How do policy levers shape the quality of a national health system?

Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.     

Assessing social work and nursing students’ intentions to work with dying patients

This study assessed social work and nursing students’ intentions to provide end-of-life care, based on the Theory of Planned Behavior. A total of 181 social work and nursing students completed a questionnaire examining intentions to provide end-of-life care, attitudes, subjective norms, perceived control, death anxiety, subjective knowledge, and sociodemographic characteristics. Students manifested a moderate level of intentions to provide end-of-life care, with nursing students indicating higher levels of intentions than social work students. Multiple regression analyses revealed that attitudes, subjective norms, and previous experience were the main predictors of intentions to provide end-of-life care. Recommendations for academic programs are discussed.     

Evaluating the effect of a campus-wide social norms marketing intervention on alcohol-use perceptions,consumption, and blackouts

Objective: To evaluate the effect of a campus-wide social norms marketing intervention on alcohol-use perceptions, consumption, and blackouts at a large, urban, public university. Participants: 4,172 college students (1,208 freshmen, 1,159 sophomores, 953 juniors, and 852 seniors) who completed surveys in Spring 2015 for the Spit for Science Study, a longitudinal study of students' substance use and emotional health. Methods: Participants were e-mailed an online survey that queried campaign readership, perception of peer alcohol use, alcohol consumption, frequency of consumption, and frequency of blackouts. Associations between variables were evaluated using path analysis. Results: We found that campaign readership was associated with more accurate perceptions of peer alcohol use, which, in turn, was associated with self-reported lower number of drinks per sitting and experiencing fewer blackouts. Conclusions: This evaluation supports the use of social norms marketing as a population-level intervention to correct alcohol-use misperceptions and reduce blackouts.     

Alcohol consumption among undergraduate social work students at a South African university

ABSTRACT

Alcohol consumption among tertiary level students is a public health problem that can adversely affect students’ performance at university. This study therefore investigated the drinking patterns; reasons for drinking; and the perceived impact of drinking on academic performance of undergraduate social work students at a South African university. Of the 145 students who completed a group administered survey questionnaire, 88% reported using alcohol mainly for social purposes and enjoyment, with two-fifths admitting to participating in binge drinking. Despite these findings, a high proportion (78%) reported not performing poorly on a test or exam due to alcohol consumption in the preceding 12 months. Recommendations are provided for the education and support of social work students as future healthcare professionals.     

Non-government organization study awards: enhancing successful completion of social work qualification

ABSTRACT

The current study used a sequential, exploratory mixed-method design to explore how a social work study scholarship implemented in Aotearoa New Zealand impacted on recipients’ qualification completion and their professional and practice competence. Phase one involved 13 individual interviews with past award recipients which described how the study award impacted on their qualification completion. Thematic analysis was used to extract themes. These themes were examined in the second phase through a quantitative battery completed by 107 past recipients to examine their professional and practice competence. The findings from interviews showed the award enabled recipients to complete their studies and improve their social work practice without causing undue stress or financial pressure on the recipient and their family. Quantitative analysis corroborated and extended these findings to demonstrate that the award contributed to lifting the level of social work knowledge, competence, and skills in the recipients. Accompanying the successful qualification completion, these qualified social workers were equipped with essential skills, promoting social work values and competence to contribute and safeguard the benefit of children, families, and communities. The awards offered a ‘wrap around’ support and was not limited by age or ethnicity but provided a support system to achieve qualification completion.     

Peer support and food security in deaf college students

Abstract

Objective: The purpose of the study was to investigate whether peer support and demographic characteristics predicted food security among deaf college students. Participants: The sample included 166 deaf college students at Gallaudet University. Methods: Participants completed a bilingual online survey in American Sign Language (ASL) and English. This survey included USDA’s 6-item food security survey, questions about peer support and socio-demographic characteristics. Results: Out of 166 students (mean age =23; SD?=?6), 60.7% were food secure. About 26.4% were at-risk for low food security and another 12.9% had very low food security. The sample included respondents who identified as people of color (54%) and women (52%). Binary logistic regression revealed that compared to people who reported always receiving peer support, people who never received peer support were 16.3 times more likely to experience food insecurity (adj OR: 16.325, 95% CI 1.824–146.107). Conclusions: This study demonstrates a strong relationship between peer support and deaf college students' food security experiences.     

Are college students health literate?

Abstract

Objective: To examine the health literacy of college students. Participants: A convenience sample of 245 graduate and undergraduate college students. Methods: During February–April of 2018 participants completed the Short Test of Functional Health Literacy which assessed literacy on two passages describing a thyroid scan, and basic healthcare insurance information. Results: Most college students displayed adequate health literacy (99.2%). The ANOVA analyses revealed college classification was the most significant predictor, followed by ethnicity, sex, and primary language. Age was significantly related to health literacy, when holding college classification constant. Interestingly, college major, healthcare work experience, or having health care credentials were not predictors of health literacy. Conclusion: This group of college students had adequate health literacy skills. However, the results of this study revealed demographic disparities that suggest further study.     

Truth® ads,receptivity, and motivation to use or quit tobacco among college students

Abstract

Objective: Examine receptivity and motivation to use/quit tobacco among college students after viewing Truth ads. Participants: Random sample of 10,000 college students invited to complete online survey February 2016 (8.5% response rate). Methods: Quasi-experimental. Participants (N?=?854) watched four ads and answered survey items for each ad. Results: Students rated ad receptivity and decreased motivation to use tobacco higher for the Catmageddon ad than the others. Regardless of ad, men and current cigarette smokers reported lower receptivity. Younger age was associated with lower motivation to use tobacco for all ads. Tobacco users reported greater motivation to quit with the Catmageddon ad. Conclusions: College students were receptive to the Truth ads, and many indicated lower motivation to use tobacco. Men, older college students, and current cigarette smokers were less receptive to the ads, reinforcing the need to develop tailored campaigns to reach these subgroups.     

Rural-urban differences in college students’ cardiovascular risk perceptions

Abstract

Objective: To examine rural-urban differences in college students’ cardiovascular risk perceptions. Participants: College students in rural (n?=?61) and urban (n?=?57) Kentucky counties were recruited from November 2012 to May 2014. Methods: This was a secondary data analysis of a cross-sectional study examining rural-urban differences in cardiovascular risk factors. Students rated their risk for developing high blood pressure, diabetes, high cholesterol, heart disease, having a stroke, and gaining excess weight. Chi-square and logistic regression were used for data analysis. Results: Rural students had lower odds of perceived high risk for developing high blood pressure compared to urban students (odds ratio (OR): 0.32, 95% CI: 0.11–0.96) after adjusting for race, sex, and body mass index. This association was not observed after adjusting for healthcare access variables. No other significant differences were observed. Conclusions: Efforts to raise perceived risk for developing hypertension among rural college students may be warranted.     

Knowledge of Suicide Risk Factors,But Not Suicide Ideation Severity,Is Greater Among College Students Who Viewed 13 Reasons Why

Abstract

Objective: To test associations between viewing 13 Reasons Why, Season 1 and past week suicide ideation severity, behavior risk, stigma, and knowledge in college students. To explore whether personal exposure to suicide and depressive symptom severity moderated these associations. Participants: Eight-hundred and eighteen college students, 64% (n?=?522) of whom watched 13 Reasons Why. Methods: Students completed surveys online. Multivariate negative binomial regressions were used to test associations between watching 13 Reasons Why and suicide-related variables, and interaction terms. Results: Suicide ideation severity and suicide behavior risk were not significantly associated with viewing 13 Reasons Why; however, there was limited statistical power to detect associations. The association between watching 13 Reasons Why and greater suicide knowledge was stronger among those who did not have personal exposure to suicide. Conclusions: 13 Reasons Why may be a platform for psychoeducation on suicide, particularly among those who do not have personal exposure.