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 passive sensing utility for digital health. 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. 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 outperformed domain-adapted models for most outcomes, with domain adaptation showing relative advantage for autonomic outcomes. Zero-shot classification of concern topics produced no significant associations, while affective dimensions across all three methods were consistently associated with outcomes, indicating emotional register rather than topical content carries the signal. These findings offer design guidance: ultra-brief affective prompts enrich the psychological interpretability of passive physiological data at minimal burden.