setting (e.g., university faculty), the country of study (Australia), and the data collection period (month/year). – Clarify how participants were selected and provide justification for the sample size.

– Please specify the academic level of the student participants (e.g., undergraduate, postgraduate). – The results section lacks substantive findings. Include key outcomes supported by descriptive statistics or thematic summaries. – Participant demographics and characteristics should be clearly presented to contextualize the findings.

– The stated aim is overly detailed and should be streamlined. Consider summarizing the aim in one concise sentence. – Clarify whether the study has one primary aim or multiple objectives, and ensure these are aligned with the abstract and methods sections.

Could you provide a completed CROSS checklist as supplementary material or clarify which specific items were most influential in shaping your survey design and reporting? Were any psychometric properties (e.g., reliability, construct validity) assessed for the BOOST-Well survey items? Why were only three student leaders included in the pilot phase? Would broader pilot testing have helped capture more diverse feedback? How was the sample size determined to ensure adequate power for subgroup comparisons? Were any demographic groups underrepresented in the final sample, and if so, how might this affect the generalizability of your findings? How were missing or incomplete responses handled during analysis, particularly for questions with revised instructions (e.g., physical activity)? Which specific variables were marked as “NR” due to unmet assumptions, and how did this affect interpretation of group comparisons? Why was Jamovi selected for analysis, and were any limitations encountered compared to other platforms like SPSS or R?

Table 2-It is better to separate results those with NR from those with P-value (using different tables) Table 4 seems part of review article summarizing previous studies. Please justify why your research includes such a summary, given it is a research article.

“An online survey was developed to better understand the health behaviors and health and well-being for medical and allied health students, with a completion rate that is substantially higher than that typically reported.” This sentence is not supported by results (at least they are not shown in the abstract results). - Is the work clearly and accurately presented and does it cite the current literature? No - Is the study design appropriate and is the work technically sound? Partly - Are sufficient details of methods and analysis provided to allow replication by others? No - If applicable, is the statistical analysis and its interpretation appropriate? Partly - Are all the source data underlying the results available to ensure full reproducibility? Partly - Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Social and Administrative Pharmacy, Pharmacy Education, Pharmacy Practice, Clinical Pharmacy, Public Health, and Pharmacoeconomics. CITE HOW TO CITE THIS REPORT Al-Jumaili AA. Reviewer Report For: Reflections on the development and implementation of a university student health and well-being online survey: the BOOST-Well project [version 2; peer review: 2 approved with reservations, 1 not approved]. F1000Research 2026, 14:808 (https://doi.org/10.5256/f1000research.185745.r407853) The direct URL for this report is: https://f1000research.com/articles/14-808/v1#referee-response-407853 https://f1000research.com/articles/14-808/v1#referee-response-407853 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. Alongside their report, reviewers assign a status to the article: - Approved - Approved with reservations - Not approved | Invited Reviewers | ||| |---|---|---|---| | 1 | 2 | 3 | | | Version 2 (revision) 22 Feb 26 | read | read | | | Version 1 20 Aug 25 | read | read | Sign up for content alerts You are now signed up to receive this alert Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. 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