USC American College Health Association- National College Health Assessment Report: International Students

Transcription

1 USC American College Health Association- National College Health Assessment Report: International Students 2010 Health Promotion and Prevention Services University Park Health Center A Division of Student Affairs University of Southern California 1

2 Table of Contents Executive Summary...4 Trends Summary... 5 Introduction....6 Methods.6 Questionnaire design 6 Procedure...6 Response rate 6 Representativeness..6 Analytic strategy/data preparation..7 Report Design 7 Demographics.8 Health, Wellness, and Academic Success...9 Frequency of Students Whose Academic Performance was Impeded 9 Frequency vs. Threat to Academic Success (Undergraduate Students)...10 Frequency vs. Threat to Academic Success (Graduate Students).11 Emotional Status.12 Traumatic or Difficult to Handle.12 Level of Stress.13 Daytime Sleepiness 13 Safety and Violence.14 Safety Perception Safety Helmet Usage..14 Physical Fights Physical Assaults Abusive Relationships and Unwanted Sexual Advances or Sexual Assault.15 General Health, Healthcare, and Medical Status..16 General Health.16 Disabilities Status 16 Medical Status: Physical 17 Medical Status: Mental...18 Depression History...18 Sexual Behavior and Contraception 19 Unintended Pregnancy...19 Emergency Contraception...19 Number of Sexual Partners...19 Contraceptive/Birth Control Methods...20 Condom Use 20 Alcohol, Tobacco, and Other Drugs 21 Blood Alcohol Level 21 Driving Under the Influence of Alcohol 21 Consequences of Drinking Alcohol..22 Protective Drinking Behaviors...22 Substance Use v. Perceptions of Use.23 Alcohol Consumption v. Perceptions of Alcohol Consumption 24 Exercise, Nutrition, and Weight 25 Fruit and Vegetable Intake. 25 Weight...25 Body Mass Index (BMI)..26 Additional Questions...27 Descriptive Characteristics 27 Friendship Base..27 Student Involvement...27 Feeling Comfortable/Discrimination.28 Help-Seeking Behavior..29 Limitations..30 Conclusion.30 References.31 Acknowledgments 31 2

3 Appendix A.32 Appendix B.34 3

4 Executive Summary In Fall 2009, Health Promotion and Prevention services conducted the American College Health Association National College Health Assessment II (ACHA-NCHA II) on the University Park Campus (UPC). The resulting data provided valuable insights about the attitudes, perceptions, and behaviors of USC-UPC international undergraduate and graduate students regarding the following topics: safety, emotional and medical status, 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 Undergraduate students reported that the factors which most negatively impacted their academic functioning (high frequency) were stress, cold/flu/sore throat, participation in extracurricular activities, and sleep difficulties. None of these factors were a high frequency for graduate students. Traumatic or Difficult to Handle Situation Undergraduates reported that their personal appearance was more traumatic and/or difficult to handle than graduates (18.5 and 11.3, respectively, p<.01). Graduate students reported that careerrelated issues were more traumatic and/or difficult to handle than undergraduate students (40.2 and 26.3, respectively, p<.001). Sleepiness of undergraduate students and 14.2 of graduate students reported feeling tired, dragged out, or sleepy during the day 5 to 7 days out of the past week (p<.01). Safety and Violence Physical Fights and Assaults- Undergraduate students were more likely than graduate students to have engaged in a fight or to have been physically assaulted (p<.01). Healthcare, Medical, and Emotional Status General Health 93.2 of undergraduate and 91.7 of graduate students described their general health as being excellent, very good, or good. Sexual Behavior and Contraception Number of Sexual Partners of undergraduate students and 90 of graduate students reported having no more than one sexual partner in the last 12 months (p<.01). Blood Alcohol Level- Undergraduates were more likely to have a blood alcohol level of 0.10 or higher than graduates (p<.001). Consequences of Drinking Alcohol As a consequence of drinking, 25.7 of undergraduate students and 11.8 of graduate students who consumed alcohol within the last 12 months also reported that they forgot where they were or what they did (p<.001). Protective Drinking Behaviors- Compared to undergraduates, graduate students were more likely to avoid drinking games; determine in advance not to exceed a set number of drinks; keep track of how many drinks they had; pace their drinks to 1 or fewer per hour; and stick with only one kind of alcohol when drinking (p<.001). Substance Use- Undergraduates were more likely to have not used either cocaine or ecstasy in the last 30 days (p<.001), while graduates were more likely to never have used hookah or marijuana (p<.001). Alcohol Consumption- During the last time they partied, undergraduates were more likely to have consumed 5 or more alcoholic drinks than graduates (p<.001). 4

5 Exercise, Nutrition, and Weight Calculated Body Mass Index 76.7 of undergraduate students had a calculated BMI indicating a healthy weight, compared to 66.6 of graduate students (p<.05). Trends Summary In previous reports, the ACHA-NCHA Trends Summary was included to reflect noticeable variations between the report from previous years and the current report. The revised survey, the ACHA-NCHA II, includes the same categories as the previous survey, but has a number of modified and added questions. As a result, the ACHA-NCHA II is not appropriate for examining trends from the original ACHA-NCHA survey, except for specific isolated questions. 5

6 Introduction A college health program is the constellation of services, strategies, policies, and facilities an institution of higher education assembles to advance the health of its students and the academic community. On many campuses, college health programs move well beyond health care and refer to a variety of services. These services often include a combination of some or all of the following: student health services, disability services, counseling services, crisis intervention and public safety services, health promotion and wellness services, alcohol tobacco and other drug programming, student health insurance/benefit programs, sexual assault advocacy services, sports medicine services for intercollegiate athletics, and intramural recreation sports and fitness programs. In order to provide high quality services in these diverse areas, it is imperative to possess data that adequately describes the health behaviors and status of the student population. This data helps to inform policy makers, administrators, faculty, staff, and students about current health behaviors and helps determine programmatic priorities. 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 mental health. The goal of this assessment is to provide data on the prevalence, status, and misperceptions about student behavior and the campus community. This data can serve as a guide to campus leadership by providing a firm basis for planning and evaluating services that will positively impact international students safety, well-being, and academic success. This report provides data on the population of international students at the University Park Campus and highlights differences in the undergraduate and graduate student populations whose numbers are uniquely equally proportionate on the campus. There is an aggregate report which is compiled by ACHA. While the sample is large, is it not a true national sample, as it is not representative of the vast diversity of neither the institutions nor the students enrolled therein. To view the report, please visit This report summarizes key points from the survey. Due to the length of the survey, not all data points have been included. For more information about the analysis of additional questions, please contact Health Promotion and Prevention Services at the University Park Health Center at (213) 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 Fall The ACHA-NCHA II was ed to the 6,100 international undergraduate and graduate student populations at the University Park Campus. All 6,100 international students were sent an alerting them to the forthcoming survey, as well as two follow-up s after receiving the survey in an effort to increase the return rate. To incentive completing the survey, every 25th participant received an itunes gift card and ten $100 Visa gift cards were drawn by lottery. Response rate: In 2009, completed surveys were returned for a 16.0 response rate. Of those who responded, 22.4 indicated that they were undergraduate students and 77.6 indicated that they were graduate students. Representativeness: It appears the data collected accurately represents the USC University Park Campus international student population, based upon the representativeness analysis performed on the Fall 2009 data. Though the sample was robust, biases exist in the data. The largest bias occurred with regard to graduate status; there was an overrepresentation of graduate students, with 79.3 returning the survey compared to USC s 71.3 international graduate student representation. There was also an overrepresentation of female students, with 44.7 returning the survey as compared to the 38.7 international female demographic representation at USC. Furthermore, other discrepancies occurred, such as an underrepresentation of seniors by 3.9 and an underrepresentation of juniors by 6

7 2.8. Additionally, there was an overrepresentation of engineering students by 33.0, though this is to be expected due to the overrepresentation of graduate students. Several other discrepancies exist as well. (Please refer to Appendix A for the representativeness table). Analytic strategy/data preparation: This report focuses on the surveys that were conducted in Fall Appropriate 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. Report Design: While many of the questions from the previous version of the survey are still present, new questions regarding special health concerns for the international students on the University Park Campus are included at the end of this report. Please refer to Appendix A for more information. 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 Paula Swinford, Director of Health Promotion and Prevention Services at or <swinford@usc.edu>. 7

8 Demographics Descriptor Category Undergraduate (n=207 ) Graduate (n=717) Age Under and higher Gender Female Male Transgender Year in school 1st year undergraduate nd year undergraduate rd year undergraduate th year undergraduate th year or more Graduate Full-time student status Transferred to USC within last 12 months Ethnicity White not Hispanic (includes Middle Eastern) Black not Hispanic Hispanic or Latino Asian or Pacific Islander American Indian, Alaskan Native, or Native Hawaiian Biracial or Multiracial Other International student status Membership in fraternity or sorority Relationship status Not in a relationship In a relationship but not living together In a relationship and living together Marital status Single Married/Partnered Separated Divorced Other Sexual orientation Heterosexual Gay/Lesbian Bisexual Unsure Living situation Campus residence hall Fraternity or sorority house Other campus housing Parent/guardian s home Off-campus housing Other Source of health insurance USC sponsored plan Parents plan Another plan I don t have health insurance Paid hours worked per week None to or more Volunteered 1 or more hours per week Organized college athletics participation Varsity Club sports Intramurals All results are reported as percentages. The discrepancy between the total number of participants reported on p.5 of this booklet 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. 8

9 Health, Wellness, and Academic Success 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 or dropped a course; received a lower grade in a course, on an exam or on an important project) Undergraduate Graduate P-Value Anxiety NS Cold/Flu/Sore throat <.001 Concern for a troubled friend or family member NS Depression <.05 Internet use/computer games <.05 Participation in extracurricular activities <.001 Relationship difficulties NS Sleep difficulties <.001 Stress <.001 Work NS Death of a family member <.05 Homesickness NS Bold items represent the top ten items. In previous years, only a frequency list, as seen above, was reported. What follows is a cluster analyses, created by making a two dimensional graph representing a set of bi-variate data (scatter plot) of those who reported 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 10-11: Scatter Plots - Threat to Academic Success as Related to the Frequency of Health-Related Behavior or Concerns 9

10 Scatter Plot- Threat to Academic Success as Related to the Frequency of Health Related Behavior or Concern (Undergraduate Students) 80.0 Threat: Percent of Those Experiencing Condition with Academic Impact Learning disability Depression Other Attention Deficit and Hyperactivity Disorder (ADHD) Chronic pain Assault (sexual) Sexually transmitted disease/infection (STD/I) Drug use Death of a friend or family member Pregnancy (yours or your partner s) Sinus infection/ear infection/bronchitis/strep throat Eating disorder/problem Finances Chronic health problem or serious illness Gambling Assault (physical) Discrimination Work Injury (fracture, sprain, strain, cut) Allergies Anxiety Relationship difficulties Concern for a troubled friend or family member Roommate difficulties Sleep difficulties Homesickness Internet use/computer games Participation in extracurricular activities Cold/Flu/Sore throat Stress Alcohol use Frequency: Percent in Population Experiencing Condition 10

11 60.0 Scatter Plot- Threat to Academic Success as Related to the Frequency of Health Related Behavior or Concern (Graduate Students) Other Threat: Percent of Those Experiencing Condition with Academic Impact Attention Deficit and Hyperactivity Disorder (ADHD) Sexually transmitted disease/infection (STD/I) Learning disability Pregnancy (yours or your partner s) Assault (sexual) Chronic health problem or serious illness Assault (physical) Death of a friend or family member Discrimination Chronic pain Eating disorder/problem Depression Anxiety Work Relationship difficulties Concern for a troubled friend or family member Finances Sleep difficulties Roommate difficulties Participation in extracurricular activities Injury (fracture, sprain, strain, cut) Allergies Sinus infection/ear infection/bronchitis/strep throat Internet use/computer games Cold/Flu/Sore throat Homesickness Stress Drug use Gambling Alcohol use Frequency: Percent in Population Experiencing Condition 11

12 Emotional Status - Refer to Question 30 of the survey. Have you ever? Yes, in the last 12 months No, not in last 12 months No, never P-Value UG G UG G UG G Felt things were hopeless NS Felt overwhelmed by all you had to do NS Felt exhausted (not from physical activity) NS Felt very lonely NS Felt very sad NS Felt so depressed that it was difficult to function NS Felt overwhelming anxiety NS Felt overwhelming anger NS Intentionally injured yourself NS Seriously considered suicide NS 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? Undergraduate Graduate P-Value Academics <.05 Career-related issue <.001 Death of a family member or friend NS Family problems NS Finances NS Health problem of a family member or partner NS Intimate relationships NS Personal appearance <.01 Personal health issue NS Sleep difficulties NS Other relationships <.05 Other <.05 Bold items represent the top 5 items. 12

13 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? Undergraduate Graduate Percentage No stress Less than average stress Average stress More than average stress Tremendous stress Level of Stress 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? Percentage Undergraduate Graduate Not at all A little More than a little Big Very big Problem level of daytime sleepness 13

14 Safety and Violence Safety Perception Refer to Question 7 of the survey. How safe do you feel (at the following place and time combinations)? Percentage Not safe at all Somewhat unsafe Somewhat safe Very safe On campus (daytime) On campus (nighttime) Community around USC (daytime) Community around USC (nighttime) In the graph above, undergraduate and graduate results were combined. Graduate students were more likely to perceive the community surrounding USC during the daytime as very safe while more undergraduate students perceived it as somewhat safe (p<.05). Safety Helmet Usage - Refer to Question 4 of the survey. Within the last 12 months, how often did you wear a helmet when you rode a bicycle/rode a motorcycle/were inline skating? Percentage* Bicycle Motorcycle Inline skating Most of the time or always Rarely or sometimes Never 5.1 In the graph above, undergraduate and graduate results were combined. *Percentages represent students who have participated in this activity within the last 12 months. 14

15 Physical Fights 7.8 of undergraduate and 3.4 of graduate students reported being involved in a physical fight within the last 12 months (p<.01). Refer to Question 5 of the survey. Physical Assaults 4.9 of undergraduate and 1.7 of graduate students reported that they were physically assaulted (does not include sexual assault) within the last 12 months (p<.01). Refer to Question 5 of the survey. 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 experienced? Undergraduate Graduate P-Value Sexual touching without your consent NS Attempted sexual penetration without your consent NS Sexual penetration without your consent NS Within the last 12 months, have you been in a relationship that was? Undergraduate Graduate P-Value Emotionally abusive NS Physically abusive NS Sexually abusive NS 15

16 General Health, Healthcare, and Medical Status General Health - Refer to Question 1 of the survey. How would you describe your general health? Percentage Excellent Very good Good Fair Poor Undergraduate Graduate General health Disabilities Status - Refer to Question 65 of the survey. Do you have any of the following disabilities or medical conditions? Undergraduate Graduate P-Value Attention Deficit and Hyperactivity Disorder (ADHD) NS Chronic illness NS Deaf/Hard of hearing NS Learning disability NS Mobility/Dexterity disability NS Partially sighted/blind NS Psychiatric condition NS Speech or language disorder NS Other disability NS 16

17 Medical Status: Physical - Refer to Question 41 of the survey. Within the last 12 months, have you been diagnosed or treated by a professional for? Undergraduate Graduate 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 NS Genital warts/human Papillomavirus (HPV) <.05 Gonorrhea NS Hepatitis B or C NS High blood pressure NS High cholesterol <.05 Human Immunodeficiency Virus (HIV) NS Irritable Bowel Syndrome (IBS) NS Migraine headache NS Mononucleosis NS Pelvic Inflammatory Disease (PID) NS Repetitive stress injury NS Sinus infection NS Strep throat NS Tuberculosis NS Urinary tract infection NS 17

18 Medical Status: Mental - Refer to Question 31 of the survey. Within the last 12 months, have you been diagnosed or treated by a professional for? Treated with medication, psychotherapy, or other treatments Diagnosed but not treated UG G UG G P-Value Anorexia NS Anxiety NS Attention Deficit and Hyperactivity Disorder (ADHD) NS 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 Depression History 5.9 of students surveyed (7.8 of undergraduate students and 5.0 of graduate students) responded yes to Have you ever been diagnosed with depression? Refer to Question 32 of the survey. 18

19 Sexual Behavior and Contraception Unintended Pregnancy Among respondents who have had vaginal intercourse, 0.5 of undergraduate students and 0.9 of graduate students have unintentionally become pregnant or gotten someone else pregnant within the last 12 months. Refer to Question 25 of the survey. Emergency Contraception Among respondents who indicated that they are sexually active, 6.4 of undergraduate students and 7.2 of graduate students have used or had a partner who used emergency contraception ( morning after pill ) within the last 12 months. Refer to Question 24 of the survey. 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? Undergraduate 50 Graduate Percentage or more Number of partners There was a statistically significant difference between undergraduate and graduate students on the number of sexual partners within the last 12 months (p<.01). 19

20 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? Undergraduate Graduate P-Value Birth control pills (monthly or extended cycle) NS Birth control shots NS Birth control implants NS Birth control patch NS Condom (male) NS Condom (female) NS Contraceptive sponge NS Diaphragm or cervical cap NS Fertility awareness (e.g. calendar, mucous, basal body temperature) NS Intrauterine device (IUD) NS Spermicide (e.g., foam, jelly, cream) NS Sterilization (e.g., hysterectomy, tubes tied, or vasectomy) 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. Bold items represent the top 3 items. Condom Use - Refer to Question 21 and Question 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? Engaged in this sexual activity Undergraduate Always used a condom Engaged in this sexual activity Graduate Always used a condom Oral sex Vaginal intercourse Anal intercourse

21 Alcohol, Tobacco, and Other Drugs Blood Alcohol Level Refer to Question 10 and Question 50 of the survey. Undergraduate Graduate P-Value Mean Median or higher < or higher <.001 The formula for estimating BAC is applied to the reported number of drinks and number of hours for the last time students "partied"/socialized, weight, as well as 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 the alcohol was consumed at a constant rate over the drinking episode. Driving Under the Influence of Alcohol- Refer to Question 14 of the survey. Within the last 30 days, did you drive after having 5 or more drinks? Percentage Undergraduate Graduate Don't drive Don't drink No Yes 21

22 Consequences of Drinking Alcohol 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 Undergraduate Graduate P-Value Did something you later regretted NS Forgot where you were or what you did <.001 Got in 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 <.05 Physically injured another person NS Seriously considered suicide NS Since multiple responses were possible, more than 100 may be indicated. Protective Drinking Behaviors - Refer to Question 15 of the survey. During the last 12 months, when you partied/socialized, [did you always]? Undergraduate Graduate P-Value Alternate non-alcoholic with alcoholic beverages NS Avoid drinking games <.001 Choose not to drink alcohol <.05 Determine, in advance, not to exceed a set number of drinks <.001 Eat before and/or during drinking NS Have a friend let you know when you have had enough <.05 Keep track of how many drinks you were having <.001 Pace your drinks to 1 or fewer per hour <.001 Stay with the same group of friends the entire time you were drinking NS Stick with only one kind of alcohol when drinking <.001 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 presented in the table for simplicity, however the p-values represent the range from never to always, not just Always. 22

23 Substance Use v. Perceptions of Use - Refer to Question 8 and Question 9 of the survey, respectively. Within the last 30 days among UNDERGRADUATE students (): Actual Use: How many days did you use the following substances? Perception of Use: 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 Never One or more days Used daily Cigarettes Hookah Cigars, little cigars, clove Smokeless tobacco Alcohol Marijuana Cocaine Methamphetamine Other amphetamines Sedatives Hallucinogens Anabolic steroids Opiates Inhalants MDMA (Ecstasy) Other club drugs Other Illegal drugs All results are reported as percentages. Within the last 30 days among GRADUATE students (): Actual Use: How many days did you use the following substances? Perception of Use: How often do you think the typical student at your school used? Never One or Used more days daily Substance Never Not in last 30 days One or more days Used daily Cigarettes Hookah Cigars, little cigars, clove Smokeless tobacco Alcohol Marijuana Cocaine Methamphetamine Other amphetamines Sedatives Hallucinogens Anabolic steroids Opiates Inhalants MDMA (Ecstasy) Other club drugs Other Illegal drugs All results are reported as percentages. There is a statically significant difference between undergraduates and graduate students on hookah usage (p<.001), marijuana usage (p<.001), cocaine usage (p<.001), ecstasy usage (p<.001), and other illegal drug usage (p<.01). There is a statically significant difference between undergraduates and graduate students on the perception of cigarettes usage (p<.05), hookah usage (p<.001), marijuana usage (p<.001), and cocaine usage (p<.01). 23

24 Alcohol Consumption v. Perceptions of Alcohol Consumption - Refer to Question 10 and Question 12 of the survey, respectively. The last time you partied /socialized, how many drinks of alcohol did you have? Undergraduate Students Percentage Actual Perceived to 4 5 to 7 8 or more Number of drinks Graduate Students Percentage Actual Perceived to 4 5 to 7 8 or more Number of drinks There is a statistically significant difference between undergraduate and graduate students and the consumption of alcohol (p<.01) and a statistically significant difference between undergraduate and graduate students and perceived consumption of alcohol (p<.001). 24

25 Fruit and Vegetable Intake - Refer to Question 28 of the survey. Exercise, Nutrition, and Weight How many servings of fruits and vegetables do you usually have per day? Percentage Undergraduate Graduate I don't eat fruits and vegetables 1-2/day 3-4/day 5 or more Fruit and vegetable intake Weight - Refer to Question 26 of the survey. How do you describe your weight? Undergraduate Graduate Percentage Very underweight Slightly underweight Right weight Slightly overweight Very overweight Weight description 25

26 Body Mass Index (BMI) Calculated using Questions 47, 49a, 49b, and 50 of the survey. BMI Undergraduate Graduate P-Value <18.5 Underweight NS Healthy Weight < Overweight < Class I Obesity < Class II Obesity NS 40 Class III Obesity NS Mean Median 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 Obesity: Preventing and Managing the Global Epidemic. WHO Tech Report Series:

27 Additional Questions This section of the report highlights important findings in the data from additional questions that were created specifically for this questionnaire, in an effort to better understand the adjustment of the international student population at the University Park Campus for the fall of Please refer to Appendix A for the full list of additional questions. Descriptive Characteristics - Refer to Question 66 and 73 of the survey. How long have you lived in the U.S.? Male Female UG Grad Total Less than 6 months months to 1 year More than 1 year to less than 3 years More than 3 years to less than 5 years years or more **All results are reported as percentages within the column. There is a statistically significant difference between undergraduate and graduate students and time lived in the U.S. (p<.001). How well do you speak English? Male Female UG Grad Total Fluently Well Average Poor **All results are reported as percentages within the column. Friendship Base - Refer to Question 67 of the survey. Which statement best describes the majority of your friends? Male Female UG Grad Total People from my own country who are students at USC People from my own country who are not students at USC People from many countries, other than Americans, who are students at USC A mixture of American and international students American students **All results are reported as percentages within the column. There is a statistically significant difference between undergraduate and graduate students and description of friends (p<.001) and between sex and description of friends (p<.01). Student Involvement - Refer to Questions 68 through 71 and Question 72 of the survey, respectively. Do you participate in any student organizations that are Nationality clubs? Male Female UG Grad Total Yes No **All results are reported as percentages within the column. 27

28 Do you participate in any student organizations that are Sports/Recreation clubs? Male Female UG Grad Total Yes No **All results are reported as percentages within the column. There is a statistically significant difference between undergraduate and graduate students and participation in student organizations that are sports/recreation clubs (p<.001) and between sex and participation in student organizations that are sports/recreation clubs (p<.05). Forty percent of first year students participated in student organizations that are sports/recreation clubs. Do you participate in any student organizations that are Religious clubs? Male Female UG Grad Total Yes No **All results are reported as percentages within the column. Do you participate in any student organizations that are Academic clubs? Male Female UG Grad Total Yes No **All results are reported as percentages within the column. There is a statistically significant difference between undergraduate and graduate students and participation in student organizations that are academic clubs (p<.001). Do you have an On-Campus job? Male Female UG Grad Total Yes No **All results are reported as percentages within the column. There is a statistically significant difference between undergraduate and graduate students and having an on-campus job (p<.001) and between sex and having an on-campus job (p<.01). Feeling Comfortable/Discrimination - Refer to Questions 80 and 74 of the survey. While on campus, I am able to purchase the food that I want to eat. Male Female UG Grad Total Always Often Sometimes Rarely Never **All results are reported as percentages within the column. Have you been treated unfairly by your teachers or professors because you are an international student? Male Female UG Grad Total Yes No **All results are reported as percentages within the column. There is a statistically significant difference between undergraduate and graduate students and being treated unfairly because of international status and between sex and being treated unfairly because of international status (p<.001). Twenty-eight (27.7) percent of third-year undergraduates have been treated unfairly by teachers because of their international status. 28

29 Help-Seeking Behavior - Refer to Question 75 of the survey. In general, when you are experiencing problems, which USC office are you most likely to go to first to seek help? Male Female UG Grad Office of International Services Departmental Academic Advisor Student Health Center Student Counseling Services Housing Resident Advisor I do not seek help at USC There is a statistically significant difference between undergraduate and graduate students and where they go to seek help and between sex and where they go to seek help (p<.001). Within the last 12 months, I have talked about personal concerns with: Male Female UG Grad Total A medical healthcare professional (physician, nurse, physician assistant, nurse practitioner) A traditional, non-western medical healthcare professional (acupuncturist, herbalist) A mental healthcare professional (psychologist, social worker, psychiatrist) A community or religious leader **Only yes responses are reported as percentages within the column. Participants who did not answer all the 4 questions were excluded. There is a statistically significant difference between sex and students discussing their personal concerns with a medical professional, a nonwestern medical professional (p<.001), and a mental health professional (p<.01). 29

30 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 international students on the USC University Park Campus in terms of demographics and college major, 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 respondent an opportunity to share more accurate information than may 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 sixteen percent achieved in these surveys is in alignment with the steady downward trend of response rates over the past few years. However, unsuccessful delivery and bounced messages may have led to this year s low response rate. As such, the response rate is not of sufficient size to ensure representativeness on all important factors. Therefore, until further research is done, the results described in this report should be regarded as preliminary research data. Conclusion USC prides itself on being a pluralistic, global institution that is home to more international students than any other American university. By selecting to survey the international student population for this year s report, HPPS acknowledges that international students face different challenges than domestic students, but also have unique opportunities. It is crucial then, to look at the health related attitudes, behaviors, and perceptions of international students to determine if their specific needs are being met, and what USC can do better to make this their home away from home. This report paints a picture of the health-related experience of international students while at USC. Most students reported their general health as being excellent, very good, or good. Despite being in generally good health, students reported specific health related behaviors or concerns, such as stress and inadequate sleep, which impeded their academic performance. In addition, the vast majority of students felt overwhelmed by all they had to do and exhausted (not from physical activity) at least once in the past year. Perhaps most tellingly, when international students are facing problems, the Office of International Services was the most likely destination students reported to seek help. While the reason for this is unclear, it may be because this is the department with which international students are most familiar, feel most comfortable at, and know that they can go for help. It is necessary to both provide the Office of International Services with resources they can use to better assist these students and to make available services on campus more familiar and welcoming to the international student population. Ultimately, collaborating with various departments on campus, particularly the Office of International Services, will allow us to best reach, and ultimately serve our large international student population here at USC. 30

31 References ACHA-NCHA website: Health Promotion and Prevention Services website: Student Counseling Services website: Student Medical Services website: Healthy Trojans website: If you have any questions about this document and/or the data presented please call or Acknowledgments This report would not have been possible without the contributions, dedication, and patience of the following individuals: Michael Jackson, Vice President of Student Affairs Tony Tambascia, Assistant Dean of Students and Executive Director, Office of International Services Anne Kaufman, Business Manager, Office of International Services Rebecca Peterson, International Student Advisor, Larry Neinstein, Executive Director, University Park Health Center Paula Swinford, Director, Health Promotion and Prevention Services Brittney Stewart, Undergraduate Assistant, Health Promotion and Prevention Services Natasha Mmeje, Health Educator, Health Promotion and Prevention Services Lauren Perez, Intern, Health Promotion and Prevention Services Ali Fahmy, Director, Student Outcomes Research Ray Gonzalez, Senior Director, Research and Reporting A special thanks to the entire Health Promotion and Prevention Services staff, including the Peer Health Educators (PHEs) for their continued support and feedback. And finally, thank you to all the students who sent in completed surveys; your efforts help us to serve you better. 31

32 Appendix A Additional Questions 1. How long have you lived in the U.S.? 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 year to less than 5 years E. 5 years or more 2. 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, other than Americans, who are students at USC D. A mixture of American and international students E. American students 3. Do you participate in any student organizations that are Nationality clubs? A. Yes B. No 4. Do you participate in any student organizations that are Sports/Recreation clubs? A. Yes B. No 5. Do you participate in any student organizations that are Religious clubs? A. Yes B. No 6. Do you participate in any student organizations that are Academic clubs? A. Yes B. No 7. Do you have an On-Campus job? A. Yes B. No 8. How well do you speak English? A. Fluently B. Well C. Average D. Poor 9. Have you been treated unfairly by your teachers or professors because you are an international student? A. Yes B. No 10. In general, when you are experiencing problems, which USC office are you most likely 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 USC when I am experiencing problems 32

33 11. Within the last 12 months, have you talked about personal concerns with a medical healthcare professional (for example: Physician, Nurse Practitioner, Physician Assistant, Nurse)? A. Yes B. No 12. Within the last 12 months, have you talked about personal concerns with a traditional non-western medicine healthcare professional other than (for example: Acupuncturist, Herbalist)? A. Yes B. No 13. Within the last 12 months, have you talked about personal concerns with a mental healthcare professional (for example: Counselor, Psychologist, Social Worker, Psychiatrist)? A. Yes B. No 14. Within the last 12 months, have you talked about personal concerns with a community or religious leader? A. Yes B. No 15. 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 33

34 Appendix B Representativeness of the 2009 Sample DESCRIPTOR All Students Returned Survey Difference Class Doctoral/Masters/ Professional Freshman Sophomore Junior Senior Gender Female Male Ethnicity International Cumulative GPA by Class Doctoral Masters Freshman Sophomore Junior Senior OWNING UNIT ACCT ANSC ARCH BUAD CNTV DENT EDUC ENGR FA GERO GSBA JDPP LASH LASN LASO LASS LAW MUS PPD SOWK THTR SOWK USC CITIZENSHIP Citizen of: India China South Korea Taiwan Canada Hong Kong Japan Indonesia Iran United Kingdom