Using nursing students to enhance one college's immunization program.

In New York State, all college students who were born on or after January 1, 1957, are required to show proof of immunity against measles, mumps, and rubella (MMR) before the 1st day of classes. Colleges have established immunization programs so that those students who do not have the required proof can be given the necessary injections. Often, our health service office does not have enough staff to administer the MMR shots during the registration period, resulting in long lines of students waiting to be immunized. In this article, the authors describe how one college used nursing students to assist with and enhance its immunization program. The 45 nursing students who participated in this project administered 694 injections over a 5-day period, They received credit from the nursing department for clinical time and all of the participants agree that the project was a success.     

Measles and Rubella on College Campuses: The Need to Act

Abstract

The lack of immunization requirements at the nation's colleges and universities threatens the maintenance of the interruption of indigenous measles in the United States. The high susceptibility rates in some college populations coupled with the high mobility of college students who may travel to countries where measles is endemic or epidemic increases the potential for measles outbreaks.

Preventing measles in college-age populations is particularly important because the disease can be more serious in adults. In view of the importance of preventing measles in college students, the Immunization Practices Advisory Committee (ACIP) of the U.S. Public Health Service has recommended that officials strongly consider immunization requirements for college entry.

The ultimate goal of rubella immunization is the protection of a future fetus against damage from intrauterine infection. Although rubella cases are reported routinely on college campuses, most colleges make no effort at controlling these outbreaks or instituting immunization requirements. The ACIP strongly urges educational institutions to require proof of immunity to rubella for registration or employment.     

Cost of Including Males in a University Rubella Immunization Program: A Recommendation to Change a Discriminatory Policy

Abstract

Twenty-seven University of Rochester students developed clinical manifestations of rubella during 1976–77. Twenty-five were male and had not been immunized against this disease; 18 required infirmary care costing $4,876. On the basis of data for freshman males, a cost analysis demonstrates the feasibility of changing the university policy which encourages immunization only of females to encouragement of either selective or mass immunization of all males as well. Immunization during childhood with combined MMR vaccine is least expensive and should be encouraged. In certain circumstances, selective immunization of susceptible males may be less expensive than the present selective policy, which leaves males at risk.     

Rubella Susceptibility and Immunization in a University Population: Experience,Strategy, and Policy

Abstract

Despite the availability of a safe and effective vaccine, rubella continues to occur in the United States. In recent years 70% of all cases have occurred in college aged individuals. Since 1978 the University of Rochester has required all entering students to have either rubella immunization or rubella serology. Compliance with this requirement has been excellent and has resulted in an increase in the rubella immunization rate from 52% to 71 %. Of those obtaining serology, the overall susceptibility rate (HI titer < 1:16) was 18%. Less than half of susceptible women accepted immunization, and few susceptible men sought immunization. College entry is a logical time to define an individual's rubella status.     

Impediments to Health Care for the Foreign Student

Abstract

Today's college students occupy a “window” between older adults, whose need for hepatitis B vaccination is minimal, and younger people who receive the vaccine as part of their childhood immunization series. However, because of the high-risk activities that are often part of student behavior, college students are among the individuals who are at the highest risk for this disease; 75% of all reported hepatitis B cases occur in persons between the ages of 15 and 39 years. It is therefore imperative that college health professionals take seriously their responsibility to educate students about issues related to hepatitis B and make available programs that enable the students to receive immunizations. This article briefly describes a successful hepatitis B education and immunization program at an institution that has no mandatory prematriculation immunization requirements.     

Investigating metacognition,cognition, and behavioral deficits of college students with acute traumatic brain injuries

ABSTRACT

Objective: Executive dysfunction in college students who have had an acute traumatic brain injury (TBI) was investigated. The cognitive, behavioral, and metacognitive effects on college students who endorsed experiencing a brain injury were specifically explored. Participants: Participants were 121 college students who endorsed a mild TBI, and 121 college students with no history of a TBI were matched on sex and ethnicity to examine potential differences between groups. Methods: Participants completed the Dysexecutive Questionnaire (DEX). Results: A Rasch analysis indicated that the TBI group had significantly higher total scores on the DEX than the control group. Moreover, when compared with the control group, the students with a TBI had higher scores on all 3 subcomponents of the DEX. Conclusion: These findings suggest that students who endorse brain injuries may experience more difficulty with specific facets of college. Thus, the importance of academic and personal resources available for students with a TBI is discussed.     

A/H1N1 Vaccine Intentions in College Students: An Application of the Theory of Planned Behavior

Abstract

Objective: To test the applicability of the Theory of Planned Behavior (TPB) in college students who have not previously received the A/H1N1 vaccine. Participants: Undergraduate communication students at a metropolitan southern university. Methods: In January–March 2010, students from voluntarily participating communication classes completed a hardcopy survey assessing TPB and clinically significant constructs. Hierarchical regression equations predicted variance in vaccine intentions of students who had not received a flu shot (N = 198; 70% Caucasian). Results: The TPB model explained 51.7% (p < .001) of variance in vaccine intentions. Controlling for side effects, self-efficacy and perceived comparative susceptibility predicted intentions when entered in the first block, whereas attitudes, subjective norms, and perceived behavioral control significantly contribute when entered in the second block. Conclusions: For students who have not previously received a flu vaccine, vaccine communication should utilize self-efficacy and perceived comparative susceptibility to employ the TPB to promote vaccine intentions.     

US college and university student health screening requirements for tuberculosis and vaccine-preventable diseases, 2012

ABSTRACT

Objective: Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the US college student health screening requirements among US resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPDs) as they relate to the American College Health Association (ACHA) guidelines. Methods/Participants: In April 2012, US college health administrators (N = 2,858) were sent online surveys to assess their respective school's TB screening and immunization requirements. Results: Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%). Conclusion: Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges.     

Socioeconomic Correlates of Current and Regular Smoking Among College Students in Rhode Island

Objective: The objective of this study was to determine how sociodemographic variables, in particular socioeconomic status, correlate with current and regular smoking among college students in Rhode Island. Participants and Methods: Over a 4-year period (academic year 2000-2001 to 2003-2004), the authors examined sociodemographic correlates of cigarette use among 3,984 students aged 17 to 24 years from 10 colleges and universities in Rhode Island. Results: One-third of participants (32.0%) had smoked a cigarette in the 30 days preceding the questionnaire. Findings from a pair of logistic regression models indicated that participants from upper-income families were more likely to be current smokers—although not regular smokers—suggesting that the effect of socioeconomic status on smoking is partly dependent on the level of addiction. In addition, freshmen were more likely to be current and regular smokers than were upperclassmen, and white students were most likely to be regular smokers. Conclusions: The frequency of college students who reported that they first tried smoking and first smoked regularly while in college increased from freshman to senior year, indicating that the college years are a vulnerable period for smoking initiation and habituation.     

Effectiveness of a Web-based Alcohol-Misuse and Harm-Prevention Course Among High- and Low-Risk Students

Objective: In the current study, the authors assessed whether a new online alcohol-misuse prevention course (College Alc) is more effective at reducing alcohol use and related consequences among drinkers and nondrinkers. Participants: The authors compared incoming college freshmen who reported any past 30-day alcohol use before the beginning of the semester with those who did not. Method Summary: The authors randomly assigned students who completed a precollege baseline survey to either complete a 3-hour noncredit version of College Alc or serve as members of a control group. The authors conducted a follow-up survey 3 months later. Results: Findings indicated that among freshmen who were regular drinkers before college, College Alc appeared to reduce the frequency of heavy drinking, drunkenness, and negative alcohol-related consequences. Among freshmen who did not report any past-30-day alcohol use before college, College Alc did not appear to have any beneficial effects. Conclusions: Results suggest that College Alc may be an effective program for students with a history of alcohol use.     

Intimate partner violence,trauma, and mental health need among female community college students

ABSTRACT

Objective: The impact of interpersonal violence on college students has received considerable attention, yet no studies have been conducted among community college students, who comprise 40% of all American college students, and have unique risk factors and needs. Community College students are more likely to be women, people of color, working, parenting, and first generation college students. Participants: Data were collected from a simple random sample from four community colleges (n=435). Methods: A cross-sectional quantitative survey was used to assess the extent of intimate partner violence, trauma exposure, sexual violence, and associated mental health consequences among female students. Results: Over 27% of participants reported IPV in the past year, while 25% reported sexual assault and 34% reported other uncomfortable sexual experiences in their lifetime. Nearly 20%of participants were currently reporting PTSD symptoms. Conclusions: Community Colleges should work with service providers to build their capacity to respond to students' needs.     

Impediments to Academic Performance of Bisexual College Students

Abstract

Objective: To investigate health-related impediments to academic success for bisexual college students. Participants: Respondents to the Fall 2011 American College Health Association–National College Health Assessment II (ACHA-NCHA II) survey who self-identified as bisexual, heterosexual, gay, or lesbian. Methods: Secondary analyses of the ACHA-NCHA II data were conducted to compare the experiences of bisexual students with both each other (bisexual men and bisexual women) and those of their nonbisexual counterparts (heterosexual and gay/lesbian students). Results: Bisexual college students are a large and distinct sexual minority group. On all measures with the exception of discrimination, bisexual college students reported the strongest threats to academic success of all sexual orientations. Conclusions: Given the unique impediments for bisexual students, college health professionals should consider specifically addressing needs for bisexual students, bisexual women in particular.     

Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.     

Mental Health Among College Students: Do Those Who Need Services Know About and Use Them?

Objective: The objective of this study was to examine connections between university students' mental health and their knowledge and use of campus mental health services. Participants and Methods: In March 2001, a sample of undergraduate students (N = 266) completed a Web-based questionnaire, providing information related to their mental health, knowledge of mental health services, and use of those services. Results: Students who were mentally distressed were more likely to know about and use services; however, some students who reported to be mentally distressed either did not know about services or knew about services but did not use them. Living off campus, identifying as male, and having fewer years in college were related to less knowledge of campus mental health services. In addition, female sex and number of years in college were predictive of higher service use. Conclusions: With the high prevalence rates and severity of mental health problems, university mental health providers must continue to make strategic efforts to disseminate knowledge about mental health services to all students.     

Patterns of Compensatory Behaviors and Disordered Eating in College Students

Abstract. Objective: The current study investigated rates of endorsement of eating-related compensatory behaviors within a college sample. Participants: This sample included male and female students (N = 1,158). Methods: Participants completed the Eating Disorder Examination Questionnaire (EDE-Q). The study defined 3 groups of students: those who did not endorse purging behaviors, those who endorsed only exercise, and those who endorsed laxative use or vomiting. Rates of related eating disorder risk variables were compared across the 3 groups. Results: Almost half of college students reported utilizing exercise as a compensatory strategy over the past 28 days. Those reporting compensatory exercise did not differ from other community and college samples on EDE-Q subscales. Conclusions: Findings suggest that college students report significant rates of compensatory exercise, and those who report exercise as their only compensatory behavior also report relatively low levels of eating disorder risk.     

The Impact of Educational Efforts on First-Year University Students' Acceptance of Meningococcal Vaccine

Abstract

The authors measured the impact of educational efforts on the number of college students who received meningococcal vaccine. First-year Brown University students from the classes of 2004 (n = 1,562) and 2005 (n = 1,518) received educational vaccine materials before they arrived on campus, whereas students from the class of 2003 (n = 1,441) did not. Students in the class of 2003, 13% (n = 184) of whom had received vaccine before their arrival on campus, served as the baseline. These educational efforts by the college health services before students arrived on campus increased the number of students immunized before campus arrival to 46% (n = 724) for the class of 2004, and 60% (n = 913) for the class of 2005. Education about the benefits of meningococcal vaccine before students' arrival on campus increased both the number of immunized students and the overall immunization rate among students.     

TigerPlace,A State-Academic-Private Project to Revolutionize Traditional Long-Term Care

ABSTRACT

The Aging in Place Project at the University of Missouri (MU) required legislation in 1999 and 2001 to be fully realized. An innovative home health agency was initiated by the Sinclair School of Nursing specifically to help older adults age in place in the environment of their choice. In 2004, an innovative independent living environment was built and is operated by a private long term care company, as a special facility where residents can truly age in place and never fear being moved to a traditional nursing home unless they choose to do so. With care provided by the home care agency with registered nurse care coordination services, residents receive preventative and early illness recognition assistance that have markedly improved their lives. Evaluation of aging in place reveal registered nurse care coordination improves outcomes of cognition, depression, activities of daily living, incontinence, pain, and shortness of breath as well as delaying or preventing nursing home placement. Links with MU students, faculty, and nearly every school or college on campus enrich the lives of the students and residents of the housing environment. Research projects are encouraged and residents who choose to participate are enjoying helping with developing cutting technology to help other seniors age in place.     

A Pilot for Improving Depression Care on College Campuses: Results of the College Breakthrough Series–Depression (CBS-D) Project

Abstract

Objective: To implement a pilot quality improvement project for depression identification and treatment in college health. Participants: Eight college health center teams composed primarily of primary care and counseling service directors and clinicians. Methods: Chronic (Collaborative) Care Model (CCM) used with standardized screening to identify, treat, and track depressed students for 12 weeks to monitor predetermined process and clinical outcomes. Results: Of all students receiving primary medical care services between January 2007 and May 2008, 69% (n = 71,908) were screened for depression. A total of 801 depressed students were treated and tracked; most predetermined treatment process and clinical outcome targets were achieved. Conclusion: The CCM for depression shows promise for improving depression identification and care for college students.     

Sexual and Reproductive Health Behaviors of California Community College Students

Abstract

Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was administered in class to randomly selected classrooms at 12 institutions and electronically to randomly selected e-mails of students at 1 institution from March through April 2007. Results: This sample of community college students reported higher rates of risky sexual behaviors, unintended pregnancy, emergency contraception, and sexually transmitted diseases, and lower rates of human immunodeficiency virus (HIV) testing, than the overall ACHA-NCHA reference group. Those who had been tested for HIV reported more sexual partners, and lower rates of condom use. Conclusions: The data provide justification for broader educational programs and access to family planning services, condoms, and HIV testing on community college campuses.     

Immunization documentation practices and vaccine-preventable disease surveillance capacity among institutions of higher education in Indiana

Objective: Complete and accurate documentation of immunization records and surveillance of disease transmission are critical to the public health response to outbreaks of communicable disease in institutions of higher education (IHEs). This study aims to describe immunization documentation practices and disease surveillance capacity among IHEs in Indiana in order to inform public health action. Methods: IHEs in Indiana were identified and included in the study if they offered on-campus housing and had a dedicated student health center. Phone surveys were administered in September 2015 to each institution, inquiring about current immunization documentation policies and practices, disease surveillance capacity, and use of statewide electronic reporting systems. Additionally, IHE websites were searched to identify immunization documentation requirements for matriculating students. Results: Surveys were completed for 33 of 38 eligible IHEs. Twenty-three (70%) IHEs reported that student immunization records are entered into an accessible electronic system or database. Matriculating student immunization requirements were identified for 32 institutions. Of these, 22 (69%) required a physician-signed proof of immunization. No IHEs reported documenting historical immunizations in the statewide electronic immunization system and three IHEs (9%) reported utilizing the state electronic disease surveillance program. Conclusions: Immunization documentation practices vary among IHEs in Indiana and use of statewide immunization and disease reporting systems is minimal. Robust utilization of immunization and disease surveillance systems has been shown to improve public health response to communicable disease outbreaks. Improving mutual understanding of policy and practice between health departments and IHEs could improve the ability to respond to public health challenges.