The impact of a health education intervention on health behaviors and mental health among Chinese college students

Abstract

Objective: This study aimed to assess the impact of a health education intervention on health behaviors, self-efficacy, and well-being among college students. Participants: Between March and October 2016, a total of 532 undergraduates participated. Methods: A theory-based intervention was conducted at Wuhan University, China. Participants were assigned to a control or intervention group (IG). The IG attended a 7-week health education class on knowledge, attitude, and practice of health behaviors. Results: Participants in the IG, compared with those in the control group (CG), reported significantly increased prevalence of high physical activity and regular breakfast, as well as lower screen time, sugar beverage intake, and Internet addiction tendency. Furthermore, intervention students improved in health behavior scores (p?=?0.040), compared with the CG, while the changes in subjective well-being and self-efficacy remained similar between the two groups. Conclusions: Health education may promote health behaviors among Chinese college students.     

A gender-informed model to train community health workers in maternal mental health

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers.     

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.     

Protecting the economic health of the poor in India: Are health mutuals the right medicine?

In addition to government‐sponsored health insurance schemes (GSHIS), many microfinance institutions (MFIs) and community‐based organizations (CBOs) in India have started microinsurance health insurance schemes. These include health mutuals for the benefit of their members. This article explores these as an alternative health‐financing model in India. A literature search produced 926 relevant publications. After applying advanced search options and removing duplicates, abstracts of 324 papers were read and then 47 papers reviewed, and finally 29 were included in this review. Five key themes emerged: (1) “Health for all” arguments and opportunities in favour of micro health insurance schemes; (2) micro health insurance products; (3) impact of micro health insurance schemes; (4) systematic irregularities and regulatory framework; and (5) innovation. We also look at the emerging market patterns that will define micro health insurance products. Health mutuals can effectively provide mass health protection to the poor and not so poor through efficient business models, bespoke benefit packages and multiple payment plans. They can reduce financial vulnerability and improve health outcomes. While GSHIS can cover a substantial tranche of expected health‐related costs, the balance can be supplemented through innovative financial products that reduce financial risk.     

Lifetime exposure to abuse,current stressors,and health in federally qualified health center patients

ABSTRACT

Purpose: The purpose of this study was to examine the impacts of lifetime exposure to abuse and current stressors on health, an integrative concept of physical, mental and social health, among patients of a Federally Qualified Health Center.

Method: The sample included 1,055 patients (male: N = 346; female: N = 709) who were at least 18 years of age and completed an assessment on their first visit between January 2015 and March 2017 at a Federally Qualified Health Center. The assessment contained subscales of the DUKE Health Profile measuring physical, mental, and social health; four questions assessing lifetime exposure to abuse; and a relational and socioeconomic stressor checklist.

Results: Results from structural equation modeling analyses showed that for both male and female groups, lifetime exposure to abuse, relational stressors and socioeconomic-related stressors were strongly associated with health. In the male group, socioeconomic-related stressors were the strongest predictor of health, while in the female group, lifetime exposure to abuse was the strongest predictor of health.

Conclusions: Understanding the relationships between health and the combined factors of a lifetime exposure to abuse, relational stressors, and socioeconomic stressors can provide insight to patient care professionals who treat patients in lower income, underserved communities. Ecological Systems Theory provides a framework to plan interventions or to prevent potential negative outcomes associated with these stressors.     

Oral health among student veterans: Effects on mental and physical health

Abstract

Objective: The purpose of this study was to explore differences in oral health among students by military service status in postsecondary settings. Participants: Secondary data were obtained from the American College Health Association’s 2011–2014 National College Health Assessment II. Method: Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with maximum likelihood multiple logistic regression. Results: Service member and veteran students are at greater risk for neglecting health behaviors associated with positive oral health, including that they were less likely to get dental exams and that those who deployed in the past were the least likely to be practicing good oral health. Conclusions: The results suggest that improving oral health will contribute to improving health and mental health outcomes in this population, and provide important information for health specialists working with service members and veterans on college campuses.     

Perceptions of transition-related health and mental health services among transgender adults

The opportunity to live authentically is critical for the well-being of transgender individuals. For many this requires accessing transition-related services. Current knowledge of transition-related care is limited. This study aims to elucidate experiences and needs of transgender individuals (N = 65) related to (a) therapeutic support, (b) medical care, and (c) aspects of living authentically in order to inform the development and delivery of trans-affirmative services. Findings reveal challenges accessing health care providers with trans-specific competency; gaps between critical aspects of transition-related care and receipt of services; and heterogeneity of experiences and needs. Recommendations for improving transgender-affirmative services are provided.     

Family health care decision making

How do families choose a health plan when offered the option of insurance or a Health Maintenance Organization (HMO)? Choices are influenced by health consumerism, decision variables, family health needs, family composition, family socioeconomic status, and knowledge about HMOs. Subjects in the research reported here chose insurance or one of four HMOs; control subjects had no HMOs available. The model is estimated with LOGIT regression, yielding a pseudoR ² of.22 for the adjusted model. Participation in the decision process, number of chronic illnesses, and knowledge about HMOs all are significantly and positively associated with choosing an HMO; also, young adults are more likely than older adults to choose HMOs. The consumerism variable fails to attain significance. LOGIT analysis of the adjusted model indicates that the model predicted 72% of plan choices correctly. Suggested research for other family forms, for the poor, and for the elderly's health plan choices are discussed.     

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.     

Applying health determinants and dimensions in social work practice

Dimensions and determinants related to physical health, mental health and well-being can be used as tools in social work practice. These frameworks are useful for assessment, planning and intervention activities in complex client situations, alerting social workers to consider diverse features and processes that influence well-being in people's lives. They can be applied in social work with individuals, families, groups, and communities. In our view health and well-being need to be viewed holistically, broadly and in each unique situation, changing over time over the life course. Literature based on key word searches of concepts we use in our teaching and research and that has informed our conceptualisation of dimensions and determinants in physical health, mental health and well-being, is reviewed. A case illustration is presented to illustrate how the dimensions and determinants are used to inform practice and compare and apply alternative frameworks. Finally, the implications of these and other frameworks for social work, not only in health care settings, but also in other fields of social work practice, are discussed.     

Parental involvement,health behaviour and mental health among school-going adolescents in seven Pacific Island countries

ABSTRACT

The study aimed to estimate the relationship between parental involvement, health behaviour and mental health among school-going adolescents in seven Pacific Island countries. Data utilized were from the cross-sectional “Global School-Based Student Health Survey (GSHS)”. The total sample included 10968 adolescents (mean age 14.1 years, SD = 1.4) from Cook Islands, Kiribati, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu in 2011 to 2013. In two-level, mixed-effects logistic regression analyses, adjusted for age, sex, a proxy for socioeconomic status, and support by peers, greater parental involvement was inversely associated with smoking, drunkenness and cannabis use, bullying victimization, in physical fight, injury and school truancy, and anxiety and having no close friends, and positively correlated with fruit and vegetable consumption and physical activity. Interventions for improving well-being among this adolescent population should consider the positive impact of parental involvement.     

The state of sexual health services at U.S. Colleges and Universities

Objective: To describe the array of sexual health care services provided at US colleges and universities. Participants: During 2014–2015, 885 colleges were surveyed about their provision of sexual health services. Methods: 55% of colleges responded. Data were weighted and stratified by minority-serving institutions (MSIs), 2-year and 4-year institutions. Results: 70.6% of colleges reported having a health center (HC), of which 73.0% offered STI diagnosis/treatment (4 years vs. 2 years; 77.9% vs. 53.1%) and contraceptive services (70.1% vs. 46.4%), all p < .001. HCs less frequently offered LARC (19.7%), express STI testing (24.4%) and self-collection (31.4%). Condoms were available on 66.8% of campuses. HPV vaccination was available at more 4-year colleges (73.7% vs. 48.5%, p < .003) and non-MSIs (74.4% vs. 58.5, p = .019). Regarding MSM-targeted services, 54.6% offered pharyngeal and 51.8% rectal STI testing. Conclusions: 2-year colleges may require additional support with providing sexual health care. Improvements could entail increasing express testing, extra-genital STI testing, and LARC.     

Self-reported health problems,health care utilisation and unmet health care needs of elderly men and women in an urban municipality and a rural area of Bhaktapur District of Nepal

The study aimed to identify the felt common health problems, utilisation of health services and unmet needs of urban and rural elderly people of Bhaktapur district, Nepal. It was a cross sectional population study of people aged 60 years or more where 204 respondents were interviewed in 2009. The common felt problems were pain and swelling of joints (65.7%), indigestion (63.7%), excessive tiredness (38.2%) and hypertension (35.8%). Pain and swelling of joints (72.5%) and back pain (40.4%) were higher in rural elderly population whereas indigestion (67.6%) and hypertension (37.85%) were higher in urban population. Pain and swelling of joints (66.7%) and indigestion (69.6%) were higher in males, and hypertension (50.0%), back pain (38.2%) and chronic bronchitis/asthma (39.2%) were higher in females. The unmet needs varied between different health problems. In general women had more unmet needs than men, where 80 unmet needs were identified for the 102 men compared with 105 for the 102 women, and these unmet needs increased dramatically with age. This approach yields new insights into the health care needs of the elderly and will be helpful to health care planners.     

Framing public policy towards a public health paradigm for gambling

This paper examines the public policy value of looking at gambling from a public health perspective. The manner in which social issues are framed will either expand or curtail public policy debates. The existing and traditional frames for gambling (e.g. gambling as a matter of individual freedom, gambling as a form of recreation) fail to consider research on the social and economic impacts of gambling. Because a public health frame offers a broad viewpoint of society, it encompasses a number of social and economic impacts not considered in traditional frames. However, the existing gambling frames enjoy varying degrees of cultural, economic, and political support and, as a result, creating a higher profile for a public health framework will encounter a number of barriers. Research can play a decisive role in overcoming these barriers, as it has in a number of related fields (e.g., tobacco use, addiction and product liability, the epidemiology of AIDS). The paper concludes that research that identifies and quantifies the public health factors of gambling will substantially contribute to a public shift toward a public health frame.     

Variability in measures of health and health behavior among emerging adults 1 year after high school according to college status

Objective: To examine changes in health behaviors among US emerging adults 1 year after high school. Participants: The national sample of participants (N = 1,927), including those attending 4-year college/university (n = 884), 2-year colleges/technical schools (n = 588), and no college (n = 455), participated in annual spring surveys 2013–2014. Methods: Health behaviors were assessed the last year of high school and first year of college; differences by college status controlling for previous-year values were estimated using regression analyses. Results: Relative to 4-year college attendees, those attending technical school/community college were less likely to binge drink (odds ratio [OR] = 0.57, confidence interval [CI] = 0.38–0.86) but more likely to speed (OR = 1.26, CI = 1.0–2.84), consume sodas (OR = 1.57, CI = 1.0–2.47), and report lower family satisfaction (p < .01), with marginally more physical and depressive symptoms. College nonattendees reported more DWI (driving while intoxicated; OR = 1.60, CI = 1.05–2.47), soda drinking (OR = 2.51, CI = 1.76–3.59), oversleeping (OR = 4.78, CI = 3.65–8.63), and less family satisfaction (p < .04). Conclusions: Health risk behaviors among emerging adults varied by college status.     

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.     

Toward total student health: A qualitative pilot study

Objective: Colleges should aim to cultivate healthy behaviors among students by addressing alterations in wellness students view as important. The purpose of this study was to determine the self-perceived wellness-related concerns and behaviors of college students. Participants: Thirty-seven undergraduate students participated in this study between January and March 2017. Methods: Focus groups served as a data collection method. Groups were recorded and transcribed verbatim. Directed and conventional approaches to data analyses were employed. Results: Participants expressed concern regarding four campus wellness topics: nutrition, economics, mental health, and campus safety. Participants offered solutions for improving campus wellness, representing a fifth theme. Conclusions: Health concerns for college students and realistic solutions to address concerns were identified across focus groups. Overall, students cared about their own health, as well as the well-being of other students. Future directions include conducting a Web-based survey among students to assess prevalence and impact of select health and wellness topics.     

Concept mapping as a method to enhance evidence-based public health

In this paper we explore the suitability of concept mapping as a method for integrating knowledge from science, practice, and policy. In earlier research we described and analysed five cases of concept mapping procedures in the Netherlands, serving different purposes and fields in public health. In the current paper, seven new concept mapping studies of co-produced work are added to extend this analysis.For each of these twelve studies we analysed: (1) how the method was able to integrate knowledge from practice with scientific knowledge by facilitating dialogue and collaboration between different stakeholders in the field of public health, such as academic researchers, practitioners, policy-makers and the public; (2) how the method was able to bring theory development a step further (scientific relevance); and (3) how the method was able to act as a sound basis for practical decision-making (practical relevance).Based on the answers to these research questions, all but one study was considered useful for building more evidence-based public health, even though the extent to which they underpinned actual decision-making varied. The chance of actually being implemented in practice seems strongly related to the extent to which the responsible decision-makers are involved in the way the concept map is prepared and executed.