College health centers: An update on medical issues

College health centers are an important source of health care for large numbers of young adults throughout the country. With 16.9 million students enrolled in 2023 in post-secondary institutions in the United States, the potential impact that health centers at these institutions have is significant. Late adolescence and early adulthood is a particularly vulnerable stage of both cognitive and psychosocial development, and college health centers that provide comprehensive medical and mental-health care play an important role in providing comprehensive care for this age group. As we move into a post-pandemic era, colleges and universities across the country continue to navigate all the changes that have been brought about by the COVID-19 pandemic. It is perhaps now more important than ever to review and assess the clinical care college health centers provide, who they provide this care to, and identify opportunities for improvement and where there may be need for change.

Provider perspectives on implementing a student health and counseling center intervention for sexual violence

Objective: To describe provider experiences with implementation of the GIFTSS (Giving Information for Trauma Support and Safety) intervention. Participants: Health and counseling center staff from participating campuses attended trainings between August 2015 and August 2016. Interviews were conducted between May and August 2017. Methods: Providers (n = 230) completed surveys prior to and six months following a 3-hour training on the intervention. Structured phone interviews were conducted with a purposively selected subset of 14 providers. Results: Overall, staff found the intervention acceptable. Implementation barriers noted were time and competing patient priorities. Providers noted variation based on patient and visit characteristics. Clinic commitment, particularly in adopting strategies for universal dissemination of the GIFTSS card, was seen as helpful. Conclusion: Implementation of a brief trauma-informed intervention in campus health and counseling centers was feasible and acceptable to most providers. Opportunities to change organizational culture regarding ensuring adequate time and safety for patients are discussed.

Showcasing Nursing Leadership and Contributions to a University's COVID-19 Student Contact Tracing Process

The COVID-19 pandemic was an unprecedented event that impacted every segment of healthcare, including universities preparing healthcare professionals. Instituting processes to coordinate student return to campus and ongoing COVID-19 testing and contract tracing challenged university campuses, but also brought opportunities for collaboration. This article reports on the experiences of one nonprofit private higher education university in management of the COVID-19 testing and contact tracing that were led by school of nursing faculty and nursing leadership.

Mental health interventions for college and university students during the COVID-19 pandemic: A critical synthesis of the literature

BACKGROUND

The aim of the study is to compare the emotional effects of COVID-19 among three different groups, namely: health personnel, medical students, and a sample of the general population.

METHODS

375 participants were recruited for this study, of which 125 were medical students (preclinical studies, 59; clinical studies, 66), 125 were health personnel (COVID-19 frontline personnel, 59; personnel not related with COVID-19, 66), and 125 belonged to the general population. The PHQ-9, GAD-7, and CPDI scales were used to assess the emotional impact. A multinomial logistic regression was performed to measure differences between groups, considering potential confounding factors.

RESULTS

Regarding CPDI values, all other groups showed reduced values compared to COVID-19 frontline personnel. However, the general population, preclinical and clinical medical students showed increased PHQ-9 values compared to COVID-19 frontline personnel. Finally, confounding factors, gender and age correlated negatively with higher CPDI and PHQ-9 scores.

CONCLUSIONS

Being frontline personnel is associated with increased COVID-19-related stress. Depression is associated, however, with other groups not directly involved with the treatment of COVID-19 patients. Female gender and younger age correlated with COVID-19-related depression and stress.

More Than Inconvenienced: The Unique Needs of U.S. College Students During the COVID-19 Pandemic

U.S. college students are a distinct population facing major challenges due to the COVID-19 pandemic. Before the pandemic, students were already experiencing substantial mental health concerns, putting both their health and academic success in jeopardy. College students now face increasing housing and food insecurity, financial hardships, a lack of social connectedness and sense of belonging, uncertainty about the future, and access issues that impede their academic performance and well-being. There is also reason to believe that COVID-19 is exacerbating inequalities for students of color and low-income students. We provide several recommendations for institutions of higher education to mitigate these obstacles, including engaging in data-driven decision making, delivering clear and informative messaging to students, prioritizing and expanding student support services, and using an equity framework to guide all processes.

Understanding vaccine knowledge, attitudes, and decision-making through college student interviews

Objective: We aimed to explore knowledge, attitudes, and beliefs about vaccines required for college-entry and vaccine-related behaviors among college students. Participants: Thirty-three full-time undergraduate students, ≥ 18 years old, enrolled at public (2) and private (3) colleges and universities in metropolitan Philadelphia in fall 2016. Methods: We conducted semistructured interviews, which were double-coded with 5,015 comments overall and 99.3% intercoder reliability (κ = 0.779) using NVivo 11 software. Results: Six key themes emerged: (1) low knowledge about vaccines and requirements; (2) mixed attitudes about required vs. recommended vaccines; (3) high trust in medical professionals; (4) low perceived risk for vaccine-preventable disease outbreaks; (5) substantial parental influence on students' decision-making; and (6) low utilization of Student Health Services. Conclusions: This study revealed lack of knowledge about and low prioritization of vaccination despite overall positive attitudes towards vaccines. Prematriculation education of college students is critical to increasing vaccine knowledge and use.

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

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.

Implementation of an intimate partner violence screening program in a university health care clinic

Objectives: To examine whether an intimate partner violence (IPV) screening program is related to a positive change in health care providers' knowledge, attitudes, and self-efficacy of IPV screening. Participants: Eleven health care providers at a university health care clinic participated in the IPV screening program. Methods: A one-group pretest-posttest design was used to examine whether an IPV screening program was related to a change in health care providers' knowledge, attitudes, and self-efficacy of IPV screening. Results: Findings indicated that there was a significant difference (p < 000) between the posttest scores and the pretest scores on the Domestic Violence Healthcare Provider Survey Scale. Domain analysis of the scale revealed a significant difference in perceived self-efficacy (p = .001), system support (p = <.002), victim provider safety (p = .015), and beliefs of blaming victims (p = <.004). No statistical difference was found in professional role resistance/fear of offending (p = .158). Conclusions: A university health care clinic IPV screening program was related to a positive change in health care providers' knowledge, attitudes, and self-efficacy of IPV screening.

Essential Partners for Student Health and Safety: Round Table Discussion With School Nurses and School Resource Officers

This article explores the partnership between school nurses and school resource officers. Through an interviewing process, the authors summarize current examples of how the partnership is essential and effective in 21st-century schools across the United States.

"What Should Sex Look Like?" Students' Desires for Expanding University Sexual Assault Prevention Programs to Include Comprehensive Sex Education

Rates of sexual assault and sexual violence among college-aged adults are much higher than the national rates of sexual assault and sexual violence. Therefore, reduction and prevention of sexual violence among university students is critical and is consistent with national public health priorities. Often times, messages to students focus only on sexual assault and omit larger notions of sexual health. Four focus groups with a total of 24 participants (nine men, 15 women) highlighted three main perceptions about the sexual assault programming offered at this large university: themes of resistance to traditional programming, a need for holistic sexual health programming, and a desire to have an environment, which normalizes conversations surrounding sex, sexuality, and sexual health.

Toward total student health: A qualitative pilot study

Objective: Colleges should aim to cultivate healthy behaviors among students by addressing alterations in wellness students view as important. The purpose of this study was to determine the self-perceived wellness-related concerns and behaviors of college students. Participants: Thirty-seven undergraduate students participated in this study between January and March 2017. Methods: Focus groups served as a data collection method. Groups were recorded and transcribed verbatim. Directed and conventional approaches to data analyses were employed. Results: Participants expressed concern regarding four campus wellness topics: nutrition, economics, mental health, and campus safety. Participants offered solutions for improving campus wellness, representing a fifth theme. Conclusions: Health concerns for college students and realistic solutions to address concerns were identified across focus groups. Overall, students cared about their own health, as well as the well-being of other students. Future directions include conducting a Web-based survey among students to assess prevalence and impact of select health and wellness topics.

Viewpoint: WHO World Mental Health Surveys International College Student initiative: Implementation issues in low- and middle-income countries

The university system and students are rapidly growing and changing in low‐ and middle‐income countries (LMICs). This growth can facilitate enhanced national productivity yet it can also bring potential risks to student mental health. The World Mental Health Surveys International College Student (WMH‐ICS) initiative could increase information and support in a relatively low‐cost manner for university students in LMICs—a group that is particularly vulnerable to mental health problems and who live in an environment where few targeted resources may be available. Effective implementation of the WMH‐ICS initiative, however, requires long‐term planning and consideration of the specific challenges present in LMIC settings. Planning as to what types of interventions would be needed and achievable in the next 10 to 15 years and consideration of local issues related to uptake, acceptability, appropriateness, feasibility, fidelity, and sustainability from the very beginning would be needed to ensure that the initiative would be useful in the future.

Puberty Education in a Global Context: Knowledge Gaps, Opportunities, and Implications for Policy

Youth programs and policies provide opportunities for institutions and societies to support healthy adolescent development. Puberty education programs are universally important, as they provide crucial knowledge and skills to help youth and their caregivers navigate the physical, emotional, and interpersonal changes of puberty with positive outcomes. However, few puberty programs have been rigorously evaluated, resulting in a lack of evidence-based knowledge and practice in this area. This review examines the status of research on puberty education and related programs and draws on the broader intervention literature and recent research findings on adolescence to identify program features that might improve program effectiveness. Implications for policy are also discussed. The need for rigorous program evaluation is emphasized throughout.

A Web-based review of sexual and reproductive health services available at colleges and universities in Georgia

OBJECTIVE

Although two-thirds of graduating high school seniors attend college or university in the U.S., there is a paucity of national or state specific research regarding SRH services available on or near college and university campuses.

METHODS

A review of websites for all colleges and universities in Georgia was conducted to evaluate sexual health services available on campuses and evidence of referral to community providers.

RESULTS

Of 96 colleges in Georgia, 44 had campus-located health centers, with only 3 at two-year colleges. Overall SRH service provision was low, with great variation between colleges. Distances between colleges and Title X clinics ranged from 0.33 to 35.45 miles.

CONCLUSIONS

Many students lack access to campus health centers, and information on college websites regarding SRH service availability and referrals differs dramatically between campuses. In the absence of robust campus-located services, schools should highlight where students can obtain comprehensive SRH care in the community.

On-Campus Clinics in Allied Health Education: Necessity or Legacy?

On-campus clinics have been a pillar of graduate education in allied health programs for decades. However, traditional clinical education is under scrutiny due to budget cuts, reimbursement rates, and supervision requirements. Some universities opening new programs have opted out of building on-campus clinics. The purpose of this multisite qualitative case study was to examine an alternative model of clinical education. Four graduate programs were selected that did not have an on-campus clinic and were not affiliated with a medical school. Four main themes emerged: authentic experiences, professional networking, collaborative partnerships, and responsiveness. The findings suggested on-campus clinics are not necessary for providing clinical education. The participants suggested more programs should consider this alternative model of clinical education to expose students to authentic and diverse clinical experiences throughout their graduate education.

Overloaded and overlooked: Improving resident advisors' self-care

The purpose of this viewpoint is to discuss the lack of research on resident advisor (RA) self-care and how behavioral interventions can be used in housing programs to educate and improve RA self-care. It is essential for live-in housing staff (both professional and paraprofessional) to learn how to develop appropriate strategies that target problem behaviors to improve self-care. An overview of the RA position, the effects of increased demands (i.e., burnout), and the research on self-care behavioral interventions are discussed. Lastly, the call to use behavioral interventions within housing programs to educate RAs on self-care awareness and improve and monitor their health behaviors to prevent burnout and psychological distress is provided.

Call to action: Better care, better health, and greater value in college health

It is time for action by leaders across higher education to strengthen quality improvement (QI) in college health, in pursuit of better care, better health, and increased value - goals closely linked to students' learning and success. The size and importance of the college student population; the connections between wellbeing, and therefore QI, and student success; the need for improved standards and greater accountability; and the positive contributions of QI to employee satisfaction and professionalism all warrant a widespread commitment to building greater capacity and capability for QI in college health. This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring QI to the forefront of college health practice - and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.

Community health workers on a college campus: Effects on influenza vaccination

OBJECTIVE

To assess the impact of a campus community health worker program (HealthPALs) on student influenza vaccination.

PARTICIPANTS

Undergraduate students at a northeastern US university (enrollment 6650), influenza seasons 2011-2012 through 2015-2016.

METHODS

Study design: Difference-in-differences analysis of student vaccination at campus dormitory influenza clinics during intervention vs. baseline.

INTERVENTION

In the first intervention year, HealthPALs conducted in-person peer outreach at several campus dormitory flu clinics. Subsequent years, HealthPALs conducted an enhanced intervention, with the addition of a personalized, dormitory-specific social media campaign appealing to students' community identity.

RESULTS

The initial intervention increased vaccinations by 66% (IRR = 1.66, 95%CI 1.39-1.97) at intervention clinics relative to control. The enhanced intervention increased vaccinations by 85% (IRR = 1.85, 95%CI 1.75-1.96).

CONCLUSION

Community health workers can be a highly effective, low-cost strategy for increasing influenza vaccination among college students. This model could also be used to address other campus health challenges where student engagement is key.

College students with congenital heart disease: A critical time for transition

As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition.

PARTICIPANTS

A case of a male with CHD presenting to the college health clinic with a new onset headache.

METHODS

The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers.

RESULTS

This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes.

CONCLUSIONS

As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.

A cluster-randomized trial of a college health center-based alcohol and sexual violence intervention (GIFTSS): Design, rationale, and baseline sample

INTRODUCTION

Sexual violence (SV) on college campuses is common, especially alcohol-related SV. This is a 2-arm cluster randomized controlled trial to test a brief intervention to reduce risk for alcohol-related sexual violence (SV) among students receiving care from college health centers (CHCs). Intervention CHC staff are trained to deliver universal SV education to all students seeking care, to facilitate patient and provider comfort in discussing SV and related abusive experiences (including the role of alcohol). Control sites provide participants with information about drinking responsibly.

METHODS

Across 28 participating campuses (12 randomized to intervention and 16 to control), 2292 students seeking care at CHCs complete surveys prior to their appointment (baseline), immediately after (exit), 4months later (T2) and one year later (T3). The primary outcome is change in recognition of SV and sexual risk. Among those reporting SV exposure at baseline, changes in SV victimization, disclosure, and use of SV services are additional outcomes. Intervention effects will be assessed using generalized linear mixed models that account for clustering of repeated observations both within CHCs and within students.

RESULTS

Slightly more than half of the participating colleges have undergraduate enrollment of ≥3000 students; two-thirds are public and almost half are urban. Among participants there were relatively more Asian (10 v 1%) and Black/African American (13 v 7%) and fewer White (58 v 74%) participants in the intervention compared to control.

CONCLUSIONS

This study will offer the first formal assessment for SV prevention in the CHC setting. Clinical Trials #: NCT02355470.

Collaboration, confidentiality, and care

There is an increasing call to attend to the needs of students in distress (Reynolds, 2013). Furthermore, research has begun to highlight links between distress, risky, or dangerous behaviors as well as issues in mental health in the higher education population (Deasy, Coughlan, Pironom, Jourdan, & Mannix-McNamara, 2014). The National Alliance on Mental Health and the Jed Foundation (National Alliance on Mental Illness & the Jed Foundation, 2016) estimate that about 20% of enrolled college students will face some type of mental illness. As such, the work of mental health professionals, which has been increasing with time, will continue to play a pivotal role on today's campus (Kitzrow, 2009). Yet mental health in higher education is too pervasive and significant of a topic for counseling and psychological centers to handle by themselves (Joint Task Force in Student Learning, 1998; Mitchell et al., 2012). Therefore, a collaborative approach is warranted as higher education professionals strive to meet the increasing mental health demands of the student population. Case studies amalgamated from housing and residence life professionals are used to gain a greater understanding of how interdepartmental work is carried out without compromising or breaching ethical or legal regulations as set by the Family Educational Rights and Privacy Act, the Health Insurance Portability and Accountability Act, and/or organizational standards like that of the International Association of Counseling Services Inc. (International Association for Counseling Services Inc., 2014) Specifically, the cases demonstrate ways inter- and intradepartmental staffers can work as a team, safeguard private and confidential information, and concurrently create an environment in which care is nurtured. (PsycINFO Database Record

Obesity: Implementation of a Weight Management Pharmaceutical Care Service

Background:

Obesity, a national epidemic, is one of the leading causes of preventable morbidity and mortality in the US. Pharmacists can play an integral role in weight management. Offering weight management services provides an opportunity to increase public awareness of pharmaceutical care and attract patients to pharmacy programs.

Objective:

To describe the implementation and evaluate outcomes of a weight management pharmaceutical care service in a stand alone pharmaceutical care center on a college campus.

Methods:

A retrospective review of data was conducted on 289 patient charts to evaluate the change in weight, body mass index (BMI), percent body fat, and weight-related health conditions in patients who participated in the Healthy Habits program.

Results:

The net change (change in values observed from first to last appointment) in weight was a loss of 1021.8 kg. The maximum weight change (change seen from the first appointment to the lowest value obtained during the program) was a loss of 1530.5 kg. These values correspond to a net mean weight loss of 3.6 kg per patient (10% of baseline weight) and a maximum mean weight loss per patient of 5.5 kg (15% of baseline weight). Eighty-three patients were able to decrease their BMI category and 76 patients had a decrease in risk status from baseline.

Conclusions:

The Auburn University Pharmaceutical Care Center's Healthy Habits program has been successful in helping patients decrease total body weight, BMI, and risk of weight-related complications. In addition, the program has increased the opportunity to identify other pharmaceutical care needs of patients and help establish the role of pharmacists in the management of obesity.

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.

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.