The missing element: Incorporating culturally-specific clinical practices in HIV prevention programs for African-American females

African American females are disproportionally affected with new cases of HIV. High risk sexual practices contribute significantly to the incidence and prevalence of this public health problem. It is critical for advance practice nurses to acknowledge the relevance of cultural sensitivity when providing optimal care to African-American females. This article describes behavioral change interventions tailored to address cultural and socioeconomic aspects of HIV prevention among African-American females who attend historically black colleges and universities and is relevant for the African-American community at large.

Setting up a sexual health one stop shop for young people at college

This article describes the development of a nurse led drop-in sexual health service in a further education college. It looks at the issues for practitioners to consider when setting up a nurse led clinic in this environment and the importance of working in partnership with education and youth services.

Colleges and universities should give more broad-based attention to health and wellness-at all levels

Higher Education needs to give more broad-based attention to health and wellness. Our graduates will all have to deal with the facts that the general state of health of Americans is not good and our national health care system is badly in need of reform. We should offer innovative approaches to helping our graduates establish positive, lifetime health habits and we should demonstrate to them our own model approaches to promoting health and wellness through more effective health insurance and worksite wellness programs.

"It has made college possible for me": feedback on the impact of a university-based center for students in recovery

OBJECTIVE

The authors aimed to gain information on (1) the challenges for recovering students on a university campus and (2) the most helpful components of a collegiate recovery program.

PARTICIPANTS

The 15 students in the study were all in recovery from substance abuse. They entered the university and also entered the campus recovery program either in fall 2002 or fall 2003.

METHODS

Semistructured interviews were conducted with students multiple times during their first academic year.

RESULTS

Participants identified several challenges on the university campus. Many believed they would have dropped out of school or relapsed without the support of the recovery program, and they described aspects of the program that were particularly important to them.

CONCLUSIONS

Support from a campus recovery program is essential for many recovering students. There are a variety of recovery program components that can foster the sense of community that was so important to the students in this study.

Don't forget the "b": considering bisexual students and their specific health needs

Many college health center staff are consciously addressing issues of cultural competency; however, the needs of 1 minority group--bisexuals--are often overlooked. In this article, the author briefly discusses bisexuality, provides an overview of health issues related to bisexuals, and lists specific strategies to address the needs of bisexuals within college health.

Clinicians' perspectives on motivational interviewing-based brief interventions in college health

Brief interventions based on motivational interviewing (MI) are emerging as effective strategies for behavior change in college students. However, implementation of MI-based brief interventions may be challenging in the college health environment, and their practicality is controversial. The author explored college health clinicians' perspectives on the use of MI brief interventions in a college health study to reduce alcohol harms among high-risk college students. The author describes the challenges, benefits, and practicality of using this health promotion strategy in college health. Although MI-based brief interventions may be adapted and implemented and are beneficial in the college health setting, clinician education and further research is warranted.

Prevalence of psychological distress in university students--implications for service delivery

BACKGROUND

Mental health problems are one of the leading causes of disability in Australia. General practitioners are often the first and only point of service for people suffering mental health problems, while many do not access services at all. University students can face numerous stressors in addition to academic demands that can contribute to the development or exacerbation of mental health problems.

OBJECTIVE

The aim of this study was to identify the prevalence of psychological symptoms in students who were patients at a university health service to enable appropriate planning of services to meet the needs of students.

METHODS

Participants were 384 students attending a university health service in urban Queensland over a period of 4 weeks during semester. At their first visit, patients completed the Kessler Psychological Distress Scale, a measure of psychological distress.

RESULTS

Results showed there were significantly more patients experiencing high levels of distress compared with the general population and, consistent with the general population, almost two-thirds had not sought assistance for this distress. Increased distress was associated with increased disability among students.

DISCUSSION

Within a university setting, co-location of specialist mental health services can promote a team approach to mental health care, with GPs, psychiatrists and clinical psychologists working together to increase the availability of care to students in need. The recent introduction of Medicare items for psychological treatment also facilitates greater access to clinical psychologists and other mental health professionals.

Primary care providers' perceptions of and experiences with an integrated healthcare model

OBJECTIVE AND PARTICIPANTS

The authors examined the experiences of primary care providers participating in an integrated healthcare service between mental health and primary care in a university health center. In this program, behavioral health providers work collaboratively with primary care providers in the treatment of students. Participants consisted of the 10 primary care providers participating in the program during the summer of 2004.

METHODS

The authors evaluated the program using a descriptive survey, analyzed by a combination of measures of central tendency and multidimensional scaling with cluster analysis.

RESULTS

They found a 2-dimensional, 3-cluster solution for the last 3 items. Findings indicate that although primary care providers valued behavioral health as a resource, a gap exists between what they believe behavioral health can assist with and their actual referral practice.

CONCLUSIONS

These findings indicate a need for further communication about the roles that mental health can play in the collaborative treatment of physical symptoms.

The history of SHSAAMc: Student Health Services at Academic Medical Centers

This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at academic medical centers.

Comprehensive college student suicide assessment: application of the BASIC ID

Whether one knows someone who is thinking of suicide, has attempted suicide, or has completed suicide, nearly all individuals who encounter suicide are affected. The influence and residual affects of suicide are further amplified as the issue reaches across communities such as college or university campuses. College and university staff must improve their response to suicidal ideation with comprehensive assessment and intervention. The authors discuss risk factors and basic screening methods for suicide risk. They present Lazarus' BASIC ID tool (ie, Behavior, Affective Responses, Sensations, Images, Cognitions, Interpersonal Relationships, and Drugs or Biological Influences) as a method for conducting a comprehensive suicide assessment. The authors demonstrate assessment procedures through a case vignette.

Heart ed 101

Cardiovascular disease is the leading cause of death for men and women in the United States. Risk factors and health behaviors combine over time to contribute to the disease process. College communities provide a unique environment for health promotion, risk reduction, and primary intervention. Heart health should be an integral part of college health.

American College Health Association - National College Health Assessment spring 2007 reference group data report (abridged)

OBJECTIVE

Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey that ACHA developed in 1998 to assist institutions of higher education in achieving this goal. The ACHA-NCHA contains approximately 300 questions assessing student health status and health problems, risk and protective behaviors, and impediments to academic performance.

PARTICIPANTS

The spring 2007 reference group includes ACHA-NCHA data from 71,860 students at 107 institutions of higher education.

METHODS

Officials at participating institutions administered the ACHA-NCHA to all students, to randomly selected students, or to students in randomly selected classrooms. ACHA collected data between January and May 2007.

RESULTS

Results from the spring 2007 reference group (N= 71,860) are presented.

CONCLUSIONS

These data expand the understanding of the health needs and capacities of college students.

Campus physicians' tobacco interventions with university students: a descriptive study of 16 Ontario university clinics

OBJECTIVE

About one-quarter of Canadian post-secondary students smoke cigarettes. We examined how physicians from Ontario university health clinics intervene with these young adult smokers.

METHOD

A convenience sample of 16 universities was identified and surveys were hand-delivered to all 228 physicians from these schools. A total of 125 doctors (54.82%) responded; 70 were from universities that were involved in a government-sponsored, coordinated, multi-campus, tobacco control initiative.

RESULTS

Twenty percent of doctors reported asking all or almost all patients about tobacco use; 25.22% asked fewer than half. Describing how they respond to patients identified as smokers, 96.00% of physicians advised cessation, 72.00% offered assistance, and 64.00% arranged for follow-up. Doctors discussed patients' tobacco use with 78.59% of smokers. Nicotine replacement therapies were rarely offered to patients wanting to quit. Doctors from universities involved in the tobacco control initiative were more likely to keep patient education materials in the examining room.

CONCLUSION

Because most doctors ask only some patients about tobacco use, they may be missing opportunities to provide appropriate advice and assistance to all smokers.

PRACTICE IMPLICATIONS

Physician education and support to the clinic are needed to improve the frequency and quality of physician-delivered smoking cessation services to post-secondary students.

The implementation of buprenorphine/naloxone in college health practice

Opiate abuse and dependence have become important concerns for college healthcare providers. The passage of the Drug Addiction Treatment Act of 2000 and the approval of the combination buprenorphine/naloxone for office-based treatment of opiate dependence have increased the options available for college students and their healthcare providers. The authors review the pharmacology of buprenorphine/naloxone and discuss how it can be implemented in college health practice. They also present a case report.

Supporting Positive Living and Sexual Health (SPLASH): a clinician and behavioral counselor risk-reduction intervention in a university-based HIV clinic

Effective HIV prevention interventions with HIV-positive persons are paramount to stemming the rate of new infections. This paper describes an HIV-clinic-based demonstration project aimed at decreasing patient HIV-transmission risk behaviors and sexually transmitted infections. Systematic, computer-assisted assessment of patient risk aided primary care providers in delivering prevention messages. Patients at greater risk were referred to an HIV Prevention Specialist for behavioral counseling. Patients completed a computerized behavioral staging assessment to self-identify risk behaviors and readiness to change behaviors and counseling messages were individually tailored based on computer assessment. Challenges to project implementation: primary care provider buy-in, patient privacy concerns during risk assessment, and low participation in behavioral counseling. Forty-six percent of persons completing a risk assessment (2,124) were at risk for HIV transmission. Of 121 patients who scheduled counseling appointments, 42% completed at least one session. Despite challenges, successful implementation of a clinic-based prevention intervention is feasible, particularly with attention to patient and provider concerns.

Tuberculosis screening on a health science campus: use of QuantiFERON-TB Gold Test for students and employees

Detecting and managing Mycobacterium tuberculosis (TB) infection in a health-science center population is a clinical dilemma. Tuberculin skin tests are still the preferred method for detecting present or past infection of TB. The authors discuss the performance of whole blood interferon gamma release assay test commercially known as QuantiFERON-TB Gold Test (QFT-G) as an additional tool for a TB surveillance program for the students and employees at an academic medical center. QFT-G was successfully implemented as a confirmatory test for screening of TB infection.

Australian rural adolescents' experiences of accessing psychological help for a mental health problem

OBJECTIVE

This study aims to explore Australian rural adolescents' experiences of accessing help for a mental health problem in the context of their rural communities.

DESIGN AND SETTING

A qualitative research design was used whereby university students who had sought help for a mental health problem during their adolescence were interviewed about their experiences. Interviews were conducted face-to-face at the university.

MAIN OUTCOME MEASURES

A semi-structured interview schedule was designed around the study's main research questions. Audio-taped interviews were transcribed and thematically coded using a constant comparative method.

PARTICIPANTS

Participants were first-year undergraduate psychology students between the ages of 17 and 21 years who sought help for a mental health issue during their adolescence and who at that time resided in a rural area.

RESULTS

Participants highlighted various barriers to seeking help for mental health problems in the context of a rural community, including: social visibility, lack of anonymity, a culture of self-reliance, and social stigma of mental illness. Participants' access to help was primarily school-based, and participants expressed a preference for supportive counselling over structured interventions. Characteristics of school-based helpers that made them approachable included: 'caring', 'nonjudgemental', 'genuine', 'young', and able to maintain confidentiality.

CONCLUSIONS

The findings support previous research that reveals barriers to help seeking for mental health problems that are unique to the culture of rural communities. The study raises questions about the merit of delivery of primary mental health care to young people via GPs alone and suggests that school-based counsellors be considered as the first step in a young person's access to mental health care.