Connecting Student Health and Learning at Emory: A Summary of the Spring 2006 NCHA at Emory

Transcription

1 Connecting Student Health and Learning at Emory: A Summary of the Spring 2006 NCHA at Emory Heather Zesiger, MPH, CHES Director of Health Promotion Emory University Student Health Services and Jill Augustine, MPH Candidate, RSPH April 2, 2007 A National Public Health Week Event at Rollins School of Public Health, Emory University

2 Overview Introductions Overview of Services at EUSHS Real World Application of a Needs Assessment Highlights of the Spring 2006 NCHA Opportunities to Get Involved Next Steps

3 Introductions Who is here? Students Staff Faculty A few words about Heather A few words about Jill

4 EUSHS Health Promotion

5 Health Education and Promotion at Emory University Student Health Services Mission Health Education and Promotion at Emory University Student Health Services contributes to success in and out of the classroom by encouraging students to take responsibility for their lifelong wellness. Using strategies that are student-oriented, evidence-based, and dynamic, we challenge students to develop beliefs and habits that advance personal and community health.

6 Health Promotion Team

7 Health Education and Promotion at Emory University Student Health Services Nutrition Education and Counseling; Alcohol, Tobacco, and Other Drug Education and Counseling; Sexual Health Education and Counseling; Stress Management Education; Other topics on request

8 Health Education and Promotion at Emory University Student Health Services Methods of delivery: Appointments for individuals and couples Campus programs, classes and events Peer education , online education, resource library Policy development, collaboration Phone consults

9 Emory University Student Health Services Primary medical care Women s s health care Allergy and immunization clinic Travel clinic Educational programs Collaboration with students, staff, faculty Referrals and in-house specialty clinics

10 Counseling Center

11 Counseling Center Short-term term individual counseling and couples therapy Group counseling Specialty services: eating disorders, sexual assault response and education, stress management Psychiatry services (at 1525 Clifton Road) Referral services Outreach, consultations, workshops

12 Why do a Needs Assessment?

13 Why do a Needs Assessment? Can help answer the question Where to begin? Contrast with clinical indicators regarding student needs; population-based vs. individual Clarify priorities Design, implement and evaluate programs Advocate for policy change Allocate resources Highlight connections with the academic mission, strategic plan and vision statement

14 Rationale for Needs Assessment in College Health Planning Public Health Model CHES Competency Standards of Practice for Health Promotion in Higher Education (ACHA) 5.2 Conduct population-based assessments of health status, needs, and assets of students

15 Assure Assess Develop Policy The Building Blocks of Public Health

16 Assess individual and community needs Plan effective programs Implement programs Communicate needs and resources; advocacy Health Educators Evaluate programs Act as a resource person Coordinate provision of services CHES Competencies

17 A survey is not the only way The NCHA is one example of a population- based needs assessment Consider also aggregate clinical indicators (intake forms, reasons for visit) Conduct an environmental assessment (a.k.a. environmental scan) Focus groups, interviews, etc. Listen to students! (and staff and faculty)

18 What is the NCHA? National College Health Assessment Online survey of health behaviors, knowledge and attitudes; template has 300 questions, we added 19 more Implemented by the American College Health Association (ACHA) Through Fall 2006, over 324 colleges and universities and over 350,000 students had participated in the NCHA nationwide Validity and reliability analyses performed on the survey template

19 What is the NCHA? Areas queried: General health Sources of health information (and believability) Preventive health Academic impacts Violence Alcohol, tobacco, other drug use Sexual behavior Nutrition and exercise Depression Demographics Student characteristics

20 The NCHA at Emory April 19 May 10, 2006 IRB approved Collaboration campus-wide ed the survey to 11,678 students with a letter of introduction from President Wagner (+ 3 reminders) Response rate of 11% or 1,293 students

21 Demographics of Respondents N=1,293 Female = 74.8% 65.5% ages % graduate or professional 53.3% undergraduate 91.9% heterosexual 77.6% White 10.8% Asian and Pacific Islander 7.6% Black not Hispanic 51.2% live off-campus

22 Limitations Self-report ( 30( 30-day and past academic year recall) Cross-sectional sectional research design Smaller than desired response rate (but our response rate still conformed to ACHA guidance that we needed at least 800) Respondents predominately female Cannot generalize to the entire Emory student population nor within specific schools

23 Highlights from NCHA at Emory The topics we highlight today represent just a fraction of the total data available to analyze and apply! We hope to make the ACHA-produced reports and some of the custom analysis available on our website soon

24 The Good News A majority of Emory respondents (61.7%) reported that their health was very good or excellent. excellent. Many Emory respondents reported engaging in preventive health screenings and behaviors (vaccines, dental care, BP check, gynecological care) The majority of Emory respondents reported having never used marijuana (61.6%) or cigarettes (66.2%).

25 The Good News 46% of Emory respondents reported having 0-22 alcoholic drinks the last time they socialized. For many students, this quantity of alcohol represents a lower-risk risk choice. 13% of respondents reported that they had never used alcohol and an additional 10% reported that they had not used alcohol in the past 30 days. The majority of Emory respondents (65%- 76%) rated their satisfaction with EUSHS and CC as either very satisfied or somewhat satisfied.

26 Stress and Coping 61% of Emory respondents reported having experienced stress without it negatively affecting their academics as compared to only 47% of the national comparison sample. Open-ended ended responses to What are the three strategies you most often use to relieve stress? (see handout)

27 Challenges Preliminary analysis on these topics: Impediments to academic success Mental health Sexual health Alcohol use and other substance use

28 Academics impediments

29 The Question Within the last school year, have any of the following affected your academic performance? (list of 45 health problems) Response options: Did not happen to me/na Experienced this problem but academics not affected Received a lower grade on an exam Received a lower grade in a course Received an incomplete or dropped a course

30 Top 10 Academic Impediments by Severity* Emory sample: n=1, Attention deficit disorder 11% of respondents experienced it 56% of those who experienced it reported a negative academic impact 2. Depression/Anxiety/SAD 35% of respondents experienced it 51% of those who experienced it reported a negative academic impact *Severity is indicated by the percentage of those respondents who reported having experienced one of these issues who also reported a negative academic impact as a result of that issue. The aggregate data reported by ACHA only takes the percent experiencing a negative impact from among all respondents. An analysis based on severity rather than frequency takes into account the specific impact among just those students who report experiencing the health issue.

31 3. Learning disability 6% of respondents experienced it 46% of those who experienced it reported a negative academic impact 4. Mononucleosis 3% of respondents experienced it 43% of those who experienced it reported a negative academic impact 5. Sleep difficulties 64% of respondents experienced it 32% of those who experienced it reported a negative academic impact

32 6. Death of a friend or family member 26% of respondents experienced it 31% of those who experienced it reported a negative academic impact 7. Stress 88% of respondents experienced it 31% of those who experienced it reported a negative academic impact 8. Relationship difficulties 50% of respondents experienced it 30% of those who experienced it reported a negative academic impact

33 9. Pregnancy 2% of respondents experienced it 26% of those who experienced it reported a negative academic impact 10. Sexual assault 4% of respondents experienced it 26% of those who experienced it reported a negative academic impact 11. Cold/flu/sore throat 85% of respondents experienced it 24% of those who experienced it reported a negative academic impact

34 12. Internet/computer games 59% of respondents experienced it 23% of those who experienced it reported a negative academic impact 13. Concern about a friend/family member 70% of respondents experienced it 23% of those who experienced it reported a negative academic impact

35 What health issues did RSPH respondents say affected their academic performance? Data from the 2006 NCHA at Emory, RSPH respondents only: n=138 Academic Unit Cold/Flu/ Sore throat Concern for a troubled friend or family member Depression/ Anxiety Disorder/ Seasonal Affective Disorder Internet Use/ Computer games Relationship difficulty Sleep difficulty Stress Rollins School of Public Health 17 (12%) 14 (10%) 15 (11%) 14 (10%) 9 (7%) 15 (11%) 33 (24%)

36 Mental Health

37 Rates of Anxiety and Depression National respondents vs. Emory respondents Experienced anxiety during the past academic year Experienced depression during the past academic year Experienced Seasonal Affective Disorder during the past academic year Ever been diagnosed with an anxiety disorder Ever been diagnosed with depression Ever been diagnosed with Seasonal Affective Disorder National Sample Spring 2006 n=94,806 11,418 (12%) 16,423 (18%) 7,458 (8%) 7,459 (8%) 13,017 (14%) 2,339 (3%) Emory Sample Spring 2006 n=1, (17%) 248 (20%) 105 (8%) 157 (12%) 253 (20%) 37 (3%)

38 Responses to Open-Ended Stress Management Question: Stress Management Strategy Number of students who listed this strategy in their Top 3 Sleep/Nap 444 Gym/Exercise 400 Talk to Friends/Family 339 Watch TV or movies 228 Music (listen to) 137 Go out socially/visiting others/hang out with friends 130 Breathing/Meditation 126 Eat comfort foods or drink tea, coffee 115 Run/other sporting activities 102 Read 99 Take a walk 82 Make a list/schedule/plan/prioritize 80 Drink alcohol 66 Pray/read religious book 61 Do the work 60

39 Sexual Health

40 Many Emory respondents reported first engaging in sexual behavior before the college years Percent Distribution of Emory Respondents' Age of First Sexual Activity (n=1,006) Data from the 2006 National College Health Assessment Emory Sample n=1, Percent Age 2-11 Age Age Age 25 or older Missing Age Ranges

41 Many Emory respondents had at least one partner last year, but one-quarter reported no partner 100 Emory Respondents' Self-Reported Number of Sexual Partners for Last School Year Data from the 2006 National College Health Assessment (NCHA) Emory Sample n=1, percent male female no sexual partner one sexual partner tw o sexual partners three sexual partners four or more sexual partners

42 Respondents reported a variety of contraceptive methods Emory Respondents' Self-Reported Contraceptive Options Data from the 2006 National College Health Assessment (NCHA) Emory Sample n=1, Percent have not had vaginal sex birth control pills depo provera norplant condoms diaphragm spermicide fertility awareness withdrawal other nothing Method (may select more than one)

43 Perception vs. Reality Emory Respondents' PERCEIVED Condom Use Past 30 Days of the "typical student at your school" Data from the 2006 National College Health Assessment (NCHA) Emory Sample n=1,293; National Sample n=94, Percent Emory Spring 2006 National Spring oral sex mostly and alw ays vaginal sex mostly and alw ays anal sex mostly and alw ays

44 Emory Respondents' ACTUAL Condom Use Past 30 Days "Within the last 30 days, how often did you or your partner(s) use a condom?" Data from the 2006 National College Health Assessment (NCHA) Emory Sample n=1,293; National Sample n=94, Percent Emory Spring 2006 National Spring oral sex mostly and alw ays vaginal sex mostly and alw ays anal sex mostly and alw ays

45 Alcohol and Other Substance Use

46 Most Emory respondents first consumed alcohol before arriving at Emory Reported Age at First Drink Data from the 2006 Spring National College Health Assessment (NCHA) Emory sample, n=1, Percent less than or equal to or older Years of Age

47 Reported rates of alcohol use Reported Alcohol Use Data from the 2006 Spring National College Health Assessment (NCHA) Percent 50 n=1,293 Emory Spring 2006 n=94,806 National Spring Never Used Alcohol Have Used, But Not in Past 30 Days Used 1-9 Days in Past 30 Used Days in Past Used All 30 Days

48 Respondents' Self-Report of Driving After Drinking Data from the 2006 Spring National College Health Assessment (NCHA) Percent n=1,293 Emory Spring 2006 n=94,806 National Spring Reported Driving After Any Drinking At All Reported Driving After Having 5 or more drinks in the last 30 days

49 NCHA 2006 Peers' Actual Use vs. Perceived Use (N=1293, American College Health Association. ACHA-NCHA: Emory University Executive Summary Spring 2006) Percent % 50 Alcohol Cigarettes Marijuana Never Used - Reported Never Used - Perceived Used Daily - Reported Used Daily - Perceived

50 Reported Tobacco Use by Emory Respondents Past 30 Days (N=1,293; American College Health Association. ACHA-NCHA: Emory University Executive Summary Spring 2006) Percent cigarettes cigars smokeless tobacco have never used have used, but not in past 30 days used 1-29 days used all 30 days

51 OTC and Rx drug misuse 4.3% (n=55) of Emory respondents reported that they have used an over the counter (OTC) product in the last year for a purpose other than that for which it was intended. Respondents listed several reasons for misusing OTC medications including off- label use of OTC meds as sleeping aids, for allergy relief, and for pain relief. 7.5% (n=96) of Emory respondents reported that they have used a prescription medication in the last year for a purpose other than that for which it was intended. Respondents listed several reasons for misusing prescription medications: self-medication for ADHD, pain relief, and to relieve anxiety.

52 Rx Misuse 7.5% (n=97) of the Emory respondents who responded that they currently take prescription medication reported that they have had a friend or peer ask to take their medicine. 4.4% (n=57) of the Emory respondents who reported taking a prescription medicine also reported having either sold or given away some of their medicine.

53 Opportunities to Get Involved Working Group on Health and Learning Student volunteers (SHAC, programs, practicums) Thesis projects Faculty and staff research Class assignments Advocacy campaigns

54 One Example.Jill! A student s s perspective Experience using statistical software Opportunity for thesis Examined fraternity and sorority members drinking habits Also, examines members drinking behaviors and attitudes compared to non-members Thesis defense presentation: Thursday, April 5 th at 11 am in the DeHaan Room (RSPH 5 th floor)

55 Next Steps Encourage RSPH and other Emory community involvement Utilize data in HEP program development, implementation and evaluation per our strategic plan Further data analysis Prepare for next implementation IRB modification Seek greater response rate

56 Contact: Heather Zesiger, MPH, CHES Director, Health Promotion Emory University Student Health Services (404)

57 Resources for More Information Health Education and Promotion website Check out our programs, services, events and more! ACHA-NCHA website Check out this site to view the full scantron survey and the JACH article about the Spring 2006 Reference Group