What do urban college students really think about health insurance? A qualitative study

Abstract

Objective: To determine barriers and opportunities to health insurance enrollment among an undergraduate students at a large urban university. Participants: Participants were 31 college students enrolled in 4-year and community colleges in the City University of New York (CUNY), and six health services and insurance enrollment specialists who facilitate and assist in the health insurance enrollment process for CUNY students. Methods: Focus groups were conducted with students and in-depth interviews with key informants in May 2017. Results: The research revealed important insights into how students perceive and value insurance and yielded recommendations for the university to improve enrollment of its students. Conclusions: Many colleges can increase student enrollment in health insurance by informing and educating students about the process. Improving enrollment processes can increase insurance rates and improve student population health.     

Mental health literacy,stigma, and help-seeking behaviors among male college students

Objective: Mental health literacy (MHL) is low in college-aged men potentially resulting in impaired mental wellbeing. This study assessed MHL, psychosocial determinants, and help-seeking behaviors among male university students. Participants: Male undergraduate and graduate students were surveyed in Spring 2017 (n = 1,242) at a large southeastern university in the United States. Methods: Preexisting validated scales for MHL, psychosocial determinants, and help-seeking intention were used in measurement and demographic variables were collected. T-tests and one-way ANOVA were performed to measure differences between groups. Results: Participants showed low scores for all constructs with statistically significant differences between undergraduate and graduate students, as well as between races and major classifications. Undergraduate men had moderate MHL and low intentions to seek professional care. Conclusions: Interventions focusing on increasing mental health knowledge and improving beliefs can improve MHL among male college students. Further, interventions should be tailored for racial groups and major classifications.     

Exploring college students’ sexual and reproductive health literacy

Abstract

Objective: To assess college students’ sexual and reproductive health (SRH) literacy experiences, specific to contraception use and STI prevention. Participants: In Spring 2015, participants (n?=?43) from a large institution participated in six focus groups (two male and four females groups). Methods: Focus groups were guided by the health literacy domains (access; understand; appraise; apply); data were analyzed in MaxQDA using the constant comparative method. Results: The Internet was the most commonly accessed source for SRH information. Participants discussed facilitators (eg, use of visuals) and barriers (eg, medical jargon) to understanding information; and personal lifestyle, advice from family/friends, symptoms, and sexual partners as appraisal factors. Participants applied information by communicating with friends/providers and seeking healthcare. However, findings were not linear nor mutually exclusive, representing the interaction of health literacy skills. Conclusion: Findings suggest that a patient-centered intervention capitalizing on technology and trusted individuals (providers/peer educators) may facilitate college students’ SRH literacy.     

Are college students health literate?

Abstract

Objective: To examine the health literacy of college students. Participants: A convenience sample of 245 graduate and undergraduate college students. Methods: During February–April of 2018 participants completed the Short Test of Functional Health Literacy which assessed literacy on two passages describing a thyroid scan, and basic healthcare insurance information. Results: Most college students displayed adequate health literacy (99.2%). The ANOVA analyses revealed college classification was the most significant predictor, followed by ethnicity, sex, and primary language. Age was significantly related to health literacy, when holding college classification constant. Interestingly, college major, healthcare work experience, or having health care credentials were not predictors of health literacy. Conclusion: This group of college students had adequate health literacy skills. However, the results of this study revealed demographic disparities that suggest further study.     

An examination of ecological predictors of health literacy in black college students

Objective: Health literacy is a determinant of health, but disparities in health literacy persist. This study examined the influence of ecological factors on college students’ health literacy. Participants: During January 2016 a nonrandom sample of black undergraduate students (n = 298) aged 18–24 were recruited from enrollment lists at two urban universities in the Southeastern United States. Methods: Information on health literacy as well as numerous intrapersonal, social, and cultural-environment factors was obtained using an electronic questionnaire and then statistically modeled. Results: Ecological factors accounted for 28.7% of the variance in health literacy. In particular, reappraisal (B = 0.323, p < .001), suppression (B = ?0.289, p < .001), campus health education (B = 0.192, p < .05), campus tobacco culture (B = ?0.174, p < .05), and perceived norms (B = ?0.153, p < .05) directly predicted health literacy. Conclusions: Although intrapersonal factors influence health literacy, the sociocultural environment of college can also foster or hinder college students’ health literacy.     

A National Survey of the Provision of Sexual Health Clinical Services by Public Health in Canada: First Insights

Objectives: Data documenting the scope of sexual health clinical services offered as public health in Canada are unavailable. This article provides first insights into the scope of STI and clinical sexual health services available nationally. Methods: Data were gathered using an online survey of 113 Canadian public health units. Results: Almost half of the clinics were not providing expedited partner therapy, one third were not providing point of care testing for HIV and one third were not using syndromic management of sexually transmitted infections (STIs). Low rates of physician support were evident. Conclusion: Given the ever-higher rates of STIs, findings from this study identify important challenges to providing comprehensive services.     

Solution-focused wellness coaching: a mixed methods,longitudinal study with college students

ABSTRACT

Research indicates that college students are experiencing mental health challenges of greater severity and frequency. College students present with a variety of wellness-related challenges, resulting in increased demand on campus health resources and service limitations including extended wait lists and increased off-campus referrals. This research study examined the effectiveness of a short-term solution-focused intervention on perceptions of wellness and stress among the college student population. This study utilized a longitudinal, mixed-methods design to assess the impact of a brief (seven-week) intervention on perceived stress and wellness among 52 college students at a large Midwestern University, using the Perceived Stress Scale (PSS) and Five-Factor Wellness Evaluation of Lifestyle (5 F-WEL). Repeated measures analysis of variance (RM-ANOVA) results indicated significant differences across time for perceived stress and wellness (p <.01). To augment quantitative data, a brief, semi-structured interview was completed with 24 study participants post-intervention, and an Applied Thematic Analysis (ATA) was conducted as a means of identifying themes. This study demonstrates the effectiveness of a solution-focused wellness (SFW) approach in changing perceptions of stress and wellness. Findings provide support for a prevention model in which college students are encouraged to proactively engage in lifestyle activities that enhance their wellness.     

Family Home Businesses: Who Buys Health Insurance?

This study uses data from the Cooperative States Regional Research Project NE-167 to examine the factors that influence family home business owners in purchasing health insurance. Results indicate that net business income, full-time work, and a hospital reimbursement rate are positively related to the likelihood of buying health insurance although income from other sources is negatively related to purchasing it. Being male, a contractor, and having more education also indicates a greater probability of buying insurance. Implications for working with self-employed families are discussed.     

Health behaviors of culturally diverse inner-city community college students

ABSTRACT

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College Health Association National College Health Assessment II (ACHA-NCHA II) paper survey and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 for frequencies and chi-square test of independence. Results: The sample population reported poor diet, low rates of physical activity, high rates of overweight/obesity, low rates of condom use for vaginal sex, multiple sexual partners, and unintentional pregnancy. Protective health behaviors included low rates of cigarette smoking and alcohol use, high rates of condoms use for anal sex, and high rates of human immunodeficiency virus (HIV) testing. Conclusion: Students are at high risk for health problems related to poor diet, lack of exercise, and risky sexual behaviors. Additional research is recommended to determine the most effective intervention strategies.     

Development of a Health Literacy Assessment for Young Adult College Students: A Pilot Study

Abstract

Objective: The purpose of this study was to develop a comprehensive health literacy assessment tool for young adult college students. Participants: Participants were 144 undergraduate students. Methods: Two hundred and twenty-nine questions were developed, which were based on concepts identified by the US Department of Health and Human Services, the World Health Organization, and health communication scholars. Four health education experts reviewed this pool of items and helped select 87 questions for testing. Students completed an online assessment consisting of these 87 questions in June and October of 2012. Item response theory and goodness-of-fit values were used to help eliminate nonperforming questions. Results: Fifty-one questions were selected based on good item response theory discrimination parameter values. Conclusions: The instrument has 51 questions that look promising for measuring health literacy in college students, but needs additional testing with a larger student population to see how these questions continue to perform.     

Diverse students and literacy in social work education: pedagogies for a new tertiary landscape

In the Western policy landscape, students from diverse cultural, linguistic, economic and other backgrounds are increasingly represented in an expanded tertiary education system. Structural and technological changes have challenged traditional pedagogies designed for more elite cohorts, and shifted the boundaries of textual practices in both universities and professional worlds. In spite of these momentous trends, university literacies often remain tacit and inaccessible to those new to them, and pedagogies rarely explicitly engage with the complexities of these shifting boundaries. University students unfamiliar with these tacit literacies can become marginalised and ultimately struggle with the literacy demands of their academic and professional worlds. This is problematic in social work education, as professional practice demands complex written and oral communication, with potentially significant social and legal repercussions. This paper reports on pedagogies initiated by action research in a Bachelor of Social Work programme in an Australian University. Pedagogies were introduced to make elite codes explicit, use students’ literacies as assets for learning and encourage ‘code switching’ between literacy practices to resist colonising into more powerful literacies. Students’ capacities in academic and professional literacies were significantly enhanced by these practices, and their cultural inheritances valorised, encouraging their contribution to the social work discipline.     

Domesticating insurance,financializing family lives: the case of private health insurance for children in Finland

This article explores the domestication of a financial instrument that is much used in contemporary Finland, but that most of its users do not primarily think about in terms of being a financial instrument: the private health insurance for children. In Finland, all children are covered by social insurance and are entitled to free public health service with very low costs, if any. Yet, some 40 percent of families want to supplement this service with private products. Many fear that the popularity of the private health insurance for children contributes to a vicious circle that ends up weakening the legitimacy of, and the service given by, the public health sector; inequality in the face of health risks threatens to be aggravated, as well. Therefore, this financial instrument has become an object of political controversy. The main question of the article is: how do economic, political and moral valuations become intertwined in the domestication of insurance? The concept of ‘domestication’ is found helpful for analysing the pragmatics of valuation and for appreciating the dynamics and the heterogeneity of forces at play when financialization influences everyday life. The study argues that when financial instruments are appropriated they are also transformed; thus, they should not be viewed as homogeneous tools that have similar effects in all contexts of use. The main empirical materials studied are interviews with families with and without private health insurance policies for their children.     

Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college

Objective: To determine the feasibility of a mobile health (mHealth), media literacy education program, Media Aware, for improving sexual health outcomes in older adolescent community college students. Participants: 184 community college students (ages 18–19) participated in the study from April–December 2015. Methods: Eight community college campuses were randomly assigned to either the intervention or a wait-list control group. Student participants from each campus completed web-based pretest and posttest questionnaires. Intervention group students received Media Aware in between questionnaires. Results: Several intervention effects of the Media Aware program were significant, including reducing older adolescents' self-reported risky sexual behaviors; positively affecting knowledge, attitudes, normative beliefs, and intentions related to sexual health; and increasing media skepticism. Some gender differences in the findings were revealed. Conclusions: The results from this study suggest that Media Aware is a promising means of delivering comprehensive sexual health education to older adolescents attending community college.     

Undergraduate students survey their peers on mental health: Perspectives and strategies for improving college counseling center outreach

Abstract

Objective: The purpose of the study was to examine student perspectives about college mental health including the primary mental health issues affecting students, common college student stressors, student awareness of campus mental health resources, and mental health topics students want more information about. Participants: Participants were 822 undergraduate and graduate students enrolled in a private university. The study was conducted during September 2016. Methods: As part of a public health course in program planning, undergraduate students surveyed their peers about their experience with mental health and mental health resources. Results: Stress was perceived as the largest mental health issue. Students most wanted more information about school/work/life balance followed by stress management. Electronic newsletters, social media, and on-campus seminars were the top strategies that students suggested as ways to reach them. Conclusions: The results provide student perspectives on mental health that may be useful in developing effective outreach efforts.     

Assessing competency-based evaluation course impacts: A mixed methods case study

The contexts in which evaluators develop and apply their expertise are increasingly complex; evaluator education needs to provide robust opportunities to support and assess the progressive, lifelong development of relevant knowledge and skills. This mixed methods case study begins to address the dearth of empirical evidence assessing the impacts and learner experiences of competency-based approaches to evaluator education. A decade-in-the-making doctoral evaluation course based on the Canadian Evaluation Society’s Competencies for Canadian Evaluation Practice created an opportune study setting. We applied a systems perspective to Stufflebeam’s Context, Input, Process, and Product (CIPP) model to frame the case study analysis and presentation of the complex impacts generated by pre/post course competency self-assessments and reflections, integrated with an end-of-course focus group. Seven insights shed new light on the effective course design and implementation features for developing intended and unintended evaluator competencies. We conclude with a discussion of the theoretical, practical, and methodological implications for effective competency-based evaluator education.

• •Keywords: Case study; Competency-based approach; Evaluator education; Mixed methods research

     

The understudied half of undergraduates: Risky sexual behaviors among community college students

Abstract

Objective: This study examines the prevalence and risk factors associated with risky sexual behaviors in community college students. Participants: A diverse sample of 18–19-year-old community college students (N?=?264). Methods: Baseline data from an online prevention program administered in 2015. Results: Community college students in this sample disproportionately experienced sexual assault and were unlikely to test for STIs. Higher intentions to engage in risky sexual behaviors were associated with gender and sexual experience, but also with having lower intentions to communicate with a sexual partner about pregnancy and STIs, and having higher gender norm endorsement. Conclusions: Older adolescents attending community colleges may be at high risk for poor sexual health outcomes, and appropriate theory-based education should be tailored to meet the needs of these underserved students.     

TECHNOLOGICAL DEVELOPMENTS IN CENTRAL-EASTERN EUROPE:A case study of a computer literacy project in Slovenia

Based on in-depth interviews and a political economy analysis, this paper offers an evaluation of a Computer Literacy Project in Slovenia that was created as a part of a larger technological development project in the region. The article is divided into three main parts. The first part offers some critical arguments on the notions of development and technology. The second part contains an analysis of why the Computer Literacy Project received much support from the educational authorities in Slovenia - and it is argued that this is because it falls in line with general political and economic principles promoted by the dominant neo-liberal vision in the Central-Eastern European region. In the third part, a case study of the Computer Literacy Project in Slovenia is assessed. We attempt to unveil the discourses of the Computer Literacy teachers that were geared towards creating a specific vision of a Slovene future: a vision that continues to promise economic progress, and democracy through technology and the rise of the Internet. This section explores how their discourses stem from mainstream perspectives of development and technology. We attempt to unravel the paradoxes within the disourses, while showing how this vision sidesteps a morecritical analysis of the Internet's potential. Entrenched in a technological-deterministic perspective, the study respondents recognize that education and the democratic public sphere can be guaranteed by virtue of a technology access alone. We suggest that education policy-makers everywhere should carefully review their computer literacy policies, and we argue for a course on Information Literacy that would provide an alternative educational experience.     

Health Care of American Indian Elderly: Determinants of the Perceived Difficulty Obtaining Access to Health Care

This study examines the perceived areas of difficulty in obtaining access to health care and the factors influencing that difficulty among elderly American Indians in a rural environment. One hundred thirty-seven elderly Indians in the Ponca and Pawnee tribes of Oklahoma were interviewed. Four major difficulties are reported: a long waiting period at Indian health centers, difficulty in making appointments to see physicians, language and cultural barriers to communication with the health care providers, and lack of available transportation. The long waiting period is the most serious problem, and lack of transportation is the least serious. The results of probit analysis show that physical health, automobile ownership, education, employment, and the presence of an informal caregiver are related to difficulty obtaining access to health care. Ways to minimize this difficulty are discussed.     

Promoting healthy transition to college through mindfulness training with first-year college students: Pilot randomized controlled trial

Objective: Given the importance of developmental transitions on young adults' lives and the high rates of mental health issues among U.S. college students, first-year college students can be particularly vulnerable to stress and adversity. This pilot study evaluated the effectiveness and feasibility of mindfulness training aiming to promote first-year college students' health and wellbeing. Participants: 109 freshmen were recruited from residential halls (50% Caucasian, 66% female). Data collection was completed in November 2014. Methods: A randomized control trial was conducted utilizing the Learning to BREATHE (L2B) program, a universal mindfulness program adapted to match the developmental tasks of college transition. Results: Participation in the pilot intervention was associated with significant increase in students' life satisfaction, and significant decrease in depression and anxiety. Marginally significant decrease was found for sleep issues and alcohol consequences. Conclusions: Mindfulness-based programs may be an effective strategy to enhance a healthy transition into college.     

Young African American Males: Barriers to Access to Health Care

African American males continue to experience an unacceptable and disproportionate number of health disparities when compared with other racial and ethnic groups. Young African American males can expect to live the least amount of time when compared to any other ethnic minority or racial sub-group. Understanding the obstacles and barriers that impede access to health care and wellness services among young African American males is essential to begin the process of decreasing health disparities. The goal of this qualitative study was to explore and identify the barriers experienced by young African American males in accessing health care services while also creating a rare opportunity to give voice to young African American males. The study results indicate that young African American males have multiple perceptions of barriers to health care services. Their perceptions fell into three categories: the negative impact of environment or community, lack of finances or no insurance, and distrust of medical practices associated with race history resulting in accessing healthcare as a last resort. Additional research is needed to craft community-based programs to: a) educate young African American males on the importance of preventative strategies to maintain wellness; and b) ensure that the appropriate medical and wellness services are available and reaching young African American males in need.