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The Health Mode On and Health Mode On Plus protocols implement a stepped, integrated model of prevention and care to assess and promote mental wellbeing and healthy lifestyles among Italian university students.

The paper describes a multisite protocol (HMO and HMO+) funded by the Italian Ministry of University and Research, which combines harmonized surveillance with a stepped care model aligned with the WMH-ICS framework. It includes a cross-sectional survey, longitudinal follow-up, and an embedded randomized evaluation of digital cognitive-behavioral therapy (e-CBT) versus counseling-as-usual for students with anxiety risk. Primary outcomes are DSM-5 disorder status and safety outcomes, with secondary outcomes including sleep, physical activity, and other lifestyle factors.

Last updated: Aug 9, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Health Mode On and Health Mode On Plus: a multisite protocol to assess and promote mental wellbeing and healthy lifestyles among Italian university students.

observational

Vigezzi GP, Mosconi G, Albini G, Brusaferro S, Carli A, Emdin M, Faggiano F, Ogliari A, Raglio A, Rizzo C, Rossi E, Odone A · Frontiers in public health (2026)

Participants: N/A
Duration: 12 months follow-up for HMO+
Intervention: Stepped, integrated model of prevention and care including an online survey, integrated counseling pathway, Virtual Academy, and an embedded two-arm randomized evaluation of e-CBT versus counseling-as-usual.
Outcome: 12-month and lifetime DSM-5 disorder status, suicidal ideation, non-suicidal self-injury, psychological distress, role impairment, sleep, physical activity, dietary habits, nicotine and cannabis use, behavioral addictions, social connectedness, academic engagement, service access.
Effect Size: N/A
Population: Italian university students across five universities, four AFAM institutes, and one Scuola Superiore Universitaria.

Result:

PubMed: 42553706DOI: 10.3389/fpubh.2026.1786142

Mechanism Graph

Step 1: Implement cross-sectional census-style online survey to assess mental health and lifestyle.
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Step 2: Provide integrated counseling pathway and Virtual Academy for staff and student mentors.
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Step 3: Offer e-CBT or counseling-as-usual to students with anxiety risk profile.
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Result: Improved mental wellbeing and healthy lifestyles through coordinated prevention and care.

Limitations

  • ⚠The paper is a protocol description, not a results report, so no efficacy data are provided.
  • ⚠The embedded e-CBT trial is only for students with anxiety risk, limiting generalizability to other conditions.
  • ⚠Accelerometry for physical activity is only in subsamples, potentially limiting objective data completeness.

Frequently Asked Questions

What is the Health Mode On protocol?▼

Health Mode On is a multisite protocol funded by the Italian Ministry of University and Research that implements a cross-sectional survey and an integrated counseling pathway to assess and promote mental wellbeing and healthy lifestyles among Italian university students.

What is the difference between Health Mode On and Health Mode On Plus?▼

Health Mode On Plus adds a 12-month re-contact, objective lifestyle sub-studies, and a strengthened shared digital platform for first-contact intake, triage, and orientation to services, compared to the cross-sectional Health Mode On.

What are the primary outcomes measured in this study?▼

Primary outcomes are 12-month and lifetime DSM-5 disorder status (mood, anxiety, trauma, OCD, eating, ADHD, substance use) and safety outcomes including suicidal ideation, planning, and non-suicidal self-injury.

What is the embedded randomized evaluation in this protocol?▼

Students with an anxiety risk profile may be offered participation in a two-arm randomized evaluation comparing digital cognitive-behavioral therapy (e-CBT) versus counseling-as-usual.

Products

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References

  1. 1.Vigezzi GP, Mosconi G, Albini G, Brusaferro S, Carli A, Emdin M, Faggiano F, Ogliari A, Raglio A, Rizzo C, Rossi E, Odone A. "Health Mode On and Health Mode On Plus: a multisite protocol to assess and promote mental wellbeing and healthy lifestyles among Italian university students.." Frontiers in public health, 2026. PMID: 42553706 DOI: 10.3389/fpubh.2026.1786142
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.