Student healthcare needs, attitudes, and behavior: marketing implications for college health centers

This article presents the findings of a 1987 cross-institutional study of the healthcare needs, attitudes, and behavior of college students, based on a comprehensive survey of 1,050 students at three different institutions. The paper focuses on student health concerns, use of facilities, and healthcare knowledge and outlook. For each of these topics, the authors present their findings and discuss the marketing implications of these findings for college health centers. In order to increase utilization rates, match services with student needs, and make maximum use of resources, the authors suggest that college health centers may need to develop and promote programs and services that better address student healthcare concerns; investigate media alternatives and effectiveness; develop aggressive promotion messages; consider joint interinstitutional development of healthcare advertising; and train and develop staff through internal marketing seminars.     

One hundred years of college mental health

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.     

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.     

Community College Health Service Programs: A Progress Report

Abstract

What progress has been made in improving the health service programs available to the millions of students attending the nation's public community colleges? This question was investigated by sending a follow-up survey to deans of students in 1977; the original study was done five years earlier and resulted in a national profile of health service programs at public two-year institutions.

Some of the significant findings were: the percent of colleges offering health service programs has increased from 41.5% to 51.3%; the campus nurse continues to be the most common health professionals available to students; facilities are considered to be adequate and accessible; and a broad range of student health needs are met. New elements in the survey covered health education and mental health services, and these were positively evaluated.

On the basis of survey results it was concluded that community colleges have made considerable progress in improving student health services, but there is still much to be done.     

On the Integration of Science and Practice in College Health

Abstract

College health professionals want to assure the unique healthcare and health education needs of college students will continue to be met under national and state healthcare reform. This may be an “all or nothing” proposition. Either colleges and universities will have exclusive control of healthcare delivery for the college student population or else college health will not be a major force in healthcare reform. If college health is to play a meaningful role in future government-controlled health insurance programs, it must first demonstrate that current health services and insurance financing programs meet minimum quality standards. This proposal calls for expanding existing federal laws to create qualified student health plans and integrating the college health model into a reform package based on employer-sponsored health insurance. The concept of qualified student health plans allows for a high degree of flexibility that can be integrated into the majority of state and federal healthcare reform proposals, including the plan proposed by President Clinton, that are not based on a single-payer system. Ultimately, the authors suggest, their proposed plan would eliminate the current situation, in which large numbers of college students are uninsured or underinsured.     

The American College Health Association National College Health Assessment (ACHA-NCHA), Spring 2003 Reference Group report

Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey instrument developed by the American College Health Association (ACHA) in 1998 to assist institutions of higher education in achieving this goal. The ACHA-NCHA contains approximately 300 questions assessing student health status and health problems, risk and protective behaviors, access to health information, impediments to academic performance, and perceived norms across a variety of content areas, including injury prevention; personal safety and violence; alcohol, tobacco, and other drug use; sexual health; weight, nutrition, and exercise; and mental health. Twice a year, ACHA compiles aggregate data from institutions using the ACHA-NCHA to provide a reference group for data comparison. A portion of the data from the Spring 2003 Reference Group is provided in this article for use by professionals, researchers, institutions, departments, and organizations invested in advancing the health of college students.     

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.     

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.     

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.     

Internet use among college students: an exploratory study

The author and associates surveyed 1,300 college students in classrooms at eight academic institutions to identify how the students' use of the Internet has affected their social or academic lives. Although the typical Internet-using student uses the Internet for 100 minutes per day, a small group of students use the Internet to a degree that interferes with other aspects of their lives. Most of them are men and are found among the hard science academic majors. Some ideas for dealing with this problem are suggested.     

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.     

A systematic analysis of college substance use policies

College substance use policies provide guidelines for student behavior and influence campus culture. Although they are the primary environmental strategy to address campus substance use, policies have not been systematically compared and studied. We constructed a systematic review method to examine the accessibility, comprehensiveness, enforcement procedures, and clarity of college substance use policies. We developed an objective evaluation scheme for each of these 4 dimensions and then applied it to documented substance use policies from a sample of colleges and universities (N = 24). Policies were found to vary considerably but tended to specify compliance with local laws and emphasize student health and well-being. The next stage of campus policy review should examine actual implementation, evaluate potential differentiating factors among institutions, and assess the influence of policy on campus climate and student outcomes.     

Internet Use Among College Students: An Exploratory Study

Abstract

The author and associates surveyed 1,300 college students in classrooms at eight academic institutions to identify how the students' use of the Internet has affected their social or academic lives. Although the typical Internet-using student uses the Internet for 100 minutes per day, a small group of students use the Internet to a degree that interferes with other aspects of their lives. Most of them are men and are found among the hard science academic majors. Some ideas for dealing with this problem are suggested.     

The status of nutrition education in ACHA college and university health centers.

An assessment of the prevalence and scope of nutrition services offered through 208 randomly selected American College Health Association member student health centers revealed that 79% of the 160 respondents provided some type of nutrition education for students. One-to-one counseling, available at 96% of the institutions, was the most common approach. The larger the school's enrollment, the more likely it was to provide programs in nutrition. All of the institutions with student populations of more than 35,000 offered some type of nutrition service, as did 52% of the 19 schools with enrollments between 2,000 and 5,000. Health educators, nurses, doctors, dietitians, and trained peer educators provided the services, with registered dietitians the most common providers and often coordinators of the programs. Costs to students for nutrition interventions were nominal; weight-management programs were the most expensive and showed the greatest variation in content.     

College psychiatry as public health psychiatry. 1967

This ten-year survey of the use of student mental health services offered by the University of North Carolina suggests that increased usage over time has been due to greater availability of staff and a broadening of services offered rather than to an increase of the prevalence of mental illness among the student body. The authors believe that college psychiatry, as one of the earliest examples of the provision of mental health services to a community, can be used as a model for other aspects of public health psychiatry.     

Contracting in College Health Instruction

This ten-year survey of the use of student mental health services offered by the University of North Carolina suggests that increased usage over time has been due to greater availability of staff and a broadening of services offered rather than to an increase of the prevalence of mental illness among the student body. The authors believe that college psychiatry, as one of the earliest examples of the provision of mental health services to a community, can be used as a model for other aspects of public health psychiatry.     

A Systematic Analysis of College Substance Use Policies

College substance use policies provide guidelines for student behavior and influence campus culture. Although they are the primary environmental strategy to address campus substance use, policies have not been systematically compared and studied. We constructed a systematic review method to examine the accessibility, comprehensiveness, enforcement procedures, and clarity of college substance use policies. We developed an objective evaluation scheme for each of these 4 dimensions and then applied it to documented substance use policies from a sample of colleges and universities (N = 24). Policies were found to vary considerably but tended to specify compliance with local laws and emphasize student health and well-being. The next stage of campus policy review should examine actual implementation, evaluate potential differentiating factors among institutions, and assess the influence of policy on campus climate and student outcomes.     

Deficits in young men's knowledge about accessing sexual and reproductive health services

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). Results: Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. Conclusions: Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.     

Variations in Student Mental Health and Treatment Utilization Across US Colleges and Universities

Abstract

Objective: On US college campuses, mental health problems are highly prevalent, appear to be increasing, and are often untreated. Concerns about student mental health are well documented, but little is known about potential variations across the diversity of institutions of higher education. Participants: Participants were 43,210 undergraduates at 72 campuses that participated in the Healthy Minds Study from 2007 to 2013. Methods: Multivariable logistic regressions focus on associations between institutional characteristics and student mental health and treatment utilization. Results: The following institutional characteristics are associated with worse mental health: doctoral-granting, public, large enrollment, nonresidential, less competitive, and lower graduation rates. Among students with apparent mental health problems, treatment utilization is higher at doctorate-granting institutions, baccalaureate colleges, institutions with small enrollments, and schools with strong residential systems. Conclusions: Although high rates of mental health problems and low treatment utilization are major concerns at all types of institutions of higher education, substantial variation occurs across campuses.     

The Status of Nutrition Education in ACHA College and University Health Centers

Abstract

An assessment of the prevalence and scope of nutrition services offered through 208 randomly selected American College Health Association member student health centers revealed that 79% of the 160 respondents provided some type of nutrition education for students. One-to-one counseling, available at 96% of the institutions, was the most common approach. The larger the school's enrollment, the more likely it was to provide programs in nutrition. All of the institutions with student populations of more than 35,000 offered some type of nutrition service, as did 52% of the 19 schools with enrollments between 2,000 and 5,000. Health educators, nurses, doctors, dietitians, and trained peer educators provided the services, with registered dietitians the most common providers and often coordinators of the programs. Costs to students for nutrition interventions were nominal; weightmanagement programs were the most expensive and showed the greatest variation in content.