Developing a screening questionnaire for problem drinking in college students.

The CAGE questionnaire is one of several brief screening instruments that has been successful in detecting alcoholism in a general population. There is evidence, however, indicating that none of these instruments has sufficient validity for detecting the less severe pattern of problem drinking that is more typical of college students. This study analyzed survey data, including CAGE questions, to identify items that would have sufficient test operating characteristics more valid for screening problem drinkers. Problem and normal drinking patterns were defined by combining certain categories of quantity-frequency data with categories of alcohol-related problems. Problem and normal drinkers were identified as those students at the ends of the quantity-frequency/alcohol-problems continuum. Differences between the two groups in response frequencies to a 17-item alcohol-use survey were examined using chi-square analyses. Five items showing highly significant differences were identified, and sensitivity, specificity, and positive predictive values were calculated at possible cutoff points. These items were (1) a positive response to any 2 of the 4 CAGE items, (2) reporting rarely or never choosing nonalcoholic beverages at social events, (3) driving under the influence at least 6 to 10 times or more in the last year, and (4) having started regular use of alcohol before the college years. At the recommended cutoff score for a positive test, the items have a sensitivity of 88%, specificity of 87%, and positive predictive value of 52%. When used for screening in a population similar to this, it will fail to identify 12% of the problem drinkers and will falsely classify 13% of all normal drinkers as problem drinkers.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effect of self-care information on health-related attitudes and beliefs of college students

We conducted a study to determine whether an intervention using self-care information would change college students' attitudes and beliefs concerning personal responsibility and involvement in their own health care. Individuals entering a student health service were randomly assigned to a treatment or control group. Members of the treatment group (n = 187) received the intervention and completed the survey instrument. Members of the control group (n = 204) completed the survey instrument only. The intervention consisted of one page of general information about the benefits to individuals of taking responsibility for their own health and a booklet containing excerpts from a consumer-oriented health care book. The survey instrument was composed of a measure of attitudes toward information and behavioral involvement in health care and a measure of beliefs regarding control over one's health. Results indicated that the intervention was able to change the treatment group's attitudes regarding active participation in health care. The treatment group's responses also reflected less belief that health was outside of the individual's control. The study showed that a positive change in health-related attitudes and beliefs can result from a relatively uncomplicated informational intervention.     

Results of a heart disease risk-factor screening among traditional college students

The author collected data on serum cholesterol, blood pressure, and self-reported health behavior in 226 college students aged 18 to 26 years. Twenty-nine percent had undesirable total cholesterol levels, 10% had high cholesterol, 10% had high systolic blood pressure, and 11% had high diastolic blood pressure. Half or more of the participants consumed a diet high in saturated fats, engaged in binge drinking, had a parental risk for high cholesterol or blood pressure, or reported they experienced elevated stress levels. Men had higher risk-factor levels than women. Findings from a regression analysis revealed that smoking, binge drinking, lack of cardiovascular exercise, and eating a high saturated-fat diet were predictive of undesirable cholesterol levels. Study limitations included self-selection of participants and single measurements of blood pressure and cholesterol. Trained students served as screeners in the program for providing an effective, low-cost screening intervention.     

The effect of stimulus content on volunteering for sexual interest research among college students

Much of the literature on volunteer bias in sexual interest research has been limited to either identifying variables on which volunteers differ from nonvolunteers or examining how the intrusiveness of the measurement device affects volunteer rates. The present study was designed to examine whether stimulus content would affect volunteer rates and volunteer/nonvolunteer differences in a large sample of college students (206 men and 358 women). The study also sought to determine whether such findings could also apply to research that recruits from exclusively heterosexual samples. Students completed questionnaires in small groups and were asked whether they would be willing to volunteer for studies that would involve viewing and rating five different types of sexually explicit images (nude men, nude women, heterosexual behavior, male homosexual behavior, and female homosexual behavior). Results indicate that men and women differed in the types of images that they would volunteer to view, based upon the content of the images. Furthermore, volunteers for each type of image reported significantly greater self-monitoring as well as sexual and general sensation seeking than did nonvolunteers, while differences on other measures were less consistent. Discussion is given to specific ways in which the findings and generalizability of sexual interest study results can be affected.     

The effect of stimulus content on volunteering for sexual interest research among college students

Much of the literature on volunteer bias in sexual interest research has been limited to either identifying variables on which volunteers differ from nonvolunteers or examining how the intrusiveness of the meaurement device affects volunteer rates. The present study was designed to examine whether stimulus content would affect volunteer rates and volunteer/non‐volunteer differences in a large sample of college students (206 men and 358 women). The study also sought to determine whether such findings could also apply to research that recruits from exclusively heterosexual samples. Students completed questionnaires in small groups and were asked whether they would be willing to volunteer for studies that would involve viewing and rating five different types of sexually explicit images (nude men, nude women, heterosexual behavior, male homosexual behavior, and female homosexual behavior). Results indicate that men and women differed in the types of images that they would volunteer to view, based upon the content of the images. Furthermore, volunteers for each type of image reported significantly greater self‐monitoring as well as sexual and general sensation seeking than did nonvolunteers, while differences on other measures were less consistent. Discussion is given to specific ways in which the findings and gen‐eralizability of sexual interest study results can be affected.     

Serum cholesterol levels in college students: opportunities for education and intervention

Elevated serum cholesterol levels have been shown to be associated with premature atherosclerosis in adolescents and young adults. The National Cholesterol Education Program recommends cholesterol screening for all adults aged 20 years or older, but normative data on the college-age population are limited. At a university where lipid profiles are made available to students in selected health/wellness courses, the authors analyzed and summarized lipid profiles on 1,088 undergraduates. Mean total cholesterol levels were similar for men (165 +/- 33 mg/dL) and women (168 +/- 27 mg/dL). The men, however, had significantly lower high-density lipoprotein (HDL) cholesterol and higher low-density lipoprotein (LDL) cholesterol than the women. One hundred twenty-one students (11.1% of the sample) had elevated serum cholesterol levels (LDL-C > or = 130 mg/dL). Cholesterol screening can be used as an educational tool for college students to reinforce the link between lipid levels and health habits.     

The periodic health examination in college students revisited.

The periodic health examination is a group of tasks carried out by physicians and nurses at regular intervals, but not always yearly, to determine either the risk of subsequent disease or to identify disease in its early, asymptomatic state. The Guide to Clinical Preventive Services, published in 1989 by the United States Preventive Services Task Force, sets common American standards for these procedures. The guide lists those preventive activities recommended for persons aged 19-39 years. Every patient encounter in our student health services should be considered an opportunity for preventive activities. This article offers a simple check list for office use.     

Recurrent pain in college students.

The authors investigated the prevalence of recurrent pain in a college student sample. Of the 1,564 students surveyed, 467 (29%) indicated that they had experienced recurrent pain at an intensity that was mostly in the mild-to-moderate range. Students who reported having recurrent pain were significantly older and more depressed than students who did not indicate they suffered from recurrent pain. Pain intensity was positively correlated (r = .14) with depression among the students who reported having recurrent pain. Implications of the findings for future research, treatment, and health promotion efforts are discussed.     

Screening college students for hypercholesterolemia.

Selective screening for children and mass screening for adults are the two strategies for detecting hypercholesterolemia and identifying individuals at risk for early heart attacks that have been recommended by the American Academy of Pediatrics and the American Medical Association. The interval marking the end of childhood and the beginning of adulthood is a time of transition without an unwavering demarcation line. It is a time when many adult disorders that demand attention and detection begin. Because of the close relationship of elevated cholesterol levels in youth to subsequent cardiovascular disease, a small liberal arts university began mandatory mass cholesterol screening for all full- or part-time students who matriculated in September 1977. More than thirty 18- and 19-year-old first-year students with unknown hypercholesterolemia were detected each year. The mean cost per case identified is estimated to have been $212. The author concluded that mass screening of students entering college can identify, at a reasonable cost, students who have high levels of cholesterol.     

Improving alcohol screening for college students: Screening for alcohol misuse amongst college students with a simple modification to the CAGE questionnaire

ABSTRACT

Objective: To improve the CAGE (Cut down, Annoyed, Guilty, Eye opener) questionnaire's predictive accuracy in screening college students. Participants: The sample consisted of 219 midwestern university students who self-administered a confidential survey. Methods: Exploratory factor analysis, confirmatory factor analysis, receiver operating characteristics (ROC), and Cronbach's alpha were used to analyze factor structure, validity, and reliability. Results: The modified CAGE correctly classified students with alcohol abuse (“AA students”; area under the curve [AUC] = 0.7765) and students with alcohol dependency (“AD students”; AUC = 0.8392) more often than CAGE (AA students: AUC = 0.6977; AD students: AUC = 0.7437), and these differences are statistically significant (AA students: χ²(1) = 14.72, p < .001; AD students: χ²(1) = 7.71, p < .01). Using 2-point cut scores, CAGE correctly identified 59.38% of AD students as AD, whereas the modified CAGE correctly identified 87% of AD students as AD. Using 1-point cut scores, CAGE correctly identified 65% AA students, whereas the modified CAGE identified 85.29%. Conclusions: The modified CAGE has better accuracy than CAGE in predicting AA and AD among college populations.     

Perspectives of college students and their primary health care providers on substance abuse screening and intervention

The authors conducted a needs assessment among students and health-care providers of a southwestern university health center with the goal of developing health-care-provider training addressing substance-abuse screening and intervention. They collected data from focus groups of undergraduate students and structured interviews and questionnaires with health-care providers. They identified gaps in provider and student perspectives on the extent of substance abuse on campus and the perceived roles of health-care providers and patients in screening and conducting interventions for substance abuse. These findings suggest that training for college health-care providers regarding substance-abuse brief screening and intervention should emphasize confidentiality of student medical records, the importance of nonjudgmental attitudes toward students, and the role of the provider as one who is competent and appropriate to address substance abuse. Such training should also educate providers about the types of substances students are using.