Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

Abstract

Objective: This study assessed college students’ reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.     

Internet and Mobile Phone Text Messaging Intervention for College Smokers

Objective: The authors developed a smoking cessation program using mobile phone text messaging to provide tailored and stage-specific messages to college smokers. Participants and Methods: The authors recruited 31 daily smokers who desired to quit from a college campus and asked them to use an Internet and mobile phone text messaging program to quit smoking. Results: Six weeks after program initiation, 45% reported abstinence with 42% abstinent based on cotinine verification. Continued smokers reported significantly reduced smoking rates and dependence. Overall, participants accepted the text messages. Conclusions: These results replicate findings from an earlier study and indicate that mobile phone text messaging is a potentially efficacious and easily disseminated method for providing cessation interventions to young adult smokers.     

Changes in self-efficacy and readiness for smoking cessation among women with high school or less education

The most common theory of smoking cessation postulates that readiness to quit begins with changes in attitudes that move the smoker toward behavioral change and eventual cessation. However, trends in smoking indicate that many who currently smoke are not ready to quit. Hence, strategies that both enhance readiness and focus on quitting are likely to be most effective. We hypothesize that an intervention addressed to motivating behavior change will enhance readiness to change, which will in turn increase the smokers self-efficacy regarding further change. A smoking cessation intervention that combined a self-help booklet and televised segments was developed to address these issues in a population of women smokers with high school or less education. Readiness to quit was measured prior to the intervention, immediately following the intervention, and again at six and 12 months after intervention. The results indicate that the intervention had its effects on readiness to quit, which in turn affected self-efficacy, which further enhanced readiness to quit. These findings indicate that interventions aimed at this group of smokers may need to provide achievable objectives that focus on preparing the smoker to quit as well as promote cessation.     

Personalized boosters for a computerized intervention targeting college drinking: The influence of protective behavioral strategies

ABSTRACT

Objective: Computerized interventions are cost-effective and can quickly deliver individual feedback to many students. However, in-person interventions are more efficacious. The current study sought to improve the efficacy of a popular online intervention via e-mailed boosters with personalized feedback. Participants: Participants were 213 student drinkers at a southeastern public university, ages 18–24. Methods: Students were randomized into (1) intervention only, or (2) intervention plus booster. Alcohol consumption and related problems were assessed at baseline, 2 weeks post, and 4 weeks post. Results: Boosters yielded reductions in drinking, but not alcohol-related problems. Boosters were associated with significant reductions for drinking frequency, heavy drinking days, peak drinks, and associated blood alcohol concentration (BAC). Protective behavioral strategies (PBS) moderated this effect, with significant reductions for students low in PBS, but not students already highly engaged in PBS use. Conclusions: Easy dissemination and low cost make e-mailed boosters a very efficient way to promote student health.     

College Students' Exposure to Tobacco Marketing in Nightclubs and Bars

Abstract

Objective: To examine whether a college student's exposure to tobacco marketing in nightclubs and bars was affected by the presence of a smoke-free law. Participants: A random sample (N = 478) of students participated in the survey (no smoke-free law, n = 240; smoke-free law, n = 238). The analysis was limited to students who reported being in nightclubs and bars (n = 171). Methods: A nonexperimental, cross-sectional, 2-group design was used. Results: Students in the smoke-free law city were more likely to be approached by tobacco marketers (34.7% versus 20.2%, p = .02), offered free gifts (41.7% versus 24.2%, p = .02), and take free gifts for themselves (34.7% versus 19.2%, p = .02). They were more likely to be exposed to direct marketing strategies (1.83 versus 1.12, p = .02). There was no difference on indirect tobacco marketing by site. Conclusions: Tobacco marketing is pervasive in nightclubs and bars. Smoke-free laws may protect against exposure to secondhand smoke but not the “pro” smoking messages students encounter.     

The Receptlveness of Health Risk Appraisals in Health Instruction

Abstract

Objectives: Data on effective strategies to enforce policies banning outdoor smoking are sparse. This study tested the effects of an enforcement package implemented on a college campus. Participants: Thirty-nine observers recorded compliance of 709 outside smokers. Methods: Smoking within 25 feet of buildings was noncompliant. The intervention included moving receptacles, marking the ground, improving signage, and distributing reinforcements and reminder cards. Results: The proportion of smokers complying with the ban was 33% during the baseline observation period, increased to 74% during the intervention week, and was at 54% during the follow-up. Differences across conditions was statistically significant (χ² (2, N = 709) = 6.299, p <.001). Compliance proportions varied by location in all conditions. Conclusions: Enforcing an outdoor smoking ban using a multiple component package increased compliance with the nonsmoking policy on a college campus.     

Prevalence of Human Immunodeficiency Virus Testing and Associated Risk Factors in College Students

Abstract

Objective: This study documents the prevalence of human immunodeficiency virus (HIV) testing in a sample of college students and examines associated demographic and behavioral characteristics. Participants: College students aged 18 or older were randomly selected to participate in a health behavior survey at a southeastern university in September 2011. Methods: Only sexually active students were included (N = 905). Relationships between demographic and sexual behavior characteristics were explored using logistic regression and classification regression tree (p ≤.05). Results: Only 36.2% reported having been tested for HIV. Age was the most significant factor associated with testing. Factors associated with those least likely to be tested were race and anal sexual activity. Unsafe sexual behaviors were also associated with lower rates of HIV testing. Conclusions: Findings support the need for targeted HIV interventions on college campuses. Such interventions need to be tailored for at-risk students and take into consideration factors likely to contribute to HIV testing.     

The effects of a pedometer-based intervention on first-year university students: A randomized control trial

ABSTRACT

Objectives: To assess the effects of a 12-week pedometer-based intervention on the physical activity behavior, health-related quality of life (HRQOL), and psychological well-being of first-year university students. Participants: First-year university students (N = 184) were recruited during September 2012 and randomly assigned to an intervention or a control group. Methods: Intervention participants were provided with a pedometer, monthly tracking logs, and follow-up e-mails. Control participants received no intervention. Physical activity, HRQOL, and psychological well-being were measured at baseline and post intervention. Data were analyzed using multivariate/univariate analysis of variance (MANOVA/ANOVA). Results: All participants experienced an increase in mild physical activity (p < .01) from baseline to follow-up. The intervention failed to produce significant differences between groups for physical activity (p = .28), HRQOL (p = .80), or psychological well-being (p = .72). Psychological well-being (p < .001), vigorous physical activity (p = .04), and mental health status (p < .001) decreased across the duration of the study. Conclusions: More intensive interventions may be required to elicit physical activity behavior change.     

Efficacy of a Web-Based,Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings

Abstract

Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called Michigan Prevention and Alcohol Safety for Students (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1 years. Methods: Intervention group participants (n = 616) attended 4 online M-PASS sessions, receiving feedback tailored to individual drinking patterns and concepts from 4 behavior change theories. Control group participants (n = 521) completed a mid-phase survey, and both groups were surveyed at baseline and posttest. Results: Evidence of M-PASS's efficacy was found. The intervention was associated with advanced stage of change, lower tolerance of drinking and drink/driving, fewer reasons to drink, and use of more strategies to avoid ARD. Preliminary evidence of behavioral change was also found. Efficacy was greater for women than men. Conclusions: Web-based programs may be useful in reducing alcohol-related risk among college students. Further evaluation is needed.     

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.     

The Effects of Discriminate Message Interventions on Behavioral Intentions to Engage in Physical Activities

Objective: The authors attempt to show the usefulness of discriminate messages designed to increase college students' intentions to engage in physical activities. Participants: The authors selected a sample of undergraduate students enrolled in communication courses at a university in the southeastern United States for a baseline online survey (n = 683) and an experiment (n = 99). Methods: The authors selected discriminate beliefs with highest regression weights and sizable effect size with behavioral intention to build messages for classroom intervention. The authors used an analysis of covariance to test the intervention effect of discriminate messages on intention to do physical activities. Results: Students exposed to the discriminate messages were more likely to report positive changes in their self-efficacy and behavioral intentions related to physical activity. Conclusions: Further research on communication theories is required to help design the selected beliefs so that they will be comprehended and ultimately lead to behavioral changes.     

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.     

Cigarette Smoking and Cessation Among Trade or Technical School Students in Texas

Although students enrolled in trade or technical colleges are at an elevated risk for tobacco use, virtually no information exists regarding their smoking behaviors. Objective and Participants: In the present study, the authors examined (1) the prevalence of smoking and quitting among 617 students in 2 trade or technical colleges in East Texas and (2) on-campus media exposure to antitobacco messages. Methods: Students voluntary completed the 42-item Texas Trade and Technical School Tobacco Survey during a required introductory-level class. Results: Of the participating students, 34% reported past-30-day smoking (current smoking). Of current smokers, 74% reported a previous quit attempt and 64% wanted to quit before graduation. Although most current smokers expressed a desire to quit smoking, the antitobacco message they were least likely to see on campus was that regarding how to quit. Current smokers cited their own health as the most likely reason to quit smoking, and most reported wanting to quit on their own, without the use of resources. However, of the 9 listed resources, students were most likely to report the possible use of medication. Conclusions: Given that most smoking students desire to quit smoking—and that they are enrolled in trade or technical schools for an extended period of time—additional research should examine how successful interventions can be delivered at the trade or technical school itself.     

An Evaluative Review of Outcome Research on Universal Mental Health Promotion and Prevention Programs for Higher Education Students

Abstract

Objective: This review is the first large-scale attempt to evaluate the effectiveness of universal promotion and prevention programs for higher education students on a range of adjustment outcomes. Participants/Methods: The current review examined 83 controlled interventions involving college, graduate, and professional students, with a focus on 3 main outcomes: social and emotional skills, self-perceptions, and emotional distress. Results/Conclusions: Skill-oriented programs that included supervised practice demonstrated the strongest benefits, thus showing promise as a successful mental health promotion and preventive intervention. In comparing different intervention strategies, mindfulness training and cognitive-behavioral techniques appear to be the most effective. Furthermore, interventions conducted as a class appear to be effective, suggesting the potential for exposing higher education students to skill training through routine curricula offerings. This review offers recommendations for improving the experimental rigor of future research, and implications for enhancing campus services to optimize student success in psychosocial—and thus ultimately academic—domains.     

Smoking and Membership in a Fraternity or Sorority: A Systematic Review of the Literature

Abstract

Objective: Fraternity and sorority members have higher rates of smoking than other college students. This systematic review examines studies that included fraternity/sorority membership in their investigation of smoking behaviors. Participants/Methods: Studies identified in MEDLINE, PsychInfo, JSTOR, CINAHL, ERIC, and Google Scholar published between 2003 and 2013 were included if they included fraternity and/or sorority membership, were written in English, published in a peer-reviewed journal, and had smoking as an outcome variable. Nineteen studies were identified for the review. Results: Fraternity/sorority members were more likely to be nondaily smokers. Members who lived in the fraternity/sorority house had higher rates of smoking than members who lived elsewhere. Fraternity/sorority member smoking was associated with alcohol and other substance use. The influence of no-smoking policies on fraternity/sorority member smoking was also examined. Conclusions: Fraternity/sorority membership was associated with higher rates of smoking, but this association was influenced by other substance use and environmental factors.     

A randomized controlled trial of the effects of mindfulness practice on doctoral candidate psychological status

Objectives: To examine the impact of guided mindfulness practice on psychological distress and psychological capital (hope, optimism, resilience, and efficacy) in doctoral candidates. Participants: Recruitment of a convenience sample of doctoral candidates occurred in July 2015 and participants were randomly allocated to the control or intervention group (38 and 34 participants completed the trial, respectively). Methods: A single-blinded, randomized controlled trial with intention-to-treat analysis was conducted. The intervention consisted of a daily guided mindfulness practice, using an audio CD. Indicators of psychological distress and psychological capital were measured pre- and post-trial with validated questionnaires. Results: Compared to the control group, the intervention group reported a statistically significantly reduction in depression (p?=?.045) and increased self-efficacy (p?=?.004), hope (p?=?.000), and resilience (p?=?.011). Conclusions: These results highlight the effectiveness of self-administered mindfulness practice on the psychological health of doctoral candidates, and the positive effect on psychological capital is reported as a key finding.     

Exploring chlamydia positivity among females on college campuses, 2008–2010

ABSTRACT

Objective: Describe chlamydia positivity among young women tested at college health centers by student characteristics: age, race/ethnicity, and institution type. Participants: During 2008–2010, colleges participating in a national infertility prevention program provided chlamydia testing data from females aged 18–24. Methods: Chlamydia positivity (number of positive tests divided by the number tested) among females stratified by college type (4-year versus 2-year and minority serving institutes [MSIs]) was determined. Results: Chlamydia testing data were provided by 148 colleges: 37 (26%) MSIs and 21 (15%) 2-year colleges. Of the 118,946 chlamydia tests, 6.5% were positive. Chlamydia positivity in females at 4-year colleges was 6.6% versus 5.3% at 2-year colleges (p = .0001). Positivity at MSIs was almost double of that at non-MSIs, 10.0% versus 5.4% (p = .0001). Conclusions: Chlamydia positivity may be higher among college females than previously thought. Higher positivity at MSIs suggests that targeted sexually transmitted infection prevention efforts may be useful for high-risk college populations.     

Reducing depression among mothers in a residential treatment setting: building evidence for the PST4PPD intervention

ABSTRACT

Objective

The prevalence of postpartum depression (PPD) nearly doubles among low-income mothers in the United States compared to the general population. Problem Solving Therapy (PST) is an effective treatment for populations of low-income women and more accessible than costly, long term interventions. This study aimed to assess the feasibility of implementing a problem-solving-focused intervention originally designed for home visits. Method: This study was conducted in a residential treatment facility (RTF). A chemical dependency counselor delivered the 5-session intervention named “PST4PPD”. A one-group pretest/posttest design was adopted. The standardized tools: Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) were used to assess depressive symptoms. The New General Self-Efficacy Scale (NGSE) was used to measure self-efficacy. Results: Among the 41 eligible women, 90% (n = 37) completed the intervention. The research found statistically significant decreases in depression (EPDS t(36) = 6.70, p <.001; PHQ-9 t(36) = 4.67, p <.001) and increases in self-efficacy (NGSE t(36) = ?2.41, p =.02). Conclusions: This pilot study finds positive results and feasibility of “PST4PPD”, a community-based, affordable intervention to lower symptoms of postpartum depression. Recommendations for future research and practice, including suggestions for engaging and retaining low-income mothers in PPD interventions, are discussed.     

Using smartphones to collect daily sexual behavior data from college students

ABSTRACT

Objective: Our objectives were to measure reporting differences between sexual behavior data from daily diary and retrospective estimates and to assess the utility of using smartphones to collect sexual behavior data from a college student population. Participants: Eighty-six participants (68 women, 18 men) completed the study. Methods: For 30 days during the Spring 2017 semester, participants received prompts to participate in daily diaries about their previous day's sexual behavior on their smartphones. Participants then retrospectively reported their past 30 days of sexual behavior and provided feedback on the process of receiving daily diaries on their smartphones. Results: We found that college students overreported their sexual behavior on the retrospective survey compared to their daily diary reports (ps < .001; Cohen's ds ≥ 1.51). Participants provided positive and constructive feedback. Conclusions: Using smartphones to administer daily diaries is a promising technique for obtaining reliable sexual behavior data from college students.     

Predictors of college-student food security and fruit and vegetable intake differ by housing type

ABSTRACT

Objective: We assessed whether college-student characteristics associate with food security and fruit and vegetable (FV) intake and whether these associations differ in students in housing with and without food provision. Participants: 514 randomly-sampled students from a large, Midwestern, public university in 2012 and 2013 Methods: Ordered logistic regression tested how student characteristics associate with food security. Linear regression tested how student characteristics associate with FV intake. Analyses were stratified by housing type – that is, housing with food provision (dormitory, fraternity/sorority house, cooperative) vs. housing without food provision.Results: Only among those living in housing without food provision, males (p = 0.04), students without car access (p = 0.005), and those with marginal (p = 0.001) or low (p = 0.001) food security demonstrated lower FV intake. Conclusions: Housing with food provision may buffer the effects of student characteristics on food.