Student bodies, past and present

This article examines how the field of college health has evolved over time to address the needs of an increasingly diverse student population. The central argument is that college and university health programs developed in conjunction with shifting standards of medical care and public health practices in the United States. The author reviews the role of college health programs as public health agencies for campus communities, and describes contemporary public health challenges facing college campuses. She shows how the history of college health is intertwined with the history of diversity in higher education. In particular, the author outlines how the growth of health services made higher education accessible to women, racial minorities, veterans, and persons with disabilities.     

Promoting the Health of Young Adults in Urban Public Universities: A Case Study From City University of New York

Abstract

Changing demographics of college students and new insights into the developmental trajectory of chronic diseases present universities with opportunities to improve population health and reduce health inequalities. The reciprocal relationships between better health and improved educational achievement also offer university health programs a chance to improve retention and graduation rates, a key objective for higher education. In 2007, City University of New York (CUNY), the nation's largest urban public university, launched Healthy CUNY, an initiative designed to offer life-time protection against chronic diseases and reduce health-related barriers to educational achievement. In its first 5 years, Healthy CUNY has shown that universities can mobilize students, faculty, and other constituencies to modify environments and policies that influence health. New policies on tobacco and campus food, enrollment of needy students in public food and housing assistance programs, and a dialogue on the role of health in academic achievement are first steps towards healthier universities.     

The History of College Health Nursing

Abstract

Almost from the beginning of formal college health programs in the second half of the 19th century, college health nurses were there to care for students in college and university settings. By the end of the 20th century, the role of college health nurses had evolved with the nursing field in general, but with enough unique features for the American Nurses’ Credentialing Center to recognize college health nursing as a professional subspecialty and administer the first College Health Nurse Certification examinations. In addition, new nurse practitioner programs provided practicing nurses with more independence, and their duties continued to expand beyond care of the sick to include health promotion, administrative, and teaching activities. As a result of these changes, college health nurses now play a larger role in the life of students and promoting a healthy campus community than ever before in the history of college health.     

One Hundred Years of College Mental Health

Abstract

Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, “mental hygiene” was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student bodies.     

A Review of Multicomponent Interventions to Prevent and Control Tobacco Use Among College Students

Abstract

Objective: Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program implementation. Methods: MEDLINE, PsycINFO, ERIC, and PubMed databases were used to search the research literature concerning tobacco prevention and control programs conducted on college campuses published between 2000 and 2009. Results: No studies were found that implemented all 5 recommended components of a comprehensive program. Tobacco control programs containing policy and prevention education were used the most and promotion of tobacco-free environments and banning sales of tobacco products were used the least. Conclusion: The review suggests that despite the recommendation of comprehensive tobacco control programs to reduce tobacco use on college campuses, few institutions have implemented and evaluated programs consisting of multiple components.     

Deficits in young men's knowledge about accessing sexual and reproductive health services

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). Results: Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. Conclusions: Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.     

Abortion,Limited Medical Resources,and the Meaning of Health Care

Abstract

Although accidents are the leading cause of death among college students, literature about developing student health safety programs is limited. In this article, we present preliminary recommendations based on literature review, epidemiologic data, and Nominal Group Process (NGP) activities, for developing university student safety programs. Our recommendations include appointing a coordinator to oversee all on-campus safety activities, providing for university-wide education programs dealing with alcohol and drug use, promoting personal safety efforts in areas such as family violence and rape prevention, and encouraging students to use safe transportation alternatives.     

Campus-Based College Health Services Before the Amherst Program (1860): Military Academies Lead the Way

Abstract

Over the past 70 years a legend has evolved that the first college health program in the United States was established at Amherst College in 1861. Although the program at Amherst was innovative in its day and served as a model for the field of college health, several other institutions prior to 1860 appropriated funds, hired staff, and established on-campus programs to improve the health of their students. The military academies led the way, and the first of these early programs to become operational was located at the US Military Academy at West Point, New York, in 1830.     

Perceived Continuing Education Needs and Job Relevance of Health Education Competencies Among Health Education and Promotion Practitioners in College Health Settings

Objective and Participants: The author conducted this study to determine college health education and promotion practitioners' perceived continuing education needs and perceived job relevance in relation to national health education responsibilities and competencies. Methods: In Spring 2006, the author invited college health education and promotion professionals to participate in an online survey, using 3 listservs. Of 276 individuals visiting the Web site, 141 participants completed the survey (51%). Participants rated their perceived training needs and job relevance for the 35 National Commission for Health Education Credentialing (NCHEC) competencies as well as preferred training formats. Results: Participants identified the following competencies as those in which they needed additional training: designing data-collection instruments, securing fiscal resources, interpreting evaluation and research results, carrying out evaluation and research plans, and developing plans for evaluation and research. They identified the following competencies as being the most relevant to their jobs: demonstrating a variety of skills in delivering strategies, interventions, and programs; using a variety of methods to implement strategies, interventions, and programs; initiating a plan of action; and using health-related information resources. The most preferred methods of obtaining additional continuing education were attending the American College Health Association annual meeting (67%) and completing home self-study print materials (67%). Conclusions: Collegiate professional organizations should offer a variety of continuing education opportunities centering on NCHEC competencies, specifically those perceived as needed by study participants.     

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.     

Stages of Change and Possible Selves: 2 Tools for Promoting College Health

When considering health promotion among college students, 2 questions that arise are how to (1) most effectively offer health initiatives and (2) motivate students to participate in these efforts. Objective: In responding to these questions, the author considered 2 health-promotion tools: the transtheoretical model and the concept of possible selves. Participants: There were 304 college students who participated in this study. Methods: To explore how such information can assist health-promotion planning by determining which behaviors to target and how to match interventions to the overall population's stage of change, the author had students report their stage of change for 6 health behaviors. In addition, to explore possible motivations for moving from the precontemplation to the preparation stage of change, the author had students generate future self-concepts regarding their health (health-related possible selves). Results: The number of illness-related possible selves cited was significantly related to stage of change for smoking and stress management. For smoking, precontemplators had the fewest number of illness-related possible selves; however, the author observed the opposite for stress management. Conclusion: The findings have implications for how the transtheoretical model and the concept of possible selves can serve as useful tools in promoting college health.     

What College Students Do Not Know: Where Are the Gaps in Sexual Health Knowledge?

Abstract

Objective: This study aimed to understand the gaps in college students’ knowledge regarding sexual health information. Participants: A sample of 242 participants enrolled in an introductory college course participated in this study in the Fall 2009 semester. Methods: Students participated in 1 of 2 brief interventions and wrote a response paper about their experience. The papers were analyzed using conventional content analysis for information that was new to participants by looking for key words that suggested learning took place. Results: The findings indicated that the majority of participants learned new information. Most learning occurred regarding sexually transmitted infections (ie, types, symptoms, prevalence, treatment, testing) and correct condom use. There were also demographic differences regarding reported new information. Conclusions: Findings can be used to develop future sex education programs for college students by providing college educators with an understanding of where students lack knowledge of sexual health.     

Variations in Student Mental Health and Treatment Utilization Across US Colleges and Universities

Abstract

Objective: On US college campuses, mental health problems are highly prevalent, appear to be increasing, and are often untreated. Concerns about student mental health are well documented, but little is known about potential variations across the diversity of institutions of higher education. Participants: Participants were 43,210 undergraduates at 72 campuses that participated in the Healthy Minds Study from 2007 to 2013. Methods: Multivariable logistic regressions focus on associations between institutional characteristics and student mental health and treatment utilization. Results: The following institutional characteristics are associated with worse mental health: doctoral-granting, public, large enrollment, nonresidential, less competitive, and lower graduation rates. Among students with apparent mental health problems, treatment utilization is higher at doctorate-granting institutions, baccalaureate colleges, institutions with small enrollments, and schools with strong residential systems. Conclusions: Although high rates of mental health problems and low treatment utilization are major concerns at all types of institutions of higher education, substantial variation occurs across campuses.     

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.     

Using Nursing Students to Enhance One College's Immunization Program

Abstract

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.     

Mens Sana: The Growth of Mental Health in the American College Health Association

Abstract

In 1910, the first college mental health service sought to help college students with personality development and building a healthy mind. In 1920, the meeting that founded the American College Health Association (ACHA) identified “mental hygiene” as important, although a separate Mental Health Section was not established in ACHA until 1957. Between 1920 and 1960, a series of national meetings helped define the role and functioning of college mental health and counseling services. Most colleges employed a multidisciplinary staff of psychologists, psychiatric social workers, and psychiatrists to provide clinical services for students and consultation and education for faculty and staff. Mental health services on college campuses grew rapidly in the 1960s and 1970s, leading to discussions in the late 20th century of the use of brief psychotherapies, prevention and treatment of drug and alcohol abuse, prevention of suicide and homicide, the use of psychotropic medications, and effective campus interventions.     

Implementation of a Mental Health Task Force in a collegiate-based emergency medical services organization

Abstract

Objective: A Mental Health Task Force (MHTF) was implemented in 2016 by a collegiate-based emergency medical services (CBEMS) organization to (1) improve mental health emergency response and to (2) address concerns for the mental health of CBEMS providers. Participants: Skidmore College EMS is a Basic Life Support First Response service staffed by volunteer undergraduate students. Methods: In coordination with faculty and staff, students in the MHTF developed trainings, peer support structures, community events, policies, and informational resources. Results: Sixteen students joined the MHTF within 1 year. Over 35 Skidmore College EMS members received training on mental health emergency response, peer-support, and self-care. Debriefing programs, mindfulness-based events, shift-length limitations, and access to informational resources promoted the mental health of Skidmore College EMS members. Conclusions: Implementing an MHTF is an innovative, student-led approach to coupling education on emergency response with programming that supports the mental health of CBEMS providers.     

Understanding barriers to healthy behaviors in black college men

Objective: Due to the short life expectancy of black men, it is important to understand what impacts health behaviors in this group so that interventions and programs can be developed to improve their health behaviors which may help in increasing the life expectancy of black men. The purpose of this study was to understand what perceived barriers exist for black college men that prevent them from engaging in healthy behaviors. Participants and Methods: Thirty-five black male students at a southern Historically Black College and University participated in five focus groups and four interviews. A qualitative analysis was used to analyze data for similar themes and codes. Results: Perceived barriers to engaging in healthy behaviors appear to be influenced by image, food cost, and education. Cues to action for not engaging in healthy behaviors appear to be related to role models. Conclusions: Black college men are not adequately informed or educated about elements that can impact their health and how they can improve it. College administrators and researchers should develop interventions that include elements of increasing health knowledge and age-appropriate role models to improve health behavior change among this group.     

The Health Education Section: 38 Years of Growth

Abstract

The author traces the growth of ACHA's Health Education Section from its beginnings with a handful of members in the late 1950s to its position of increasing leadership in the organization. She describes the growth of innovative programs the section's more than 300 health educators developed as they expanded the concept of health education and promotion beyond the walls of traditional health centers into the broader university community. College health educators must participate in efforts to establish accountability for prevention and promotion strategies that include community health as well as clinical preventive services.