Alcohol-Related Emergency Department Visits Associated With Collegiate Football Games

Abstract

Objective: In 2003, after several post–college football game riots, multiple strategies including strict enforcement of open container laws were instituted by the authors’ city and university. The authors compared alcohol-related visits to the on-campus emergency department (ED) associated with home football games in 2002 and 2006, hypothesizing that alcohol-related visits should decline. Participants: ED patients during home game weekends. Methods: Retrospective cohort study comparing the 2002 and 2006 home games—similar seasons wherein the team went undefeated. Logistic regression assessed the impact of environmental and patient characteristics on the likelihood of an ED visit being alcohol related. Results: In total 2,220 visits in 2002 and 2,146 visits in 2006 were reviewed. Alcohol-related visits increased from 2002 (7.9%) to 2006 (9.5%, p = .06). Despite community interventions, the odds of an ED visit being alcohol related increased (odds ratio [OR] 1.3, 95% confidence interval [CI₉₅] 1.06–1.64). Conclusions: Community measures did not reduce alcohol-related visits to the ED.     

The Infirmary as a Short-Term Psychiatric Facility

Abstract

The purpose of this study was to describe the role of the Oregon State University Infirmary (inpatient unit) in the provision of crisis intervention services for students with emotional problems. The focus was on the working assumptions of the infirmary program, the patient population which utilized the infirmary, the dimensions of treatment, and treatment outcomes.

Data were collected for a three year span on all patients who had contact with the infirmary for problems of an emotional nature. Records were reviewed for demographic variables, presenting symptomatology, diagnosis, treatment, disposition, and outcomes. Comparisons were made between these patients and those who received outpatient services through the Oregon State University Mental Health Clinic.

Demographic data indicated that patients who were treated in the infirmary differed only slightly from either the general student population of the university or from students receiving outpatient services. Presenting symptoms reflected a wide range of emotional problems. The severity of psychopathology was demonstrated by the finding that one-quarter of the patients manifested symptoms of acute psychosis, suicidal preoccupation, acute drug reaction, or toxic alcohol reaction. Consistent with the working assumptions of the program, the focus of treatment was short-term, intensive, and symptom directed. Treatment outcomes as determined by followup data were generally positive.

It was concluded that the infirmary provided an important treatment option which extended rather than duplicated outpatient services. The need for such an option was clearly demonstrated. The study was supportive of the concept that a university infirmary has the potential for utilization as a multipurpose facility.     

Counseling Brazilian Undergraduate Students: 17 Years of a Campus Mental Health Service

Objective: The authors reviewed demographic and clinical characteristics of undergraduates at a Brazilian public university (UNICAMP) who visited the campus mental health service (SAPPE) and compared their demographics with those from all undergraduate students enrolled in the university. Participants: The authors looked at data from all undergraduates who sought counseling or mental health care at SAPPE over a 17-year period (N = 2,203; 1987-2004). Methods: They obtained this information from clinical charts and a UNICAMP database. Results: Women, students from other Brazilian states, students living in the campus residence hall, and students whose main source of income was a scholarship were overrepresented. Female student-clients complained about family conflicts more frequently than did their male counterparts, and male student-clients reported concern about poor academic performance more frequently than did their female counterparts. Conclusions: Sex, living in a university residential facility, and reliance on a scholarship grant were predictive of undergraduates' mental health-seeking behavior and pattern of complaints.     

Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

Abstract

Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.     

Prevalence of Sufficient Physical Activity Among Parents Attending a University

Objective: The benefits of regular physical activity are well documented. However, approximately half of all university students are insufficiently active, and no research to date exists on the activity behavior of university students who are also parents. Participants and Methods: Using an adapted version of the Godin Leisure Time Exercise Questionnaire (ie, the Physical Activity Prevalence Questionnaire), the authors examined the prevalence of sufficient physical activity among 245 parent students from 6 faculties and 12 programs. Results: Half (49.5%) of the students who were not parents (n = 90) were sufficiently physically active, compared with 16% of students who were parents (n = 3, p < .002). The authors found that 33.3% of parents and 13% of nonparents limited their activity level as a result of illness or injury (p < .05). Conclusions: Most parent students in this study were insufficiently active and at potential risk for the negative health consequences of inactivity. This is a grossly understudied population, and researchers must conduct further studies to understand what can be done to facilitate physical activity among this potentially vulnerable group of students.     

Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors

Objective: The authors assessed the prevalence of pathogenic eating and weight-control behaviors among female college athletes, using a psychometrically valid measure. Participants: Participants were 204 college athletes (M age = 20.16 years, SD = 1.31 years) from 17 sports at 3 universities. On average, they participated in their sport for 10.88 years (SD = 16.68 years) and on their college team for 2.10 years (SD = 1.03 years). Methods: Participants completed a demographic and weight background questionnaire, Questionnaire for Eating Disorder Diagnoses, and the Bulimia Test-Revised. Results: The authors classified participants as eating disordered (n = 4, 2.0%), symptomatic (n = 52, 25.5%), and asymptomatic (n = 148, 72.5%). Few participants engaged in binge eating; most used exercise, as opposed to vomiting, dieting, laxatives, or diuretics, to control their weight. Conclusions: Female athletes suffer from eating disorders, and most experience symptom levels that are subclinical but problematic.     

Implementing a college mental health program – an overview of the first twelve months

Objective: To evaluate the demographics and clinical utilization patterns among college students during the initial 12 months of a novel, multi-disciplinary, collaborative, college mental health program (CMHP). Participants: Undergraduate and graduate students receiving treatment at the CMHP from Jan-Dec 2015. Methods: De-identified data was obtained via electronic health records for all students receiving care through the CMHP. Results: 1.2 FTE clinical providers treated 278 undergraduate and graduate students during the year (65.1% < age 26, 53.6% female, 49.6% caucasian). There were 1822 CMHP outpatient visits, 318 other medical visits and 103 total emergency room (ER)/inpatient visits. Ten students were identified as high utilizers of ER/inpatient services, while charges to the CMHP totaled $470,157 and total charges to the Health System were $2,378,315. Conclusions: Students with complex psychiatric/medical co-morbidities received cost effective, convenient and integrative treatment. Over time, we hope to intervene earlier and decrease ER/inpatient visits.     

Meditation Lowers Stress and Supports Forgiveness Among College Students: A Randomized Controlled Trial

Objective and Participants: The authors evaluated the effects on stress, rumination, forgiveness, and hope of two 8-week, 90-min/wk training programs for college undergraduates in meditation-based stress-management tools. Methods: After a pretest, the authors randomly allocated college undergraduates to training in mindfulness-based stress reduction (MBSR; n = 15), Easwaran's Eight-Point Program (EPP; n = 14), or wait-list control (n = 15). The authors gathered pretest, posttest, and 8-week follow-up data on self-report outcome measures. Results: The authors observed no post-treatment differences between MBSR and EPP or between posttest and 8-week follow-up (p > .10). Compared with controls, treated participants (n = 29) demonstrated significant benefits for stress (p < .05, Cohen's d = -.45) and forgiveness (p < .05, d = .34) and marginal benefits for rumination (p < .10, d = -.34). Conclusions: Evidence suggests that meditation-based stress-management practices reduce stress and enhance forgiveness among college undergraduates. Such programs merit further study as potential health-promotion tools for college populations.     

Partying Before the Party: Examining Prepartying Behavior Among College Students

Objective: The authors examined the phenomenon known to college students as prepartying, which is the consumption of alcohol prior to attending an event or activity (eg, party, bar, concert) at which more alcohol may be consumed. Participants: To explore the extent of this behavior, the authors surveyed 227 college students about each drinking event over a 1-month period. Results: Principal results revealed that 64% of participants engaged in prepartying (75% of drinkers) and that prepartying is involved in approximately 45% of all drinking events. Prepartying was predictive of more drinking throughout the day of the drinking event and alcohol-related negative consequences. Men and women engaged in this behavior at similar rates, and prepartying was most related to social reasons for drinking. Conclusion: Because prepartying is well-known among students, the authors suggest that clinicians and researchers target it to better understand college drinking and to help students understand the associated dangers.     

Health Information-Seeking in the Digital Age

Abstract

Objective: The authors examined the sources of health information among first-year university students and whether the predictors of information-seeking varied by information source. Participants: First-year students in a required course at a midwestern public university were eligible to participate, and 82% (n = 1,060) completed the study. Methods: Students completed a survey questionnaire regarding information-seeking behaviors and Internet uses in domains including health. The authors used regression analyses to examine predictors of source-specific health information-seeking. Results: Young women are much more likely than young men to seek health information. The characteristics associated with looking online for health information are different than those for using other information sources, and students who look online for health information also report greater use of other information sources. Conclusions: Although the Internet is an important source of health information for students, health professionals should be aware that not all students equally utilize this resource.     

The Impact of Work and Volunteer Hours on the Health of Undergraduate Students

Abstract

Objective: To examine the impact of work and volunteer hours on 4 health issues among undergraduate college students. Participants: Full-time undergraduate students (N = 70,068) enrolled at 129 institutions who participated in the Spring 2011 American College Health Association–National College Health Assessment II survey. Methods: Multiple linear regression and binary logistic regression were used to examine work and volunteer hour impact on depression, feelings of being overwhelmed, sleep, and physical activity. Results: The impact of work and volunteer hours was inconsistent among the health outcomes. Increased work hours tended to negatively affect sleep and increase feelings of being overwhelmed. Students who volunteered were more likely to meet physical activity guidelines, and those who volunteered 1 to 9 hours per week reported less depression. Conclusions: College health professionals should consider integrating discussion of students' employment and volunteering and their intersection with health outcomes into clinical visits, programming, and other services.     

Does the Andersen Behavioral Model of Health Services Use predict college students’ use of on-campus mental health services?

Abstract

Objective: 10–50% of college students meet the diagnostic criteria for one or more mental illnesses; unfortunately, less than half seek treatment. This study assessed the predictive power of specific variables on students’ use of on-campus mental health resources using the American College Health Association’s National College Health Assessment (ACHA-NCHA) II. Participants: Respondents included undergraduate and graduate students ages 18–35?years (n?=?96,121). Methods: We analyzed data from the ACHA-NCHA II Fall 2014 and Spring 2015. Andersen’s Behavioral Model of Health Services Use enabled selection of predisposing, enabling, and need predictor variables; these were analyzed individually and collectively. Results: Predisposing, enabling, and need variables accounted for 9%, 2.3%, and 17% of the overall variance. Significant variables associated with a student’s decision to access on-campus mental health services accounted for 23% of variance total. Conclusions: This insight could allow universities to better recognize students at-risk for needing but not accessing mental health services.     

Depressive Symptoms,Stress, and Social Support Among Dental Students at a Historically Black College and University

Objective: The authors measured the prevalence of depressive symptoms among dental students at a historically black college in the United States to determine how depressive symptoms, stress, and social support influence each other within this student population. Participants: Dental students (n = 143) completed a self-administered survey to assess depressive symptoms, stress, and social support, using validated and reliable instruments. Participants also reported demographic variables. Methods: The authors used multivariable linear regression controlling for potential confounding. Results: The prevalence of depressive symptoms was 16.7%. There were significantly higher levels of stress for students with depressive symptoms compared with those without such symptoms (p < .01), and students with depressive symptoms had significantly lower levels of social support (p < .01). Results show higher levels of depressive symptomatology to be related to decreased social support at both high and low stress levels (p < .01). Conclusions: Stress and social support are associated with depressive symptoms among dental students.     

The Association of Multiple Risk Factors With Fruit and Vegetable Intake Among a Nationwide Sample of College Students

Few college students meet fruit and vegetable intake recommended requirements, and most receive no information from their institutions about this issue. The avoidable disease burden among students is large, the necessary information infrastructure exists, and Healthy People 2010 objectives indicate efforts should be taken to increase intake. Objective: The authors examined the association of high-risk behaviors and fruit and vegetable intake to inform design of multiple risk factor interventions. Participants and Methods: The authors obtained data from a sample of 40,209 18- to 25-year-old college students who completed the American College Health Association-National College Health Assessment during the spring 2002 and 2003 semesters. Results: Predictors of high fruit and vegetable intake for men and women included better: seatbelt and helmet use, physical activity, perceived health, sleep, self-care behaviors, and grades. Other notable predictors of high intake were reduced likelihood of cigarette smoking, alcohol use, drinking and driving, and feeling hopeless in both sexes; reduced likelihood of drinking and driving among men; and a greater likelihood of anorexia among women. Conclusions: The authors discuss implications of these findings.     

Stalking Victimization Among College Women and Subsequent Help-Seeking Behaviors

Objective: The authors examined the incidence of stalking victimization and subsequent help-seeking behaviors among college women. Participants and Methods: A stratified random sample of college women (N = 391) completed an anonymous Internet-based questionnaire in spring 2006. Results: One-fifth of women reported stalking victimization while enrolled at their current institution. Individuals known by victims, such as the following, were most commonly reported as stalkers: acquaintances (48.7%), classmates (37.2%), and boyfriends or ex-boyfriends (34.6%). Approximately half of the women reporting stalking victimization acknowledged not seeking help from anyone in relation to these incidents. Of those seeking some sort of help, most sought assistance from friends (90.2%), parents (29.3%), residence hall advisors (12.2%), or police (7.3%). Conclusion: Comparing their findings to a national study of college women, the authors report that being watched, followed or spied on, and sent unsolicited emails are stalking behaviors on the rise. They present implications for college health and future directions for research.     

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.     

American College Health Association Annual Pap Test and Sexually Transmitted Infection Survey: 2006

Objective: The authors describe the cervical cytology and sexually transmitted infection (STI) testing patterns of US college health centers. Participants and Methods: A total of 128 self-selected US college health centers—representing more than 2 million college students—completed an online survey during February and March 2007. Results: Almost 13% of cervical cytology results were abnormal; most of these were atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions. In women, 2.9% of chlamydia tests and 0.4% of gonorrhea tests were positive. Human immunodeficiency virus (HIV) and syphilis tests were positive in 0.1% and 0.3% of students tested, respectively. Herpes simplex virus type 1 (HSV-1) accounted for 59.9% of genital herpes infections. Conclusions: College health centers are important sources for Pap and STI test data. Pap tests frequently yield low-grade abnormalities, and screening tests for chlamydia and especially gonorrhea are infrequently positive. Rates of HIV and syphilis in this population are low, raising concerns about positive predictive value when screening low-risk students. A majority of genital herpes infections are caused by HSV-1.     

College Health Professionals and Academic Librarians: Collaboration for Student Health

College health professionals must find new ways of educating students on finding and evaluating consumer health information, specifically in the online environment. Librarians are trained as information professionals; however, librarians at general academic libraries are not taking a lead role in providing consumer health information. Objective: The authors' purpose in this research was to determine the health information resource needs of college and university students and provide a model for collaboration between college health professionals and academic librarians. Participants and Methods: The authors compared data from a national survey on college health (N = 54,111) with their own results from a survey of general academic librarians (N = 17) to create recommendations for synching students' reported health information needs with librarians' resources. Results: Although the Internet was students' second most-often consulted health information source, they ranked the believability of online health information above only television. In the librarian survey, although 12 respondents indicated that health information provision is a library's responsibility, the majority (n = 11) believed their library's consumer health outreach to be passive. Conclusions: The authors offer recommendations for partnerships between college healthcare professionals and academic librarians to better provide this information to students.     

Athletic Involvement and Its Relevance to Hazardous Alcohol Use and Drinking Game Participation in Female College Athletes: A Preliminary Investigation

Objective and Participants: The authors designed this cross-sectional study to examine sports team differences in hazardous alcohol use and drinking game participation, as well as the social correlates of these behaviors among female college athletes (N = 176; M age = 19.9 years, SD = 1.24, range = 18-22). Methods: Respondents completed self-report surveys in small groups. They reported drinking behaviors, frequency of team social events involving alcohol use, and team cohesion. Results: The authors found significant differences across sports teams with regard to hazardous alcohol use and participation in drinking games with teammates. Findings also revealed that a high frequency of team social events involving alcohol use was associated with elevated use and an increased likelihood of drinking game participation. Conclusions: The authors discuss future research directions and implications.