Health Information-Seeking in the Digital Age

Abstract

Objective: The authors examined the sources of health information among first-year university students and whether the predictors of information-seeking varied by information source. Participants: First-year students in a required course at a midwestern public university were eligible to participate, and 82% (n = 1,060) completed the study. Methods: Students completed a survey questionnaire regarding information-seeking behaviors and Internet uses in domains including health. The authors used regression analyses to examine predictors of source-specific health information-seeking. Results: Young women are much more likely than young men to seek health information. The characteristics associated with looking online for health information are different than those for using other information sources, and students who look online for health information also report greater use of other information sources. Conclusions: Although the Internet is an important source of health information for students, health professionals should be aware that not all students equally utilize this resource.     

Meningococcal serogroup B outbreak response University of Wisconsin-Madison

A meningococcal serogroup B (MenB) outbreak at a large public university prompted an emergency response to immunize undergraduates. Objective: To report on a successful meningococcal serogroup B (MenB) vaccine clinic response at a large public university. Methods: We assembled the team leaders to write this case report. Results: Activation of the emergency plan and points of dispensing required cooperation of many units on campus under the leadership of university health officials with support from Centers for Disease Control and Prevention, state division of public health and the city-county health department. Significant efforts to provide consistent messages to students and parents regarding the outbreak and the availability of the MenB vaccines were made. Volunteers were recruited to staff the clinics alongside university healthcare providers. Over 22,000 doses of vaccine were administered. Conclusion: We report our experience and lessons learned which may be helpful to universities in preventing and responding to disease outbreaks.     

Addressing Sexually Transmitted Infections (STIs), including HIV/AIDS,in the Context of Sexual Health

ABSTRACT

Sexually transmitted infections (STIs) have occupied a central place in public health agendas for at least the past 500 years, but have been the subject of opinions, decrees and “moral positions” for much longer. Societies have long tried to control the sexual behaviors of their populations, not only for reasons of social control, but also with the objective of controlling the spread of disease—HIV is the latest example of how societies respond to infections spread through the most private of individual behaviors. The article outlines the burden of disease associated with sexually transmitted infections including HIV, and explores their impact on efforts to achieve the Millennium Development Goals (MDGs). A large number of options for prevention and care of the sexually transmitted infections and HIV are currently available in both resource-rich and resource-constrained settings. In this article I move beyond the narrow focus of biomedical interventions concentrated on the individual and explore the evidence for public health measures aimed at controlling these infections. Using a public health framework I outline the various measures that can be implemented for STI/HIV control, and in addition to exploring the evidence for their public health effectiveness, I also look at how each of these interventions can be delivered within a paradigm of sexual health more generally. Finally, the article proposes recommendations for which effective strategies should be incorporated into a broader framework for promoting sexual health.     

Normative Beliefs as Risk Factors for Involvement in Unhealthy Weight Control Behavior

Objective: The authors' aim in this study was to determine, after adjustment for the effects of body mass index and sociodemographic measures, whether sex-specific weight control norms would have significant independent relationships with the weight control behavior of college women and men. Participants: The authors used an anonymous questionnaire to assess a sample of 470 college students, aged 18 to 26 years, attending either a 2- year community college or a 4-year public university. Methods: To calculate body mass index, the authors objectively measured the height and weight of each participant. They conducted separate discriminant function analyses for women and men. Results: The discriminant function analyses clearly indicated that weight control norms of same-sex, close friends were the best discriminators of involvement in weight control. Conclusions: The findings indicate that perceived peer norms may be important but overlooked risk factors for engaging in unhealthy weight control practices. The authors discuss the implications of these findings in the context of student health promotion.     

Results from a psychometric assessment of a new tool for measuring evidence-based decision making in public health organizations

BackgroundIn order to better understand how to improve evidence-based decision making (EBDM) in state health departments, measurement tools are needed to evaluate changes in EBDM. The purpose of this study was to test the psychometric properties of a new measurement tool to assess EBDM in public health practice settings.MethodsA questionnaire was developed, pilot-tested and refined in an iterative process with the input of public health practitioners with the aim of identifying a set of specific measures representing different components of EBDM. Data were collected in a national survey of state health department chronic disease practitioners. The final dataset (n = 879) for psychometric testing was comprised of 19 EBDM items that were first examined using exploratory factor analysis, and then confirmatory factor analysis.ResultsThe final model from confirmatory factor analysis includes five latent factors representing components of EBDM: capacity for evaluation, expectations and incentives for EBDM, access to evidence and resources for EBDM, participatory decision making, and leadership support and commitment.ConclusionsThis study addresses the need for empirically tested and theory-aligned measures that may be used to assess the extent to which EBDM is currently implemented, and further, to gauge the success of strategies to improve EBDM, in public health settings. This EBDM measurement tool may help identify needed supports for enhanced capacity and implementation of effective strategies.     

Uptake of HPV vaccine in traditional-age undergraduate students: Knowledge,behaviors, and barriers

Abstract

Objective: This study investigated potential factors associated with HPV vaccine uptake in a diverse population of traditional-age undergraduate students. Participants: One hundred and twenty-nine undergraduate students aged 18–24 attending a small southeastern university completed surveys in January to March of 2013. Methods: Questionnaires included demographic information, basic HPV knowledge, HPV vaccine uptake, and factors influencing uptake decision. Survey results were analyzed with chi-square and t-test analyses. Results: Vaccine uptake was significantly higher in students who reported that health care provider, public health information, parents, and access to vaccine were important factors in their decision to get vaccinated. Female students had a significantly higher vaccine uptake in comparison to males and the HPV knowledge scores differed significantly by race but not gender. Conclusions: It is especially important to consider how public health campaigns and communication with parents and health care providers help promote HPV vaccine uptake in this high-risk group.     

Health insurance literacy: A mixed methods study of college students

Objective: This study examines the health insurance literacy, or the ability to use health insurance effectively, of college students. Participants: A total of 455 students from a large, public university completed an online questionnaire in November 2016. Methods: A questionnaire examined students’ knowledge of commonly encountered health insurance terms and ability to apply that knowledge to determine cost-sharing in a clinical setting. Results: The majority of students were able to correctly identify the most commonly encountered terms, but could not identify terms related to plan types and options. Eighty-eight percent of students could not determine their cost-sharing for two presented scenarios. Approximately half of the students indicated they had been confused about their health insurance plan, with one-quarter of students stopping or delaying medical care due to confusion. Conclusions: Outreach and education for students should target specific deficits in knowledge such as those identified in this study.     

Student Bodies,Past and Present

Abstract

This article examines how the field of college health has evolved over time to address the needs of an increasingly diverse student population. The central argument is that college and university health programs developed in conjunction with shifting standards of medical care and public health practices in the United States. The author reviews the role of college health programs as public health agencies for campus communities, and describes contemporary public health challenges facing college campuses. She shows how the history of college health is intertwined with the history of diversity in higher education. In particular, the author outlines how the growth of health services made higher education accessible to women, racial minorities, veterans, and persons with disabilities.     

Status of personal health requirement for graduation at institutions of higher education in the United States

Objective: The purpose of this study was to examine the proportion of higher education institutions in the United States that require a personal health course (PHC) for graduation and to describe the nature of such requirements. Participants: This study included a random sample of public and private institutions of higher education (IHE) with undergraduate programs within the United States (N = 310). Data were collected between September 2014 and May 2015. Methods: University catalogs were accessed from the institutions' public Web sites to determine whether a PHC was offered, and whether it was exclusively or optionally required for graduation. Results: The majority (55.8%) of the sample offered at least 1 PHC, with only 10% exclusively requiring the course and an additional 10% optionally required the course. Conclusions: Although the utility of undergraduate students completing a PHC is clear, the majority of institutions do not require such a course for degree conferral.     

Immunization documentation practices and vaccine-preventable disease surveillance capacity among institutions of higher education in Indiana

Objective: Complete and accurate documentation of immunization records and surveillance of disease transmission are critical to the public health response to outbreaks of communicable disease in institutions of higher education (IHEs). This study aims to describe immunization documentation practices and disease surveillance capacity among IHEs in Indiana in order to inform public health action. Methods: IHEs in Indiana were identified and included in the study if they offered on-campus housing and had a dedicated student health center. Phone surveys were administered in September 2015 to each institution, inquiring about current immunization documentation policies and practices, disease surveillance capacity, and use of statewide electronic reporting systems. Additionally, IHE websites were searched to identify immunization documentation requirements for matriculating students. Results: Surveys were completed for 33 of 38 eligible IHEs. Twenty-three (70%) IHEs reported that student immunization records are entered into an accessible electronic system or database. Matriculating student immunization requirements were identified for 32 institutions. Of these, 22 (69%) required a physician-signed proof of immunization. No IHEs reported documenting historical immunizations in the statewide electronic immunization system and three IHEs (9%) reported utilizing the state electronic disease surveillance program. Conclusions: Immunization documentation practices vary among IHEs in Indiana and use of statewide immunization and disease reporting systems is minimal. Robust utilization of immunization and disease surveillance systems has been shown to improve public health response to communicable disease outbreaks. Improving mutual understanding of policy and practice between health departments and IHEs could improve the ability to respond to public health challenges.     

Promoting the Health of Young Adults in Urban Public Universities: A Case Study From City University of New York

Abstract

Changing demographics of college students and new insights into the developmental trajectory of chronic diseases present universities with opportunities to improve population health and reduce health inequalities. The reciprocal relationships between better health and improved educational achievement also offer university health programs a chance to improve retention and graduation rates, a key objective for higher education. In 2007, City University of New York (CUNY), the nation's largest urban public university, launched Healthy CUNY, an initiative designed to offer life-time protection against chronic diseases and reduce health-related barriers to educational achievement. In its first 5 years, Healthy CUNY has shown that universities can mobilize students, faculty, and other constituencies to modify environments and policies that influence health. New policies on tobacco and campus food, enrollment of needy students in public food and housing assistance programs, and a dialogue on the role of health in academic achievement are first steps towards healthier universities.     

Social movements and public relations in the early twentieth century: How one group used public relations to curtail venereal disease rates

ABSTRACT

A case study of the American Social Hygiene Association (ASHA) campaign to craft a national vision for social health showed that the group used public relations-like strategies to, as one of their officials said, “crystallize public opinion” years before Edward Bernays wrote a book of the same title. Although these efforts might not have been labeled public relations at the time, this study introduces some precedents of contemporary public relations. In this study, social activism offered a more robust approach to addressing an issue than using media relations alone could do. ASHA members used communication strategies such as segmenting audiences, utilizing events to reach appropriate audiences, using visual media, and creating house organs to arouse public sentiment, influence attitudes, and promote desired behavior.

This case study expands public relations history theory by examining why ASHA members practiced public relations as they did. In this case, ASHA used persuasive communication to pierce the veil of silence around venereal disease to craft a national vision for social hygiene and legitimize the group as the major voice on this topic. Lessons from this case can illustrate how public relations can be conducted more effectively, especially in relation to social movements.     

Promoting public health through community engagement: Embracing the journey

ABSTRACT

This case study recounts and analyzes the journey that graduate students, enrolled in an experiential, interdisciplinary health promotions course, took with a diverse, urban, Black, Midwest community. Community members, faculty, and graduate students in social work and public health were fellow travelers on this voyage into uncharted territory. A major goal of the journey was to teach students how to recognize community strengths and to facilitate the community in using those strengths. The learner’s stance is used as the guiding principle for this reflective journey that generated serendipitous benefits and challenges. The article concludes with recommendations for interdisciplinary education and curriculum development.     

GotFlu Channel: An Online Syndromic Surveillance Tool Supporting College Health Practice and Public Health Work

Abstract

Objective: Develop a tool to ease the burden of H1N1 influenza on a campus clinic by promoting self-care, generating medical notes, and identifying vulnerable students. Participants: Students at Brock University, a mid-sized urban campus; Brock's Student Health Services; and Niagara Public Health. Methods: Students accessed a controlled portal of Brock's Web site and self-identified onset/offset of influenza-like symptoms. Daily sign-in numbers were monitored and nonidentifiable aggregate data transferred to the local public health unit. Results: There was concordance among the number of college students signing in, local school absenteeism rates, and local rates of laboratory-confirmed influenza. Many visits to the campus health clinic were averted, 1,432 students used the tool. Conclusion: The online, real-time surveillance tool was effective in monitoring influenza activity on campus, providing timely health advice, decreasing unnecessary visits to the campus medical clinic, and assisting local public health in surveillance activities.     

Self-leadership and stress among college students: Examining the moderating role of coping skills††

Abstract

Objective: Stress remains a major health concern among college students today. Consequently, research on student stress is imperative, from both an organizational and an individual perspective. This research study explores the moderating role of coping skills on the relationship between self-leadership and stress among college students. Participants: Data from 643 full-time undergraduate students attending a 4-year public university in the mid-Atlantic region were collected in February 2017 and analyzed using a moderated regression model. Results: The results indicate self-leadership practices do reduce student stress levels and that this relationship is moderated by student coping skills. Conclusion: The findings from this study deepen our understanding of how self-leadership practices may decrease student stress and showcases self-leadership as an effective tool for reducing college student stress.     

Interactive Health Communication Technologies in the Public Health Sector: Positive Perceptions Still Outpace Actual Utilization

ABSTRACT

Effective population-based and patient-centered public health care is highly dependent on timely and reliable health-related information. The continuous growth and availability of health-related information brought about by the emergence of a new digital communications environment offers a range of opportunities that facilitate access to useful health information for the public health sector–for providers as well as patients. Such advancements, however, can only be realized if public health professionals are knowledgeable about existing sources of online health information, have the ability to successfully judge the reliability of online health information, and are able to acquire the information in a timely and efficient manner. This research follows on the heels of a survey of public health professionals in New York State that concluded that limited access and knowledge negatively impacted utilization of interactive health communication technologies. In this study, a survey was administered to providers at a large county health department located in central Michigan. Results indicate that perceptions regarding the advantages of online health information still far outweigh actual utilization. Barriers to actual utilization include lack of easy access to computers with high-speed connections, trusted and timely online information, training and staff development issues, and organizational policies concerning computer access and usage.     

Masturbation as a Means of Achieving Sexual Health

Abstract

Research on masturbation has indicated that, contrary to traditional beliefs, masturbation has been found to be a common sexual behavior and linked to indicators of sexual health. While there are no general indicators of ill health associated with masturbation, it can be powerfully negative or positive for many individuals. As an example, it is widely used in sex therapy as a means of improving the sexual health of the individual and/or relationship. Promoting masturbation as a means of a public health strategy for sexual health is highly controversial; however, there are arguments and evidence that suggest that this may be an important part of any public health approach to improving sexual health. There is a need for more research on the impact of masturbation on self-esteem, body image, sexual functioning and sexual satisfaction and methods for using masturbation to promote sexual health. There is also a need for more of a theoretical approach to the formation of hypotheses to be tested.     

Understanding innovation in health program planning and development

IntroductionA need for innovative public health programs is evident as the field adapts to address changes in health priorities and target populations. The Innovative Teen Pregnancy Prevention Program (iTP₃) was created to support and enable innovation in teenage pregnancy prevention, developing programs to reach the most at risk youth.MethodsA formative evaluation was conducted to understand what innovation means in the context of program development, and examine the process of innovation. Qualitative data was collected through baseline interviews with program development teams, referred to as Innovators, prior to the start of the project period and follow-up interviews conducted at the end of a 12-month funding period. Additional open-ended written responses were collected in the middle of the funding cycle. A thematic analysis with an open-coding scheme was used to identify emergent themes.ResultsInnovators considered programs innovative because of the target population of focus, program delivery mechanism, and/or program development approach. They specifically identified that a “culture” of innovation must be present if new programs are to be developed. Over time, Innovators began to shift their definition of innovation toward unique design processes and ecological approaches.DiscussionThrough creating a culture of innovation and utilizing systems thinking, this project provides important insights in how to develop innovations in public health.     

A Review of Multicomponent Interventions to Prevent and Control Tobacco Use Among College Students

Abstract

Objective: Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program implementation. Methods: MEDLINE, PsycINFO, ERIC, and PubMed databases were used to search the research literature concerning tobacco prevention and control programs conducted on college campuses published between 2000 and 2009. Results: No studies were found that implemented all 5 recommended components of a comprehensive program. Tobacco control programs containing policy and prevention education were used the most and promotion of tobacco-free environments and banning sales of tobacco products were used the least. Conclusion: The review suggests that despite the recommendation of comprehensive tobacco control programs to reduce tobacco use on college campuses, few institutions have implemented and evaluated programs consisting of multiple components.