A Report on Student Health Services

Abstract

Objective: Stress impacts college students, faculty, and staff alike. Although meditation has been found to decrease stress, it is an underutilized strategy. This study used the Reasoned Action Approach (RAA) to identify beliefs underlying university constituents’ decision to meditate. Participants: N = 96 students, faculty, and staff at a large midwestern university during spring 2012. Methods: A survey measured the RAA global constructs and elicited the beliefs underlying intention to meditate. Thematic and frequency analyses and multiple regression were performed. Results: Quantitative analyses showed that intention to meditate was significantly predicted (R² = .632) by attitude, perceived norm, and perceived behavioral control. Qualitative analyses revealed advantages (eg, reduced stress; feeling calmer), disadvantages (eg, takes time; will not work), and facilitating circumstances (eg, having more time; having quiet space) of meditating. Conclusions: Results of this theory-based research suggest how college health professionals can encourage meditation practice through individual, interpersonal, and environmental interventions.     

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.     

Old and New Environmental Issues for College and University Health Services

Abstract

Exercise improves physical and mental health. Nevertheless, most 20-year-olds do not exercise, and approximately 50% of the participants in exercise programs drop out in the first 3 to 6 months. In view of the health benefits of exercise, college health educators and clinicians need to be able to identify factors that predict exercise relapse in a student population. The authors administered questionnaires measuring Prochaska's 10 processes of change for exercise, self-efficacy, and decisional balance to 52 physically active undergraduate students. They assessed baseline exercise levels in October and reassessed them about 8 weeks later. At baseline, relapsers had significantly lower self-efficacy scores than those who maintained their exercise levels. The relapsers also had higher perceived negative views of exercise. These findings provide support for applying the transtheoretical model of behavioral change to a college population.     

College Smoking Policies and Smoking Cessation Programs: Results of a Survey of College Health Center Directors

Abstract

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 cessation 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.     

A Mandatory Student Health Insurance Program at a Large State University

Abstract

A new compulsory-with-waiver health insurance plan at the State University of New York at Buffalo (SUN-YAB) was designed in 1976 after assessing available literature on students' insurance, morbidity, health care costs, attitudes, data from past SUNYAB insurance plans and health service statistics. Previous findings that the morbidity of this population is low is corroborated by the data available on the students considered within this project. Illnesses common to this age group are predominantly acute, and require a low rate of hospitalization. The new insurance program cost an unmarried single student $67.00 and was a success by several criteria. Approximately 5,000 more students were enrolled in the complusory plan than in the previous voluntary one. Among students interviewed, both those who enrolled and those who did not, felt that the idea of compulsory health insurance for students was a good idea. Virtually all full-time students in the university were covered by some health insurance.     

Variables Affecting Patient Satisfaction with Health Care Services in the College Health Setting

Abstract

Patient satisfaction with health care services is an important factor in health care delivery. It will significantly influence whether or not a patient seeks medical care, complies with prescribed treatment, and/or maintains a continuing relationship with a medical practitioner.

A survey questionnaire, relating patient satisfaction with a number of variables identified through a literature review, was mailed to a random sample of 500 students utilizing Student Health Service (SHS) at Kent State University (KSU) during the five week study period. The data obtained would be utilized to help with planning future health care services and staff inservice education programs.

The findings of this survey indicate that patient satisfaction has a statistically significant correlation with perceived technical competence of the practitioner and perceived adequacy of the interpersonal aspects of the practitioner-patient relationship. A significant relationship did not exist between satisfaction and expectations the patient holds of the practitioner's role performance. A statistically significant relationship was found to exist between receiving health information/education related to diagnosis, prognosis, and treatment plan and satisfaction with health care services. This relationship did not hold for health information/education related to activity restrictions or preventive measures. The study also revealed that time waited during the medical care encounter was inversely related to satisfaction. Last, stepwise regression found that perceived technical competence of the practitioner was the most important variable influencing patient satisfaction with health care services.

This study provides data about factors important to personal satisfaction with health care services for a selected group of college students.     

Exploring the Climate for Overweight and Obese Students in a Student Health Setting

Attitudes and beliefs of health care providers, in conjunction with a nonthreatening physical environment, are important components in establishing a constructive and supportive climate for care of overweight and obese students. Objective: The authors explored providers' attitudes about obesity and assessed the physical environment in a student health clinic to identify areas that may be detrimental to the care of overweight and obese students. Participants: Eighteen direct care providers participated in the project. Methods: The authors conducted focus groups with direct care providers and assessed their experiences and perceived challenges in working with overweight and obese students. The authors also conducted a walk-through assessment of the physical environment. Results: Direct care providers expressed discomfort in deciding how and when to discuss weight with students. The authors found that elements of the physical environment could present barriers to care for overweight and obese students. Conclusions: The authors make recommendations for improving the health care climate for overweight and obese students.     

Rapid Assessment for Psychopathology in a College Health Clinic: Utility of College Student Specific Questions

Abstract

Objective: The purpose of this study was to determine the utility and unique benefits of employing the College Health Questionnaire (CHQ) in a college health care setting. The CHQ is a newly designed measure to assess psychosocial issues commonly problematic among college students. Participants: One hundred nine patients participated in the study during their medical appointments. Methods: Participants completed the study questionnaires (CHQ and Patient Health Questionnaire) in the waiting room. Their provider had the opportunity to use the responses in treatment decision making. Results: A majority (66.1%) endorsed at least one CHQ item. Patients who indicated traditional mental health problems were more likely to be prescribed psychotropic medications, whereas patients who endorsed psychosocial issues commonly problematic among college students were more likely to be referred for behavioral treatment. Conclusions: Screening for behavioral problems in college primary care settings without the use of college-related questions would result in missing numerous important psychosocial problems.     

Differences in College Student Typical Drinking and Celebration Drinking

Abstract

Objective: The purpose of the study was to determine whether students consume alcohol in greater quantities when drinking in celebration of an event or holiday versus typical drinking use. Celebratory occasions include tailgating during football games, holidays, and the beginning and ending of academic semesters. Participants: Traditional undergraduates, ages 18 to 24, who attended the university full time in the Fall 2007 and the Spring 2008. Methods: Eight hundred participants were randomly selected to participate in the study. A stratified random sample was drawn according to class rank and sex. A total of 287 survey responses were collected. Results: Alcohol consumption was greatest during typical weekend drinking, followed by celebration drinking and then by typical weekday drinking. Conclusions: Celebration drinking was expected to be greater than typical drinking; however, typical weekend drinking episodes were greates than celebratory drinking. Intervention efforts should focus on reducing weekend alcohol consumption.     

Pilot Testing a Cognitive-Behavioral Protocol on Psychosocial Predictors of Exercise,Nutrition, Weight,and Body Satisfaction Changes in a College-Level Health-Related Fitness Course

Abstract

Objective: Small-scale pilot testing of supplementing a required college health-related fitness course with a cognitive-behavioral exercise-support protocol (The Coach Approach). Participants: Three classes were randomly assigned to Usual processes (n = 32), Coach Approach–supplemented: Mid-size Groups (n = 32), and Coach Approach–supplemented: Small Groups (n = 34) conditions. Methods: Repeated-measures analyses of variance (ANOVAs) assessed overall and between-class changes in the behavioral/physiological factors of exercise, fruit/vegetable intake, and body mass index (BMI); and the psychosocial factors of self-regulation, exercise self-efficacy, mood, and body satisfaction. Dependent t tests evaluated within-class changes. Multiple regression analyses tested prediction of exercise by changes in self-regulation, self-efficacy, and mood. Results: Significant improvements in self-regulation and fruit/vegetable intake were found in all classes. The Coach Approach–supplemented classes demonstrated significant increases in exercise. Significant improvements in BMI, self-efficacy, and body satisfaction were found in only The Coach Approach–supplemented: Small Groups class. Psychosocial changes predicted increased exercise. Self-regulation was the strongest contributor. Conclusions: Overall, results were positive and warrant more comprehensive testing.     

College Students Define Binge Drinking and Estimate Its Prevalence: Results of a National Survey

Abstract

Data from the 1999 College Alcohol Study were used to examine how students define the term binge drinking, to determine how much binge drinking the students think exists on their campuses, and to analyze how students' estimates compare with aggregated self-reports of student drinking. The findings indicate that the median of the students' definitions of binge drinking is 6 drinks in a row for men and 5 for women, 1 drink higher than the definition used by researchers. Students' definitions of binge drinking vary with their own drinking levels, suggesting that dissenting views of the research definition may represent voices of the heaviest drinkers. At the median, students estimated that 35% of all students were binge drinkers. Half (47%) of the students underestimated the binge drinking rate at their school, 29% over-estimated it, and 13% were accurate. Although programs designed to reduce the frequency or prevalence of binge drinking by emphasizing healthier norms would be most useful in addressing binge drinkers who overestimate drinking norms, this group includes only 13% of college students.     

The History of SHSAAMc: Student Health Services at Academic Medical Centers

This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at academic medical centers.     

Financing Rural New England University Health Services: A Pilot Study

Abstract

Patient satisfaction in university health settings has received little research attention, and it is unclear whether the issue is being addressed in college health clinics. Because providers may make their own evaluations of patient satisfaction in the absence of other information, the authors conducted a study to determine whether healthcare providers at a university health clinic could accurately assess patient satisfaction. Ten providers completed a 10-item questionnaire immediately following the medical encounter to rate their perceptions of selected patients' levels of satisfaction. After seeing a healthcare provider, 201 patients completed a comparable questionnaire indicating how satisfied they were with the experience. Responses of providers and patients were compared, using a paired-sample t test. The results showed that providers' ratings were significantly lower than patients' ratings, indicating that providers were unable to judge patient satisfaction accurately. The results suggest that formal evaluations of patient satisfaction should be included in college health services.     

Relationship of Work Hours With Selected Health Behaviors and Academic Progress Among a College Student Cohort

Approximately 57% of college students work while attending school. Health risks related to working while in college have not been widely studied. Objective: The authors' purpose in this study was to determine associations between hours worked, binge drinking, sleep habits, and academic performance among a college student cohort. Participants and Methods: The authors randomly selected a sample of 1,700 undergraduates from a southeastern US university and mailed to them a survey requesting a variety of self-reported health behaviors and hours worked. A total of 903 completed questionnaires were received, indicating a response rate of 57.3%. Results: Binge drinking, less sleep, and lower academic performance were significantly associated with working 20 or more hours per week. Those variables were not associated with working fewer than 20 hours per week. Conclusions: Although administrators and others in higher education are aware of the impact of economics on a school's ability to operate, they may not be aware of the impact on students' health.     

Health Promotion Project for University Students at a South African University: Results of a Pilot Survey

Globally, chronic diseases place a tremendous burden on health care systems all over the world. The increased prevalence of chronic diseases is mainly influenced by industrialization and decreased levels of physical activity. A cross-sectional qualitative and quantitative pilot survey, using a self-administered questionnaire and focus group discussions, was conducted with 73 students to assess the need for and feasibility of a health promotion program for university students at a rural South African university. The results of this survey suggest that there is a need for a health promotion program aimed at young adults who attend university.     

Keynote Address: Impact of the Future on College Health

Abstract

Objective: The authors investigated the effect of gain-framed (GF) compared with loss-framed (LF) messages on exercise behaviors in normal weight and among overweight/class I obese. The authors also examined which groups would have significantly improved exercise behaviors over time. Participants: Sixty-four undergraduates were randomized to the 4 groups by message type and weight category from September 2008 to December 2011. Methods: After screening, students received messages and attended an exercise instruction session. Results: There were no significant differences between GF or LF message groups among normal weight or overweight/obese on the primary outcomes at posttest. After receiving the GF messages, the overweight/obese group was the only group to have a significant increase on all 3 primary outcomes: fitness center attendance (p = .038), combined moderate- and vigorous-intensity activity (p = .005), and strength training (p = .037). Conclusions: The exercise behaviors of undergraduate students who are overweight or obese can benefit from GF messages.     

Predictors of Student Health Care Utilization Patterns

Abstract

In recent years, interest has been renewed concerning student utilization and nonutilization of university and college health services. A study was conducted at James Madison University to examine for prediction purposes: (a) student utilization patterns; (b) knowledge of available services; and (c) attitudes toward the student health service. Questionnaires were sent to a 10% random sample of the student population. Employing multiple regression analysis, the predictive value of the independent variables of knowledge, attitudes, convenience, and sociodemographic data were evaluated for the three criterion (dependent) variables related to utilization and non-utilization of health services. These had been identified as (1) frequency of use, (2) number of different types of use, and (3) user-nonuser. Results of the analysis indicated that certain predictor variables could predict to an extent the utilization and nonutilization patterns of students. The implications of these findings as well as their reflections on previous studies are discussed.     

The Manageable Approach to College Health Services Planning Part I

Abstract

College health services must function effectively within two dynamic and complex environments-higher education and health. College health services are also increasingly expected to respond to emerging forces within the fields of adolescent medicine and college health itself and to seize opportunities to improve the health status and lifestyles of college-age adults. Thus, it is essential that college health services be well planned to meet student needs more completely and to ensure a more appropriate role for college health in both the health and higher education fields. This article depicts the strategic and operational planning that is necessary and delineates how such planning can be accomplished within 10 weeks through the application of the “Manageable Approach.” Basic concepts of the Manageable Approach are presented, its six major stages are described, and detailed guides to the success of each stage are included. These guides focus on the purposes and results of each stage, the group maintenance activities necessary, the specific steps to be followed, the special techniques to be employed, and the planning aids to be used in the discussion of substantive issues. In this first part of a two-part series, strategic and operational health planning are described, the Manageable Approach is introduced, and the first two stages—organization and education, and mission and program goals—are delineated.     

Student Acceptance of a Multicultural Education

Abstract

While the virtues of a multicultural education are debated in the general US populace, most social work educators and organizations have embraced such an approach. Subsequently, social work journals have offered numerous essays on multicultural teaching techniques. Yet, these same journals have rarely explored the multicultural attitudes of social work students. To fill this gap, this paper empirically explores the ways in which BSW students accept or reject some multicultural goals. To do so, close-ended surveys were distributed to 437 undergraduates. After describing their responses to the authors' multicultural index, the project explores the survey results via demographic, social-psychological, and educational variables. With the assistance of a multiple regression, this project suggests that student acceptance of multiculturalism is swayed by the matters of gender and their stances on White privilege and institutional racism. However, student perceptions do not seem static since students become more positive toward a multicultural education after they have initiated interracial exchanges and completed a social diversity class.     

Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health

Abstract

Objective: This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood. Participants: The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200). Methods: An online questionnaire (collected 2013–2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health. Results: Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology. Conclusions: This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.