The COVID-19 pandemic is one of the most profound crises of our time. The socioeconomic impact of the crisis has been devastating, as have the repercussions on the well-being of the populations. In France, the general population has undergone 3 confinements (March 17 to May 10, 2020; October 30 to December 15, 2020; and April 3 to May 3, 2021). Since the beginning of the COVID-19 pandemic, university students have not been spared and have faced many challenges. They have had to adapt to many constraints (eg, reduced number of students in classrooms, wearing masks) and significant changes in teaching (eg, distance and/or hybrid education). It was only at the beginning of the academic year September 2021 that the university has returned to an almost normal functioning (ie, almost all face-to-face teaching with the full complement of students but with the wearing of masks maintained). However, the re-increase in COVID-19–positive cases since November 2021 suggests that students’ conditions could be affected again in the coming weeks.

Students are among the population for whom the pandemic has had the most negative impact on their lives [1]. Even before the pandemic, university students were identified as a population with unhealthy lifestyles and habits, notably reflecting unhealthy diet [2], poorer mental health than their nonstudent peers [3], high levels of sedentary behavior (SB), and low levels of physical activity (PA) [4,5]. During the pandemic, and more specifically during the first lockdown, this unprecedented sanitary crisis clearly had a massive impact on the lifestyle and mental health of university students around the world [6], and French students have not been spared [7,8]. Studies conducted during the first lockdown have shown an increase in unhealthy lifestyles as evidenced by their high levels of SB [9,10] and their low levels of PA [8,11,12]. In the same vein, high levels of anxiety and depressive symptoms among university students were reported during the first lockdown in different countries around the world [13-15], just like in France [7,16]. The few longitudinal studies conducted during the following lockdown attest to a maintenance of the difficulties or even a worsening of them [7,17-19]. The authors suggest that adverse health effects will persist long after the COVID-19 pandemic and note the need for long-term interventions [20,21]. In this perspective, interventions in PA appear particularly appropriate. Indeed, even if this was already known before, this pandemic reinforces the protective role of PA on physical and mental health [22,23]. This has led many governments and sports science societies to provided recommendations on PA and SB during the COVID-19 pandemic, particularly to prevent the occurrence or worsening of chronic diseases [24-26]. Despite these recommendations, very few interventional studies to promote PA and reduce SB have been conducted.

As noted above, students were particularly affected by the COVID-19 pandemic and were already a vulnerable population before the pandemic. Therefore, they are a prime target for this type of intervention. It is essential to conduct interventional studies with university students to accompany them in this (even more) complex period and prevent the deterioration of student health in a COVID-19 context. However, getting students to engage in health promotion interventions is often difficult. Indeed, many students do not seek help [27] due to barriers such as stigma or lack of information [28]. Therefore, it is essential to go beyond traditional interventions and provide more innovative and accessible interventions to achieve real student engagement. This is especially important because if we don’t implement interventions to which students adhere, we may see lasting alterations in their lifestyles and, more broadly, in their health.

This study is conducted in order to reduce or prevent deterioration of the health of university students related to the COVID-19 pandemic. Specific objectives of this study are to measure the impact of this innovative program on physical capacities, lifestyle, and psychological issues. We hypothesized that our program can have beneficial effects on university students’ physical capacities, improve their motivation to engage in PA, reduce their SB, and improve psychological issues.

To this end, students from the University of Nîmes have benefited from an innovative intervention aimed to improve their motivation to engage in PA and reduce sedentary lifestyle. First, co-construction workshops were conducted with participants to define the modalities of the expected PA program. Once the program was co-constructed between pairs, they participated in the new program. This paper aims to describe the protocol of this study.

The COVID-19 pandemic has increased unhealthy lifestyles of students that were already prevalent before the pandemic. Their difficulty in engaging in PA programs justifies the need for innovative interventions to address their specific needs. First, in February 2021, our team conducted a pre-study to evaluate the effects of a PA program conducted by students for other students to promote PA and social interactions. However, the restricted access of students in the university to minimize COVID-19 propagation did not permit us to obtain a large sample size. In order to conduct a larger study, we have developed a research project called Cov’Etu. It was submitted in April 2021 in the framework of a call for proposals about COVID-19 (AAP Résilience–COVID-19) managed by the French research agency (Agence Nationale de la Recherche) and approval was granted. The Cov’Etu project includes 2 axes of research. The first axis aims to identify the role of individual factors (eg, symptoms of COVID-19, health concerns) on students’ psychological health (eg, anxiety and well-being) and lifestyle (eg, SB, alcohol) over the course of the pandemic. The second axis of research evaluates the health effects of 2 programs. Our research protocol refers to one of these programs as it is called in French, UNIMES EN FORME.

This study was conducted among students from the University of Nîmes. Nîmes is a midsize city in the southern part of France that has 4 university campuses. In academic year 2021/2022, 5201 students were registered at this university, of which approximately 4000 are on the main university campus named Vauban. This campus site is located in the heart of the city and includes the administrative and sports infrastructures in addition to auditoriums and classrooms. The inclusion criteria were as follows: (1) have their courses mainly on the Vauban campus (this campus site includes students in the bachelor and master levels mainly in psychology, law, and art/design); (2) be aged 18 years or older; (3) have never benefited from any intervention in the field of PA; and (4) sign a consent form to participate in the study. Three principal exclusion criteria were established: (1) with physical diseases that prevent PA practice (eg, cardiovascular disease), (2) in sport sciences, and (3) not signing the consent form to participate in the study.

The study was designed as a randomized controlled trial with 2 groups. The first was the intervention group including participants who have benefited from a co-construction workshop and an innovative PA program based on their workshop. The second was the control group, which included students who had not benefited from any intervention. In total, 110 university students agreed to participate in the program, with 55 students in the intervention group and 55 in control group and randomization by age and gender. The number of students enrolled and chronological stages of the study are reported in the flowchart (Figure 1).

An ethics review was not applicable for this study because all personal data was collected anonymously and the program evaluated has been integrated into the University Service of Physical and Sports Activities at the Université de Nîmes (governed by decree No. 2018-792 of September 13, 2018 relating to university common services) established by the Ministry of Higher Education, Research and Innovation.

The recruitment of the students was done with the approval of the Université de Nîmes health service to ensure good physical condition of the participants and was available to students throughout the program. Participants agreed to participate in this study after reading a consent form. They were informed that their personal data would remain anonymous, their participation was voluntary, and they could withdraw at any time. The study was conducted in accordance with the Declaration of Helsinki.

First, a workshop with the participants of the intervention group was realized to co-construct the PA program in order to remove barriers to the practice of PA. The aim of co-construction with users was to obtain better adherence to the program by being based on needs of the users themselves and not imposed by others. Second, the co-constructed PA program was conducted with them for 8 weeks with sessions twice per week.

For both groups, during September/October 2021, baseline assessments (T0) were conducted: measurements of PA and sedentary time (ST; with an accelerometer), physical fitness and body composition (face-to-face measurement), and psychological variables (online assessment). The final assessments (T1) were conducted in December 2021.

During the first week, participants from the intervention group were invited to a meeting to co-create a PA program. Two workshops (10 participants per group) were organized in order to clarify the students’ expectations. The objectives of these workshops were as follows: (1) understand their motivations to engage in PA and/or sports, (2) understand the barriers and levers to these engagements, (3) determine the types of sports and/or PA that particularly interest both athletic and nonathletic people, and (4) determine their understanding and perception of communication supports on these topics.

The PA program was established according to these workshops. It consisted of weekly sessions (on the day of the participant’s choice) less than an hour in length. Activities such as cross-training and cardioboxing make up most of the program sessions. Table 1 provides an example of cross-training and cardioboxing sessions. Cross-training consisted of exercises organized in circuit training with kettlebells, swissballs, slamballs, battle rope, suspension straps, and elastic bands. Cardioboxing consisted of exercises such as shadow boxing, kickboxing, and muay Thaï sequences organized in several rounds. Once a week, a team sports event was organized (volleyball, baseball, tchoukball, spikeball, etc). The PA program was designed to develop strength, endurance, and flexibility/mobility in each session. Participants participated in at least 1 session a week and had a privileged access to all on-campus sports activities without registration. To communicate with participants about the program, the schedule, or any other important information, a group was created on the Discord social media platform with a subgroup for each main topic.

To further analyze changes in anthropometric values, physical fitness, objective and subjective PA and ST, sleep, and psychological variables, statistical comparisons might include (but will not be limited to) t tests, analysis of variance, Mann-Whitney U test, Kruskal-Wallis test, Pearson/Spearman correlation analyses, or linear and multiple regression analyses. Analyses will be performed using JASP software (version 0.14.1, JASP Team).

This protocol paper describes the methodology processes of an innovative intervention, encompassing both PA and psychosocial components, designed to help university students. We expect that our intervention based on a co-construction program will lead to an improvement in students’ motivation to engage in PA, reduce their SB, and have positive effects on their psychological states, which appears to be even more essential during and after COVID-19 pandemic.

Indeed, the COVID-19 pandemic has profoundly influenced our behaviors in terms of PA and SB at all ages of life [28], especially among university students [52]. This study is in line with a recent systematic review on PA and physical capacities among students [53] that revealed it is crucial to get their awareness and have them maintain a satisfactory level of PA and physical fitness.

Moreover, unlike most studies that conduct conventional PA programs without taking into consideration the expectations of the participants [54], our study includes an innovative protocol based on users’ preferences. In this study, the co-construction of a PA program was used as a creative way to re-engage students in PA and modify their lifestyles, which have been deteriorated during the COVID-19 pandemic.

This approach seems particularly interesting because it has been shown that a co-constructed participative workshop was efficient to promote healthy eating habits in a socioeconomically disadvantaged population [55] and for children [56,57]. Engaging in a chosen and desired recreational PA could maintain active behaviors through healthy lifestyle habits [58].

Finally, while most studies mobilize either objective or subjective measures, our protocol proposes to cross the two in order to provide as many insights as possible on the effects of our program. For illustration, our research protocol includes several objectives measures (eg, anthropometric values, flexibility, strength) and subjective measures (eg, psychological variables) but also double measures (accelerometry and questionnaires) for PA and SB as well as sleep in order to compare the measures with this population.

Despite the inclusion of 110 participants, the loss of participants was substantial even before the program began. This can be partly explained by the lack of time at the beginning of the academic year or the fear of doing a PA with others during a pandemic period. It may also be due to the requirement to complete different assessment sessions (physical fitness and questionnaires, at approximately 30 minutes each) and 5 days of accelerometer wearing for baseline and T1 measurements. However, it is important to note a high adherence of participants to the PA program, suggesting that the engagement of the students who remained in the program was high.

To the best of our knowledge, there have been no comparable protocols conducted on students, even more so during COVID-19. The pandemic has highlighted the need to pay more attention to the physical and psychological health of students. For this, the development and evaluation of innovative interventions to address their specific needs is essential and could be transferred to people with chronic diseases or older people. In the future, this co-construction approach could be used later by organizations and universities in order to limit unhealthy habits and promote PA while increasing motivation.