Help Seeking and Treatment Use Among Suicidal College Students

Abstract

Objectives: Many suicidal college students do not receive mental health treatment, and the reasons for this are not fully understood. This study examines how attitudes, beliefs, and social network factors relate to help seeking among suicidal students. Participants: A random sample of 8,487 undergraduate and graduate students from 15 US universities participated. Methods: A Web-based survey administered in spring 2009 examined correlates of mental health service utilization among students reporting serious thoughts of suicide in the previous year (n = 543). Results: Correlates of treatment use included perceived need, beliefs that treatment is effective, contact with service users, lower personal stigma, higher perceived stigma, fewer positive relationships, and sexual minority or Caucasian identity. Conclusions: Help seeking among suicidal students is associated with a range of personal and social network factors. Campus strategies to enhance help seeking should be tailored to address identified facilitators and barriers to treatment use among target populations.     

Unmet demand for short-acting hormonal and long-acting reversible contraception among community college students in Texas

Objective: To identify preferences for and use of short-acting hormonal (e.g., oral contraceptives, injectable contraception) or long-acting reversible contraception (LARC) among community college students in Texas. Participants: Female community college students, ages 18 to 24, at risk of pregnancy, sampled in Fall 2014 or Spring 2015 (N = 966). Methods: We assessed characteristics associated with preference for and use of short-acting hormonal or LARC methods (i.e., more-effective contraception). Results: 47% preferred short-acting hormonal methods and 21% preferred LARC, compared to 21% and 9%, respectively, who used these methods. A total of 63% of condom and withdrawal users and 78% of nonusers preferred a more effective method. Many noted cost and insurance barriers as reasons for not using their preferred more-effective method. Conclusions: Many young women in this sample who relied on less-effective methods preferred to use more-effective contraception. Reducing barriers could lead to higher uptake in this population at high risk of unintended pregnancy.     

Exploring the association between alcohol,marijuana, and secondhand effects with rural college students

ABSTRACT

The current study investigated the association between secondhand effects and personal consequences with substance use in a sample of rural college students (N = 412; 55.1% women; 92.2% white/non-Hispanic). The study extends the body of secondhand effects research by (a) investigating the association of marijuana use with the experience of secondhand effects; (b) examining the association of onset risk of substance use (< 18 years old) with the experience of secondhand effects; (c) exploring the multiplicity of experienced effects associated with substance use by employing a four-category typology that exhaustively represents exposure to secondhand effects and personal consequences. Bivariate and multiple regression analyses were used to evaluate the data. The majority of students (90.3%) experienced undesirable effects from substance use, with 15% reporting only secondhand effects, 28.5% only personal consequences, and 46.8% reporting both secondhand effects and personal consequences. Residing on-campus, onset risk, and past 30-day alcohol or marijuana use increased risk for experiencing personal consequences and the combination of secondhand effects and personal consequences. Secondhand effects are likely to compound the harm for substance users because they often experience both secondhand effects and personal consequences.     

Longitudinal predictors of cigarette use among students from 24 Texas colleges

ABSTRACT

Objective: The purpose of this study is to examine differences between current and non-current cigarette users, focusing on sociodemographic factors, non-cigarette tobacco product use, parental and friend use, and alcohol and marijuana use; and to identify predictors of cigarette use sixmonths later. Participants: Participants included young adults (n = 4,296) from 24 Texas colleges, participating in a young adult cohort study, beginning in fall 2014. Methods: Mixed effects logistic regressions were conducted accounting for school-level variability. Results: Cigarette users were older, more likely to report use of non-cigarette tobacco products and peer use of cigarettes than non-current users. Wave 1 cigarette and non-cigarette tobacco product use, marijuana use and binge drinking, and peer use all uniquely predicted cigarette use at wave 2. Conclusions: Colleges need prevention programs targeting multiple tobacco products, because non-cigarette tobacco use and other risky behaviors appear to be independent risk factors for cigarette use in young adults.     

Sociocognitive factors and perceived consequences associated with alternative forms of alcohol use

Objective: Popular media have highly publicized alternative forms of alcohol use (eg, eyeballing, inhaling alcohol vapor) among college students as a growing concern, possibly associated with severe health risks. Formative research indicates rarity of use. Participants and Methods: College students (Study 1: n = 411; Study 2: n = 687) completed an online survey. Results: Findings confirmed infrequent use of alternative methods of alcohol use and low likelihood of trying them in the future (Study 1). Participants indicated varied reasons for possibly trying each alternative form of alcohol use, but consistently perceived consequences for all forms (ie, health concerns), as well as very low perceived approval from close friends (Study 2). Social and environmental contextual factors associated with possible use were also explored. Conclusions: College students in the current sample have low prevalence and future likelihood of alternative forms of alcohol use. This information can be used by campus health practitioners to promote accurate normative data for alternative forms of alcohol use. However, with increased perceptions of approval and media presence, future trends could change. Findings revealed important risk factors for these potentially hazardous forms of alcohol use.     

Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

Abstract

Objective: This study assessed college students’ reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.     

College students' perceptions of risk and addictiveness of e-cigarettes and cigarettes

Background: As conventional cigarette use is declining, electronic cigarette (“e-cigarette”) use is rising and is especially high among college students. Few studies examine dual use of e-cigarettes and cigarettes among this population. This study explores the relationship between dual and exclusive e-cigarette / cigarette use and perceptions of harm and addictiveness of both products. Methods: This is a cross-sectional analysis of data from students attending 24 colleges in Texas (n=5,482). Multinomial logistic regression was employed to test the association between current e-cigarette / cigarette use and perceived harm and addictiveness of both products. Three tobacco groups were included: cigarette only users, e-cigarette only users, and dual users. Results: Dual users reported lower perceived harm of e-cigarettes most consistently (p<0.001, all comparisons). Perceived harm of cigarettes was significantly lower among cigarette only and dual users only, compared to non-users (p<0.001, all comparisons). Compared to non-users, all three groups reported significantly lower perceived addictiveness of e-cigarettes (p<0.001, all comparisons). The same finding was observed for perceived addictiveness of cigarettes, though findings were less consistent for the e-cigarette only group (p<0.02, all comparisons except one). Conclusion: Findings demonstrate that among college students, perceptions of harm and addictiveness of e-cigarettes are lower than those for conventional cigarettes. For both products, perceptions of harm and addictiveness were lower among exclusive and dual users, compared to non-users.     

Truth® ads,receptivity, and motivation to use or quit tobacco among college students

Abstract

Objective: Examine receptivity and motivation to use/quit tobacco among college students after viewing Truth ads. Participants: Random sample of 10,000 college students invited to complete online survey February 2016 (8.5% response rate). Methods: Quasi-experimental. Participants (N?=?854) watched four ads and answered survey items for each ad. Results: Students rated ad receptivity and decreased motivation to use tobacco higher for the Catmageddon ad than the others. Regardless of ad, men and current cigarette smokers reported lower receptivity. Younger age was associated with lower motivation to use tobacco for all ads. Tobacco users reported greater motivation to quit with the Catmageddon ad. Conclusions: College students were receptive to the Truth ads, and many indicated lower motivation to use tobacco. Men, older college students, and current cigarette smokers were less receptive to the ads, reinforcing the need to develop tailored campaigns to reach these subgroups.     

Concurrent binge drinking and current tobacco use and its social and health correlates among adults in Laos

ABSTRACT

The aim of this study was to examine sociodemographic and health correlates of concurrent binge drinking and tobacco use in a national adult population in Laos. A cross-sectional study based on a stratified cluster random sampling was conducted in 2013. The total sample included 2,543 individuals 18–64 years. Questionnaire interview, blood pressure, and anthropometric measurements, and biochemistry tests were conducted. Results indicate that 18.6% (38.3% in men and 5.2% in women) of the participants had engaged in concurrent current tobacco use and past month binge drinking, 15.2% in current tobacco use only and 28.4% in past month binge drinking only. Among current tobacco users, 42.2% engaged in frequent heavy drinking (3 or more times/month), and among past month heavy alcohol users, 55.8% were daily current tobacco users. In adjusted analysis, being 35 to 49 years old, lower education, having normal weight, and moderate or high physical activity were associated with concurrent current tobacco use and past month heavy drinking. Current tobacco use alone increased with age and decreased with education and heavy drinking alone decreased with age and increased with education. Findings suggest sociodemographic and health factors are important for public health interventions in addressing concurrent tobacco and alcohol use.     

Socio-Demographic Characteristics of Contraceptive Users in Ghana

ABSTRACT

This paper describes the social and demographic characteristics of contraceptive users in Ghana, using the Ghana Demographic and Health Survey (GDHS) data (1993). Analysis has revealed that contraceptive use among women is quite low. Women's age, marital status, educational level, and place of residence are some of the factors that relate significantly to contraceptive use. The reasons most frequently cited for non-use of a modern birth control method are the desire to have children, lack of knowledge, and health concerns. The data show little motivation among women to practice family planning. Suggestions for effective family planning are provided.     

Knowledge of Suicide Risk Factors,But Not Suicide Ideation Severity,Is Greater Among College Students Who Viewed 13 Reasons Why

Abstract

Objective: To test associations between viewing 13 Reasons Why, Season 1 and past week suicide ideation severity, behavior risk, stigma, and knowledge in college students. To explore whether personal exposure to suicide and depressive symptom severity moderated these associations. Participants: Eight-hundred and eighteen college students, 64% (n?=?522) of whom watched 13 Reasons Why. Methods: Students completed surveys online. Multivariate negative binomial regressions were used to test associations between watching 13 Reasons Why and suicide-related variables, and interaction terms. Results: Suicide ideation severity and suicide behavior risk were not significantly associated with viewing 13 Reasons Why; however, there was limited statistical power to detect associations. The association between watching 13 Reasons Why and greater suicide knowledge was stronger among those who did not have personal exposure to suicide. Conclusions: 13 Reasons Why may be a platform for psychoeducation on suicide, particularly among those who do not have personal exposure.     

Social Context of Smoking Hookah Among College Students: Scale Development and Validation

Abstract

Objective: To develop an instrument that measures the social context of hookah use among college students. Participants: A pool of 50 potential items, based on 44 in-depth interviews with regular college hookah smokers, was administered to a sample of 274 hookah users between October and December 2011. Methods: Participants were approached in hookah bars and asked to complete the survey. Results: A principle components analysis revealed 3 reliable factors: social facilitation, family/cultural influence, and alternative to smoking cigarettes and drinking. These were examined across different categories of hookah use: Weekly hookah users were more likely to smoke in a context of social facilitation than the other 2 groups. Similar effects were observed for family/cultural influence. Asians were more likely to smoke in a context of family and cultural influence than non-Asians. Conclusions: This scale has potential for identifying situation-specific contexts of hookah use that may help in designing effective interventions for college students.     

Building Social Inclusion for Rural Older People Using Information and Communication Technologies: Perspectives of Rural Practitioners

Abstract

The literature identifies rural, older people as at risk of social exclusion, as a result of rural disadvantage. In this context, improved access to information and communication technologies (ICTs) has potential to build social inclusion, yet current evidence shows that rural, older people are the lowest current users of technology. This paper draws on the practice and local knowledge of rural practitioners from one Victorian region in order to explore: (a) the practice issues associated with ICT use among rural, older people; and (b) the characteristics of effective practice models in the rural, social work context. An analysis of findings highlights the need to respond to the diverse skills, needs, and learning styles of older people, to demonstrate the benefits of ICTs, involve users, and build confidence. Major barriers include poor ICT usage by many rural agencies and low practitioner capacity, as well as access and resources.     

Actual Versus Perceived Risk of Cervical Cancer Among College Women Smokers

Cervical cancer is a well-established smoking-related illness, but many at-risk women are unaware of this link. Objective: The authors designed this study to (1) investigate the relationship of smoking behavior with the history of abnormal Pap test results, sexual history, and perceived risk of cervical cancer and (2) determine whether self-classified smoking status (and hence perceived risk) corresponds with actual smoking behavior in a college student population. Participants and Method Summary: College women students (N = 135) completed a survey assessing smoking history, health history, sexual risk behavior, and risk awareness. Results: Relative to those who had not smoked in the past month, current smokers (n = 36, or 27% of the total sample) perceived themselves to be at higher risk for developing cervical cancer, but did not demonstrate increased awareness of specific cervical cancer risk factors, including smoking. Twenty-eight percent (10 of 36) of past-month smokers did not define themselves as current smokers. Conclusion: The authors conclude that antismoking and health-related messages targeting smokers may misfire for individuals who do not define themselves as smokers but are nonetheless at risk for smoking-related consequences and escalating use.     

Self-reported Barriers to Professional Help Seeking Among College Students at Elevated Risk for Suicide

Abstract

Objectives: This study sought to describe self-reported barriers to professional help seeking among college students who are at elevated suicide risk and determine if these barriers vary by demographic and clinical characteristics. Participants: Participants were 165 non–treatment seekers recruited as part of a Web-based treatment linkage intervention for college students at elevated suicide risk (from September 2010 through December 2011). Methods: Data were collected using Web-based questionnaires. Two coders coded students’ responses to an open-ended question about reasons for not seeking professional help. Results: The most commonly reported barriers included perception that treatment is not needed (66%), lack of time (26.8%), and preference for self-management (18%). Stigma was mentioned by only 12% of students. There were notable differences based on gender, race, and severity of depression and alcohol abuse. Conclusions: Efforts aimed at reaching students at elevated risk for suicidal behavior should be particularly sensitive to these commonly described barriers.     

Is Hba1c level of diabetic patients associated with penile prosthesis implantation infections?

Background and objectives: Diabetes mellitus is an important risk factor for erectile dysfunction (ED). Penile prosthesis implantation surgery is the final solution for diabetic patients with ED, but infections thereof are still a serious risk factor. While some studies suggest that most infections associated with penile prosthesis implantation are associated to high glycated hemoglobin (HbA1c) levels, other research did support such relationship.

Materials and methods: The current study assessed retrospectively, the association between HbA1c level and penile prosthesis surgery infection. We retrieved and reviewed the records of 300 diabetic patients who had penile prosthesis surgery at our Institution (January 2012–November 2016). Patients’ mean age was 55.26?±?10.9 years (31% patients were <50 years of age), and mean HbA1c was 7.60?±?1.90%.

Results: Infection rate among diabetics was 0.67%. Prevalence of prosthesis infection among patients with HbA1c?≤?9% was 0.9%, compared with 0% among patients with HbA1c?>?9%. Prosthesis infection risk did not significantly increase with higher HbA1c levels, with no meaningful difference in the median or mean level of HbA1c in the infected and non-infected diabetic patients.

Conclusion: Findings do not support the use of HbA1c values among diabetic patients who are candidates for penile prosthesis implantation surgery in order to identify and exclude those who might be prone to increased risk of prosthesis infections. Future studies would benefit from larger sample sizes in order to support or refute our findings.     

Dimensions of ethnic identity as protective factors for substance use and sexual risk behaviors in African American college students

Objective: To examine ethnic identity and ethnic socialization as potential protective factors for risk behaviors among US college students. Participants: Participants were 398 African American and Afro-Caribbean students recruited from 30 colleges and universities during September 2008–October 2009. Methods: Data on hazardous alcohol use, substance use, sexual behaviors, ethnic identity, and ethnic/racial socialization were collected. Hierarchical linear and negative binomial regression analyses were conducted to determine the degree to which ethnic identity and ethnic/racial socialization predicted the risk behaviors. Results: Ethnic Identity affirmation, belonging, and commitment (EI-ABC) significantly predicted lower substance use and hazardous alcohol use. Ethnic/racial socialization was not a significant predictor of substance use or sexual risk behaviors. Conclusions: Components of ethnic identity are potentially protective against alcohol and substance use behaviors. Additional research is recommended to determine effective intervention strategies.     

Using the Ecological Model to understand influences on college student vaping

ABSTRACT

Objective The Ecological Model was used to examine the social and environmental influences of the college environment on e-cigarette use (vaping) among college students. Participants: Undergraduate college student e-cigarette users (vapers) across three large college campuses in the southwest US from Jan 2015- Aug 2016. Methods: Thirty-three interviews were conducted. Transcribed interviews were coded then analyzed for themes. Results: College student vapers report multiple levels of influence on their vaping beyond personal beliefs and peer influences, including parents, explicit campus and community messaging, community member requests, and respect for others. College student vapers also describe constant associations with smokers in allowable public places to vape. Conclusions: Parents, community members, campus policy, and the physical environment all influence where and when college students vape. Health communication messages to prevent college student vaping should incorporate alternative messages that are important to college students, such as respect for others and social image.     

The Paradox of Risk: Historically Black College/University Students and Sexual Health

Abstract

Objective: This literature review provides an analysis of the current state of the empirical research on sexual health among students attending historically black colleges and universities (HBCUs). Methods: Several electronic databases were used to identify 24 empirical studies that met criteria for inclusion in this review. Results: The results indicated that perceived human immunodeficiency virus (HIV) risk, religiosity, HIV testing, condom use, and substance use were as high or higher for black HBCU students in comparison with students of other racial/ethnic groups. Comment: Consistent with past findings, sexually transmitted infections continue to be of concern among HBCU students, as seen in the general black population. Limitations: This review only examined cross-sectional studies published between 2000 and 2013. Conclusions: The findings in this review suggest the importance of moving beyond individual risk models to examining structural barriers and assets related to promoting sexual health on HBCU campuses.