Programmatic Evaluation of College Initiatives to Reduce Tobacco Use

College students are particularly vulnerable to tobacco initiation and use, but college prevention services are rare and often unevaluated. The present project evaluated 27 tobacco use prevention initiatives on college campuses in one southern U.S. state. Each initiative included one 20 hour/week on-campus student coordinator, a faculty or staff advisor, and a monitor. An outside evaluator rated each initiative on compliance with seven activities and five administrative necessities. Most (22) initiatives nearly met, met, or exceeded expectations, but five were noncompliant. Initiative scores correlated positively with students' and advisors' ratings, but were unrelated to the on-campus coordinator's sex, longevity in office, or past tobacco prevention experience. Though limited by not including a rating of the quality of the interventions, this program evaluation provided college tobacco prevention initiatives with an overall rating and specific feedback on how to improve, and allowed each initiative to tailor programs to its specific campus.

Creating Lasting Attitude and Behavior Change in Fraternity Members and Male Student Athletes

Fraternity members and male student athletes responded to open-ended questions assessing the impact of an empathy-based rape prevention program. All participants reported either lasting attitude or behavior changes; most reported both. Participants reported increased understanding of how rape might feel and attributed this change to seeing a videotape describing a male-on-male rape situation. Participants refrained from telling jokes about rape and reported feeling more effective when helping survivors seeking assistance. These behavior changes were attributed to the videotape and to a section of the program encouraging participants to confront rape jokes and challenge sexist behaviors.

Development of a community pharmacy human papillomavirus vaccine program for underinsured university students along the United States/Mexico border

OBJECTIVE

To describe the development and implementation of a human papillomavirus (HPV) vaccine patient assistance program (PAP) for university students, and to acquire information on the number who accessed the program and completed the series.

SETTING

University of Texas at El Paso University Student Health Clinic Pharmacy, Fall 2011-Spring 2014.

PRACTICE DESCRIPTION

A community pharmacy located within the university student health clinic providing services to an underinsured student population.

PRACTICE INNOVATION

Existing evidence shows the benefit of using PAP in community pharmacies but is nonspecific regarding the use of PAP for vaccines in an uninsured and underinsured Hispanic student population. The implementation of this unique HPV vaccine program in a community setting aims to increase awareness, access, and rates.

MAIN OUTCOME MEASURES

Primary measures included results from a needs-assessment questionnaire that were used to implement the HPV vaccine program. After implementation, utilization data were collected on the number of students who qualified and enrolled in the HPV PAP and the number of students who completed the HPV series.

RESULTS

The preliminary data from a needs assessment indicated that a majority (72.1%, n = 80) of students did not understand how HPV is transmitted. A total of 89 students qualified for PAP. The majority were women (81%). A total of 71 students (79.8%) received their second dose and 43 (48.3%) completed the series.

CONCLUSIONS

Although pharmacists continue to provide vaccine services, minorities such as the Hispanic population continue to be underimmunized. Students may not be taking the proper precautions to prevent the acquisition of HPV. For these reasons services such as this HPV vaccine program are warranted. Pharmacists need to continue to educate and advocate on the importance of vaccines and how they prevent disease.

The office of student wellness: innovating to improve student mental health

OBJECTIVE

Despite increasing mental health needs among medical students, few models for effective preventive student wellness programs exist.

METHODS

This paper describes a novel approach developed at the University of California (UC) Davis School of Medicine: the Office of Student Wellness (OSW).

RESULTS

Improved access and mental health service utilization have been documented, with over half of all students receiving support and clinical care. UC Davis student satisfaction mean scores on the Association of American Medical Colleges Graduation Questionnaire wellness questions have reached or exceeded national average over the last 4 years, since the OSW was founded.

CONCLUSIONS

This program may serve as a blueprint for other medical schools in developing effective student wellness programs.

Brief Behavioral Interventions for Symptoms of Depression and Insomnia in University Primary Care

OBJECTIVE

To describe how behavioral activation (BA) for depression and stimulus control (SC) for insomnia can be modified to a brief format for use in a university primary care setting, and to evaluate preliminarily their effectiveness in reducing symptoms of depression and insomnia, respectively, using data collected in routine clinical care.

PARTICIPANTS/METHODS

Chart review data were obtained for 11 patients treated between August 2009 and December 2010 with 1 session of brief BA for depression and 17 patients treated with 1 session of brief SC for insomnia.

RESULTS

At 2-week follow-up, patients reported significant decreases in symptoms of depression on the Patient Health Questionnaire-9, t(10) = 3.95, p < .05, and insomnia on the Insomnia Severity Index, t(16) = 5.43, p < .05, respectively.

CONCLUSIONS

This case report provides preliminary evidence of the external validity of brief BA and SC after they were adapted for use within university primary care.

Patient- and family-centered transitions from pediatric to adult care

This article is the second in a series addressing the critical issue of the transition from pediatric to adult care for young adults with complex chronic conditions. Using the analogy of her daughter's recent transition from high school to college, the author highlights some of the needs of young adults and their families in a transition process. Then, drawing upon her years of experience in the field, she explains why the core principles of patient- and family-centered care are foundational to successful transitioning from pediatric to adult health care.

College clinic service quality and patient satisfaction

PURPOSE

The purpose of this paper is to identify the service quality dimensions that play an important role in patient satisfaction in campus clinics in Delhi; assess student satisfaction with service; and suggests ways to improve areas of dissatisfaction.

DESIGN/METHODOLOGY/APPROACH

A questionnaire was distributed to students who had completed at least two consultations at the college clinic. Convenience sampling was used to approach respondents. The questionnaire uses modified SERVQUAL and other instruments, including original dimensions and those constructed through detailed discussions. Factor analyses, reliability tests and the Kaiser-Meyer-Olkin measure of sampling adequacy were conducted. The final sample had a total of 445 respondents.

FINDINGS

After factor analysis, the authors found that the dimensions affecting patient satisfaction are: staff professionalism; clinic staff reliability; clinic accessibility and basic facilities; tangibles; cleanliness; awareness of the clinic/diseases and how clinic staff deals with emergencies. Most students were satisfied with the professionalism of the clinic staff. More than 70 percent of the respondents reported that the clinic staff paid good attention to them. The campus clinic was deemed reliable by more than 50 percent of respondents. The students found the clinic's location convenient, with more than 50 percent supporting its location. However, there was dissatisfaction among the students regarding the tangibles of the clinic, with more than 50 percent favoring upgrading. There was satisfaction among the respondents regarding the availability of the doctor after clinic hours, but contact details for the clinic staff were not easily accessible on campus. More than 60 percent of respondents were satisfied with the cleanliness of the campus clinic. More than 50 percent felt that the campus clinic was not equipped to deal with emergencies efficiently. At the same time, 90 percent of respondents reported the availability of referral facilities in case of emergencies.

ORIGINALITY/VALUE

The authors believe that this is the first study conducted to assess patient satisfaction in the campus clinics of engineering institutes in Delhi region. This paper provides valuable information to college clinic administrators.

Care of the college student

There are approximately 20 million students in U.S. colleges and universities. Although this population is characterized as having good health, 600,000 students report some form of disability or some type of medical problem, including attention-deficit/hyperactivity disorder, learning disabilities, psychiatric disorders, and chronic illnesses, among others. Physicians can enhance youth transition to an adult model of health care; the use of self-care skills checklists is one recommended method to assist with the transition. Stimulant medications are effective for treating adults with attention-deficit/hyperactivity disorder, but physicians should use caution when prescribing stimulants to college students because of the high rates of medication diversion in this population. Depression, anxiety, posttraumatic stress disorder, sleep problems, and eating disorders are common in college students and can significantly impact performance. Emphasis on immunization of students for influenza, meningococcus, and pertussis is necessary because of the low rates of compliance. Screening and interventions for obesity, tobacco use, and substance abuse are important because of the high prevalence of these problems in college students. Screening for alcohol abuse facilitates identification of students with problem drinking behaviors. Students who are war veterans should be monitored for suicidal ideation and posttraumatic stress disorder. Lesbian, gay, bisexual, transgender, and questioning students are at risk of harassment and discrimination. Caution should be exercised when prescribing medications to college athletes to avoid violation of National Collegiate Athletic Association eligibility rules.

Developing and implementing a bereavement support program for college students

The death of a loved one can be particularly difficult for college students, as significant losses are not anticipated during this time. Bereavement experiences are, however, not uncommon among college students, and campus environments can be isolating and nonconducive to recovery. To date, few interventions have been developed to meet bereaved college students' needs. The authors describe the rationale, development, and structure of a campus-based bereavement support program in New England, which provided a series of 17 support groups serving 105 students. They present feedback data from a subset of participants and discuss issues to consider in providing similar on-campus services.

The three Ts of adopting tobacco-free policies on college campuses

This article describes a 3-pronged compliance strategy to implement a tobacco-free campus policy at 1 large, land grant public university in the South, and evaluates its impact on outcomes and costs. Although there has been a recent wave of tobacco-free colleges, policy restrictiveness and implementation vary, and compliance remains a challenge. The 3 Ts strategy (Tell-Treat-Train) involves regular, consistent communications, access to tobacco treatment medications and counseling, and ongoing training of supervisors and student leaders. Administrative support, access to tobacco treatment, campus buy-in, sustained communications, and careful implementation planning are critical to instituting a tobacco-free university policy.

[Fundamentals of socio-hygienic monitoring of environmental conditions for students of higher education schools]

Socioeconomic transformations and the poor environment of an industrial megalopolis negatively affected quality of life and morbidity rates in students (n = 2160). Academic intensity contributed to an increase in overall morbidity and morbidity from nervous system involvement. The regional sociohygienic monitoring of high-school training conditions within the framework of the surveillance system substantiates programs to prevent worse health and life quality in high school students.

A partnership model for implementing electronic health records in resource-limited primary care settings: experiences from two nurse-managed health centers

OBJECTIVE

To present a partnership-based and community-oriented approach designed to ease provider anxiety and facilitate the implementation of electronic health records (EHR) in resource-limited primary care settings.

MATERIALS AND METHODS

The approach, referred to as partnership model, was developed and iteratively refined through the research team's previous work on implementing health information technology (HIT) in over 30 safety net practices. This paper uses two case studies to illustrate how the model was applied to help two nurse-managed health centers (NMHC), a particularly vulnerable primary care setting, implement EHR and get prepared to meet the meaningful use criteria.

RESULTS

The strong focus of the model on continuous quality improvement led to eventual implementation success at both sites, despite difficulties encountered during the initial stages of the project.

DISCUSSION

There has been a lack of research, particularly in resource-limited primary care settings, on strategies for abating provider anxiety and preparing them to manage complex changes associated with EHR uptake. The partnership model described in this paper may provide useful insights into the work shepherded by HIT regional extension centers dedicated to supporting resource-limited communities disproportionally affected by EHR adoption barriers.

CONCLUSION

NMHC, similar to other primary care settings, are often poorly resourced, understaffed, and lack the necessary expertise to deploy EHR and integrate its use into their day-to-day practice. This study demonstrates that implementation of EHR, a prerequisite to meaningful use, can be successfully achieved in this setting, and partnership efforts extending far beyond the initial software deployment stage may be the key.

Examining the presence of problem gambling awareness messages on college counseling center websites

College students are more at-risk for developing a gambling problem than the general adult U.S. population. Information behavior and information seeking theories, as well as empirical evidence, indicate that one resource that may provide guidance for students dealing with this issue is the college counseling center website (CCW). This study addressed the presence and nature of problem gambling messages on CCWs. As a random sample, 203 CCWs were selected to assess how frequently they provided any information about problem gambling, as well as the specific types of communications CCWs offered on this topic. Results showed that CCWs rarely included any messages about problem gambling. Specifically, only 15% of all CCWs contained information about problem gambling. Furthermore, messages about problem gambling were presented significantly less frequently than messages involving alcohol abuse, substance abuse, depression, anxiety/stress, and psychological struggles with food. Given the prevalence of problem gambling among college students, as well as the value that college students place on information provided on CCWs, it is important that these sites offer more information concerning this issue.

Unintended pregnancy and termination of studies among students in Anambra state, Nigeria: are secondary schools playing their part?

This study evaluated efforts of secondary schools to prevent unintended pregnancy among students and their reactions to pregnant students before and after delivery. A cross-sectional survey of 46 teachers in three public and two private schools in Anambra state, Nigeria was carried out. Information was collected using self-administered questionnaire. Of all the teachers in the study, 87% reported unintended pregnancies among students in the previous 3 years. Expulsion (43%) and suspension (28%) were the most common reactions. Private schools were more likely to expel pregnant students than public schools. Following the delivery of their babies, 43% discontinued their education in the same school, whereas 37% continued their education in a different school. Counselling was given before suspension or expulsion in 4% of public schools and 15% of private schools. Majority of the schools (61%) did not have sex education as part of their schools' curriculum. Students should be re-admitted in order to ensure continuity of their academic development, prevent unemployment and mitigate poverty-induced repeat pregnancy.

Health administrator perspectives on human immunodeficiency virus/acquired immunodeficiency syndrome prevention and services at historically black colleges and universities

OBJECTIVE

Due to the disproportionate impact of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) among African American young adults, the authors explored (1) number of historically black college and university (HBCU) campuses with existing HIV prevention policies and services and (2) perceived barriers for implementing HIV prevention services.

METHODS

Semistructured telephone surveys were conducted with health administrators from 25 HBCUs.

RESULTS

Twenty-four of 25 (96%) health administrators responded. Twelve of 24 administrators (50%) reported having no formal HIV prevention policies or services on campus, 11 of 24 (46%) described having formal HIV prevention policies and services (eg, condom distribution, HIV testing), and 1 was unsure. Seven of 11 (64%) administrators who reported having policies or services indicated that the availability of condoms on campus facilitated HIV/AIDS prevention by promoting safer sex. Perceived barriers to more effectively providing services included negative student attitudes regarding HIV and lack of support from school administration and parents.

CONCLUSION

There are inadequate HIV/AIDS prevention services on some HBCU campuses.

A collaborative university model for employee wellness

Universities are taking a more active approach in understanding and monitoring employees' modifiable health risk factors and chronic care conditions by developing strategies to encourage employees to start and sustain healthy behaviors. WellBama, the University of Alabama's signature health and wellness program, utilizes a collaborative model in partnership with select colleges and departments to implement strategies to improve employees' health status. The program provides onsite health screenings and assessments, timely health advising sessions, assistance in setting and monitoring individual health goals to promote improved health, and preventive examination referrals.