The Effect of Mixing Events on the Dynamics of pH1N1 Outbreaks at Small Residential Colleges

Abstract

Objective: The authors examine the dynamics and the impact of all-campus events on pH1N1 spread at Bates College in fall 2009, with comparisons to 3 other campuses. Participants: Students (N = 285) presented or called in to the Bates Health Center with symptoms consistent with influenza-like illness. Methods: Health Center staff at Bates collected data on the outbreak; data from other colleges are from Web sites and journal articles. Data were analyzed using a mathematical model for influenza. Results: Bates held 2 vaccine clinics mid-outbreak. The data are consistent with the hypothesis that the vaccine clinics may have altered routine student interactions, facilitating transmission of pH1N1 among students who otherwise might not have encountered each other. Conclusion: The vaccine clinics, held when vaccine became available, were too late to halt transmission. The disruptions to campus rhythms due to the vaccine clinics may instead have contributed to pH1N1 spread.     

2009–2010 Seasonal Influenza Vaccination Coverage Among College Students From 8 Universities in North Carolina

Abstract

Objective: The authors sought to describe the 2009–2010 seasonal influenza vaccine coverage of college students. Participants: A total of 4,090 college students from 8 North Carolina universities participated in a confidential, Web-based survey in October–November 2009. Methods: Associations between self-reported 2009–2010 seasonal influenza vaccination and demographic characteristics, campus activities, parental education, and e-mail usage were assessed by bivariate analyses and by a mixed-effects model adjusting for clustering by university. Results: Overall, 20% of students (range 14%–30% by university) reported receiving 2009–2010 seasonal influenza vaccine. Being a freshman, attending a private university, having a college-educated parent, and participating in academic clubs/honor societies predicted receipt of influenza vaccine in the mixed-effects model. Conclusions: The self-reported 2009–2010 influenza vaccine coverage was one-quarter of the 2020 Healthy People goal (80%) for healthy persons 18 to 64 years of age. College campuses have the opportunity to enhance influenza vaccine coverage among its diverse student populations.     

Measles and Rubella on College Campuses: The Need to Act

Abstract

The lack of immunization requirements at the nation's colleges and universities threatens the maintenance of the interruption of indigenous measles in the United States. The high susceptibility rates in some college populations coupled with the high mobility of college students who may travel to countries where measles is endemic or epidemic increases the potential for measles outbreaks.

Preventing measles in college-age populations is particularly important because the disease can be more serious in adults. In view of the importance of preventing measles in college students, the Immunization Practices Advisory Committee (ACIP) of the U.S. Public Health Service has recommended that officials strongly consider immunization requirements for college entry.

The ultimate goal of rubella immunization is the protection of a future fetus against damage from intrauterine infection. Although rubella cases are reported routinely on college campuses, most colleges make no effort at controlling these outbreaks or instituting immunization requirements. The ACIP strongly urges educational institutions to require proof of immunity to rubella for registration or employment.     

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.     

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.     

Problem drinking among at-risk college students: The examination of Greek involvement,freshman status,and history of mental health problems

ABSTRACT

Objective: Scarce research has examined the combined effect of mental health difficulties and demographic risk factors such as freshman status and Greek affiliation in understanding college problem drinking. The current study is interested in looking at the interaction among freshman status, Greek affiliation, and mental health difficulties. Participants and Methods: Undergraduate students (N = 413) from a private and public Midwestern university completed a large online survey battery between January 2009 and April 2013. Data from both schools were aggregated for the analyses. Results: After accounting for gender, age, and school type, the three-way interaction indicated that the highest drinking levels were reported in freshman students who reported a history of mental health problems although were not involved in Greek life. Conclusions: Findings are discussed in the context of perceived social norms, as well as alcohol-related screenings and intervention opportunities on college campuses.     

College Students and the Diagnosis of Attention Deficit Hyperactivity Disorder

Abstract

Background: When H1N1 emerged in 2009, institutions of higher education were immediately faced with questions about how best to protect their community from the virus, yet limited information existed to help predict student preventive behaviors. Methods: The authors surveyed students at a large urban university in November 2009 to better understand how students perceived their susceptibility to and the severity of H1N1, which preventive behaviors they engaged in, and if policies impacted their preventive health decisions. Results: Preventive health behavior messaging had a mixed impact on students. Students made simple behavior changes to protect themselves from H1N1, especially if they perceived a high personal risk of contracting H1N1. Although policies were instituted to enable students to avoid classes when ill, almost no student self-isolated for the entire duration of their illness. Conclusions: These findings can help inform future decision making in a university setting to best influence preventive health behaviors.     

Influenza-Like Illness Among University Students: Symptom Severity and Duration Due to Influenza Virus Infection Compared to Other Etiologies

Abstract

Objective: University students with influenza-like illness (ILI) were assessed to determine whether symptom severity, duration, or missed days of school or work varied according to etiology. Participants: Sixty persons presenting to a university health clinic with ILI symptoms during 3 consecutive influenza seasons completed baseline survey and viral testing; 51 (85%) completed follow-up. Methods: Influenza viral culture and polymerase chain reaction and respiratory virus immunofluorescence assay testing were performed. Information collected at baseline and follow-up included symptom occurrence, severity, duration, and numbers of days of work and school missed. Results: Influenza virus was confirmed in 63% of participants. Influenza-positive individuals were no more likely to report any symptom or miss more days of school or work. Self-reported severity and durations of symptoms were similar between groups. Conclusions: Students with influenza-associated ILI were similar to those with noninfluenza ILI with respect to severity, duration, and numbers of days of school and work missed.     

Vaccine Preventable Disease on Campus

Abstract

Vaccine preventable diseases (VPD) have declined as a cause of morbidity and mortality in the United States. From more than 500,000 cases of measles reported annually in the prevaccine era, there were only 1,436 cases reported in 1983 (38% on college campuses); from more than 12.5 million reported cases of acquired rubella and 20,000 cases of congenital rubella syndrome (CRS) reported in 1964, there were only 954 reported cases of rubella (an unknown number occurred on campuses) and 4 cases of CRS reported in 1983. Only 6 cases of diphtheria (1 occurred on a campus), 8 cases of paralytic polio, and 75 cases of tetanus were reported in 1983 in the United States.

While these declines have been dramatic, significant morbidity from these VPDs persist. Up to 25% of college age adults remain susceptible to measles and rubella. Most students would be eligible for their first booster (10 years after preschool dose) at the time of college entrance, 62% of young adults (18–39 years of age) are estimated to be susceptible to diphtheria, and 11% are estimated to be susceptible to tetanus. Fewer than 5% of young adults are believed to be susceptible to polio.

Measles and rubella continue to be associated with college outbreaks. All cases of measles and rubella should be reported to local health departments. College and universities have the opportunity to ensure the protection of their students, faculty, and employees by establishing and enforcing immunization requirements for measles, rubella, diphtheria, tetanus, and polio as a condition of matriculation, registration, or unemployment.     

Medical Complications of Female Genital Mutilation

Abstract

More than 130 million women are subjected to genital mutilation. Despite increasing efforts to reduce the practice, there are many obstacles to eliminating this 2,000-year-old practice, which is based on strong cultural traditions. As college health clinicians provide care to more international students from countries where female genital mutilation is performed, increased awareness and knowledge of the procedure will enable clinicians to understand and manage its complications. We report a case of obstructive uropathy resulting in hydronephrosis secondary to female genital mutilation and review the medical literature regarding this and other complications of genital mutilation “surgery.”     

Perceptions of Drinking and Related Findings From the Nationwide Campuses Study

Abstract

Proponents of social norms approaches maintain that correcting misperceptions of alcohol use among college students may reduce drinking and its consequences. The author used aggregate campus-level data from the Nationwide Campuses Study to test this hypothesis. He defined the misperceptions ratio as the ratio of the frequency of the “average student's” perceived alcohol use to the frequency of self-use at each campus. Each of the 57 colleges reported misperceptions ratios greater than unity. At campuses where students had more accurate perceptions of alcohol use, students were more likely to desire alcohol availability at campus events and to drink on more days throughout the year than at campuses where students had greater misperceptions of alcohol use. The author found no data to support the preferential use of social norms programming on campuses with high levels of self-reported alcohol use or binge drinking. These findings raise questions about potentially unexpected and unintended effects of social norms approaches.     

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.     

Prevalence of Human Immunodeficiency Virus Testing and Associated Risk Factors in College Students

Abstract

Objective: This study documents the prevalence of human immunodeficiency virus (HIV) testing in a sample of college students and examines associated demographic and behavioral characteristics. Participants: College students aged 18 or older were randomly selected to participate in a health behavior survey at a southeastern university in September 2011. Methods: Only sexually active students were included (N = 905). Relationships between demographic and sexual behavior characteristics were explored using logistic regression and classification regression tree (p ≤.05). Results: Only 36.2% reported having been tested for HIV. Age was the most significant factor associated with testing. Factors associated with those least likely to be tested were race and anal sexual activity. Unsafe sexual behaviors were also associated with lower rates of HIV testing. Conclusions: Findings support the need for targeted HIV interventions on college campuses. Such interventions need to be tailored for at-risk students and take into consideration factors likely to contribute to HIV testing.     

Smoking among New England College Men and Women

Abstract

Smoking behavior was examined among college students at 34 New England colleges. Women were more often smokers (44%) than men (32%) and were also more likely to smoke daily than men (23 vs. 16%). Men in private colleges were significantly less likely to smoke (22%) than those in public colleges (26%). At both public and private colleges, women were more likely to smoke than men. Smoking was inversely related to health habits for both men and women.

The percentage of college women who smoked is similar to that reported for the general population, while that for men is less. Prevention programs should be targeted to girls in the primary and secondary grades, as well as to college women, and support for smoking cessation should be made available on college campuses.     

One Hundred Years of College Mental Health

Abstract

Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, “mental hygiene” was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student bodies.     

Creating LGBTQI+ programing in urban higher education: Considering the creation process of a campus resource room

Abstract

While many community college campuses provide resources of some kind for students who identify as lesbian, gay, bisexual, transgender, queer, intersex, or other sexual or gender-non-binary minorities (LGBTQI+), surprisingly few institutions have dedicated physical spaces designated for that purpose. This article explores, by way of a case study on the establishment of an LGBTQI+?resource room on a community college campus, the processes that must be considered and undertaken when establishing such spaces. Needs assessments, identification of stakeholders, and strategies for making an LGBTQI+?resource room a reality on campuses that have never had such spaces or initiatives are discussed for the purposes of carefully considering the components of a proposed template for campus administrators, staff, faculty, and students to follow. While outcomes described in this article are specific to one particular case, the procedures by which they were achieved were undertaken with the hopes that they might be replicable by other similar institutions, in light of the very few LGBTQI+?spaces in community college contexts.     

Reducing Firearm-Related Violence on College Campuses—Police Chiefs' Perceptions and Practices

Abstract

Context: Firearms are used in the majority of college aged suicides and homicides. With recent efforts by various gun lobbying groups to have firearms more accessible to college students on campuses, there is the potential for more firearm-related morbidity and mortality. Objective: This study assessed university police chiefs’ perceptions and practices concerning selected issues of firearm violence and its reduction on college campuses. Participants: The Directory of the International Association for College Law Enforcement Administrators was used to identify a national random sample of campus police chiefs (n = 600). The respondents were predominantly males (89%), 40 to 59 years of age (71%), Caucasian (85%), and worked for 21or more years in law enforcement (75%). Methods: In the fall of 2008, a 2-wave mailing procedure was used to ensure an adequate response rate to a valid and reliable questionnaire. Results: A total of 417 (70%) questionnaires were returned. A firearm incident had occurred in the past year on 25% of campuses and on 35% of campuses within the past 5 years. The majority of campuses (57%) had a plan in place for longer than a year to deal with an “active shooter” on campus. Virtually all (97%) of the campuses had a policy in place that prohibited firearms on campus. The primary barrier (46%) to a highly visible campus plan for preventing firearms violence was the perception that firearms violence was not a problem on their campus. Conclusions: A greater awareness of the importance of a highly visible campus firearm policy and its potential for reducing firearm trauma on college campuses is needed.     

Suicide Ideation Among College Students Evidencing Subclinical Depression

Abstract

Identifying elevated suicide ideation in college students is a critical step in preventing suicide attempts and deaths by suicide on college campuses. Although suicide ideation may be most prominent in students with severe depression, this should not suggest that only students with severe depression experience significant risk factors for suicide. Objective: The purpose of these 3 studies was to explore the relation between suicide ideation and severity of depressive symptoms in college students. Participants: In each study a sample of college students were recruited for participation. Methods: Participants completed self-report assessments of depressive symptoms and suicide ideation. Results: The results of these studies suggest that although the greatest elevation in suicide ideation occurs at the highest depressive symptoms, significant suicide ideation is also experienced by college students with mild and moderate depressive symptoms. Conclusions: The implications of these findings for the assessment of suicide ideation are discussed.