Community health workers on a college campus: Effects on influenza vaccination

Objective: To assess the impact of a campus community health worker program (HealthPALs) on student influenza vaccination. Participants: Undergraduate students at a northeastern US university (enrollment 6650), influenza seasons 2011–2012 through 2015–2016. Methods: Study design: Difference-in-differences analysis of student vaccination at campus dormitory influenza clinics during intervention vs. baseline. Intervention: In the first intervention year, HealthPALs conducted in-person peer outreach at several campus dormitory flu clinics. Subsequent years, HealthPALs conducted an enhanced intervention, with the addition of a personalized, dormitory-specific social media campaign appealing to students' community identity. Results: The initial intervention increased vaccinations by 66% (IRR = 1.66, 95%CI 1.39-1.97) at intervention clinics relative to control. The enhanced intervention increased vaccinations by 85% (IRR = 1.85, 95%CI 1.75-1.96).

Conclusion: Community health workers can be a highly effective, low-cost strategy for increasing influenza vaccination among college students. This model could also be used to address other campus health challenges where student engagement is key.     

2009–2010 Seasonal Influenza Vaccination Coverage Among College Students From 8 Universities in North Carolina

Abstract

Objective: The authors sought to describe the 2009–2010 seasonal influenza vaccine coverage of college students. Participants: A total of 4,090 college students from 8 North Carolina universities participated in a confidential, Web-based survey in October–November 2009. Methods: Associations between self-reported 2009–2010 seasonal influenza vaccination and demographic characteristics, campus activities, parental education, and e-mail usage were assessed by bivariate analyses and by a mixed-effects model adjusting for clustering by university. Results: Overall, 20% of students (range 14%–30% by university) reported receiving 2009–2010 seasonal influenza vaccine. Being a freshman, attending a private university, having a college-educated parent, and participating in academic clubs/honor societies predicted receipt of influenza vaccine in the mixed-effects model. Conclusions: The self-reported 2009–2010 influenza vaccine coverage was one-quarter of the 2020 Healthy People goal (80%) for healthy persons 18 to 64 years of age. College campuses have the opportunity to enhance influenza vaccine coverage among its diverse student populations.     

Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus

Objective: To examine the perceptions among faculty and health professional students regarding mandatory vaccination policies on a health sciences campus. Participants: A total of 296 faculty and 244 students completed surveys during Fall 2015. Methods: The online survey administered to individuals who received the influenza vaccine during the fall 2015 influenza vaccination clinic season included five items evaluating perceptions of employer mandatory vaccination requirements. Results: Chi-square analysis indicated that although faculty and students agree mandatory vaccinations in a health care environment are appropriate, faculty are more likely than students to get vaccinated in the absence of a mandate. Additionally, a small fraction of faculty would consider employment elsewhere when facing this mandate. Conclusions: Overall, faculty and students had favorable perceptions about mandatory influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, education of students should be improved to support the importance of vaccinations in a health care environment.     

College and University Compliance With a Required Meningococcal Vaccination Law

Objective: Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. Participants: The authors surveyed 32 college/university administrators via a self-administered questionnaire. Methods: The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. Results: Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000-2004 ranged from 66%-76% and 12%-17%, respectively. Two (7%) schools were compliant with all components of the law. Conclusions: Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed.     

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.     

Implementation and evaluation of an Exercise is Medicine™ on campus week

Exercise is Medicine™ (EiM) on campus targets physical activity (PA) participation on college campuses. Limited research has addressed how PA initiatives can be operationalized on college campuses.PurposeTo describe the implementation of EiM on a large U.S. university campus and present preliminary outcomes on participation and awareness.MethodsEiM week was implemented on a large university campus. Exercise stations were set-up at campus locations to encourage brief bouts of PA and educate about the benefits of PA. Evaluation included observations of participation, surveys, and intercept surveys to assess awareness and reach.ResultsEiM week was implemented during Fall 2013. Exercise stations elicited 1771 exercise bouts from participants. Surveys indicated widespread reach across the university (13 of 17 colleges); most students (50.8%) became aware of the EiM campaign by passing by the exercise stations. Campus intercept surveys 1-week post-event indicated 54% students had heard about EiM, of which 39% had heard/seen the event through messages encouraging exercise.ConclusionThe current study was successful in engaging a large, diverse population on a college campus. Lessons learned from the development, implementation, and evaluation of EiM on campus activities provide insight for university campuses looking to target student health and PA participation.     

Effects of a web-based pre-enrollment alcohol brief motivational intervention on college student retention and alcohol-related violations

Objective: To determine whether completing a pre-enrollment Web-based alcohol brief motivational intervention (BMI) increased student retention and reduced student alcohol-related violations. Participants: Fall 2011 (3,364) and Fall 2012 (3,111) entering cohorts of all first-year students at a midwestern state university. Method: Students completing the brief intervention (BI) were compared to students not completing the BI. Retention was tracked for four years for the 2011 cohort and three years for the 2012 cohort. Campus and community alcohol violations were tracked for two academic years following enrollment. Kaplan–Meier survival analysis and Cox regression were used to test retention survival. Logistic regression was used to test campus and community violations. Results: Students in both cohorts who completed the BI had significantly higher retention and significantly fewer alcohol-related violations than noncompleters. Conclusions: Population-level Web-based BIs help prevent student dropout and decrease alcohol-related violations, with impacts extending multiple years. Web-based BI is an efficacious population-level prevention tool.     

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.     

The Effect of Religiosity and Campus Alcohol Culture on Collegiate Alcohol Consumption

Abstract

Religiosity and campus culture were examined in relationship to alcohol consumption among college students using reference group theory. Participants and Methods: College students (N = 530) at a religious college and at a state university complete questionnaires on alcohol use and religiosity. Statistical tests and logistic regression were utilized to examine alcohol use, religiosity, and campus environment. Results: Alcohol consumption was significantly higher among students at the university (M = 26.9 drinks) versus students at the religious college (M = 11.9 drinks). University students also had lower religiosity scores (M = 23.8) than students at the religious college (M = 26.5). Students who attend a secular university are 4 times more likely to be moderate or heavy drinkers compared to students attending a religiously affiliated college. Students with the least religiosity were 27 times more likely to be a heavy alcohol user and 9 times more likely to be a moderate alcohol user compared to students with greater religiosity.     

Who is willing to come back? College students' willingness to seek help after using campus mental health services

Objective: To examine characteristics of college students who have previously received mental health (MH) services on campus and are willing to seek help again in the future. Participants: Spring 2015 ACHA-NCHA II (N = 12,501) undergraduate respondents who had previously used MH services on their current campus. Methods: Binary logistic regression with willingness to seek MH services in the future as the dependent variable. Results: Among students who had already utilized campus MH services, significant predictors for future help-seeking were: female, white, gay/lesbian, those not working for pay, having the college/university health insurance plan, and not currently/previously serving in the military (p < .05). Conclusions: The predictors for willingness to use services in the future were consistent with the existing literature related to initial use. Colleges and universities need to consider factors that influence openness to MH services after a previous experience in addition to initiating care. Implications for college MH professionals are provided.     

“This is not a drill”: Activation of a student-led influenza vaccination point of dispensing

Objective: To describe activation of a Point of dispensing (POD) in response to an influenza outbreak, highlighting the use of a student-led model. Participants: Faculty, staff, and students of Harris College of Nursing and Health Sciences, Texas Christian University (TCU), as well as those located in its primary building. Methods: In response to an August 2017 influenza outbreak, a vaccination clinic was conducted for a target population through POD activation. The larger campus community was served through provision of additional doses by the Texas Christian University Health Center and the annual October student-led vaccination clinic. Results: Eleven additional cases were diagnosed after vaccinations began. Conclusions: One hundred percent of the targeted population was vaccinated (n = 824), with an additional 127 participants vaccinated (others working in the building where POD held also vaccinated). This was the first time POD activation had occurred on campus in response to an outbreak.     

Examining the impact of social media on mood and body dissatisfaction using ecological momentary assessment

Abstract

Objective: To assess the effects of social media consumption on body dissatisfaction and negative affect using ecological momentary assessment, a method of assessment over time in the participants’ naturalistic environment. Participants: Woman college students (N?=?30) from a large public university participated in the study in Fall 2015. Methods: Participants were contacted via their smartphones five times per day for five days and asked to complete a battery of measures which assessed social media use, body dissatisfaction, and negative affect. Results: Results demonstrated that the number of social media sites visited was a significant predictor of body dissatisfaction while time spent using social media was not. The number of sites visited and time spent on social media were both significant predictors of general negative affect, sadness, and guilt. Conclusions: Results demonstrate the negative impact that social media use can have on body dissatisfaction and negative affect.     

Exploring College Students’ Use of General and Alcohol-Related Social Media and Their Associations With Alcohol-Related Behaviors

Abstract

Objective: Alcohol marketers have increasingly moved their advertising efforts into digital and social media venues. As a result, the purpose of this study is to investigate associations between students’ use of social media, their exposure to alcohol marketing messages through social media, and their alcohol-related beliefs and behaviors. Participants: Public and private university students (N = 637) participated November and December 2011 and April 2012. Methods: College students completed online surveys to measure their exposure to social and online media generally, as well as their alcohol-related digital media use and alcohol use. Results: Use of social media related to alcohol marketing predicted alcohol consumption and engaging in risky behaviors, whereas the use of social media more generally did not. Conclusions: Students’ use of alcohol-related social media–marketing content associates with their problem drinking. Results have implications for alcohol abuse reduction efforts targeted at college students and suggest the importance of considering social, cultural, and cognitive factors in campaign planning and design.     

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.     

Undergraduate students survey their peers on mental health: Perspectives and strategies for improving college counseling center outreach

Abstract

Objective: The purpose of the study was to examine student perspectives about college mental health including the primary mental health issues affecting students, common college student stressors, student awareness of campus mental health resources, and mental health topics students want more information about. Participants: Participants were 822 undergraduate and graduate students enrolled in a private university. The study was conducted during September 2016. Methods: As part of a public health course in program planning, undergraduate students surveyed their peers about their experience with mental health and mental health resources. Results: Stress was perceived as the largest mental health issue. Students most wanted more information about school/work/life balance followed by stress management. Electronic newsletters, social media, and on-campus seminars were the top strategies that students suggested as ways to reach them. Conclusions: The results provide student perspectives on mental health that may be useful in developing effective outreach efforts.     

Eating Disorder Symptoms Among College Students: Prevalence,Persistence, Correlates,and Treatment-Seeking

Abstract

Objective: To examine the prevalence, correlates, persistence, and treatment-seeking related to symptoms of eating disorders (EDs) in a random sample of college students. Participants: A random sample of students at a large university were recruited for an Internet survey in Fall 2005 and a follow-up survey in Fall 2007. Methods: ED symptoms were measured using the SCOFF screen and adjusted for nonresponse using administrative data and a nonresponse survey. Results: 2,822 (56%) students completed the baseline survey. Among undergraduates the prevalence of positive screens was 13.5% for women and 3.6% for men. Among students with positive screens, 20% had received past-year mental health treatment. In the follow-up sample (N = 753), ED symptoms at baseline significantly predicted symptoms 2 years later. Conclusions: Symptoms of EDs were prevalent and persistent among college students in this study. These findings suggest that brief screens can identify a large number of students with untreated EDs.     

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.     

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.     

Implementing an Early Intervention Program for Residential Students Who Present With Suicide Risk: A Case Study

Abstract

Objective: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. Participants: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for suicide between Fall 2004 and Spring 2011. Methods: Data were collected from archival records to examine quality of early intervention services, student retention, and grade point average (GPA) during the semesters prior to, during, and subsequent to the referral incident. Results: Program implementation was timely and responsive to student needs; students successfully completing the early intervention program remained in school and demonstrated small but significant rebounds in GPA the semester subsequent to the incident. Conclusions: There are benefits associated with the implementation of early intervention programs designed to respond to students manifesting risk for suicide, such as connecting the student to vital services and support networks.