Binge drinking and health behavior in medical students

Prevalence of at-risk drinking among a national sample of medical students

As limited research exists on medical students' substance use patterns, including over-consumption of alcohol, the objective of this study was to determine prevalence and correlates of at-risk drinking among a national sample of medical students, using a cross-sectional, anonymous, Web-based survey. A total of 2710 medical students from 36 U.S. medical schools (1st to 4th year) completed the survey. Included in the instruments was a 10-item scale (AUDIT) to assess at-risk drinking behaviors within the last 12 months. Over 15% of the subjects (n = 412) scored positive for at-risk drinking (>/= 8). Multivariate analysis of the data revealed the following independent predictors were statistically significant (P </= 0.05) for at-risk drinking: being of younger age, male, unmarried, using illicit drugs, smoking tobacco products within the last 30 days, having low perception of risk, showing impulsive behavior, being depressed, and having gambling problems. Findings from this study provides initial data for investigating further associations between risky drinking behavior, lifestyle, and psychosocial factors, as well as effectiveness of curriculum or campus-wide policy interventions to reduce over-consumption of drinking among this population.

Alcohol consumption and alcohol counselling behaviour among US medical students: cohort study

OBJECTIVE

To determine which factors affect alcohol counselling practices among medical students.

DESIGN

Cohort study.

SETTING

Nationally representative medical schools (n=16) in the United States.

PARTICIPANTS

Medical students who graduated in 2003.

INTERVENTIONS

Questionnaires were completed (response rate 83%) at the start of students' first year (n=1846/2080), entrance to wards (typically during the third year of training) (n=1630/1982), and their final (fourth) year (n=1469/1901).

MAIN OUTCOME MEASURES

Previously validated questions on alcohol consumption and counselling.

RESULTS

78% (3777/4847) of medical students reported drinking in the past month, and a third (1668/ 4847) drank excessively; these proportions changed little over time. The proportion of those who believed alcohol counselling was highly relevant to care of patients was higher at entrance to wards (61%; 919/1516) than in final year students (46%; 606/1329). Although students intending to enter primary care were more likely to believe alcohol counselling was highly relevant, only 28% of final year students (391/1393) reported usually or always talking to their general medical patients about their alcohol consumption. Excessive drinkers were somewhat less likely than others to counsel patients or to think it relevant to do so. In multivariate models, extensive training in alcohol counselling doubled the frequency of reporting that alcohol counselling would be clinically relevant (odds ratio 2.3, 95% confidence interval 1.6 to 3.3) and of reporting doing counselling (2.2, 1.5 to 3.3).

CONCLUSIONS

Excessive drinking and binge drinking among US medical students is common, though somewhat less prevalent than among comparably aged adults in the US general population. Few students usually discussed alcohol use with patients, but greater training and confidence about alcohol counselling predicted both practising and believing in the relevance of alcohol counselling. Medical schools should consider routinely training students to screen and counsel patients for alcohol misuse and consider discouraging excessive drinking.

Multiple health risk behaviors in German first year university students

Multiple health risk behaviors have been identified as a problem in young adults which includes university students. The goals of this study included assessing the prevalence of major health risk behaviors in a cohort of German first year university students, analyzing the clustering of these behaviors and assessing readiness to change across multiple behaviors. A total of 1262 students from the schools of law, teaching and medicine at a German university participated in a voluntary and anonymous survey in 2005. The study assessed indicators and readiness for change regarding fruit and vegetable consumption, exercise, smoking and binge drinking as well as sociodemographic variables. Confirming the hypotheses, prevalences for risk behaviors were high; over 95% ate less than five servings of fruits and vegetables, 60% did not exercise sufficiently, 31% were current smokers and 62% reported binge drinking. Only 2% had none, 10.5% had one, 34.5% had two, 34.8% had three, and 18.2% showed all four risk behaviors. Readiness for behavior change was very low across multiple risk behavior combinations, especially for reducing binge drinking and increasing fruit and vegetable consumption. Medical students showed slightly more positive patterns than other students. The results indicate the need for addressing health behaviors in the student population of this university. If these findings can be replicated in other universities, programs that promote individual behavior change as well as changes in environmental conditions in the university environment are necessary to address this urgent problem.

Strengthening public health medicine training for medical students: development and evaluation of a lifestyle curriculum

BACKGROUND

Lifestyle factors are major determinants for health and safety. Although many graduates lack interviewing and observational skills for prevention and student lifestyle often deteriorates during training, few medical schools teach comprehensive assessment of lifestyle, particularly in the context of the home environment.

AIMS

A lifestyle curriculum was developed to teach basic causality and provide practical experience in assessing nutrition, exercise, safety, tobacco addiction, and food hygiene, together with generic skills in history taking, on-site observation, researching and presenting.

METHODS

Lifestyle has been integrated into the first-year curriculum, evaluated, and improved at the United Arab Emirates University since 2001. After an introduction to determinants of health, students conduct a home interview and observational survey for family residential and traffic safety, smoking, and food hygiene. For nutrition and exercise, students assess personal lifestyle. Generic skills are developed in the context of lifestyle. Evaluations were by faculty and students, including assessed impact on knowledge, skills, and personal lifestyle. The lifestyle curriculum was compared with other countries by detailed search.

RESULTS

Detailed evaluation found strong agreement/agreement among students that knowledge had improved on: counselling of patients and families 97%, promoting healthy lifestyles 100%; interviewing 88%; history taking 84%; using research for medical practice 89%; and importance of prevention 96%. Eighty six percent were stimulated to think in new ways about health. Improved personal diet was reported by 60% (p < 0.0004) and exercise by 55% (p < 0.0004), while 36% of non-users started wearing a safety belt in front (p < 0.0004) and 20% in the rear (p = 0.008). Literature review found comprehensive lifestyle curricula to be rare.

CONCLUSIONS

A lifestyle curriculum developed prevention-oriented history-taking and observation skills for health maintenance, addressing health priorities, improving medical student lifestyle, and strengthening generic skills. Since lifestyle is a major determinant of health, medical schools should consider development of an appropriate curriculum to address their local and national health priorities.