Examining residence status as a risk factor for health risk behaviors among college students

Objective: The current study is aimed to evaluate college student residence as a unique risk factor for a range of negative health behaviors. Participants: We examined data from 63,555 students (66% females) from 157 campuses who completed the National College Health Assessment Survey in Spring 2011. Methods: Participants answered questions about the frequency of recent use of alcohol, tobacco, marijuana, and illicit drugs, as well as sexual risk behavior in the last 30 days. Sexual risk behaviors were operationalized as having unprotected vaginal sex (yes/no) and the number of sexual partners. Results: Logistic regression analyses revealed that living off-campus is a unique predictor of alcohol, tobacco, marijuana, and illicit drug use, as well as engaging in unprotected sex and a greater number of sexual partners (all ps <. 01). Conclusions: Students living off-campus exhibit more substance use and sexual risk behaviors than students living on-campus, independent of gender, age, or race.     

Drunkorexia: Understanding the Co-occurrence of Alcohol Consumption and Eating/Exercise Weight Management Behaviors

Abstract

Objective: Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective. Participants: Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment. Methods: Hierarchical logistic regression was employed to determine if physical activity and disordered eating behaviors uniquely predicted binge drinking, while controlling for age, race, gender, year in college, Greek membership, and place of residence. Results: Physical activity and disordered eating made unique, statistically significant contributions. Moreover, including physical activity and disordered eating behaviors allowed for the correct classification of an additional 431 cases (ie, binge drinkers) over and above the predictive ability of the covariate-only model. Conclusions: Findings corroborate prior research indicating highly active college students are more likely to binge drink than their nonactive peers, and highlight the potential of a drunkorexia perspective in explaining the counterintuitive alcohol–activity association among college students.     

Social Norms Theory-Based Interventions: Testing the Feasibility of a Purported Mechanism of Action

Social norms-based interventions targeting college student drinking behaviors have become increasingly popular. Such interventions purportedly modify student misperceptions of fellow student drinking behaviors, which leads to changes in individual drinking behavior. Despite claims of successful interventions, research demonstrating that social norms-based interventions modify student perceptions is lacking. Objective: The authors conducted a laboratory experiment examining the feasibility of this mechanism of action and aimed to determine the validity of the campus-specific drinking norms hypothesis. Participants and Methods: The authors randomly assigned 60 students to 1 of 3 research conditions: Alcohol 101 (national drinking norms), a didactic presentation of campus specific drinking norms, or a control condition. Results: Both intervention groups modified student misperceptions regarding peer alcohol use, and these changes were sustained 1 week later. Conclusions: Social norms-based interventions can contribute to more accurate drinking perceptions among college students.     

Associations Between Physical Activity and Health-Related Factors in a National Sample of College Students

Abstract

Objective: To examine associations between meeting the current moderate to vigorous physical activity (MVPA) recommendation and health-related factors in a national sample of college students. Participants: Participants (N = 67,861) completed the National College Health Assessment II during the Fall 2008/Spring 2009 academic year. Methods: Hierarchical binary logistic regression was used to examine the contribution of 19 variables in explaining whether or not participants met the MVPA recommendation. Results: Meeting the MVPA recommendation was associated with several protective factors among college students, including adequate daily fruit and vegetable consumption, positive perception of general health, healthy body mass index, consistent seatbelt use, not smoking cigarettes, less perceived depression, and adequate sleep. In addition, meeting the MVPA recommendation was also significantly associated with a few risky behaviors including binge drinking, physical fighting, and multiple sexual partners. Conclusions: College student PA interventions should consider also addressing fruit/vegetable consumption and binge drinking.     

Characteristics of precollege sexual violence victimization and associations with sexual violence revictimization during college

Abstract

Objective: To examine the prevalence and characteristics of precollege sexual victimization (SV) experiences and associations with revictimization and recent substance use behaviors among a sample of college students who reported precollege SV. Participants: A sub-sample of 931 college students who reported precollege SV at baseline data collection for an ongoing multi-site clinical trial. Methods: Data were collected via electronic surveys between September 2015 and March 2017. Measures included precollege and during college SV, recent substance use, and alcohol-related harm reduction behaviors. Results: Precollege SV characteristics associated with revictimization included: Nonpenile penetration (aOR: 1.51, 95%CI: 1.04–2.19); pressured sex (aOR: 1.46, 95%CI: 1.06–2.01); and stranger assault (aOR: 2.03, 95%CI: 1.22–3.40). Past 30-day binge drinking was also associated with revictimization (aOR: 1.86, 95%CI: 1.36–2.54). Conclusions: The relationship between precollege SV and alcohol, especially binge drinking, may require a more integrated approach to preventing subsequent revictimization.     

Unhealthy behavior clustering and mental health status in United States college students

Abstract

Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781?US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.     

College Student Smokers' Cognitive Appraisal of High-Risk Activities

Abstract

Objective: Students who smoke are more likely to engage in risky behaviors such as binge drinking and unprotected sex (Schnieder and Morris, Environ Behav. 1999; 23:575–591). The goals of the present study were to determine whether smokers assess these behaviors as lower risk than nonsmokers, and if smoking rate influences risk perceptions. Methods: Participants were 303 college students. Cognitive Appraisal of Risky Activities (Fromme et al., Cognit Ther Res. 1997; 21:421–442) and smoking were assessed August–November, 2006. Results: Smokers reported significantly less risk, more benefit, and more involvement in risky behaviors than nonsmokers (p < .01). In hierarchical linear regression, risk perceptions moderated the association between smoking and (a) expected benefit from risky sexual behaviors (β = ?1.121, p < .05); and (b) expected involvement with illicit drugs (β = ?.313, p < .01). Conclusions: College smokers’ assessment of high-risk behaviors influenced their intended involvement. Risk perception change may therefore alter their involvement in high-risk behaviors.     

Health behaviors of culturally diverse inner-city community college students

ABSTRACT

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College Health Association National College Health Assessment II (ACHA-NCHA II) paper survey and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 for frequencies and chi-square test of independence. Results: The sample population reported poor diet, low rates of physical activity, high rates of overweight/obesity, low rates of condom use for vaginal sex, multiple sexual partners, and unintentional pregnancy. Protective health behaviors included low rates of cigarette smoking and alcohol use, high rates of condoms use for anal sex, and high rates of human immunodeficiency virus (HIV) testing. Conclusion: Students are at high risk for health problems related to poor diet, lack of exercise, and risky sexual behaviors. Additional research is recommended to determine the most effective intervention strategies.     

The understudied half of undergraduates: Risky sexual behaviors among community college students

Abstract

Objective: This study examines the prevalence and risk factors associated with risky sexual behaviors in community college students. Participants: A diverse sample of 18–19-year-old community college students (N?=?264). Methods: Baseline data from an online prevention program administered in 2015. Results: Community college students in this sample disproportionately experienced sexual assault and were unlikely to test for STIs. Higher intentions to engage in risky sexual behaviors were associated with gender and sexual experience, but also with having lower intentions to communicate with a sexual partner about pregnancy and STIs, and having higher gender norm endorsement. Conclusions: Older adolescents attending community colleges may be at high risk for poor sexual health outcomes, and appropriate theory-based education should be tailored to meet the needs of these underserved students.     

Trends in College Binge Drinking During a Period of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

Abstract

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.     

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.     

Gender orientation and alcohol-related weight control behavior among male and female college students

Objective: We examine weight control behavior used to (a) compensate for caloric content of heavy alcohol use; and (b) enhance the psychoactive effects of alcohol among college students. We evaluate the role of gender orientation and sex. Participants: Participants completed an online survey (N = 651; 59.9% women; 40.1% men). Method: Weight control behavior was assessed via the Compensatory-Eating-and-Behaviors-in Response-to-Alcohol-Consumption-Scale. Control variables included sex, race/ethnicity, age, and depressive symptoms. Gender orientation was measured by the Bem Sex Role Inventory. The prevalence and probability of alcohol-related weight control behavior using ordinal logistic regression are reported. Results: Men and women do not significantly differ in compensatory-weight-control-behavior. However, regression models suggest that recent binge drinking, other substance use, and masculine orientation are positively associated with alcohol-related weight control behavior. Conclusions: Sex was not a robust predictor of weight control behavior. Masculine orientation should be considered a possible risk factor for these behaviors and considered when designing prevention and intervention strategies.     

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.     

College Students Define Binge Drinking and Estimate Its Prevalence: Results of a National Survey

Abstract

Data from the 1999 College Alcohol Study were used to examine how students define the term binge drinking, to determine how much binge drinking the students think exists on their campuses, and to analyze how students' estimates compare with aggregated self-reports of student drinking. The findings indicate that the median of the students' definitions of binge drinking is 6 drinks in a row for men and 5 for women, 1 drink higher than the definition used by researchers. Students' definitions of binge drinking vary with their own drinking levels, suggesting that dissenting views of the research definition may represent voices of the heaviest drinkers. At the median, students estimated that 35% of all students were binge drinkers. Half (47%) of the students underestimated the binge drinking rate at their school, 29% over-estimated it, and 13% were accurate. Although programs designed to reduce the frequency or prevalence of binge drinking by emphasizing healthier norms would be most useful in addressing binge drinkers who overestimate drinking norms, this group includes only 13% of college students.     

The Role of Positive Alcohol Expectancies in Underage Binge Drinking Among College Students

Abstract

Objective: This study explored associations between positive alcohol expectancies, and demographics, as well as academic status and binge drinking among underage college students. Participants: A sample of 1,553 underage college students at 3 public universities and 1 college in the Southeast who completed the Core Alcohol and Drug Survey in the Spring 2013 semester. Methods: A series of bivariate analyses and logistic regression models were used to examine associations between demographic and academic status variables as well as positive alcohol expectancies with self-reported binge drinking. Positive alcohol expectancies were examined in multivariable models via 2 factors derived from principal component analyses. Results: Students who endorsed higher agreement of these 2 emergent factors (sociability, sexuality) were more likely to report an occurrence of binge drinking in the past 2 weeks. Conclusions: Study results document associations between positive alcohol expectancies and binge drinking among underage students; implications for prevention and treatment are discussed.     

An Examination of Drinkers’ Consequences by Sexual Orientation

Abstract

Objective: This study examined college student drinkers by sexual orientation (SO), alcohol use, and negative consequences in a national sample that self-identified gender and SO. Participants: Students completing the Spring 2005 National College Health Assessment (N = 54,111). Methods: A secondary analysis was conducted examining student responses by SO to items regarding negative consequences associated with alcohol. Results: Bisexual students had the highest mean scores on an index of alcohol-related harm. Significant differences were found by SO among male high-risk drinkers for alcohol-related consequences of “fighting” and “injuring another,” and females for “injuring another” and “unprotected sex.” Bisexual students had significantly greater than expected cell counts for significant results, including a significant finding for bisexual low-risk female students for alcohol-related “regret.” Conclusion: These findings suggest that more research is necessary to discern real differences in alcohol-related risk among college students by sexual orientation.     

HPV Knowledge and Behaviors of Black College Students at a Historically Black University

College students are at high risk for human papillomavirus (HPV) infection, yet their knowledge and self-protective behaviors appear inadequate. Researchers who have measured HPV-related knowledge and behaviors in evaluating college intervention efforts pay secondary attention to black college students because this group generally represents only a small subset of samples of the broader college population. Objective and Participants The authors' purpose in this study was to examine HPV-related knowledge and behaviors in 351 black undergraduates attending a historically black southeastern university in the spring of 2003. Methods Voluntary and anonymous student participation was solicited in randomly selected undergraduate classes. Results Results indicated that most students lacked HPV awareness (64%), became aware of HPV largely after infection, and gained their HPV knowledge from a health-care provider or college class. The authors performed an analysis by gender and found that women were more knowledgeable about HPV than were men. Observed HPV-related knowledge and behaviors were similar to samples of the broader US college population. Conclusions Findings suggest a greater need for HPV intervention efforts for all college students, including those at black colleges.     

Binge Drinking Among Undergraduate College Students in the United States: Implications for Other Substance Use

Abstract

The authors examined the relationship between binge drinking and other substance use among US college students, using nationally representative data from the 1995 National College Health Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. Compared with nonbinge drinkers, current binge drinkers were significantly more likely to report “ever” using and current use of cigarettes, marijuana, cocaine, and other illegal drugs. The researchers also found that the more often students binge drank, the more likely they were to have ever used cigarettes, marijuana, cocaine, and other drugs, and the more likely they were to report current use of cigarettes and marijuana. Those who design programs to prevent binge drinking and use of other substances should take into account the reality that many students use more than one substance and that the more frequently students report binge drinking, the more likely they are to be using other substances as well.