USC American College Health Association - National College Health Assessment Report: International and Domestic Freshman

Transcription

1 USC American College Health Association - National College Health Assessment Report: International and Domestic Freshman 2013 Office for Wellness and Health Promotion Engemann Student Health Center Division of Student Affairs University of Southern California 1

2 Table of Contents Executive Summary. 5 Introduction.. 7 Methods.. 7 Questionnaire 7 Procedure. 7 Response Rate.. 7 Representativeness.. 8 Analytic strategy/data preparation 8 Demographics Health, Wellness, and Academic Success.. 11 Frequency of Students whose Academic Performance was Impeded 11 Frequency vs. Threat to Academic Success (International Students) Frequency vs. Threat to Academic Success (Domestic Students).. 15 Emotional Wellbeing Traumatic or Difficult to Handle 16 Level of Stress 17 Daytime Sleepiness 17 Tired. 18 Frequency of Sleep Difficulties.. 18 Safety and Violence.. 19 Safety perception 19 Physical Fights 20 Physical Assaults.. 20 Verbal Threat. 20 Stalking 20 Abusive relationships 20 2

3 Unwanted Sexual Advances or Assault. 20 General Health, Healthcare, and Medical Status. 21 General Health.. 21 Oral Health 21 Use of Healthcare System. 21 Disabilities Status. 22 Disease Status Depression History. 23 Sexual Behavior and Contraception.. 24 Unintended Pregnancy Emergency Contraception. 24 Number of Sexual Partners.. 24 Contraceptive/Birth Control Methods. 25 Condom Use 25 Alcohol, Tobacco, and Other Drugs 26 Blood Alcohol Level 26 Alcohol Consumption: Negative Consequences. 26 Alcohol Consumption: Protective Behaviors Alcohol Consumption: Actual vs. Perceived Alcohol Consumption: Binge Rate 28 Substance Use vs. Perception of Use Exercise, Nutrition, and Weight 31 Exercise Habits.. 31 Fruit and Vegetable Intake 32 Weight 32 Body Mass Index.. 33 Limitations.. 34 Conclusion 34 3

4 References.. 35 Acknowledgements.. 35 Appendix A.. 36 Appendix B

5 Executive Summary The American College Health Association National College Health Assessment II (ACHA-NCHA II) was conducted by the Office for Wellness and Health Promotion on the University Park Campus of USC in the spring of The resulting data provides a picture of the attitudes, perceptions, and behaviors of USC-University Park Campus undergraduate and graduate students on health and academic success, safety, use of healthcare services, sexual behaviors, substance use, nutrition, and exercise. The following report includes a number of key findings: Health, Wellness, and Academic Success Frequency of Students whose Academic Performance was Impeded International students reported that the factors which most negatively impacted their academic functioning and also most frequently happened (high frequency & high threat) were stress, participation in extracurricular activities, sleep difficulties, homesickness, and anxiety. Domestic students reported that the factors which most negatively impacted their academic functioning and also most frequently happened (high frequency & high threat) were stress, participation in extracurricular activities, cold/flu/sore throat, internet usage, and sleep difficulties. Traumatic or Difficult to Handle Situation International students reported that academics, other relationships, and intimate relationships had been traumatic or very difficult for them to handle within the last 12 months. Domestic students reported academics, personal appearance, and family problems as traumatic or difficult to handle. Stress Within the last 12 months, 49.3% of international students and 49.3% of domestic students experienced more than average or tremendous stress. Sleep 19.4% of international and domestic students felt tired during the day 5 to 7 days out of the past week. Over the past seven days 34.2% of international students and 23.4% of domestic students surveyed stated that they felt that sleepiness was more than a little problem, 14.5% of international and 17% of domestic students stated that they felt sleepiness was a big problem, and 3.9% of international and 6% of domestic students stated that they felt sleepiness was a very big problem. Safety and Violence Safety Perception The USC campus is considered somewhat safe or very safe during the daytime by 96.1% of international students and 99.3% of domestic students, while during the nighttime 78.7% of international students and 88.2% of domestic students consider it to be somewhat safe or very safe. Healthcare, Medical, and Emotional Status General Health 89.3% of international students and 90.8% of domestic students described their general health as being excellent, very good, or good. Disease or Injury The most frequently cited disease or injury experienced by both international (17.3%) and domestic (19.5%) students within the last 12 months were allergy problems, sinus infections (9.3% for international and 17% for domestic), strep throat for domestic students (12.5%), and asthma for international students (10.7%). Also, 7.9% of international and 12.6% of domestic students surveyed reported that they had ever been diagnosed with depression. Healthcare System Usage 34.2% of international and 22.5% of domestic students have been seen by a healthcare professional at the campus student health center. 13.2% of international and 4.3% of domestic 5

6 students have been seen by a mental healthcare professional at the campus Counseling Services. Sexual Behavior and Contraception Sexual Behaviors 78.7% of international and 75.3% of domestic students have had either zero or one sexual partner within the last school year. In addition, of those who had vaginal intercourse in the last 30 days, 50% of international and 46.9% of domestic students always used a condom. Alcohol, Tobacco, and Other Drugs Cigarette Smoking 9.3% of international students and 8.6% of domestic students reported that they smoked cigarettes one or more days in the last month, with an additional 1.3% of international and 1.8% of domestic students who reported that they smoke on a daily basis. However, most students have never smoked cigarettes (76% of international and 81.9% of domestic students). Alcohol Consumption 70.7% of international and 72.7% of domestic students had 0 to 4 drinks the last time they partied. The binge rate (5 or more drinks in one sitting in the past two weeks) is not significantly different between international and domestic students (4.4% international and 7.6% domestic). Consequences of Drinking Alcohol As a consequence of drinking, 31.3% of international and 45% of domestic students who drank within the last 12 months also reported that they did something they later regretted. Exercise, Nutrition, and Weight Exercise Habits 21.5% of international and 21.5% of domestic students participated in moderate-intensity exercise at least five days per week. 33.3% of international and 36.3% of domestic students participated in vigorous-intensity exercise at least three days per week. Fruit and Vegetable Intake 2.6% of international students and 9.7% of domestic students ate the recommended allowance of 5 or more servings of fruits and vegetables per day. Calculated Body Mass Index 76.2% of international students and 79.3% of domestic students are at a healthy weight (Healthy BMI = ). Throughout the report, there are footnotes under each table or bar chart that refer to the corresponding question in the survey instrument. If you have any additional questions regarding the data provided in this report, please contact Katherine Verrochi, Health Promotion Specialist, at the Office for Wellness and Health Promotion at or <verrochi@engemann.usc.edu>. 6

7 Introduction Health promotion is defined by the World Health Organization as the process of enabling people to increase control over and to improve their health. Health promotion is a comprehensive and multi-strategic approach to health; it encompasses skills building and individual capacities, but also recognizes the impact of social, environmental, and economic conditions on public and individual health. The Ottawa Charter outlines five action areas in health promotion: build healthy public policy; create supportive environments for health; strengthen community action for health; develop personal skills; and re-orient health services towards prevention. On college campuses, this systematic approach to health becomes the work of the whole institution, as health is essential to learning capacity. In order to provide high quality services in these diverse areas, it is essential that there is data describing the health behaviors and status of the students as a population. This data helps to inform policy makers, administrators, faculty, staff, and students about current health beliefs and helps with strategic planning and resource allocation. The National College Health Assessment II (NCHA II) is a national research initiative coordinated by the American College Health Association (ACHA), to assist institutions of higher education in collecting data about the health and wellness of their students. The ACHA-NCHA II allows each campus to generate prevalence rates for alcohol use, sexual behavior, safety, exercise, and prevalence of disease. The goal of this assessment is to provide data on the prevalence, status, and misperceptions about student behavior. This data can guide the campus leadership by providing a firm basis for planning and evaluating services that can positively impact students safety, well-being and academic success. This report provides data on the population of students at the University Park Campus and highlights differences in the international and domestic freshman student populations. The American College Health Association (AHCA) compiles an aggregate national report. While the sample is large, is it not a true national sample, as it is not representative of the vast diversity of either the institutions or the individuals enrolled therein. The report can be viewed at This current report summarizes key points from the survey administered to students at the University Park Campus. Due to the length of the survey, not all data points have been included. Analyses of additional questions are available for interested readers through the Office for Wellness and Health Promotion in the University Park Health Center at or by visiting For a sample of the instrument used, please follow this link: Methods Questionnaire design. In 2008, ACHA introduced a new version of ACHA-NCHA questionnaire (ACHA-NCHA II). The ACHA-NCHA II questionnaire consists of sixty-five questions divided into eight sections: health; health education and safety; alcohol, tobacco, and drugs; sex behavior and contraception; weight, nutrition, and exercise; mental health; physical health; impediments to academic performance; and demographic characteristics. Procedure. The survey was conducted at the University of Southern California in the spring of The NCHA was ed to 2710 randomly selected freshman students on the University Park Campus. All 2710 students were ed a letter alerting them to the forthcoming survey, as well as two subsequent s after receiving the survey in an effort to increase the return rate. Every 10 th participant was given a $10 Amazon gift card. In addition, a lottery drawing for two $500 Visa gift cards were also offered as an incentive. Response rate. In 2013, 608 completed surveys were returned for a response rate of 22%. Analytic strategy/data preparation. This report focuses on the surveys that were conducted in Appropriate 7

8 chi-squared tests or t-tests of statistical significance have been performed to determine the magnitude and direction of differences between undergraduate and graduate students. T-tests were performed on nominal data (responses to some scaled questions) and chi-squared tests were performed on categorical data (i.e. responses of yes/no, did/did not, etc). Throughout the report, p-values are reported in the charts or at the bottom of graphs. 8

9 Demographics Descriptor Category International (n = 76) Domestic (n = 515) Age Under and older Gender Female Male Transgender 0 1 Year in School 1st year undergraduate nd year undergraduate 1 3 Full-time student status Transferred to USC within last 12 months Ethnicity White- not Hispanic (includes Middle Eastern) Black - not Hispanic 4 23 Hispanic or Latino 6 73 Asian or Pacific Islander American Indian, Alaskan Native, or 0 7 Native Hawaiian Multicultural or Biracial 3 32 Other 4 12 Membership in fraternity or sorority Relationship status Not in a relationship In a relationship but not living together In a relationship and living together 1 1 Marital Status Single Married/Partnered 2 3 Separated 0 0 Divorced 0 0 Other 0 5 Sexual Orientation Heterosexual Gay/Lesbian 1 15 Bisexual 3 15 Unsure 3 19 Living Situation Campus Residence Hall Fraternity or Sorority House 0 6 Other Campus Housing Parent/guardian's home 1 13 Off-campus housing 4 6 Other 1 0

10 Source of health insurance USC Sponsored Plan Parent's Plan Another Plan 1 13 Not sure if I have health insurance 0 4 Paid hours worked per week None to to to to Volunteered hours per week None Organized college athletics participation 1 to to to Varsity 8 29 Club Sports Intramurals The discrepancy between the total number of participants reported and the total number of participants reported in this table exists because those participants who did not complete all questions on the Demographics section of the survey were excluded from this demographic analysis. 10

11 Frequency List Health-related Behavior or Concern of Students whose Academic Performance was Impeded Refer to Question 45 of the survey Within the last 12 months, have any of the following affected your academic performance? (i.e., significant disruption in thesis, dissertation, research or practicum work; received an incomplete course, dropped a course; received a lower grade in a course, on an exam, or on an important project) Impediment International % Domestic % Statistical Significance Alcohol Use NS Allergies Anxiety NS Assault (Physical) 0 0 NS Assault (Sexual) NS ADHD NS Cold/Flu/Sore Throat NS Concern for a troubled friend NS or family member Chronic health problem or NS serious illness Chronic pain NS Death of friend or family NS member Depression NS Discrimination NS Drug use NS Eating disorder/problem NS Finances NS Gambling 0 0 NS Homesickness NS Injury NS Internet use/computer games NS Learning disability Participation in NS extracurricular activities Pregnancy NS Relationship difficulties NS Roommate difficulties NS Sexually transmitted NS disease/infection Sinus infection/ear infection/bronchitis/strep throat NS 11

12 Sleep difficulties NS Stress NS Work NS Other NS 12

13 In previous years, only a frequency list, as seen above, was reported. What follows are cluster analyses, created by making a two dimensional graph representing a set of bi-variate data (scatter plot) of those who report experiencing a particular condition (frequency) crossed with those who reported the condition who experienced an academic impact (threat). This scatter plot displays health related issues that are of low threat/low frequency, low threat-high frequency, high threat/low frequency, and high threat/high frequency. Legend for pages 10 and 11: Scatter Plots - Threat to Academic Success Based on the Frequency of Health-Related Behavior or Concerns 13

14 Treat: Percent of those Experiencing Condition with Academic Impact 40 Threats to Academic Success as Related to the Frequency of Health Related Behavior of International Freshman USC data based on the responses of USC freshman students to the 2013 NCHA Survey (NCHA Report University Park Campus Freshman Students 2013) 35 Stress 30 Internet Use/Comp. Games Participation Sleep Extracurricular Difficulties Activities 15 Anxiety Cold/Flu/Sore Throat 10 Concern for Relationship Family/Friend Work Homesickness Difficulties 5 Depression Allergies Roommate Difficulties 0 Drug Learning ADHD Eating Use Finances Disability Alcohol Use Disorder/Problem Other Chronic Death of Health Assault (Sexual) Family/Friend Problem Pregnancy Discrimination Gambling Frequency: percent in Population Experiencing Condition 14

15 Threat: Percent of those Experiencing Condition with Academic Impact Threats to Academic Success as Related to the Frequency of Health Related Behavior of Domestic Freshman USC data based on the responses of USC freshman students to the 2013 NCHA Survey (NCHA Report University Park Campus Freshman Students, publication pen Stress Sleep Difficulties Cold/Flu/Sore Throat Participation in Extracurricular Internet Use/Comp. Activities Games 15 Allergies Anxiety Work Depression Concern for Family/Friend Relationship Difficulties Roommate Alcohol Use Homesickness Death of Sinus/Ear Difficulties Family/Friend Infection/Step Throat ADHD Finances Chronic Health Other Chronic Problem Pain Learning 1 Eating Disability Drug Injury Use Pregnancy STD/I Discrimination 0 Disorder/Problem Frequency: Percent in Population Experiencing Condition 15

16 Emotional Wellbeing Refer to Question 30 of the survey. Have you ever? Yes, in the last 12 months No, not in the last 12 months No, never P-Value INT DOM INT DOM INT DOM Felt things were NS hopeless Felt overwhelmed by all NS you had to do Felt exhausted (not from NS physical activity) Felt very lonely NS Felt very sad NS Felt so depressed that it NS was difficult to function Felt overwhelming NS anxiety Felt overwhelming anger NS Intentionally injured NS yourself Seriously considered NS suicide Attempted suicide NS Traumatic or Difficult to Handle Refer to Question 33 of the survey. Within the last 12 months, have any of the following been traumatic or very difficult for you to handle? International % Domestic % P-Value Academics NS Career related issue NS Death of family member or friend NS Family problems NS Intimate relationship NS Other relationships NS Finances NS Health problem of family NS member/partner Personal appearance NS Personal health issue NS Sleep difficulties NS Other NS 16

17 Level of Stress Refer to question 37 of the survey. Within the last 12 months, how would you rate the overall level of stress you have experienced? No stress Less than Average stress More than average stress average stress Tremendous stress International Domestic Daytime Sleepiness Refer to Question 43 of the survey. People sometimes feel sleepy during the daytime. In the past 7 days, how much of a problem have you had with sleepiness (feel sleepy, struggling to stay awake) during your daytime activities? International Domestic Not at all A little More than a little Big Very big 17

18 Tired 19.4% of freshman students felt tired during the day 5 to 7 days out of the past week. Frequency of Sleep Difficulties Refer to Question 44 of the survey. In the past 7 days, how often have you a) Awakened too early in the morning and couldn t get back to sleep? b) Felt tired, dragged out, or sleepy during the day? c) Gone to bed because you just could not stay awake any longer? d) Had an extremely hard time falling asleep? days 2-4 days 5-7 days Awakened too early Felt tired during the day Gone to bed because cannot stay awake Had an extrememly hard time falling asleep 18

19 Safety Perception Refer to Question 7 of the survey. How safe do you feel (at the following place and time combinations)? INTERNATIONAL STUDENTS: On campus (daytime) On campus (nighttime) Community around USC (Daytime) Community around USC (nighttime) Not safe at all Somewhat unsafe Somewhat safe Very safe DOMESTIC STUDENTS: On campus (daytime) On campus (nighttime) Community around USC (daytime) Community around USC (nighttime) Not safe at all Somewhat Unsafe Somewhat safe Very safe 19

20 Physical Fights 2.6% of international and 3.9% of domestic students reported being involved in a physical fight within the last 12 months. (Q5A) Physical Assaults 2.9% of domestic students reported that they were physically assaulted (does not include sexual assault) within the last 12 months. No international students reported a physical assault within the last 12 months. (Q5B) Verbal Threat 9.2% of international and 15.8% of domestic students reported that they were verbally threatened within the last 12 months. (Q5C) Stalking 3.9% of international and 4.7% of domestic students reported that they had been a victim of stalking within the last 12 months. (Q5G) Abusive relationships and Unwanted Sexual Advances or Sexual Assault Refer to Question 5 and Question 6 of the survey, respectively. Within the last 12 months, have you been in a relationship that was? International % Domestic % P-Value Emotionally abusive NS Physically abusive NS Sexually abusive NS Within the last 12 months, have you experienced? International % Domestic % P-Value Sexual touching without your consent NS Attempted sexual penetration without your consent Sexual penetration without your consent NS 20

21 General Health Refer to Question 1 of the survey. How would you describe your general health? International Domestic 0 Excellent Very good Good Fair Poor 0 1 Oral Health 82.5% of freshman students (70.7% of international and 84.2% of domestic) have had a dental exam and cleaning in the last 12 months. (Q39) Use of HealthCare System Refer to Question 79 and Question 80 of the survey, respectively. Within the last 12 months, have you been seen by a medical healthcare professional (e.g. Physician, Nurse Practitioner, Physician Assistant, Nurse)? Have you been seen by a medical healthcare professional Location International % Domestic % P-Value At campus Student Health Center At other healthcare facilities Both Neither

22 Within the last 12 months, have you been seen by a mental healthcare professional (e.g. Counselor, Psychologist, Social Worker, Psychiatrist)? Have been seen by a mental healthcare professional Location International % Domestic % P-Value At campus Counseling Services At other counseling facilities Both Neither Disabilities Status Refer to Question 65 of the survey. Do you have any of the following disabilities or medical conditions? International % Domestic % P-Value Attention Deficit and Hyperactivity Disorder (ADHD) NS Chronic illness NS Deaf/Hard of Hearing 0 1 NS Learning disability NS Mobility/Dexterity disability NS Partially sighted/blind NS Psychiatric condition NS Speech or language disorder NS Other disability NS Disease Status Refer to Question 41 and Question 31 of the survey, respectively. Within the last 12 months, have you been diagnosed or treated by a professional for? International % Domestic % P-Value Allergies NS Asthma NS Back pain NS Broken bone/fracture/sprain NS Bronchitis NS Chlamydia NS Diabetes NS Ear infection NS Endometriosis NS Genital herpes Genital warts/human Papillomavirus (HPV) 0 0 NS Gonorrhea 0 0 NS Hepatitis B or C High blood pressure NS High cholesterol NS 22

23 Human Immunodeficiency Virus (HIV) Irritable Bowel Syndrome (IBS) NS Migraine headache NS Mononucleosis NS Pelvic Inflammatory Disease (PID) 0 0 NS Repetitive Stress Injury NS Sinus Infection NS Strep throat NS Tuberculosis NS Urinary tract infection NS Within the last 12 months, have you been diagnosed or treated by a professional for Yes, and treated with medication, psychotherapy, or both % Yes, diagnosed but not treated % INT DOM INT DOM Anorexia NS Anxiety NS Attention Deficit and Hyperactivity NS Disorder (ADHD) Bipolar Disorder NS Bulimia NS Depression NS Insomnia NS Other sleep disorder NS Obsessive Compulsive Disorder (OCD) NS Panic Attacks NS Phobia NS Schizophrenia NS Substance abuse or addiction NS Other addiction (e.g. internet, sexual) NS Other mental health condition NS P-Value Depression History 12% of students surveyed (7.9% of international and 12.6% domestic students) responded yes to Have you ever been diagnosed with depression? Refer to Question 32 of the survey. 23

24 Unintended pregnancy Among respondents who have had vaginal intercourse, 1.5% of freshman students (0% of international and 1.8% of domestic) have unintentionally become pregnant or gotten someone else pregnant within the last 12 months. (Q25) Emergency Contraception Among respondents who indicated that they were sexually active, 19.1% (15.8% international and 19.7% domestic) of freshman students have used or had a partner who used emergency contraception ( morning after pill ) within the last 12 months. (Q24) Number of Sexual Partners Refer to Question 19 of the survey. Within the last 12 months, with how many partners have you had oral sex, vaginal intercourse, or anal intercourse? International Domestic or more 24

25 Contraceptive/Birth Control Methods Refer to Question 23B of the survey. Please indicate whether or not you or your partner used each of the following methods of birth control to prevent pregnancy the last time you had vaginal intercourse? International % Domestic % P- Value Birth control pills Birth control shots NS Birth control implants NS Birth control patch Condom (male) Condom (female) NS Contraceptive sponge 0 0 NS Diaphragm or cervical cap 0 0 NS Fertility awareness NS Intrauterine device NS Spermicide NS Sterilization 0 0 NS Vaginal ring NS Withdrawal NS Other method NS Percentages represent students who used a method of birth control to prevent pregnancy the last time they had vaginal intercourse. Columns sum to more than 100% because multiple responses were possible. Condom Use Refer to Questions 21 and 22 of the survey. Within the last 30 days, how often did you or your partner(s) use a condom or other protective barrier (e.g. male condom, female condom, dam, glove) during? International % Domestic % Engaged in this activity Always used a condom Engaged in this activity Always used a condom Oral sex Vaginal Intercourse Anal Intercourse

26 Blood Alcohol Level Refer to Question 10 and Question 50 of the survey. Blood Alcohol Level The mean of all freshmen was and the median was International % Domestic % P- Value 0.08 or higher NS 1.00 or higher NS The formula for estimating BAC is applied to the reported number of drinks and the number of hours for the last time students partied /socialized, weight, and estimates for total body water weight (58% for males and 49% for females) and the average rate of alcohol metabolism (a decline of.017 per hour). The formula does not control for food consumption and assumes that alcohol was consumed at a constant rate over the drinking episode. Alcohol Consumption: Negative Outcomes - Refer to Question 16 of the Survey. Within the last 12 months, have you experienced any of the following as a consequence of your drinking? Yes Responses, excludes non-drinkers International % Domestic% P-Value Did something you later regretted NS Forgot where you were or what you did NS Got into trouble with the police NS Had sex with someone without giving your consent NS Had sex with someone without getting their consent NS Had unprotected sex NS Physically injured yourself NS Physically injured another person NS Seriously considered suicide NS Alcohol Consumption: Protective Behaviors - Refer to Question 15 of the survey. During the last 12 months, when you partied /socialized, [did you always]? International % Domestic% P-Value Alternate non-alcoholic with alcoholic beverages NS Avoid drinking games NS Choose not to drink alcohol NS Determine, in advance, not to exceed a set number of NS drinks Eat before and/or during drinks NS 26

27 Have a friend let you know when you have had NS enough Keep track of how many drinks you are having NS Pace your drinks to 1 or fewer per hour NS Stay with the same group of friends the entire time NS you were drinking Stick with only one kind of alcohol when drinking NS Use a designated driver NS Since multiple responses were possible, more than 100% may be indicated. Students responded to a 5- point Likert scale that ranged from Never to Always. Chi-square tests were performed on all the responses; only the Always responses of students who partied/socialized are represented in the table for simplicity, however the p-values represent the range from never to always, not just Always. Alcohol Consumption: Last Time Partied /Socialized Actual v. Perceived - Refer to Question 10 and Question 12 of the survey. The last time you partied /socialized how many drinks of alcohol did you have? International Students Actual Perceived to 4 5 to 7 8 or more 27

28 Domestic Students Actual Perceived to 4 5 to 7 8 or more Binge Rate Of students who drink, 4.4% of international and 7.6% of domestic students had five or more drinks of alcohol at a sitting one or more times in the last 2 weeks. (Q13) Substance Use v. Perceptions of Use Refer to Question 8 and Question 9 of the survey. INTERNATIONAL STUDENTS: Within the last 30 days, on how many days did you use? Substance Never Not in last 30 days One or more days Used daily Alcohol Hookah Marijuana Cigarettes Cigars Smokeless tobacco Cocaine MDMA (Ecstasy) Sedatives Hallucinogens Methamphetamine Opiates Inhalants

29 Anabolic steroids Other amphetamines Other club drugs Other illegal drugs Within the last 30 days, how often do you think the typical student at your school used? Substance Never Not in last 30 days One or more days Used daily Alcohol Hookah Marijuana Cigarettes Cigars Smokeless tobacco Cocaine MDMA (Ecstasy) Sedatives Hallucinogens Methamphetamine Opiates Inhalants Anabolic steroids Other amphetamines Other club drugs Other illegal drugs DOMESTIC STUDENTS: Within the last 30 days, on how many days did you use? Substance Never Not in last 30 days One or more days Used daily Alcohol Hookah Marijuana Cigarettes Cigars Smokeless tobacco Cocaine MDMA (Ecstasy) Sedatives Hallucinogens Methamphetamine Opiates Inhalants Anabolic Steroids Other amphetamines

30 Other club drugs Other illegal drugs Within the last 30 days, how often do you think the typical student at your school used? Substance Never Not in last 30 days One or more days Used daily Alcohol Hookah Marijuana Cigarettes Cigars Smokeless tobacco Cocaine MDMA (Ecstasy) Sedatives Hallucinogens Methamphetamine Opiates Inhalants Anabolic steroids Other amphetamines Other club drugs Other illegal drugs

31 Exercise Habits Refer to Question 29 of the survey. On how many of the past 7 days did you do moderate-intensity cardio or aerobic exercise (caused by a noticeable increase in heart rate such as a brisk walk) for at least 30 minutes? On how many of the past 7 days did you do vigorous-intensity cardio or aerobic activity (caused by large increase in breathing or heart rate, such as jogging) for at least 20 minutes? International Moderate exercise Vigorous Exercise days 1 to 2 days 3 to 4 days 5 to 7 days Domestic Moderate exercise Vigorous Exercise days 1 to 2 days 3 to 4 days 5 to 7 days 31

32 Fruit and Vegetable Intake Refer to Question 28 of the survey. How many servings of fruits and vegetables do you usually have per day? I don't eat fruits and vegetables /day 3-4/day 5 or more International Domestic Fruit and Vegetable Intake The daily USDA recommended allowance of fruits and vegetables is 5-9. In 2012, 2.6% of international and 9.7% of domestic students ate the recommended allowance of 5 or more servings per day. (Q28) Weight Refer to Question 26 of the survey. How would you describe your weight? International Domestic Very underweight Slightly underweight Right weight Slightly overweight Very overweight 32

33 Body Mass Index (BMI) Calculated using Questions 47, 49a, 49b, and 50 of the survey. BMI Male % Female % <18.5 Underweight Healthy Weight Overweight Class I Obesity Class II Obesity 0 0 >40 Class III Obesity Mean Standard Deviation This figure incorporates reported height and weight to form a general indicator of physical health. Categories defined by the World Health Organization (WHO) 2000, reprinted in Obesity: Preventing and Managing the Global Epidemic. WHO Tech Report Series:

34 Limitations Surveys are only useful to the extent that they reflect the opinions of the student population. While we have documented the sample representativeness of the USC University Park Campus in terms of demographics, the degree of representativeness in terms of health-related attitudes and opinions is unknown. The survey results do correlate to similar studies completed by the Centers for Disease Control and Prevention, Monitoring the Future, and the American College Health Association. When a survey includes questions on sensitive subjects such as drug use and sexuality, there is always the possibility that a response bias has influenced the results. However, the literature shows that an anonymous health behavior survey, such as the ACHA-NCHA, gives the responder an opportunity to share more accurate information than would otherwise be provided. In general, the best way to minimize the chances of a response bias is to achieve a high response rate. The response rate of approximately twenty percent achieved in these surveys is in alignment with the steady downward trend of response rates over the past few years. As such, the response rate is not of sufficient size to ensure representativeness on all important factors. It is therefore recommended that the results described in this report be thought of as preliminary until further research is done. Conclusion The wellbeing of a college student can be related to learning, academic functioning, and performance. Therefore, this data can be utilized by various departments on campus to form partnerships in order to provide a more integrative approach to advancing health and wellness, as it supports the learning mission of our institution. Most students reported their general health as being excellent, very good, or good. However, there are a number of specific health issues such as stress, sleep, and anxiety that negatively impact the lives of students and should continue to be addressed. Safety related to bicycles in the academic core and the lack of fruit and vegetable consumption draw attention to systemic or environmental interventions. Finally, with respect to the misperceptions held by students around the alcohol and sexual behaviors of their peers, continued efforts by the campus community to create and support an accurate picture of USC students are greatly needed. The mission of the University of Southern California is the development of human beings and society as a whole through the cultivation and enrichment of the human mind and spirit. In order to truly facilitate this mission, the wellbeing of students must be a top priority. The data provided by the American College Health Association - National College Health Assessment II is a tool for all departments to use in order to advance the health and wellness of our students as these enrich student learning and cultivates the human mind and spirit. 34

35 References ACHA-NCHA website: Office for Wellness and Health Promotion (OWHP): Student Counseling Services website: Student Medical Services website: If you have any questions about this document and/or the data presented please call or Acknowledgements This report would not have been possible without the contributions, dedication, and patience of the following individuals: Ainsley Carry, Vice Provost for Student Affairs Larry Neinstein, Executive Director, University Park Health Center Paula Swinford, Director, Office for Wellness and Health Promotion Katherine Verrochi, Health Promotion Specialist, Office for Wellness and Health Promotion Eduardo Molina, Director, Institutional Research A special thanks to the entire Wellness and Health Promotion staff, including the Wellness Advocates (WAs) for their continued support and feedback. Thank you to all the students who sent in completed surveys; your efforts help us to serve you better. 35

36 NCHA 2013 Supplemental Questions 30 response fields Appendix A 1. Please choose your country of citizenship. If your country is not listed or you have multiple countries of citizenship, please enter the name of your country(ies) of citizenship in the blank text box below the other option. a. United States of America b. China c. India d. South Korea e. Taiwan f. Canada g. Hong Kong h. Iran i. Other (Please specify below): TEXT FIELD How long have you lived in the United States of America? a. Less than 6 months b. 6 months to 1 year c. More than 1 year to less than 3 years d. More than 3 years to less than 5 years e. 5 years or more 3. Which statement best describes the majority of your friends? a. People from my own country who are students at USC b. People from my own country who are not students at USC c. People from many countries who are students at USC d. People only from the United States of America 4. Are you of Hispanic or Latino descent? a. No b. Yes 5. What is your racial background? (mark all that apply) a. White b. Black or African American c. Asian d. American Indian or Alaska Native e. Native Hawaiian or other Pacific Islander 6. In general, when you are experiencing problems, which USC office are you most likely to go to first to seek help? a. Office of International Services b. Student Counseling Services c. Student Health Center d. Housing Resident Advisor e. Departmental Academic Advisor f. I do not seek help at any of these USC offices when I am experiencing problems 36

37 7. Within the last 12 months, have you been seen by a medical healthcare professional (e.g. Physician, Nurse Practitioner, Physician Assistant, Nurse)? Please choose one response. a. I have not been seen by a medical healthcare professional in the last 12 months. b. I have been seen by a medical healthcare professional on staff at the student health center on campus c. I have been seen by a medical healthcare professional on staff at a healthcare facility other than at the student health center on campus d. Both 2 and Within the last 12 months, have you been seen by a mental healthcare professional (e.g. Psychologist, Social Worker, Psychiatrist or Counselor)? Please choose one response. a. I have not been seen by a mental healthcare professional in the last 12 months. b. I have been seen by a mental healthcare professional on staff at the student counseling center on campus c. I have been seen by a mental healthcare professional on staff at a counseling facility other than at the student counseling center on campus d. Both 2 and Within the last 12 months, has anyone sent frightening or threatening messages to your cell phone, account, social media account, or posted something frightening or threatening about you on a gossip blog? a. No b. Yes 10. Within the last 12 months, has anyone said something frightening or threatening to you in person? a. No b. Yes 11. Within the last 12 months, has someone fondled, kissed, rubbed, or touched you, and you wanted it to stop, but it did not? a. No, this has not happened to me b. Yes, but not within the past 12 months c. Yes, and I was drunk at the time d. Yes, and I was out of it at the time e. Yes, and although I was not drunk or out of it the person did not stop 12. While on campus, I am able to purchase the food that I want to eat. a. Always b. Often c. Sometimes d. Rarely e. Never 13. How often do you use a bicycle on and/or around USC? a. I don t ride a bicycle at USC b. Less than one day a month c. 1-3 days per month d. 1-4 days per week e. 5-7 days per week 37

38 14. From USC, how far do you ride a bicycle? a. I don t ride a bicycle at USC b. I ride only in the USC campus academic core (Vermont, Jefferson, Figueroa, and Exposition) c. I ride in the larger USC University Park neighborhood bordered by Budlong (which is west of Vermont), Adams to the north, Figueroa to the east, and Exposition to the south d. I ride beyond the larger USC University Park neighborhood bordered by Budlong (which is west of Vermont), Adams to the north, Figueroa to the east, and Exposition to the south 15. Do you feel confident bicycling on the urban streets around campus? a. I don t ride a bicycle at USC b. Yes, I feel confident c. I do not feel confident 16. Within the last 12 months, have you visited the Office for Wellness and Health Promotion (OWHP)? a. No b. Yes 38

39 Appendix B NCHA 2013 Supplemental Questions Reported Frequencies 1. Please choose your country of citizenship. If your country is not listed or you have multiple countries of citizenship, please enter the name of your country(ies) of citizenship in the blank text box below the other option. a. United States of America: 88.8% b. China: 1.5% c. India:0.3% d. South Korea: 1.7% e. Taiwan: 1.2% f. Canada: 0.5% g. Hong Kong: 0.8% h. Iran: 0 i. Other (Please specify below): TEXT FIELD % 2. How long have you lived in the United States of America? a. Less than 6 months: 2.7% b. 6 months to 1 year: 4.7% c. More than 1 year to less than 3 years: 0.8% d. More than 3 years to less than 5 years: 0.7% e. 5 years or more: 91.2% 3. Which statement best describes the majority of your friends? a. People from my own country who are students at USC: 45.3% b. People from my own country who are not students at USC: 20.6% c. People from many countries who are students at USC: 23.3% d. People only from the United States of America: 10.8% 4. Are you of Hispanic or Latino descent? a. No: 84.1% b. Yes: 15.9% 5. What is your racial background? (mark all that apply) a. White: 58.4% b. Black or African American: 5.6% c. Asian: 35.2% d. American Indian or Alaska Native: 2.5% e. Native Hawaiian or other Pacific Islander: 2.1% 6. In general, when you are experiencing problems, which USC office are you most likely to go to first to seek help? a. Office of International Services: 0.5% b. Student Counseling Services: 10.2% c. Student Health Center: 19.2% d. Housing Resident Advisor: 15.9% e. Departmental Academic Advisor: 11.9% f. I do not seek help at any of these USC offices when I am experiencing problems: 42.3% 39

40 7. Within the last 12 months, have you been seen by a medical healthcare professional (e.g. Physician, Nurse Practitioner, Physician Assistant, Nurse)? Please choose one response. a. I have not been seen by a medical healthcare professional in the last 12 months: 14.9% b. I have been seen by a medical healthcare professional on staff at the student health center on campus: 24.6% c. I have been seen by a medical healthcare professional on staff at a healthcare facility other than at the student health center on campus: 25.4% d. Both 2 and 3: 35.1% 8. Within the last 12 months, have you been seen by a mental healthcare professional (e.g. Psychologist, Social Worker, Psychiatrist or Counselor)? Please choose one response. a. I have not been seen by a mental healthcare professional in the last 12 months: 82.2% b. I have been seen by a mental healthcare professional on staff at the student counseling center on campus: 5.7% c. I have been seen by a mental healthcare professional on staff at a counseling facility other than at the student counseling center on campus: 8.9% d. Both 2 and 3: 3.2% 9. Within the last 12 months, has anyone sent frightening or threatening messages to your cell phone, account, social media account, or posted something frightening or threatening about you on a gossip blog? a. No: 96.3% b. Yes: 3.7% 10. Within the last 12 months, has anyone said something frightening or threatening to you in person? a. No: 90.5% b. Yes: 9.5% 11. Within the last 12 months, has someone fondled, kissed, rubbed, or touched you, and you wanted it to stop, but it did not? a. No, this has not happened to me: 84.0% b. Yes, but not within the past 12 months: 2.5% c. Yes, and I was drunk at the time: 8.6% d. Yes, and I was out of it at the time: 0.8% e. Yes, and although I was not drunk or out of it the person did not stop: 4.0% 12. While on campus, I am able to purchase the food that I want to eat. a. Always: 19.2% b. Often: 28.3% c. Sometimes: 39.2% d. Rarely: 10.3% e. Never: 3.0% 13. How often do you use a bicycle on and/or around USC? a. I don t ride a bicycle at USC: 58.1% b. Less than one day a month: 1.8% c. 1-3 days per month: 4.3% d. 1-4 days per week: 10.4% e. 5-7 days per week: 25.4% 40

41 14. From USC, how far do you ride a bicycle? a. I don t ride a bicycle at USC: 58.1% b. I ride only in the USC campus academic core (Vermont, Jefferson, Figueroa, and Exposition): 22.2% c. I ride in the larger USC University Park neighborhood bordered by Budlong (which is west of Vermont), Adams to the north, Figueroa to the east, and Exposition to the south: 16.5% d. I ride beyond the larger USC University Park neighborhood bordered by Budlong (which is west of Vermont), Adams to the north, Figueroa to the east, and Exposition to the south: 3.2% 15. Do you feel confident bicycling on the urban streets around campus? a. I don t ride a bicycle at USC: 52.5% b. Yes, I feel confident: 30.5% c. I do not feel confident: 17.0% 16. Within the last 12 months, have you visited the Office for Wellness and Health Promotion (OWHP)? a. No: 83.5% b. Yes: 16.5% 41