The History of SHSAAMc: Student Health Services at Academic Medical Centers

This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at academic medical centers.     

Quality Improvement in Patient Distribution at a Major University Student Health Center

Abstract

Healthcare in a major university setting poses unusual challenges and great opportunities. Two traditionally challenging areas in patient distribution are the initial intake of allergy/immunization patients and the triage of outpatients in the general medical clinic. The authors describe the use of the FOCUS-PDCA quality improvement (QI) problem-solving process for each situation. After identifying major problems, the health center established cross-functional teams of experts representing the allergy/immunization and general medical clinics. The teams analyzed the problems with a flow chart and undertook studies to further elucidate causes and potential solutions. They listed potential solutions in order of priority and submitted them to the student health center director for review and initiation. Each team then used the PDCA (plan-do-check-act) cycle to put approved solutions into effect. Permanent improvements made in each area resulted in a more effective and efficient patient distribution system, favorable staff comment, and greater patient satisfaction.     

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.     

Relationship of Work Hours With Selected Health Behaviors and Academic Progress Among a College Student Cohort

Approximately 57% of college students work while attending school. Health risks related to working while in college have not been widely studied. Objective: The authors' purpose in this study was to determine associations between hours worked, binge drinking, sleep habits, and academic performance among a college student cohort. Participants and Methods: The authors randomly selected a sample of 1,700 undergraduates from a southeastern US university and mailed to them a survey requesting a variety of self-reported health behaviors and hours worked. A total of 903 completed questionnaires were received, indicating a response rate of 57.3%. Results: Binge drinking, less sleep, and lower academic performance were significantly associated with working 20 or more hours per week. Those variables were not associated with working fewer than 20 hours per week. Conclusions: Although administrators and others in higher education are aware of the impact of economics on a school's ability to operate, they may not be aware of the impact on students' health.     

Providing Student Health Services at Sea: A Survey of Chief Complaints Onboard a Maritime Academy Training Ship

Abstract. Objective: The authors describe the epidemiology of infirmary chief complaints aboard a collegiate maritime training ship. Participants: They assessed patients (N = 646 visits) evaluated by the USTS Enterprise medical department during a 44-day sea term from January to February 2007. Methods: The authors conducted a retrospective chart review of infirmary use and extracted information on age, sex, rank, chief complaints, and frequency of visits. Results: Overall, 646 visits were made. The most common complaints were dermatologic (30.1%): rash, skin infection, laceration, and sunburn. Together, ear, nose, and throat and dermatologic complaints accounted for 57.6% of all visits. Work-related complaints accounted for 12.5% of recorded visits. Compared with the ship population, senior and female cadets had more visits than the average. Port departure days were typically the busiest. Conclusions: Among healthy, college-aged cadets at sea, typical primary care constitute comprise the majority of visits.     

Student Assistance Program: A New Approach for Student Success in Addressing Behavioral Health and Life Events

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.     

Walking a Tightrope: Case Management Services and Outpatient Commitment

Effective case managers in community mental health are successful at forging a working alliance with recipients. This article explores one key aspect of case management practice, serving involuntary clients, specifically those on outpatient commitment orders. In 19 intensive interviews, a subset of a larger study, case managers shared their perceptions of the utility of outpatient commitment with a focus on how such orders impacted the professional relationship. We argue that the use of advance psychiatric directives and shared decision-making processes can reduce the need for coercive practice.     

Providing Medical Information to College Health Center Personnel: A Circuit Librarian Service at the University of Illinois

Abstract

College health center personnel are no different from other health practitioners in their need for medical information. To help meet this need, the McKinley Health Center, University of Illinois Urbana-Champaign, developed a partnership in 1997 with the Library of the Health Sciences-Urbana, a regional site library of the University of Illinois at Chicago campus. This partnership led to the adoption of circuit librarianship, a dynamic outreach model, to enhance access to health information for McKinley Health Center personnel. A circuit librarian consults with health center personnel during regularly scheduled on-site visits to the center and its satellite office. Upon returning to the resource library, the circuit librarian conducts research for clinical information on behalf of the center's personnel, then sees that articles, books, and relevant Web sites are identified and delivered to assist in answering questions regarding disease management, drug therapy, wellness, and health administration.     

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.     

The history of SHSAAMc: Student Health Services at Academic Medical Centers

This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at academic medical centers.     

Student Nurse Education in a University Health Center

Abstract

Objective: This study assessed the association between ethnicity and family socioeconomic status (SES) as it relates to the prevalence of vaginal douching among female undergraduates in a university community. Participants and Methods: This was a cross-sectional survey conducted between September 2011 and February 2012 among 1,535 female undergraduates using a semistructured behavioral questionnaire adapted by the authors from previous research related to vaginal douching practice. Results: The overall prevalence of vaginal douching was 79.35% and the practice was significantly associated with the mother's age, ethnicity, low SES (educational level, occupation, and monthly income), and area of residence. The father's age and SES were statistically nonsignificant. Conclusion: Ethnicity and low SES of mothers were significantly associated with a higher prevalence of douching in daughters. These factors should be considered among others in any intervention to discourage vaginal douching among college women.     

Examining the Relationships Between Resilience,Mental Health,and Academic Persistence in Undergraduate College Students

Abstract

Objective: In this study, the relationships between measures of interpersonal resilience, intrapersonal resilience, and mental health were examined with respect to academic and social integration, key determinants of academic persistence. Participants: A sample (n = 605) of undergraduate students was recruited from 2 midwestern universities during the 2007–2008 academic year. Methods: Hierarchal (or sequential) regression analysis examined whether the inter- and intrapersonal resilience and mental health measures contributed to explaining variance in the response variables of university cumulative grade point average (GPA) and university sense of belonging. Results: The intrapersonal resilience factors contributed to explaining variance in cumulative GPA in addition to aptitude and achievement. Furthermore, there was a strong statistical correlation between the inter- and intrapersonal resilience factors and mental health. Conclusions: The demands in college are significant and there is a need for more research on the concept of resilience as it relates to college health and academic persistence.     

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.     

Academic Underachievement and Recovery: Student Perspectives on Effective Career Interventions

Academic achievement has a significant influence on various career development and decision‐making factors. Therefore, it is important for career counselors to understand how past academic underachievement affects students’ current lives and to develop interventions that might ameliorate negative effects. This study examined the experiences of 9 ethnically diverse college students who had experienced and overcome academic failure. Data were collected by individual interviews and analyzed based on the consensual qualitative research method. Four themes emerged in relation to participants’ academic underachievement and recovery: attitude, study strategies, external support, and coping difficulties. The results suggest that underachieving students are better able to cope with and overcome academic difficulties when they set clear career goals, use effective learning strategies, consciously put forth more effort, and receive external support.     

The Medical Excuse Game Revisited

Academic policies that require medical excuses are based on mistrust of students and conflict with institutional honor codes. Such policies undermine the philosophical and educational foundations of higher education; namely, to model and nurture honesty, integrity, and citizenship in emerging adults. Instead, they encourage hypocrisy and exaggeration by requiring students to prove they are sick enough to produce temporary disability. More pragmatically, the "game" also consumes valuable clinician time. The authors describe their experiences with medical excuse policies at their respective institutions and offer suggestions for other colleges and universities.     

For the Health of it: A Case Study of Staff Health Education

The authors conducted a 10-year follow-up study using a telephone survey to investigate the availability of emergency contraceptive pills (ECPs) at college health centers in the mid-Atlantic region of the United States. They also examined related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, staff attitudes, changes in distribution over the past 10 years, and availability if ECPs become over-the-counter. Of the 119 completed responses, 58 schools (49%) reported distributing ECPs. The most common reasons schools listed for not distributing ECPs (n = 61, 51%) were religious convictions, understaffing, and lack of funding. Major changes in ECP distribution over the past 10 years related primarily to the number of schools distributing ECPs, protocol in ECP distribution, and advertising for ECP services.     

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]     

Rapid Assessment for Psychopathology in a College Health Clinic: Utility of College Student Specific Questions

Abstract

Objective: The purpose of this study was to determine the utility and unique benefits of employing the College Health Questionnaire (CHQ) in a college health care setting. The CHQ is a newly designed measure to assess psychosocial issues commonly problematic among college students. Participants: One hundred nine patients participated in the study during their medical appointments. Methods: Participants completed the study questionnaires (CHQ and Patient Health Questionnaire) in the waiting room. Their provider had the opportunity to use the responses in treatment decision making. Results: A majority (66.1%) endorsed at least one CHQ item. Patients who indicated traditional mental health problems were more likely to be prescribed psychotropic medications, whereas patients who endorsed psychosocial issues commonly problematic among college students were more likely to be referred for behavioral treatment. Conclusions: Screening for behavioral problems in college primary care settings without the use of college-related questions would result in missing numerous important psychosocial problems.     

Medication Abortion Within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

Abstract

Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants: Female patients presenting for medication abortion at a student health care clinic between October 1, 2006, and April 1, 2009. Methods: Retrospective consecutive case review. Results: Successful completion not requiring uterine aspiration occurred in 85% of the cases that were not lost to follow-up. Six cases (15%) required uterine aspiration for completion: 3 underwent uterine aspiration only; 3 had aspiration after failing an additional dose of misoprostol. Only 1 patient visited the emergency room. There were no hospitalizations. Conclusions: Medication abortion services in a student health care clinic are safe and feasible. However, additional treatment may be required with some patients.     

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.