The impact of a health education intervention on health behaviors and mental health among Chinese college students

Abstract

Objective: This study aimed to assess the impact of a health education intervention on health behaviors, self-efficacy, and well-being among college students. Participants: Between March and October 2016, a total of 532 undergraduates participated. Methods: A theory-based intervention was conducted at Wuhan University, China. Participants were assigned to a control or intervention group (IG). The IG attended a 7-week health education class on knowledge, attitude, and practice of health behaviors. Results: Participants in the IG, compared with those in the control group (CG), reported significantly increased prevalence of high physical activity and regular breakfast, as well as lower screen time, sugar beverage intake, and Internet addiction tendency. Furthermore, intervention students improved in health behavior scores (p?=?0.040), compared with the CG, while the changes in subjective well-being and self-efficacy remained similar between the two groups. Conclusions: Health education may promote health behaviors among Chinese college students.     

Trends in college students’ mental health diagnoses and utilization of services, 2009–2015

Abstract

Objective: To examine changes in diagnoses/treatment for 12 mental health (MH) conditions, previous use of campus MH services, and willingness to seek MH services in the future. Participants: ACHA–NCHA II participants from 2009 to 2015 (n?=?454,029). Methods: Hierarchical binary logistic regression with step 1 controlling for demographics and step 2 considering time. Results: Time was significant except for bipolar disorder, bulimia, and schizophrenia with increases for all conditions except substance abuse. Anxiety (OR?=?1.68), panic attacks (OR?=?1.61), and ADHD (OR?=?1.40) had the highest odd ratios. Use of MH services at current institution (OR?=?1.30) and willingness to utilize services in the future (OR?=?1.37) also increased over time. Conclusions: Based on a national sample, self-reported diagnoses/treatment of several MH conditions are increasing among college students. This examination of a variety of MH issues can aid college health professionals to engage institutional stakeholders regarding the resources needed to support college students’ MH.     

Characterization of psychiatrically hospitalized college students

Abstract

Objective: To characterize contemporary college students requiring psychiatric hospitalization. Participants and methods: Sociodemographic and diagnostic information was gathered retrospectively and analyzed from the electronic medical records (EMRs) of the consecutive inpatient hospitalizations of 905 college students admitted to a psychiatric inpatient unit. Results: Significantly more females compared to males experienced the following: more hospitalizations, more family and financial stressors, more depression, and less psychotic and bipolar disorder. The most frequent diagnosis was a depressive disorder, followed by bipolar disorder, psychotic disorder, and personality disorder, most frequently borderline personality disorder. Half of participants had comorbid diagnoses with substance abuse most common. More than two-thirds of students endorsed social or intimate relationship, academic, and family challenges as psychosocial stressors. In all, 15% of participants had repeat admissions. Conclusions: The present study provides demographic data from a sample of psychiatrically hospitalized college students. Findings can help improve screening and identification of decompensation in college students.     

The intersection of nonsuicidal self-injury and suicide-related behavior: Patterns of elevated risk and implications for college mental health

Objective: To analyze the overlap of nonsuicidal self-injury (NSSI) and suicide-related behaviors (SRB) among college students with regard to demographics, mental health, and coping styles. Participants: Respondents were 572 undergraduate students at a southwestern public university. Methods: Data were collected in 2015. Respondents completed a demographic survey and assessments of NSSI, SRB, internalizing symptoms (ie, anxiety, stress, and depression), aggression, and negative coping strategies. The survey was administered via a Web-based procedure. Results: Women reported more frequent cutting behaviors than men. Endorsement of NSSI was also associated with an increased likelihood of lifetime SRB. A subgroup of students endorsing both NSSI and SRB demonstrated poorer mental health, more negative coping, and self-reported female sex. Conclusions: College healthcare providers may benefit from competency-based training in techniques for the combination treatment of NSSI and SRB, as well as culturally based models of suicide.     

Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

Using the Theory of Planned Behavior to predict HPV vaccination intentions of college men

Objective: The purpose of this study was to test Theory of Planned Behavior (TPB) constructs in predicting human papillomavirus (HPV) vaccination behavioral intentions of vaccine-eligible college men. Participants: Participants were unvaccinated college men aged 18–26 years attending a large public university in the southeastern United States during Spring 2015. Methods: A nonexperimental, cross-sectional study design was employed. Instrumentation comprised a qualitative elicitation study, expert panel review, pilot test, test-retest, and internal consistency, construct validity, and predictive validity assessments using data collected from an online self-report questionnaire. Results: The sample consisted of 256 college men, and the final structural model exhibited acceptable fit of the data. Attitude toward the behavior (β = .169) and subjective norm (β = 0.667) were significant predictors of behavioral intention, accounting for 58% of its variance. Conclusions: Practitioners may utilize this instrument for the development and evaluation of TPB-based interventions to increase HPV vaccination intentions of undergraduate college men.     

Problem drinking among at-risk college students: The examination of Greek involvement,freshman status,and history of mental health problems

ABSTRACT

Objective: Scarce research has examined the combined effect of mental health difficulties and demographic risk factors such as freshman status and Greek affiliation in understanding college problem drinking. The current study is interested in looking at the interaction among freshman status, Greek affiliation, and mental health difficulties. Participants and Methods: Undergraduate students (N = 413) from a private and public Midwestern university completed a large online survey battery between January 2009 and April 2013. Data from both schools were aggregated for the analyses. Results: After accounting for gender, age, and school type, the three-way interaction indicated that the highest drinking levels were reported in freshman students who reported a history of mental health problems although were not involved in Greek life. Conclusions: Findings are discussed in the context of perceived social norms, as well as alcohol-related screenings and intervention opportunities on college campuses.     

Does the Andersen Behavioral Model of Health Services Use predict college students’ use of on-campus mental health services?

Abstract

Objective: 10–50% of college students meet the diagnostic criteria for one or more mental illnesses; unfortunately, less than half seek treatment. This study assessed the predictive power of specific variables on students’ use of on-campus mental health resources using the American College Health Association’s National College Health Assessment (ACHA-NCHA) II. Participants: Respondents included undergraduate and graduate students ages 18–35?years (n?=?96,121). Methods: We analyzed data from the ACHA-NCHA II Fall 2014 and Spring 2015. Andersen’s Behavioral Model of Health Services Use enabled selection of predisposing, enabling, and need predictor variables; these were analyzed individually and collectively. Results: Predisposing, enabling, and need variables accounted for 9%, 2.3%, and 17% of the overall variance. Significant variables associated with a student’s decision to access on-campus mental health services accounted for 23% of variance total. Conclusions: This insight could allow universities to better recognize students at-risk for needing but not accessing mental health services.     

Variability in measures of health and health behavior among emerging adults 1 year after high school according to college status

Objective: To examine changes in health behaviors among US emerging adults 1 year after high school. Participants: The national sample of participants (N = 1,927), including those attending 4-year college/university (n = 884), 2-year colleges/technical schools (n = 588), and no college (n = 455), participated in annual spring surveys 2013–2014. Methods: Health behaviors were assessed the last year of high school and first year of college; differences by college status controlling for previous-year values were estimated using regression analyses. Results: Relative to 4-year college attendees, those attending technical school/community college were less likely to binge drink (odds ratio [OR] = 0.57, confidence interval [CI] = 0.38–0.86) but more likely to speed (OR = 1.26, CI = 1.0–2.84), consume sodas (OR = 1.57, CI = 1.0–2.47), and report lower family satisfaction (p < .01), with marginally more physical and depressive symptoms. College nonattendees reported more DWI (driving while intoxicated; OR = 1.60, CI = 1.05–2.47), soda drinking (OR = 2.51, CI = 1.76–3.59), oversleeping (OR = 4.78, CI = 3.65–8.63), and less family satisfaction (p < .04). Conclusions: Health risk behaviors among emerging adults varied by college status.     

Microaggressions,perceptions of campus climate,mental health,and alcohol use among first-year college students of color

Depressive and anxiety symptoms are increasingly common, and problematic alcohol use remains prevalent in college. To expand on prior research on mostly white samples, we surveyed first-year students of color from our predominately white university (Southeastern US) to identify risk factors for mental health symptoms and potentially co-occurring problematic alcohol use. Results showed significant associations between microaggressions and poor campus climate (hypothetical predictors) with depressive, anxiety, somatic symptoms (hypothetical outcomes) that were indirectly linked through perceived stress, poor sleep, and academic burnout (hypothetical mediators). Poor campus climate, academic burnout, and using alcohol to cope were the most relevant to alcohol use disorder symptoms. Results support efforts to address and reduce racial microaggressions and promote a positive campus climate for all.     

Perceptions of transition-related health and mental health services among transgender adults

The opportunity to live authentically is critical for the well-being of transgender individuals. For many this requires accessing transition-related services. Current knowledge of transition-related care is limited. This study aims to elucidate experiences and needs of transgender individuals (N = 65) related to (a) therapeutic support, (b) medical care, and (c) aspects of living authentically in order to inform the development and delivery of trans-affirmative services. Findings reveal challenges accessing health care providers with trans-specific competency; gaps between critical aspects of transition-related care and receipt of services; and heterogeneity of experiences and needs. Recommendations for improving transgender-affirmative services are provided.     

Perceived need for care and mental health service utilization among college students with suicidal ideation

ABSTRACT

Objective: This study aimed to identify correlates of service utilization and perceived need for care among college students with suicidal ideation. Participants: Respondents were recruited from introductory psychology courses at an undergraduate college during the Fall 2014 semester. Methods: Independent correlates of (1) mental health service utilization, (2) self-perceived need, and (3) other-perceived need for mental health services among college students (N = 190) with suicidal ideation were identified. Results: Service utilization was associated with need for care as perceived by others. Perceived need for care by others was associated with suicidal ideation intensity and suicide attempt history. Perceived need by the respondents themselves was correlated with depression severity, sex, and race but was not independently associated with actual service utilization. Conclusions: Perceived need by others was the sole significant correlate of service utilization, suggesting it is an important target for public health interventions aimed at facilitating pathways into mental health treatment.     

Self-blame and stress in undergraduate college students: The mediating role of proactive coping

Objective: This study aimed to examine the mediating relationship of proactive coping on self-blame and stress among US undergraduate college students. Participants: The sample of undergraduate college students (n?=?261) were recruited through their Introduction to Psychology course and registered for the study through a research-based computer program utilized at the university in the fall 2010 and spring 2011 semesters. Methods: Participants voluntarily completed a battery of self-report questionnaires that measured self-blame, proactive coping, and stress. Correlation and regression-based mediation analyses were utilized to address the study objectives. Demographic differences were explored using comparative analyses. Results: Proactive coping was identified as a mediator between self-blame and stress. Correlation analyses revealed self-blame, proactive coping, and stress were interrelated with one another. Ethnicity differences were observed on proactive coping. Conclusions: Proactive coping mediated the relationship between self-blame and stress and was negatively related to the other included behavioral constructs.     

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.     

Stigma as a barrier to engaging in mental health services among adolescents who survive natural disasters

Many barriers impact the utilization of mental health services among adolescents who survive natural disasters. Although stigma has been identified as one of these barriers, minimal work examines the etiological factors that impact stigma and how these factors operate in perpetuating stigma among adolescents after a disaster. Understanding the role that stigma plays is a critical step to raising awareness of the cognitive and behavioral processes that preserve adolescents’ well-being, timely attainment of developmental milestones, and the potential for engagement in meaningful opportunities. We modify an existing adolescent self-stigma model to better understand how youth might respond psychologically to natural disasters both immediately after the event as well as during the long-term recovery phase. Future empirical research should assess the validity of these barriers within the suggested temporal framework. If this proposed conceptual piece is validated, interventions could be designed that directly address the role of stigma.     

An examination of ecological predictors of health literacy in black college students

Objective: Health literacy is a determinant of health, but disparities in health literacy persist. This study examined the influence of ecological factors on college students’ health literacy. Participants: During January 2016 a nonrandom sample of black undergraduate students (n = 298) aged 18–24 were recruited from enrollment lists at two urban universities in the Southeastern United States. Methods: Information on health literacy as well as numerous intrapersonal, social, and cultural-environment factors was obtained using an electronic questionnaire and then statistically modeled. Results: Ecological factors accounted for 28.7% of the variance in health literacy. In particular, reappraisal (B = 0.323, p < .001), suppression (B = ?0.289, p < .001), campus health education (B = 0.192, p < .05), campus tobacco culture (B = ?0.174, p < .05), and perceived norms (B = ?0.153, p < .05) directly predicted health literacy. Conclusions: Although intrapersonal factors influence health literacy, the sociocultural environment of college can also foster or hinder college students’ health literacy.     

An investigation of mental health and personality in Swedish social work students upon entry to university training

The aims were to describe Swedish social work students' personality characteristics upon entry to their training and to analyze relationships between personality traits, mental health, and some sociodemographic variables. One hundred and twenty-one female social work students completed a sociodemographic form, the Temperament and Character Inventory, and the Symptom Checklist. They scored significantly higher on harm avoidance, reward dependence, and self-transcendence and reported more somatization, obsessive compulsive, and phobic-anxious symptoms, and less hostility, than Swedish individuals from the general population of the same age. Personality traits significantly predicted the various mental symptom scores. It is recommended to implement modules or training courses within social work training in Sweden that bring an improvement of self-directedness and cooperativeness character trait into focus.     

Police encounters among a community sample of children and youth accessing mental health services

Generally, within the Canadian context, scholarship on police encounters with persons living with mental illness has focused on the experiences of adults and not children and youth. In this article, we present preliminary work of a secondary data analysis of intake statistics collected over a 5-year period (2009–2014) and a thematic content analysis of qualitative intake notes collected over a 2-year period (2009–2011) about police involvement among a community sample of children and youth accessing mental health services. Of 8,920 intakes completed, 1,449 children and youth, birth to 24 years old, had had police involvement at the time of accessing mental health services. Over the 5 years, the average number of young people with police involvement at the time of accessing mental health services was 16%, or one in six children and youth. Analysis of the qualitative intake notes revealed two main reasons for police involvement: (1) support in the home for a distressed child, and (2) concerns about a child’s conduct and behaviors in the community. The implications for social work practice and future research are discussed.     

Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment

Objective: We modeled design factors influencing the intent to use a university mental health service. Participants: Between November 2012 and October 2014, 909 undergraduates participated. Method: Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Results: Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. Conclusions: E-Mental Health options could engage students who may not wait for standard services.