College health services in California.

College health services are an underrecognized segment of California's health delivery system. Higher education institutions in California vary in their arrangements for the provision of health services. Some of the smaller institutions provide nurse triage, first aid, and referral only, whereas other institutions provide 24-hour-per-day/7-day-per-week comprehensive ambulatory and inpatient services. More than 200 full-time equivalent physicians are employed in college health services in California. Patient profiles served by college health services targeted the traditional college student age range. Some institutions, however, have expanded their services to include nonstudent university employees and their dependents. Comparing numbers of outpatient visits and professional staffing requirements to student enrollment showed significant variability between institutions, depending upon the scope of services provided (basic, intermediate, comprehensive) and the type of student population (residential, commuter, mixed).     

College psychiatry as public health psychiatry. 1967

This ten-year survey of the use of student mental health services offered by the University of North Carolina suggests that increased usage over time has been due to greater availability of staff and a broadening of services offered rather than to an increase of the prevalence of mental illness among the student body. The authors believe that college psychiatry, as one of the earliest examples of the provision of mental health services to a community, can be used as a model for other aspects of public health psychiatry.     

Responses of US college and university student health services to the 2004 influenza vaccine shortage

The United States experienced a shortage of influenza vaccine for the 2004--2005 influenza season. The authors surveyed college health programs to determine whether they had targeted vaccine to priority groups and knew how to reallocate remaining vaccine. They used an electronic message to distribute a Web-based survey to the members of 3 college-affiliated organizations--the Association of American Colleges and Universities, American Association of Community Colleges, American College Health Association--and to subscribers of the Student Health Service Listserv. They received 434 completed surveys. Sixty percent (259) of the respondents stated they had received vaccine and planned to vaccinate their high-risk students, staff, and faculty members; 77% (198) planned to reallocate leftover vaccine. Given the potential for future disruptions of the influenza vaccine supply, the authors recommend that college health programs establish policies to identify members of their high-risk population and also consider providing the live attenuated influenza virus vaccine.     

College smoking policies and smoking cessation programs: results of a survey of college health center directors

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessations programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.     

Simple measures of case mix in mental health services.

The concept of Case Mix in community mental health service program evaluation can be useful in mental health program evaluation if the definition of case mix is expanded beyond Diagnostic Related Groups (DRG), where DRG is solely based upon diagnosis and length of hospitalization stay. A case mix definition based upon two principal characteristics is offered. One characteristic is clinical status defined in terms of diagnostic signs and symptoms, level of functioning, and age. The other characteristic is typical treatment strategy for a given period of time (e.g., 13 weeks). Two cases mixes typical of services designed for the chronically mentally ill are discussed.     

The morphogenesis of disability policies and the personalisation of social services. A case study from Italy.

Across Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-made services came from different actors and perspectives: user-led organizations, intellectuals, policy makers, social workers, advocacy organizations, which call for a new way of programming, realizing and evaluating social policies. Personalization became a relevant part of the so called ‘welfare innovation narrative’, which concerns – to name but a few – English personalization agenda, Scottish self-directed support, Finnish education system, Norwegian cash-for-care policies. Even the European Commission is addressing new social services, reshaped through users’ capabilities. The aim of this paper is to critically explain, through a case study focused on the Sardinian disability policy, how social policy's morphogenetic cycles influence the governance of personalized disability plans and, consequently, the possibility of their implementation.     

Integration of leprosy control work with general health services as planned in Maharashtra

The current literature on integration of Leprosy Control work with General Health Services has been reviewed. In view of the introduction of Multipurpose Workers' Scheme and an experience in a pilot project, the authors feel that the time of integration of leprosy is ripe. The process of involvement of Multipurpose Workers in the Leprosy Control Programme is being introduced in a manner that ensures adequate supervision by the present Leprosy Control staff during the training period and also subsequently for one year so that the transition from unipurpose to integrated service, is a smooth one. After the successful integration of leprosy, the leprosy staff, after adequate training, can be used as Multipurpose Supervisors.     

Uniform assessments and standards of social and health care services.

This paper describes the procedures and methodology used in the development of a model In-Home Care services program for aged and disabled adults in Washington State. This program was designed to replace the existing Title XX chore services program in two geographic regions in which dissimilar chore service usage patterns have been exhibited by similar types of recipients. An analysis of the resultant cost, service utilization, and recipient health status data suggests that in the model program home-based services for the aged and disabled were provided in a more equitable and cost-effective manner than is the case with the existing chore service program in this state.     

Lessons on social and health disparities from older lesbians with alcoholism and the role of interventions to promote culturally competent services

ABSTRACT

Older adults who are lesbian, gay, bisexual, or transgender (LGBT) face greater health risks and possibly more costly care because of their reluctance to seek out health and long-term care services because of limited cultural sensitivity of service providers. This is particularly evident in older lesbians who face substantial risk of health problems associated with alcoholism and are less likely to be open with health care providers because of stigma combined with feelings of alienation, stress, and depression. An estimated 4.4 million older adults are predicted to have problems with alcohol by 2020, and the rates of alcohol-related hospitalizations are similar to those for heart attacks, creating exorbitant medical costs. More culturally competent health and long-term care may reduce health care costs by effectively addressing the dynamics of alcoholism, aging, and lesbian culture. Training initiatives such as those developed by the National Resource Center on LGBT Aging have begun to address the need of a more culturally competent aging services network. This article provides exemplars from empirical data on older lesbians with alcoholism to highlight some of the health, economic, and social disparities experienced in the aging LGBT community. Current interventions in the form of cultural competence training for service providers are presented as a potential step toward addressing health disparities among LGBT older adults.     

Underage college students' drinking behavior, access to alcohol, and the influence of deterrence policies. Findings from the Harvard School of Public Health College Alcohol Study

Underage drinking is a major problem at American colleges, but little is known about the extent of alcohol use in different student groups, in different colleges, and in states with different control policies. We used data from the 2001 and 3 previous Harvard School of Public Health College Alcohol Studies that compared responses of underage students with those of their 21-23-year-old peers. Underage students drank alcohol less frequently but were more likely to drink to excess when they drank. College educational efforts and deterrent policies were limited in their outreach, and half of underage students obtained alcohol very easily. Underage students in states with extensive laws restricting underage and high-volume drinking were less likely to drink and to binge drink. A majority of underage students supported increasing efforts to control underage drinking. The results suggest that additional policy efforts to control underage drinking may be effective and feasible.     

A meta-analysis of effectiveness of E-interventions to reduce alcohol consumption in college and university students.

Objective: To evaluate the effectiveness and moderators of E-Interventions versus assessment only (AO) controls in the reduction of alcoholic drinks per week (DPW) in university students.

Study design and methods: Cochrane library, CINAEL, ERIC, MEDLINE, PsycINFO, PubMed, and Web of Science were searched up to June 2017. Studies were included if they were: an RCT, assessed the effectiveness of E-Interventions at reducing DPW, and employed university/college students. 23 studies (N = 7,614) were included and quality was assessed using the JADAD scale.

Results: Weighted mean effect sizes were calculated using random-effects models. These showed a small, significant effect of E-Interventions at reducing the number of alcoholic DPW. Moderator analysis found a significant advantage for web-based personalised feedback interventions compared to other E-Interventions.

Conclusions: E-Interventions show a small, significant effect at reducing mean alcoholic DPW. Personalised feedback E-Interventions showed the strongest effect.     

The state of sexual health services at U.S. Colleges and Universities

Objective: To describe the array of sexual health care services provided at US colleges and universities. Participants: During 2014–2015, 885 colleges were surveyed about their provision of sexual health services. Methods: 55% of colleges responded. Data were weighted and stratified by minority-serving institutions (MSIs), 2-year and 4-year institutions. Results: 70.6% of colleges reported having a health center (HC), of which 73.0% offered STI diagnosis/treatment (4 years vs. 2 years; 77.9% vs. 53.1%) and contraceptive services (70.1% vs. 46.4%), all p < .001. HCs less frequently offered LARC (19.7%), express STI testing (24.4%) and self-collection (31.4%). Condoms were available on 66.8% of campuses. HPV vaccination was available at more 4-year colleges (73.7% vs. 48.5%, p < .003) and non-MSIs (74.4% vs. 58.5, p = .019). Regarding MSM-targeted services, 54.6% offered pharyngeal and 51.8% rectal STI testing. Conclusions: 2-year colleges may require additional support with providing sexual health care. Improvements could entail increasing express testing, extra-genital STI testing, and LARC.     

The status of nutrition education in ACHA college and university health centers.

An assessment of the prevalence and scope of nutrition services offered through 208 randomly selected American College Health Association member student health centers revealed that 79% of the 160 respondents provided some type of nutrition education for students. One-to-one counseling, available at 96% of the institutions, was the most common approach. The larger the school's enrollment, the more likely it was to provide programs in nutrition. All of the institutions with student populations of more than 35,000 offered some type of nutrition service, as did 52% of the 19 schools with enrollments between 2,000 and 5,000. Health educators, nurses, doctors, dietitians, and trained peer educators provided the services, with registered dietitians the most common providers and often coordinators of the programs. Costs to students for nutrition interventions were nominal; weight-management programs were the most expensive and showed the greatest variation in content.     

Personal value of alcohol use as a predictor of intention to decrease post-college alcohol use.

This study examines the utility of a new measure of personal value of alcohol use in predicting intentions to reduce post-college alcohol use. This measure is intended to distinguish college students who drink due to situational norms versus intrinsic commitment to alcohol use. As expected, alcohol consumption quantity/frequency and frequency of consuming five or more drinks per occasion were unrelated to intention to reduce alcohol use after college. When these alcohol consumption measures were controlled using partial correlation, the personal value of alcohol measure was significantly and negatively related to intention to reduce alcohol use. Conversely, when personal value of alcohol use was controlled in partial correlations, the relationship between alcohol consumption variables and intention to reduce alcohol use after college became positive, though only at marginally significant levels. Implications are discussed.