Emergency Contraceptive Pill (ECP) Use and Experiences at College Health Centers in the Mid-Atlantic United States: Changes Since ECP Went Over-the-Counter

Abstract

Objective: To investigate the availability of emergency contraceptive pills (ECPs) at college health centers since ECP went over-the-counter (OTC) in 2006. Related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, and staff attitudes, were examined. Participants: The sample included 135 college and university health centers in the mid-Atlantic region of the United States. Methods: Data were collected via telephone survey with the use of a 42-item survey instrument. Results: Forty-three percent of schools reported distributing ECPs, for an average of 10.6 years. Major changes in ECP distribution and usage since ECP went OTC related primarily to protocol in ECP distribution, advertising for ECP services, and ECP accessibility to university students. Conclusions: College health centers are responding to the OTC status of ECP in a number of ways, primarily relating to their distribution procedures and advertising techniques.     

Feasibility of a Telephone Follow-Up on Use of Emergency Contraceptive Pills in a College Health Center

Abstract

The authors examined the feasibility and effectiveness of a telephone follow-up procedure on use of emergency contraceptive pills (ECP) at a college health center. They made 264 telephone calls to the 97 women who had received ECPs during one 16-week academic semester and were successful in reaching 65 (67%) of the women, who responded with information about their experiences with ECPs. The women demonstrated a high rate of adherence to the medical regimen and reported very few side effects from ECPs; a majority said that ECPs did not affect their ability to carry out daily activities. On weighing the relative absence of problems following ECP distribution against the time, effort, and cost required to reach just over two thirds of the women, the researchers concluded that an ECP telephone follow-up procedure was neither cost-effective nor particularly useful.     

Maternal Health in Post-Soviet Georgia

ABSTRACT

During the post-Soviet economic and political transformation, underprivileged social groups frequently experienced economic instability, financial insecurity, and lack of political representation. During the transition from communism to democracy Georgian women with low social status experienced not only economic hardship but also deterioration of health. Among the negative outcomes of post-Soviet transition were unsafe motherhood, increased cigarette and alcohol consumption, unsafe sex, increased gender violence, and a decline of maternal health. This article analyzes maternal health conditions of Georgian women after the collapse of the Soviet Union.     

Training Camp on Safe Motherhood in Rural India: A Research Note

ABSTRACT

The Center for Women Studies at the Birla Institute of Technology & Science, Pilani (Rajasthan), India made an effort to combine theory and practice by implementing some of the discussions of an international conference that the center had organized on safe motherhood. A clinic was set up as a medical training camp in a village near Pilani. Measures to ensure safe motherhood included check-ups, interventions, advocacy, and counseling at the grassroots level. As a follow-up, the center has adopted the 12 by 12 initiative of the Government of India to ensure that each child has a percentage hemoglobin of 12 grams by the age of 12 years with special focus on adolescent girls.     

The Economic Consequences of Child Sexual Abuse for Adult Lesbian Women

This study is designed to extend the investigation of the long‐term consequences of child sexual abuse (CSA) into the workplace and to consider the effects on the economic welfare of 1,925 lesbian women from the National Lesbian Health Care Survey. It seeks to develop a two‐stage, least‐squares model that considers simultaneously the effects of child sexual abuse on four spheres of a woman's life—her physical health, mental health, educational attainment, and economic welfare; and to investigate the differential impacts of diverse forms of child sexual abuse on the adult woman's functioning. The CSA survivors experienced adverse health and mental health consequences. The type of CSA experienced was also a significant predictor of a woman's educational attainment and annual earnings.     

Risk of Unwanted Sex for College Women: Evidence for a Red Zone

Objective: University and college health and counseling centers frequently warn female students about the red zone—a period early in a student's first year at college during which she may be at higher risk for unwanted sexual experiences (UWS). The authors designed this study to assess temporal risk for UWS in 1st- and 2nd-year college women. Participants and Methods: In March 2006, the authors randomly selected 50 first-year and 52 second-year students (representing one-sixth of each class year) to complete a modified Sexual Experiences Survey. Results: First-year women were at higher risk for UWS than were second-year women—particularly, early in the fall semester. The authors observed a significant linear effect during participants' combined first years in school, with more reports of UWS occurring early in the year. Conclusion: This study provides support for a red zone and highlights the need for investigating local norms for UWS.     

The College Student Psychiatric Emergency: A Descriptive Study

Abstract

The authors utilized computerized records of a psychiatric emergency department to study the nature of psychiatric emergencies among college students. The 1156 visits made by students over an eight-year period are described using demographic variables, times of visit, and accompaniment. Implications of the findings for campus administrators and mental health service providers are discussed.     

Sexual and Reproductive Health Behaviors of California Community College Students

Abstract

Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was administered in class to randomly selected classrooms at 12 institutions and electronically to randomly selected e-mails of students at 1 institution from March through April 2007. Results: This sample of community college students reported higher rates of risky sexual behaviors, unintended pregnancy, emergency contraception, and sexually transmitted diseases, and lower rates of human immunodeficiency virus (HIV) testing, than the overall ACHA-NCHA reference group. Those who had been tested for HIV reported more sexual partners, and lower rates of condom use. Conclusions: The data provide justification for broader educational programs and access to family planning services, condoms, and HIV testing on community college campuses.     

Motivations to Pursue Accreditation in Children's Mental Health Care: A Multiple Case Study

Accreditation is a growing, worldwide phenomenon that has spread to a range of industries and fields, including nonprofit social services and mental health care. Thousands of organizations are accredited, but it is not known what is driving the growth of this phenomenon. Using a multiple case study design, this exploratory study aimed to understand children's mental health agencies' motivations to pursue accreditation. In‐depth interviews, focus groups, document reviews, and limited observations were conducted at five children's mental health agencies that had recently undergone or were undergoing the Council on Accreditation process. Agencies were influenced by external factors, such as policies that require accreditation, wanting to assert their positions in the field, and the need to increase funding opportunities. Other factors were internal, related to agency leadership using accreditation as a platform for change and agencies' genuine intent to improve services. Implications for agencies, accreditors, and future research are offered.     

Education,wage work,and marriage: Perspectives of Egyptian working women

We explore young working women's perceptions of marriage and work in contemporary Egypt, when an increase in age at marriage was evident from national survey data. Both working conditions and employment opportunities declined significantly for young women even as their educational attainment increased and marriage was delayed. In‐depth interviews were conducted over a 2‐year period between 1998 and 2000 with 27 young women between the ages of 15 and 29 who were from relatively poor families and working in a range of salaried jobs in three locations. The qualitative data indicate that young women have high expectations in terms of marital living standards. They seek to achieve this in part by saving intensively before marriage when they work, and otherwise by ensuring substantial monetary support from their families. We conclude that rising material aspirations and family nucleation rather than change in female labor force participation drive marriage change in contemporary Egypt. The driving force behind this conclusion is that there is a reinforcement of the traditional values associated with the institution of marriage rather than its erosion.     

History of the American College Health Association

Abstract

Following Dr Edward Hitchcock's lead at Amherst College in 1861, soon other institutions of higher education established physical education departments that evolved into independent college health programs. As the field of college health expanded, leaders from numerous campuses began meeting to share information and discuss formation of a national organization. As a result, the American Student Health Association was founded in 1920 to promote campus health care for students and advance the interests of college health. The name was changed to the American College Health Association in 1948. The past history of this organization has been well documented in the literature, so this review will focus more on ACHA's accomplishments over the past 20 years. ¹ Turner, H S and Hurley, J L. 2002. The History and Practice of College Health., Lexington: The University Press of Kentucky.  [Google Scholar] ^{, 2} American College Health Association. A brief history, Available at: http://www.acha.org/About_ACHA/docs/ACHA_Brief_History.pdf Published 2002. Accessed February 26, 2011 [Google Scholar] ^{, 3} Boynton, RE. 1971. The first fifty years: a history of the American College Health Association. J Am Coll Health Assoc, 19: 269–288.  [Google Scholar] ^{, 4} Christmas, W A. 1992. The history of sections in the American College Health Association. J Am Coll Health, 41: 121–125. [Taylor & Francis Online] , [Google Scholar]     

The World Bank,Organized Hypocrisy,and Women's Health: A Cross‐National Analysis of Maternal Mortality in Sub‐Saharan Africa

The theory of organized hypocrisy asserts that an organization depends upon its external environment for both financial support and conferred legitimacy, which can lead to conflicting policy agendas. We apply the theory of organized hypocrisy to World Bank structural adjustment and investment lending for reproductive health, hypothesizing these two lending policies should have differential effects on maternal mortality. We estimate a two‐way fixed effects regression model with robust standard errors clustered by country to examine the effect of World Bank reproductive health lending on maternal mortality within sub‐Saharan African nations over the period 1990–2010. We find that in every model the coefficients for World Bank structural adjustment lending in the health sector are positive and significant while the coefficients for World Bank investment lending in the reproductive health sector are negative and significant. The findings lend support to the theory that the World Bank is pursuing contradictory agendas, embodied by its lending policies, which can have differential effects on maternal mortality.     

Student Assistance Program: A New Approach for Student Success in Addressing Behavioral Health and Life Events

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.     

College Men's Health in Practice: A Multidisciplinary Approach

Abstract

After a needs assessment indicated that male students underutilized campus health services, the San Francisco State University Student Health Service developed a coordinated complement of outpatient health services for men. The authors review their experience in developing, implementing, operating, and evaluating this ongoing clinical service. The needs assessment and subsequent program evaluation data suggest that male students on a large, culturally diverse, urban campus would respond favorably to targeted, multidisciplinary health initiatives that incorporate the principles of health promotion and disease prevention.     

The Health Education Section: 38 Years of Growth

Abstract

The author traces the growth of ACHA's Health Education Section from its beginnings with a handful of members in the late 1950s to its position of increasing leadership in the organization. She describes the growth of innovative programs the section's more than 300 health educators developed as they expanded the concept of health education and promotion beyond the walls of traditional health centers into the broader university community. College health educators must participate in efforts to establish accountability for prevention and promotion strategies that include community health as well as clinical preventive services.     

Providing Student Health Services at Sea: A Survey of Chief Complaints Onboard a Maritime Academy Training Ship

Abstract. Objective: The authors describe the epidemiology of infirmary chief complaints aboard a collegiate maritime training ship. Participants: They assessed patients (N = 646 visits) evaluated by the USTS Enterprise medical department during a 44-day sea term from January to February 2007. Methods: The authors conducted a retrospective chart review of infirmary use and extracted information on age, sex, rank, chief complaints, and frequency of visits. Results: Overall, 646 visits were made. The most common complaints were dermatologic (30.1%): rash, skin infection, laceration, and sunburn. Together, ear, nose, and throat and dermatologic complaints accounted for 57.6% of all visits. Work-related complaints accounted for 12.5% of recorded visits. Compared with the ship population, senior and female cadets had more visits than the average. Port departure days were typically the busiest. Conclusions: Among healthy, college-aged cadets at sea, typical primary care constitute comprise the majority of visits.     

Walking the Tightrope: Directing a Student Health Center at a Research Institution With an Academic Medical Center

Reporting lines for directors of student health centers (SHCs) at colleges and universities are a matter of continuing interest for those of us who must follow them. SHC directors at institutions with academic medical centers face a greater number of reporting choices that also have the potential of being more politically charged. The author describes his experience at 2 such institutions and offers some cautious advice.     

Perceived Continuing Education Needs and Job Relevance of Health Education Competencies Among Health Education and Promotion Practitioners in College Health Settings

Objective and Participants: The author conducted this study to determine college health education and promotion practitioners' perceived continuing education needs and perceived job relevance in relation to national health education responsibilities and competencies. Methods: In Spring 2006, the author invited college health education and promotion professionals to participate in an online survey, using 3 listservs. Of 276 individuals visiting the Web site, 141 participants completed the survey (51%). Participants rated their perceived training needs and job relevance for the 35 National Commission for Health Education Credentialing (NCHEC) competencies as well as preferred training formats. Results: Participants identified the following competencies as those in which they needed additional training: designing data-collection instruments, securing fiscal resources, interpreting evaluation and research results, carrying out evaluation and research plans, and developing plans for evaluation and research. They identified the following competencies as being the most relevant to their jobs: demonstrating a variety of skills in delivering strategies, interventions, and programs; using a variety of methods to implement strategies, interventions, and programs; initiating a plan of action; and using health-related information resources. The most preferred methods of obtaining additional continuing education were attending the American College Health Association annual meeting (67%) and completing home self-study print materials (67%). Conclusions: Collegiate professional organizations should offer a variety of continuing education opportunities centering on NCHEC competencies, specifically those perceived as needed by study participants.     

Envisioning the Possibilities for a Good Life: Exploring the Public Policy Implications of Intersectionality Theory

SUMMARY

Public policy is one of the younger, interdisciplinary subfields in the social sciences, but one of the most promising in terms of its social relevance. While public policy has made major strides in terms of analytical and methodological development, it has largely ignored the development of intersectional theory-a broad theoretical paradigm that has much to offer public policy scholars. In this article, the author discusses the contribution made by intersectionality scholars to the social sciences and advances ways in which intersectionality theory could extend efforts to elucidate public policy outcomes and women's political leadership.