Recruitment Strategies and Motivations for Sexually Transmitted Disease Testing Among College Students

Objective The authors evaluated procedures for recruiting college students for sexually transmitted disease (STD) testing as part of a research study examining the impact of HSV serologic testing. Participants A convenience sample of 100 students was drawn from students aged 18 to 35 years enrolled at one university in a mid- Atlantic state between September 2004 and March 2006. Methods: Six strategies were used to recruit students for participation in the study. Upon enrollment, participants were asked where they heard about the study. Students were also asked about their motivations for participation. Results: Findings show that a significant recruitment strategy involves targeting places where students seek health care. Other effective strategies include those where information is directly provided to individuals. Most students were motivated to participate because of a possible past exposure to herpes simplex virus 2. Conclusions: Targeting places where students seek health care and educating students about STDs are important strategies for recruiting students for STD testing.     

Sexual Behaviors and Sexually Transmitted Diseases of Lesbians

ABSTRACT

The Boston Lesbian Health Project surveyed 1633 lesbians about their health status, health related behaviors and health problems. This paper reports on those parts of the questionnaire that dealt with sexual behaviors and sexually transmitted diseases. The sample was predominantly monogamous, but few had been in their present relationship for more than five years. Sexual practices were similar to those reported in previous studies of lesbians and to those reported in a study of heterosexual women. Sexually transmitted diseases were rare in women who had never had sex with a male partner. The majority of the sample did report a history of male sexual partners and therefore are at risk for abnormal pap smears and other sexually transmitted diseases.     

The State of the Union: Sexual Health Disparities in a National Sample of US College Students

Abstract

Objective: To examine sexual health disparities between blacks and whites in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 44,165 nonmarried undergraduates (aged 18–24; M = 20.1) responding to the Spring 2007 American College Health Association–National College Health Assessment; 64% were female and 94.7% were white. Results: Whites reported more experience in oral and anal sex, were less likely to use condoms for oral, anal, and vaginal sex, and less likely to have been tested for HIV (human immunodeficiency virus) compared with blacks. However, blacks reported more sex partners, lower use of hormonal contraceptives, and higher rates of adverse sexual health outcomes, such as sexually transmitted infections (STIs) and unintended pregnancy. Sexual behaviors and outcomes also varied across gender. Conclusions: This study highlights a need to increase access to hormonal contraceptives and early STI screening/treatment among blacks, improve HIV testing among whites, and increase condom use promotion for all students.     

Addressing Sexually Transmitted Infections (STIs), including HIV/AIDS,in the Context of Sexual Health

ABSTRACT

Sexually transmitted infections (STIs) have occupied a central place in public health agendas for at least the past 500 years, but have been the subject of opinions, decrees and “moral positions” for much longer. Societies have long tried to control the sexual behaviors of their populations, not only for reasons of social control, but also with the objective of controlling the spread of disease—HIV is the latest example of how societies respond to infections spread through the most private of individual behaviors. The article outlines the burden of disease associated with sexually transmitted infections including HIV, and explores their impact on efforts to achieve the Millennium Development Goals (MDGs). A large number of options for prevention and care of the sexually transmitted infections and HIV are currently available in both resource-rich and resource-constrained settings. In this article I move beyond the narrow focus of biomedical interventions concentrated on the individual and explore the evidence for public health measures aimed at controlling these infections. Using a public health framework I outline the various measures that can be implemented for STI/HIV control, and in addition to exploring the evidence for their public health effectiveness, I also look at how each of these interventions can be delivered within a paradigm of sexual health more generally. Finally, the article proposes recommendations for which effective strategies should be incorporated into a broader framework for promoting sexual health.     

History of the American College Health Association

Abstract

Following Dr Edward Hitchcock's lead at Amherst College in 1861, soon other institutions of higher education established physical education departments that evolved into independent college health programs. As the field of college health expanded, leaders from numerous campuses began meeting to share information and discuss formation of a national organization. As a result, the American Student Health Association was founded in 1920 to promote campus health care for students and advance the interests of college health. The name was changed to the American College Health Association in 1948. The past history of this organization has been well documented in the literature, so this review will focus more on ACHA's accomplishments over the past 20 years. ¹ Turner, H S and Hurley, J L. 2002. The History and Practice of College Health., Lexington: The University Press of Kentucky.  [Google Scholar] ^{, 2} American College Health Association. A brief history, Available at: http://www.acha.org/About_ACHA/docs/ACHA_Brief_History.pdf Published 2002. Accessed February 26, 2011 [Google Scholar] ^{, 3} Boynton, RE. 1971. The first fifty years: a history of the American College Health Association. J Am Coll Health Assoc, 19: 269–288.  [Google Scholar] ^{, 4} Christmas, W A. 1992. The history of sections in the American College Health Association. J Am Coll Health, 41: 121–125. [Taylor & Francis Online] , [Google Scholar]     

F.O.R.E.play: The Utility of Brief Sexual Health Interventions Among College Students

Abstract

Objectives: The authors aimed to determine the most effective brief sexual health intervention for college students, while also evaluating students’ preferences for learning about sexual health, in order to develop a university program. Methods: A total of 302 students enrolled in an introductory college course participated and were randomly assigned to 1 of 3 brief interventions during a regularly scheduled class and completed pre- and postsurveys assessing knowledge, motivation to use condoms, and condom self-efficacy. Results: Findings indicated that having an actual person in charge of the learning process resulted in higher knowledge gains and highlighted a student preference for discussion-based learning, viewing pictures of sexually transmitted infections, and hearing real-life experiences about the consequences of unsafe sex. Conclusions: These findings will be used to tailor a future intervention targeting college students for use with freshmen students at this university.     

Mens Sana: The Growth of Mental Health in the American College Health Association

Abstract

In 1910, the first college mental health service sought to help college students with personality development and building a healthy mind. In 1920, the meeting that founded the American College Health Association (ACHA) identified “mental hygiene” as important, although a separate Mental Health Section was not established in ACHA until 1957. Between 1920 and 1960, a series of national meetings helped define the role and functioning of college mental health and counseling services. Most colleges employed a multidisciplinary staff of psychologists, psychiatric social workers, and psychiatrists to provide clinical services for students and consultation and education for faculty and staff. Mental health services on college campuses grew rapidly in the 1960s and 1970s, leading to discussions in the late 20th century of the use of brief psychotherapies, prevention and treatment of drug and alcohol abuse, prevention of suicide and homicide, the use of psychotropic medications, and effective campus interventions.     

American College Health Association-National College Health Assessment Spring 2008 Reference Group Data Report (Abridged): The American College Health Association

Objective: 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 that ACHA developed 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, and impediments to academic performance. Participants: The spring 2008 reference group includes ACHA-NCHA data from 80,121 students at 106 institutions of higher education. Methods: Officials at participating institutions administered the ACHA-NCHA to all students, randomly selected students, or students in randomly selected classrooms. ACHA collected data between January and May 2008. Results: Results from the spring 2008 reference group (N = 80,121) are presented. Conclusions: These data expand the understanding of the health needs and capacities of college students.     

Gay and Bisexual Men’s Experiences Using Self-Testing Kits for HIV and Rectal and Urethral Bacterial Sexually Transmitted Infections: Lessons Learned from a Study With Home-Based Testing

Abstract

Objectives: This study investigated the experiences of gay, bisexual, and other men who have sex with men (GBM) conducting HIV and sexually transmitted infection (STI) self-testing procedures. Methods: We analyzed mixed-methods data from 11 GBM who self-tested HIV-positive and 1,070 HIV-negative GBM who completed the HIV self-testing and STI self-sampling procedures. Results: Nearly all (99%) reported ease in urine-based STI self-sampling and most (90%) found rectal swab self-collection easy. Most (94%) checked their rapid-HIV self-testing results during the correct window (20-40 minutes), and nearly all (99%) trusted their HIV results. Conclusions: Recommendations for future self-testing procedures are provided based on findings from free-response data.     

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.     

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.     

Abstracts of the Scientific Programs of the American College Health Association Fifty-Ninth Annual Meeting April 21–24, 1981, Boston,Massachusetts

Abstract

The authors examined changes in college students' illicit drug use, patterns of polydrug use, and the relationship between students' ages of initiation of substance use and later use of marijuana and other illicit drugs between 1993 and 2001. Data from 119 US colleges and universities in the Harvard School of Public Health College Alcohol Study were used in the study. They found significant increases in percentages of students' use of marijuana in the past 30 days (from 13% to 17%), past year (from 23% to 30%), and lifetime (from 41% to 47%) between 1993 and 2001, with most of the increase occurring between 1993 and 1997. Past 30-day use of other illicit drugs increased from 4% to 7% and past year use increased from 11% to 14%. More than 98% of marijuana and other illicit drug users used another substance. They also either smoked, were binge drinkers, and/or were users of another illicit drug. Drug prevention programs should emphasize heavy alcohol use and smoking and should start when students are in high school or earlier.     

Utilization and limitations of the American College Health Association's National College Health Assessment instrument: A systematic review

ABSTRACT

Objective: To analyze the literature in which researchers have utilized the National College Health Assessment (NCHA) I or the NCHA II. Participants and Methods: The authors selected peer-reviewed articles published between 2004 and July 2013 utilizing a single search term: National College Health Assessment. Articles were assessed for instrument use, limitations, and data analyses. Results: The search resulted in 72 articles for inclusion. Researchers used the instrument to either conduct a primary investigation or utilize reference group data for secondary analysis. Researchers used many data analyses, statistical tests, techniques, and methods. Limitations of the instrument were consistently mentioned by researchers. Conclusions: Results indicate limitations in the NCHA. To ensure college health professionals are gaining the best information possible regarding students on their campuses, specific improvements to the NCHA are recommended.     

Impact of Disability and Other Physical Health Issues on Academic Outcomes Among American Indian and Alaskan Native College Students: An Exploratory Analysis

This study investigated whether self-identified disabilities among American Indian and Alaskan Native college students impact academic performance and persistence to graduation and explored the differences in health and academic grades between American Indian and Alaskan Native students and students of other racial and ethnic identities using the National College Health Assessment. Findings indicate that American Indian or Alaskan Native students have significantly lower grades than White and Asian students, and American Indian and Alaskan Native women report the highest incidence of health problems of any demographic group. Exploratory results point to future research to determine the full impact of disabilities and poor health on academic success.     

Hookah and Cigarette Smoking Among African American College Students: Implications for Campus Risk Reduction And Health Promotion Efforts

ABSTRACT

Objective: To identify individual and institutional risks and protections for hookah and cigarette smoking among African American (AA) college students. Participants: AA college students (N = 1,402; mean age = 20, range = 18–24 years; 75% female) who completed the Fall 2012 American College Health Association–National College Health Assessment II. Methods: Respondents were stratified into 4 mutually exclusive groups by last-30-day smoking status: cigarette-only use (5.1%), hookah-only use (5.9%), dual use (2.4%), and nonuse (86.6%). Multinomial logistic regression models identified the relative odds of exclusive and dual hookah and cigarette smoking. Results: Current hookah and cigarette smoking rates were comparably low. Age, gender identity, current substance use, interest in tobacco use information, and student population prevailed as risks and protections for hookah and cigarette smoking. Conclusions: Campus health promotion campaigns may need to tailor messages to AA students, particularly those who use substances, to underscore the health risks of hookah and cigarette smoking.     

Rates of Asymptomatic Nonurethral Gonorrhea and Chlamydia in a Population of University Men Who Have Sex With Men

ABSTRACT

Objective: To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. Participants: Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. Methods: The SMS program sent drinking-related queries each Thursday and Sunday and provided tailored feedback for 6 weeks. Response rates to SMS drinking-related queries and the associations between weekend drinking plans, drinking-limit goal commitment, and alcohol consumption were examined. Gender differences were explored. Results: Ninety percent of SMS queries were completed. Weekend binge drinking decreased over 6 weeks, and drinking-limit goal commitment was associated with less alcohol consumption. Compared with women, men had greater reductions in alcohol consumption when they committed to a drinking-limit goal. Conclusions: Preliminary evidence suggests that an SMS program could be useful as a booster for helping mandated students reduce weekend binge drinking.     

Stages of Change and Possible Selves: 2 Tools for Promoting College Health

When considering health promotion among college students, 2 questions that arise are how to (1) most effectively offer health initiatives and (2) motivate students to participate in these efforts. Objective: In responding to these questions, the author considered 2 health-promotion tools: the transtheoretical model and the concept of possible selves. Participants: There were 304 college students who participated in this study. Methods: To explore how such information can assist health-promotion planning by determining which behaviors to target and how to match interventions to the overall population's stage of change, the author had students report their stage of change for 6 health behaviors. In addition, to explore possible motivations for moving from the precontemplation to the preparation stage of change, the author had students generate future self-concepts regarding their health (health-related possible selves). Results: The number of illness-related possible selves cited was significantly related to stage of change for smoking and stress management. For smoking, precontemplators had the fewest number of illness-related possible selves; however, the author observed the opposite for stress management. Conclusion: The findings have implications for how the transtheoretical model and the concept of possible selves can serve as useful tools in promoting college health.     

College Smoking Policies and Smoking Cessation Programs: Results of a Survey of College Health Center Directors

Abstract

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessation programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.     

Emergency Contraceptive Pill (ECP) Use and Experiences at College Health Centers in the Mid-Atlantic United States: Changes Since ECP Went Over-the-Counter

Abstract

Objective: To investigate the availability of emergency contraceptive pills (ECPs) at college health centers since ECP went over-the-counter (OTC) in 2006. Related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, and staff attitudes, were examined. Participants: The sample included 135 college and university health centers in the mid-Atlantic region of the United States. Methods: Data were collected via telephone survey with the use of a 42-item survey instrument. Results: Forty-three percent of schools reported distributing ECPs, for an average of 10.6 years. Major changes in ECP distribution and usage since ECP went OTC related primarily to protocol in ECP distribution, advertising for ECP services, and ECP accessibility to university students. Conclusions: College health centers are responding to the OTC status of ECP in a number of ways, primarily relating to their distribution procedures and advertising techniques.