A Formative Study of Brief Affective Text as a Complement to Wearable Sensing for Longitudinal Student Health Monitoring

Wearable devices capture physiological and behavioral data with increasing fidelity, but the psychological context shaping these outcomes is difficult to recover from sensor data alone, limiting the utility of passive sensing for digital health goals such as early detection of distress, personalized intervention, and timely clinical outreach. We examined whether ultra-brief naturalistic concern text could serve as a scalable complement to passive sensing. In a year-long study of 458 university students (3,610 person-waves) tracked with Oura rings, participants responded bimonthly to an open-ended prompt about what concerned them most; responses had a median length of three words. We compared dictionary-based, general pretrained, and domain-adapted NLP approaches using within-person mixed-effects models across nine sleep and physical activity outcomes to determine which method best recovers physiologically relevant signal from brief naturalistic text. Weeks dominated by academic concern framing were associated with lower physical activity; weeks characterized by emotional exhaustion language were associated with poorer sleep quality and lower heart rate variability. General pretrained embeddings performed as well as or better than domain-adapted models across most outcomes, with differences between the two generally small and within the range of estimation noise. Zero-shot classification of concern topics showed no consistent evidence of association with outcomes; affective dimensions across all three methods showed more associations, though these did not survive correction for multiple comparisons, offering preliminary evidence that emotional register may carry more signal than topical content. These findings offer design guidance: ultra-brief affective prompts enrich the psychological interpretability of passive physiological data at minimal burden.