Mental health represents a global public health crisis. In 2019, approximately 970 million people were living with a mental disorder [1]. These conditions are shaped by structural determinants, such as food insecurity, violence, and childhood adversity, requiring responses that are context-sensitive and multifaceted [2]. Scalable, accessible approaches that extend beyond specialist care are therefore essential, particularly for young adults who will soon enter and sustain global health, education, and economic systems [3-6].

In the United States, an estimated 59.3 million adults experience mental illness annually, including 36.2% of individuals aged 18 to 25 years [7]. The burden is particularly pronounced among college students. Data from the Spring 2024 American College Health Association National College Health Assessment indicate that 19.5% of students screened positive for serious psychological distress, 25.9% for suicidality, and 48.5% reported loneliness [8]. Despite this, only 25% received counseling in the prior year.

Longitudinal survey data further demonstrate a rising prevalence of depression (21%-38%) and anxiety (22%-34%) between 2014 and 2024, with 13% reporting serious suicidal ideation [9,10]. These trends reflect distress rates comparable to or exceeding those of the general population, alongside persistent underuse of services. Importantly, mental health needs and help-seeking behaviors vary across academic disciplines, underscoring the need for context-sensitive rather than uniform interventions [11].

A range of interventions, including digital platforms, cognitive-behavioral approaches, and mindfulness-based programs, have demonstrated moderate effectiveness in reducing depression and anxiety among university students [12]. However, systematic reviews highlight ongoing challenges, including variability in outcomes, methodological limitations, and issues with engagement and implementation [13]. Earlier work similarly identified gaps in prevention and early intervention strategies within higher education [14]. More recently, attention has shifted toward curriculum-integrated approaches, such as credit-bearing wellness courses that embed mental health promotion within academic environments. Emerging evidence suggests these interventions may improve stress, coping, and help-seeking behaviors [15], yet existing studies are often limited to single courses or specific populations and provide limited insight into student experience or mechanisms of impact [16-19]. This gap is particularly relevant given rising student distress and continued underuse of traditional services. To address this, this study explored undergraduate students’ experiences of experiential wellness courses using a descriptive qualitative design with an inductive approach.

The purpose of this study was to explore students’ experiences and the perceived effectiveness of experiential wellness courses. The research question guiding this inquiry was: How do undergraduate students describe their experiences, the perceived effectiveness, and the personal impact of experiential wellness courses?

The analytic team brought complementary clinical, multidisciplinary, and lived perspectives to the study. The research team consisted of faculty researchers and student research assistants with backgrounds in nursing, social work, counseling psychology, and statistics. Recognizing that their professional roles could shape data interpretation, team members engaged in continuous reflexive practice. Before analysis, each analyst recorded positionality statements detailing personal wellness beliefs, prior exposure to college-health settings, and expectations about course impact. These statements were revisited during peer-debrief meetings to surface implicit assumptions. Differing interpretations were explored through reflexive discussion, with attention to how analytic perspectives were shaped by researchers’ disciplinary and experiential backgrounds [20,21].

The study was conducted across 6 undergraduate wellness courses offered over 4 semesters (2021‐2022 and 2022‐2023) at a private university in the Western United States. The courses were semester-long (14‐16 weeks), credit-bearing electives, and varied in topical focus, including mindfulness-based wellness, stress management and resilience, positive psychology, cognitive and behavioral wellness, lifestyle behavior change, and integrative wellness or student development. Course content emphasized stress physiology, cognitive restructuring, mindfulness practices, behavior change strategies, and intentional self-care, with instruction delivered through weekly applied assignments, structured reflection (eg, journaling), and discussion-based learning. Table 2 summarizes the courses, including target learners, educational objectives, enrollment size, instructional format, and core content areas.

Participants were a heterogeneous undergraduate sample that included nursing and prenursing students, other health-related majors (eg, exercise science), and nonhealth profession students. The courses functioned both as general education electives and as preparatory or complementary learning experiences for students pursuing health professions. A purposive sampling strategy was used to capture variation across pedagogical approaches, topical emphases, and disciplinary contexts within the university’s wellness curriculum. All registered students in the 6 selected courses were invited to complete an anonymous end-of-semester Qualtrics survey with open-ended prompts. Inclusion criteria were age 18 years or older, English fluency, enrollment in 1 of the 6 target courses, and completion of at least 1 substantive open-ended response. Surveys with blank qualitative items were excluded. Because data were collected from a fixed set of courses, formal thematic saturation was not used as a stopping criterion. Instead, sampling prioritized conceptual breadth across course types to support transferability and the identification of cross-cutting patterns in student experience.

The Brigham Young University Institutional Review Board ethically approved this study (IRB2021-192). Participants provided informed consent, and responses were deidentified on the online platform. Incentives for completion of the survey consisted of a US $5 gift card.

Data were collected via an anonymous postcourse online survey administered through Qualtrics after course completion. All enrolled students were invited via email, and participation was voluntary. Of the 125 consenting students, 110 (88%) provided usable responses. The survey system restricted submissions to one per participant, and no duplicate entries were identified. Survey design and reporting adhered to guidelines for web-based research [22].

The research team developed open-ended survey prompts informed by literature on college student mental health, wellness education, and experiential learning. The prompts were designed to elicit perceptions of course effectiveness, engagement with experiential components, and perceived impact on well-being, including coping strategies, behavioral change, self-awareness, and personal growth. The instrument was developed collaboratively by a multidisciplinary team and was iteratively reviewed for clarity, relevance, and alignment with study aims. Consistent with the exploratory qualitative design, the instrument was not pilot tested or psychometrically validated.

Survey responses were exported to a secure, encrypted file. Identifying information was removed, and responses were assigned numeric codes. Data were organized in Microsoft Excel to facilitate coding and analysis.

Analysis was conducted using reflexive thematic analysis [20]. A total of 2 analysts engaged in iterative, reflexive coding of the dataset, initially working through the data individually and then meeting regularly to discuss interpretations, explore alternative readings, and refine the evolving analytic framework. Coding was inductive and conducted line-by-line, using a flexible combination of in vivo (participant-language) and descriptive codes, with occasional simultaneous coding where excerpts reflected multiple meanings (Table 1).

Codes were not treated as fixed entities but were developed and refined through ongoing engagement with the data, supported by memo writing and an audit trail documenting analytical decisions. Through iterative comparison across responses, codes were grouped into candidate themes, which were subsequently reviewed and refined to ensure internal coherence and conceptual distinction. Themes were then defined and illustrated using representative participant quotations. Consistent with reflexive thematic analysis, the analytic process emphasized reflexivity, interpretive depth, and the coconstruction of meaning, rather than coding consensus or reliability. Reflexive journaling supported ongoing attention to how researchers’ perspectives shaped interpretation throughout the analytic process.

To enhance rigor, triangulation was operationalized through an iterative comparison of three sources: (1) student narrative responses, (2) relevant contemporary literature on wellness education and mental health interventions, and (3) input from external content experts. During analysis, the research team engaged in ongoing cycles of comparison between emerging codes and themes and existing literature. As preliminary patterns were identified, analysts conducted targeted literature checks to examine whether these patterns aligned with, extended, or diverged from prior findings. These comparisons were documented in analytic memos and discussed during regular team meetings, allowing for the refinement of theme definitions and ensuring that interpretations were both grounded in participant accounts and situated within the broader evidence base.

External expert review was incorporated after the initial theme development. A total of 2 subject-matter experts in counseling psychology and health promotion were provided with a summary of candidate themes, representative excerpts, and the analytic rationale. The experts were asked to assess conceptual clarity, coherence, and alignment with current knowledge in the field. Their feedback was discussed by the analytic team and used to refine theme boundaries, naming, and interpretation where appropriate. All changes informed by expert input were documented in the audit trail. This triangulated approach strengthened the credibility and confirmability of the findings by ensuring that interpretations were grounded in participant narratives while also being critically examined through both scholarly and expert perspectives.

Of the 125 students enrolled in wellness courses who consented to participate, 110 (88%) provided usable postcourse responses for analysis. Demographic information was available for the 125 consented participants. These participants were drawn from 6 courses offered across 4 semesters (2021‐2022 and 2022‐2023 academic years), representing a range of disciplines, including exercise science, interdisciplinary general education (honors), nursing, and student development; the latter reflects a general undergraduate or student affairs context rather than a health professions program (Table 3). Of the 125 students, the sample was predominantly female (n=115, 92%) and non-Hispanic White (n=113, 90.4%). Participants were relatively evenly distributed across academic years: first year (n=28, 22.4%), second year (n=32, 25.6%), third year (n=26, 20.8%), and fourth year (n=26, 20.8%), with a smaller proportion in their fifth year or beyond (n=13, 10.4%).

Across themes, students described an iterative 3-part process that recurred throughout the semester (Figure 2).

Findings suggest that undergraduate students’ experiences and perceived effectiveness of experiential wellness courses are characterized by 6 cross-cutting themes that illustrate how these courses may support student well-being. In this study, participants describe meaningful changes in daily behaviors, including the development of healthier habits and the application of practical coping strategies such as mindfulness, cognitive restructuring, and time management. In addition to skill acquisition, participants report increased self-awareness and personal growth, often accompanied by shifts in how they conceptualize stress, success, and self-care. Students consistently emphasize the immediate relevance and applicability of course content, which appears to enhance engagement and the sustained use of strategies. Peer interaction and discussion-based learning emerge as central mechanisms that foster validation, connection, and motivation. Although participants identify opportunities to improve course structure and organization, the findings collectively indicate that experiential, course-based wellness education supports both behavioral change and deeper meaning-making processes related to mental health and well-being.

Alignment with and extension of existing research on mental health interventions suggest that participants may report improvements in well-being following exposure to structured interventions. For example, meta-analytic evidence demonstrates that cognitive-behavioral and mindfulness-based approaches produce moderate reductions in depression and anxiety among college students, and participants in this study similarly reported acquiring practical skills such as cognitive restructuring, relaxation techniques, and time management strategies [12]. These findings reinforce the effectiveness of skill-based approaches to mental health promotion within undergraduate populations.

The findings also extend current understanding by highlighting the importance of experiential and contextually embedded delivery. Previous research indicates that mental health interventions, particularly digital and self-guided formats, often encounter challenges related to engagement, uptake, and sustained use [13]. In contrast, participants in this study emphasize that embedding wellness strategies within structured, credit-bearing courses enhances both engagement and accountability. The integration of weekly experiential assignments and reflective activities appears to support sustained behavior change, suggesting that curriculum-based approaches may mitigate implementation challenges identified in prior research.

The findings further extend earlier work on prevention and early intervention in higher education. Foundational reviews identify a limited and inconsistent evidence base for preventive mental health interventions among university students, particularly for anxiety and depression [14]. Although recent studies demonstrate increased interest in course-based and curriculum-integrated approaches, much of the existing literature remains focused on discrete interventions or single-course implementations. Recent scoping reviews further highlight that while well-being interventions are increasingly implemented across higher education, many lack theoretical coherence and are not systematically integrated into academic curricula [27]. By examining student experiences across multiple wellness courses, this study identifies cross-cutting patterns of change, including the development of durable coping skills, increased self-awareness, and shifts in meaning-making.

The prominence of self-reflection, peer dialogue, and perceived relevance in these findings adds important nuance to the intervention literature. Prior studies primarily emphasize symptom reduction and measurable psychological outcomes, whereas participants in this study describe changes at both behavioral and identity levels. These findings suggest that wellness courses function not only as skill-building interventions but also as environments that support relational learning and meaning reconstruction. In doing so, the study bridges intervention-based research and transformative learning theory, offering a more integrated account of how mental health promotion occurs within educational settings.

Finally, the findings highlight the importance of structural and contextual features of the learning environment, including small class sizes and discussion-based formats. Participants consistently identified peer interaction and psychological safety as central to their learning experience, indicating that the instructional context plays a critical role in shaping outcomes. This perspective extends existing research by positioning classroom structure as an active component of mental health promotion rather than a neutral delivery mechanism. These findings align with broader literature demonstrating that academic stress is a pervasive driver of student distress and that effective interventions must address both individual coping strategies and the educational environments in which students learn [28].

Students’ accounts reveal an iterative learning spiral that closely mirrors the Kolb 4-mode cycle [23,24]. Experiential learning assignments provided concrete experience; guided journals and peer dialogue fostered reflective observation; minilectures on stress physiology or cognitive restructuring offered abstract conceptualization; and the following week’s assignments invited active experimentation. Progressively, learners refined tactics for sleep hygiene, emotion regulation, and time management, demonstrating the Kolb premise that knowledge is continuously rebuilt as experience is tested, reflected upon, and reapplied [23,24].

While Kolb explains how learning moves, many participants described a deeper shift: questioning long-held beliefs, such as success equals constant busyness, and embracing new self-definitions (“I schedule rest with purpose”) [25,26]. These narratives align with the Mezirow transformative learning theory: early assignments acted as disorienting dilemmas, prompting critical self-examination; dialogue enabled recognition of shared struggle; and students then explored options, planned actions, tried new roles, and reintegrated reshaped worldviews into daily life [25,26]. Thus, the experiential spiral sometimes culminated not merely in competence but in genuine perspective transformation.

The R³ Cycle offers a concise synthesis of these findings, capturing the iterative process through which students move between self-awareness, pattern recognition, and intentional behavior change. Positioned alongside Kolb and Mezirow, the model highlights how experiential learning in this context extends beyond skill acquisition to include meaning-making and identity development. Table 3 provides a practical illustration of the model.

This study advances the wellness-course literature in three key ways. First, it demonstrates that experiential learning curricula can support both discrete coping skill development and deeper shifts in meaning perspectives—outcomes that are often examined separately. Students not only reported acquiring practical strategies (eg, mindfulness, time management, and cognitive restructuring) but also described changes in how they conceptualized success, rest, and self-worth, bridging skill-based and transformative learning perspectives. Second, the R³ model offers a concise, practice-oriented framework for understanding how experiential learning translates into both behavioral and meaning-level change. Distilling complex transformational processes into 3 iterative phases allows the proposed model to suggest a structure that is adaptable to educational settings and amenable to operationalization in future research [25,26]. Third, the findings suggest that motivational and contextual factors (particularly experiential practice, reflection, and peer interaction) may help sustain the integration of new skills and perspectives over time. These insights extend existing learning theory by highlighting mechanisms that support persistence beyond the classroom [23-26]. Thus, these contributions can help shift the focus from whether wellness courses are effective to how and why they facilitate meaningful and sustained change in student well-being.

These findings should be interpreted cautiously. First, they derive from a self-selected group at a single faith-based private university; respondents may differ from nonparticipants, and the campus culture, small class sizes, and elective credit structure may limit transferability. Second, the survey instrument was developed for the purposes of this study and was not formally pilot tested or psychometrically validated, which may affect the consistency and comparability of responses. Third, reliance on a single, postcourse open-ended survey limited opportunities for probing, introduced potential social desirability and recall bias, and provided limited evidence of sustained change over time. Fourth, all data were self-reported; objective indicators (eg, physiological stress measures or behavioral logs) were not collected to corroborate perceived gains. Fifth, the sample was predominantly female and non-Hispanic White, which may limit the transferability of findings to more diverse student populations and global nursing contexts, where experiences of stress, coping, and well-being may differ across sociocultural settings. Finally, although purposive sampling enabled the capture of diverse experiences across course types, the sample was drawn from a single institution and may not be fully transferable to other student populations or educational contexts. Together, these limitations underscore the need for mixed methods, multisite, and longitudinal research before broader generalization of the R³ model or causal inferences can be made.

As universities face rising levels of student stress and increasing demand for mental health services, these findings suggest that wellness courses may serve as a scalable, curriculum-based approach to supporting student well-being. Participants reported meaningful gains in self-awareness, coping skills, and behavior change, indicating that such courses extend beyond knowledge acquisition to support personal growth. Given that only 45.5% of students rate their mental health as very good or excellent, and 41.7% identify stress as a barrier to academic success, the integration of wellness education into undergraduate curricula represents a timely and necessary response [8]. These courses may provide upstream support that could help alleviate pressure on campus counseling services. Such implications may also contribute to a broader institutional shift in viewing universities not only as academic environments but also as settings that shape lifelong well-being [27-29]. The findings of this study are consistent with calls for integrating wellness and trauma-informed approaches into nursing education, as existing curricula often lack structured preparation for managing stress and emotional burdens [30]. Wellness courses, therefore, represent both an educational innovation and a promising public health strategy.

The findings also offer several practical implications for educators in nursing and other health professions. First, experiential wellness strategies can be integrated into existing curricula without requiring the addition of standalone courses. Brief, structured activities such as reflective journaling, guided discussion, and applied skill practice (eg, stress regulation techniques) can be embedded within existing coursework to support student well-being. Second, instructional format plays a critical role in shaping student engagement. Small-group and discussion-based learning environments appear to enhance psychological safety, peer connection, and participation. Even within larger programs, incorporating periodic interactive or small-group elements may strengthen learning outcomes. Third, students consistently identify practical, immediately applicable skills as the most impactful. Incorporating content such as stress physiology, cognitive strategies, and time management into health professions education may support both academic success and professional resilience. These approaches align with the growing emphasis on prevention, self-regulation, and well-being in health care training [31]. Fourth, repetition and sustained practice emerge as essential for behavior change. Rather than relying on one-time interventions, wellness education may be more effective when delivered longitudinally through repeated, low-intensity experiential activities that support habit formation over time. Finally, these approaches are feasible within common institutional constraints. Many strategies identified (eg, reflection, peer dialogue, and applied exercises) require minimal financial investment and can be implemented without specialized infrastructure. This positions experiential wellness education as a scalable, curriculum-integrated approach to supporting student well-being in nursing and other health profession programs.

Experiential wellness courses offer a promising approach to integrating well-being into higher education. In this study, students described meaningful changes in coping, behavior, and self-awareness and perceived course content as relevant and applicable to their lives. These findings may provide insight into how students perceive, engage with, and interpret experiential wellness education. Such courses may highlight the value of combining psychoeducation, applied practice, reflection, and peer dialogue within academic settings. In the context of rising student distress, curriculum-integrated approaches may be considered a complementary strategy to support student well-being.