Quality Improvement in Patient Distribution at a Major University Student Health Center

Abstract

Healthcare in a major university setting poses unusual challenges and great opportunities. Two traditionally challenging areas in patient distribution are the initial intake of allergy/immunization patients and the triage of outpatients in the general medical clinic. The authors describe the use of the FOCUS-PDCA quality improvement (QI) problem-solving process for each situation. After identifying major problems, the health center established cross-functional teams of experts representing the allergy/immunization and general medical clinics. The teams analyzed the problems with a flow chart and undertook studies to further elucidate causes and potential solutions. They listed potential solutions in order of priority and submitted them to the student health center director for review and initiation. Each team then used the PDCA (plan-do-check-act) cycle to put approved solutions into effect. Permanent improvements made in each area resulted in a more effective and efficient patient distribution system, favorable staff comment, and greater patient satisfaction.     

Self-rated Health in Relation to Rape and Mental Health Disorders in a National Sample of College Women

Abstract

Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. Methods: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.     

Alcohol Consumption Among University Students in North Rhine–Westphalia,Germany—Results From a Multicenter Cross-sectional Study

Abstract

Objective: To assess alcohol use and problem drinking among university students in the German Federal State of North Rhine–Westphalia (NRW) and to examine the associated factors. Method: A multicenter cross-sectional study was conducted in 16 universities in 2006–2007 in NRW by a standardized questionnaire and 3,306 students provided information (response rate of 88%). Problem drinking was measured by the CAGE questionnaire. Results: Alcohol consumption in the last 3 months was reported by >90 % of students. About 80% reported heavy drinking, and 20% displayed problem drinking. Male students, students living in residence halls, and students from sport faculties had a higher risk of heavy drinking and problem drinking. When students were compared across study years, frequency of heavy drinking decreased with higher semesters. Conclusions: Overall, heavy drinking and problem drinking are common among university students in this sample. Intervention programs should be designed for students at a particularly high risk.     

Mutually Dependent Health Beliefs Associated With Breast Self-examination in British Female University Students

Abstract

Objective: Whereas research suggests young women's beliefs about breast cancer (susceptibility/severity) and its early detection (barriers/benefits) reliably distinguish breast self-examiners from nonexaminers, this study assessed whether these impressions are interreliant, especially in the context of familial risk. Participants: The sample comprised over 200 female undergraduates from a university in England, United Kingdom. Methods: Participants completed a self-administered survey on their attitudes concerning breast cancer and early detection. Data were analyzed using logistic regression analysis. Results: Nonexaminers were distinguished by a combination of greater perceived hindrances to self-examinations and stronger appraisals of breast cancer severity, and also by a permutation of fewer perceived benefits in self-examinations and lower perceived susceptibility to breast cancer. The latter interaction persisted after accounting for family history. Conclusions: Interwoven attitudes may depict sophisticated efforts on the part of nonexaminers to justify inaction. Clinical implications for college health providers are considered.     

Sexual Decision Making for the “Better Than Average” College Student

Abstract

Objectives: To examine the impact of downward social comparison and the “known partner is a safe partner” heuristic on college students’ sexual decisions. Participants: One hundred-eighty heterosexual or bisexual undergraduate college students. Methods: Participants read dating vignettes that varied on perspective and familiarity and then rated the likelihood the couple would engage in sexual intercourse and use a condom. Results: There were no differences in rated likelihood based on familiarity, suggesting that the students did not view the 2 partner types as significantly different. Students rated the likelihood of sexual intercourse lower and condom use higher when the vignette was presented from the second person perspective. Conclusions: The students’ use of downward social comparison is consistent with the “better than average effect,” suggesting that the students perceive their own behavior as safe. The implication is that safer sex messages might be most effective if they focus on what students will gain by practicing safer sex behaviors, not just avoidance of a risk behavior.     

Obesity and Food Choices Among Faculty and Staff at a Large Urban University

Abstract

Objective: In order to address increasing health care costs associated with obesity, this study sought to determine prevalence of overweight and obesity and examine eating behaviors, food choices, health beliefs, and attitudes of university employees. Participants and Methods: An online survey was distributed to > 3,800 faculty and staff at a large public metropolitan university in Winter 2008. Results: Almost half (48%) of 806 respondents were classified as overweight or obese. Compared to those with normal weights, overweight and obese respondents consumed fewer fruits and vegetables (p < .05), were less confident in making healthful food choices (p < .001), and were more influenced by food choices available in on-campus dining facilities (p < .05). Conclusions: Obesity among university employees warrants attention. Because these employees have less self-efficacy and consume less healthful diets than their normal weight colleagues, universities need to improve on-campus access to healthful foods.     

Predictors of Safer Sex on the College Campus: A Social Cognitive Theory Analysis

Abstract

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N ? 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjuction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.     

Relationship Marketing and Service Quality

Abstract

The delivery of services in college health centers is improved through the use of relationship marketing and service quality advancement. Relationship marketing works to attract, maintain, and enhance customer or client relationships with the healthcare provider. The facets of relationship marketing are explored, with the greatest emphasis placed on internal marketing. Higher quality health services come from continuous improvement, a focus on process, and intensive staff development and participation, which build a service culture.     

An Introduction to the Research Process

Abstract

College health professionals are often intimidated by the research process and thus miss opportunities to develop and communicate their ideas. The present article, the first in a series on college health research, describes the basics of the research process, including the purpose and nature of research and the ways in which ideas are developed into research hypotheses. The process of reviewing research literature is described in detail, including methods for computerized searching.