Student Health Center Research Articles

“Staying in the present moment is important”: Examining the impact of a short-term classroom-based mindfulness intervention among first-year students

Objective: To determine the impact of four classroom-based sessions on mindfulness and symptoms of psychological distress among first-year students. A secondary objective was to explore participants’ involvement experiences. Participants: First-year undergraduate students at a Canadian university were recruited. Methods: A mixed-methods pre-experimental design with repeated measures was used. The mindfulness intervention involved four, 15-minute sessions delivered by a counselor from the university’s Student Health and Wellness center. Results: A significant positive change to participants’ mindfulness scores from pre- to post-intervention was observed. Qualitatively, themes relating to intervention benefits, challenges, and logistics emerged. Conclusions: Collectively, results supported the utility of this brief mindfulness intervention delivered to first-year students. Participants were appreciative of the techniques learned and the “in-class” delivery format. Given the pressures faced by post-secondary students, collaborating with student wellness centers in this way may represent a novel and efficient approach for attenuating health risks while promoting their personal wellness.

Lowering barriers to naloxone access through a student-led harm reduction program

BackgroundIn recent years, the opioid crisis has had devastating effects on communities across the country. In the wake of 4 University of Southern California (USC) student overdose deaths in 2019, USC pharmacy students initiated a naloxone distribution program called NaloxoneSC. This program has distributed free naloxone kits, fentanyl test strips, and overdose prevention training to hundreds of students thus far. This report aims to provide a framework for the implementation of similar harm reduction programs at other universities. ObjectivesNaloxoneSC partnered with USC Student Health to implement a naloxone distribution program that expands access to naloxone and increases opioid overdose education within the USC community. SettingUSC undergraduate campus and Health Sciences Campus. MethodsStudents can follow the steps for obtaining a naloxone kit listed on the NaloxoneSC website. Watching a 10-minute training video or attending a naloxone training workshop completes the opioid overdose education. The kit is picked up by the student from 1 of 2 USC Student Health Center locations, Engemann or Eric Cohen. Each kit is packaged with Narcan nasal spray and fentanyl test strips. ResultsIn 1 year, the program received at least 320 naloxone kit requests. Demand for naloxone kits increased over time, and roughly 4 times as many students requested kits from Engemann than from Eric Cohen. Approximately 600 students have received opioid overdose education through NaloxoneSC. ConclusionsIn 1 year, more than 300 USC students voluntarily requested naloxone kits from NaloxoneSC. These findings suggest a need for increased access to this resource on college campuses. Peer-to-peer education and naloxone kit distribution are feasible and effective strategies that help address public health concerns and reduce harm among university students. NaloxoneSC can serve as an example for other college campuses or entities to newly implement or expand their own harm reduction measures.

Implementing the evidence: Routine screening for depression and anxiety in primary care

Background: Primary care providers are qualified to treat, diagnose, and manage common mental health issues like anxiety and depression. Anxiety and depression are common among college age students, with the average age of onset occurring in one’s late teens to early 20s. Screening tools are commonly used to recognize patients who may be at risk for anxiety and depression. Purpose: The purpose of this evidence-based practice project was to (a) implement evidence-based guidelines for screening and management of college-aged patients with anxiety and/or depression and (b) to develop an algorithm that describes evidence-based management to guide providers at two student health centers. Methods: All patients who registered for a sick visit or other appointment at the project site were screened for anxiety and depression using two validated tools. An algorithm to help healthcare providers properly assess and better treat anxiety and depression was developed and implemented for this project. Results: A total of 366 patients were screened for depression and anxiety over a 3-month period. Using the created algorithm, patients received education on anxiety and/or depression and a counseling referral. If warranted, patients were prescribed medication therapy for depression and/or anxiety. Conclusion: Screening for anxiety and depression has become the standard of care in primary care clinics. Routine screening tools help healthcare providers identify patients with anxiety and depression. Early identification and diagnosis of anxiety and depression leads to better outcomes in treatment.

University Student Health Services, Local Experience, and Emerging Needs: Bridging the Past With the Future.

University students' health and well-being is critical, especially in the aftermath of the coronavirus disease 2019 pandemic; however, a comprehensive and integrated approach in academic institutions remains neglected. In this context, the local experience from a pilot university-based Student Health Center at an urban campus in Greece is presented. Select health promotion and disease prevention screening and monitoring initiatives are summarized from the viewpoint of a Strengths, Weaknesses, Opportunities, and Threats analysis, with emerging health needs and policy implications. Long-term sustainability is feasible, only if synergies and close collaboration with other university units and local health authorities are developed. A post-pandemic call to action for intervention programs that integrate physical and mental health care, as well as raise awareness among university stakeholders and health policy makers, is issued. [Journal of Psychosocial Nursing and Mental Health Services, 61(3), 27-31.].

Barriers to mental health services among college students screened in student health: A latent class analysis

Background: Almost a third of college students experience significant mental health concerns, but many do not receive adequate services. This study investigated barriers to mental health services among college students screened in a student health center primary care service. Method: Students (N = 1662) presenting for primary care completed mental health screenings and a barrier measure in the student health center of a university. Latent class analysis created barrier profiles. Results: Three barrier profiles were identified (none, logistical, all barriers). Profiles related to gender (p < .001), with logistical/all barrier profiles more likely amongst female students. No significant difference found by race. Students with higher depression scores were more likely to report logistical barriers than no barriers (p < .001). Conclusion: Programs must address multiple barriers to successfully engage students in treatment. Tailored interventions, including in primary care, should assess and respond to individual barriers, not just common ones.

Antibiotic stewardship with upper respiratory tract infection patients at student health centers: Providers’ communication experiences and strategies

Effective provider-patient communication can improve antibiotic stewardship in primary care, but providers find it challenging to discuss antibiotics with patients. This study, focused on college student health centers, examines patients' tactics for obtaining antibiotics for upper respiratory tract infections and providers' communication strategies for improving patient understanding and reducing demand. Health care providers (N=103) employed at student health centers on large and primarily residential college campuses in the U.S. completed an online survey. Providers perceived patients as wanting antibiotics in approximately 50% of upper respiratory tract infection visits and noted multiple patient tactics to obtain them, including reports of prior prescribing, suggested diagnoses, and direct requests. Providers used multiple strategies to manage patient demand, including explanation of the diagnosis, antibiotic utility and risks, and treatment plan. This study extends prior research indicating that patients exercise a range of influence tactics to obtain antibiotics, and thereby create discomfort for providers. The study also elucidates providers' efforts to counter these influence tactics and steward antibiotics by educating patients. Additional research is needed to specify the most effective ways for providers to respond to patients' influence tactics, including the best approaches to explaining diagnosis, treatment, and antibiotic resistance.

Implementation of a pharmacist-led hormonal contraceptive prescribing service in a campus community pharmacy in Indiana, United States

Objective(s)College-age people have the highest numbers of unintended pregnancies and pharmacies within college campuses are in a unique position to meet student needs. Our objective was to implement a pharmacist contraceptive prescribing service in a campus pharmacy and examine the service utilization. Study designThe Purdue University Pharmacy (Indiana, United States) implemented a pharmacist hormonal contraception prescribing service via a collaborative drug therapy management agreement with the campus student health center. The collaborative drug therapy management agreement enables pharmacists to independently prescribe pills, patches, rings, injections, and emergency contraception to students meeting eligibility criteria. After completing a patient health screening and blood pressure check, the pharmacist discusses the eligible method(s) and prescribes up to a 12-month supply. A referral to another provider for long-acting reversible contraception or further evaluation may also be provided. We collected basic information about each encounter (e.g., age, blood pressure, method of contraception prescribed, and time). ResultsDuring the 2020–2021 academic year, 125 prescribing consultations took place with an average appointment length of 20 minutes (range, 12–65 minutes). The median patient age was 21 years (range, 18–30 years). Eligible patients (n = 123, 98%) received a prescription and 119 (95%) prescriptions were written: combined oral pill (n = 91, 77%), injection (n = 12, 10%), patch (n = 6, 5%), vaginal ring (n = 5, 4%), and progestin only pill (n = 5, 4%). Conclusion(s)The pharmacist contraception prescribing service developed by the Purdue University Pharmacy and Student Health Center is a unique approach to meeting the needs of students. Few external resources are required for implementation, and most patients were medically eligible to receive hormonal contraception. ImplicationsCollaboration between on-campus student health centers and pharmacies can be explored as 1 approach to increase access to hormonal contraception for students.

Quantifying the Quality of Web-Based Health Information on Student Health Center Websites Using a Software Tool: Design and Development Study.

BackgroundThe internet has become a major source of health information, especially for adolescents and young adults. Unfortunately, inaccurate, incomplete, or outdated health information is widespread on the web. Often adolescents and young adults turn to authoritative websites such as the student health center (SHC) website of the university they attend to obtain reliable health information. Although most on-campus SHC clinics comply with the American College Health Association standards, their websites are not subject to any standards or code of conduct. In the absence of quality standards or guidelines, monitoring and compliance processes do not exist for SHC websites. Thus, there is no oversight of the health information published on SHC websites by any central governing body.ObjectiveThe aim of this study is to develop, describe, and validate an open-source software that can effectively and efficiently assess the quality of health information on SHC websites in the United States.MethodsOur cross-functional team designed and developed an open-source software, QMOHI (Quantitative Measures of Online Health Information), that assesses information quality for a specified health topic from all SHC websites belonging to a predetermined list of universities. The tool was designed to compute 8 different quality metrics that quantify various aspects of information quality based on the retrieved text. We conducted and reported results from 3 experiments that assessed the QMOHI tool in terms of its scalability, generalizability in health topics, and robustness to changes in universities’ website structure.ResultsEmpirical evaluation has shown the QMOHI tool to be highly scalable and substantially more efficient than manually assessing web-based information quality. The tool’s runtime was dominated by network-related tasks (98%), whereas the metric computations take <2 seconds. QMOHI demonstrated topical versatility, evaluating SHC website information quality for four disparate and broad health topics (COVID, cancer, long-acting reversible contraceptives, and condoms) and two narrowly focused topics (hormonal intrauterine device and copper intrauterine device). The tool exhibited robustness, correctly measuring information quality despite changes in SHC website structure. QMOHI can support longitudinal studies by being robust to such website changes.ConclusionsQMOHI allows public health researchers and practitioners to conduct large-scale studies of SHC websites that were previously too time- and cost-intensive. The capability to generalize broadly or focus narrowly allows a wide range of applications of QMOHI, allowing researchers to study both mainstream and underexplored health topics. QMOHI’s ability to robustly analyze SHC websites periodically promotes longitudinal investigations and allows QMOHI to be used as a monitoring tool. QMOHI serves as a launching pad for our future work that aims to develop a broadly applicable public health tool for web-based health information studies with potential applications far beyond SHC websites.

The Other "A" Word: Assessing the Accessibility of Abortion in Academia.

Objective: To assess the accessibility of abortion providers across collegiate campuses in the State of Colorado.Participants: Analysis was on secondary data from the Integrated Postsecondary Data System and the U.S. Census Bureau.Methods: We utilized a framework of Reproductive Justice to assess and interpret the accessibility of abortion providers to college students by mapping reproductive health centers and nonprofit institutions of higher education, then using these data to statistically compare racial demographics, female employment, and insurance coverage between institutions with and without access.Results: Of nonprofit postsecondary institutions in Colorado, 11 institutions lack access, serving ∼38,900 students. Of these students, 88.7% attend a Minority Serving Institution (MSI). MSIs lacking abortion access had 8% more female enrollment [t(18.32) = −2.04, p = 0.027]. Campuses possessing student health centers are less likely to have an MSI designation (50% with vs. 82% without), have greater female Hispanic enrollment by 10% [t(23.72) = 3.11, p = 0.005] and lower female multiracial enrollment by 2% [t(37.00) = 2.20, p = 0.034]. Analysis of variance (ANOVA) results indicated significant differences in percent composition of Asian, black or African American, Two or More, and Nonresident demographics between collegiate campuses with 30-, 45-, and 60-minute drive-time access. ANOVA results indicated separate patterns of differences for Zip Code Tabulation Area (ZCTA) demographics for Asian, black or African American, Native Hawaiian or Pacific Islander, Other Race, and Nonresident populations. Planned contrasts demonstrated that this difference was greatest at the 30-minute drive-time access, supporting the use of 30-minute drive time as an important indicator of access.Conclusions: The colleges lacking access to a provider are predominantly MSIs in lower income communities. The patterns in campus and ZCTA demographics indicate that collegiate populations are affected by rurality differently than the general population. We recommend that future qualitative research to assess rural students' perceptions on access, campus health center practices, and practices on campuses without dedicated health facilities.

Contraception information on the websites of student health centers in the United States

ObjectiveAs University Student Health Centers are considered reputable sources of information by many young adults, we evaluate the presence of contraceptive information on their websites. Study DesignWe used a software tool (Quantitative Measures of Online Health Information), designed for public health research to examine online information access on four broad categories of contraception and reproductive health (LARC/injectables, Contraception, Condom, Pap test) on student health center websites from all (591) public four-year universities across the United States between July to September 2020. Using a logistic regression model, we documented factors that are associated with information disparities. ResultsOur sample consisted of 545 public universities after excluding those for which information was unavailable. In 357 (66%) of the universities in our sample, we found evidence of some information related to contraception. A one percentage point increase in the student population that are Pell grant recipients, an indicator of the proportion of low-income students enrolled, is associated with a 3% to 6% (0.01<p<0.05) decrease in the odds of the presence of contraception information. A one percentage point increase in the student population that is female is associated with a 3% to 6% (0.01<p<0.1) increase in the odds of the presence of contraception information. Universities that offer medical degrees have an 82% (p<0.1) higher odds of providing information for LARC/injectables on their websites. Universities that have an institutional size of more than 10,000 students are almost four times (p<0.01) as likely to have contraception information on their websites relative to those with a smaller institutional size. ConclusionsInformation on contraception on University student health center websites is associated with on a host of factors related to student demographics, institutional characteristics, and university location. ImplicationsExamining student health center websites for contraception information can reveal important systemic gaps, especially at universities that serve nontraditional or vulnerable groups. An ongoing review is necessary to ensure equal access for all college students.

Use of a Smartphone Medication Reminder Application to Support Emerging Adult Adherence to Non-Antibiotic Treatment for Viral Upper Respiratory Tract Infection.

Objective:This research study is a test of the efficacy of a smartphone-installed medication reminder application to support provider-recommended treatment plans for young adult patients who were seen for upper respiratory tract infections (URTIs) and were not prescribed an antibiotic.Methods:Two hundred seventy-five patients seen at a university student health center for URTI symptoms were randomly assigned to the medication reminder app intervention or a control group and then surveyed both 1 and 14 days after their medical visits with questions about the treatment plan, their satisfaction with medical care, and the electronic support tools.Results:Compared to the control condition, patients using the reminder app reported more adherence to provider-recommended treatment plans. Patients with lower social support availability benefited more from being provided with these tools.Conclusion:These findings suggest that medication reminder apps have utility for increasing patient adherence to non-antibiotic URTI treatment plans, particularly among patients who lack high-quality informational and tangible social support.Innovation:This study demonstrates innovation in use of the medication reminder app to promote antibiotic stewardship with young adult patients in primary care.

Increasing reproductive health services through Family PACT participation among California community college student health centers

Objective Community college students engage in more risky sexual behavior compared to their four-year counterparts, yet have access to fewer reproductive health services. The study’s purpose was to examine whether California Community College student health centers’ participation in Family PACT, a state publicly-funded family planning program, increased reproductive health services to community colleges students. Participants California community college student health centers. Methods Bivariate analyses of student health centers with and without Family PACT participation and qualitative analysis of five participating campuses. Results Among the 60 colleges in the study, 25 student health centers participated in the Family PACT program. Family PACT campuses reported greater provision of sexual and reproductive health services and higher levels of staffing and revenue. Conclusions Key benefits of Family PACT participation among community colleges include expansion of sexual and reproductive health services to an underserved population and increased student health centers’ financial sustainability.

An immunization quality improvement learning collaborative in the college health setting

Objective To increase administration of influenza (flu), human papillomavirus (HPV) and meningococcal serogroup B (MenB) vaccinations to students at college student health centers (SHCs). Participants Improvement teams from 45 US-based SHCs. Methods Teams participated in a 7-month virtual learning collaborative to implement immunization delivery best practices at their SHCs. A pre-post-intervention design was used to compare vaccination coverage in May 2017 to May 2018 among students who were unvaccinated at the start of the academic year. Results Data were compared from 29 SHCs and 152,648 students (2017) and from 18 SHCs and 122,315 students (2018). Percent of newly vaccinated students increased for ≥1 dose of flu vaccine by 14.3 percentage points to 32.3% (p < .01), ≥1 dose of HPV vaccine by 3.9 points to 7.8% (p < .05) and ≥3 doses of HPV vaccine by 0.7 points to 1.5% (p < .05). Conclusions Participating in a learning collaborative may help SHCs improve vaccination delivery.

Strategies to improve human papillomavirus (HPV) vaccination rates among college students

Objective Improve (HPV) vaccination rates in a college-aged population using a strategic toolkit for student health services. Participants Eighteen to twenty-six year-olds enrolled at Johns Hopkins University who utilized the Student Health & Wellness Center (JHU SHWC) during the study period. Methods The toolkit comprised of a) continuing medical education (CME) presentation on strategies to improve HPV vaccination, b) campus-wide visual messaging regarding HPV prevalence, genital warts, cancer, and vaccine availability, and c) an electronic medical record (EMR) form prompting discussion about the HPV vaccine during visits. Results HPV vaccination rates at JHU SHWC improved from historical baseline 290/2,372 students/year (12.2%) to 515/2,479 students/year (20.8%), [risk ratio (RR) 1.70 (95% CI, 1.47–1.96), p < 0.001]. Additional changes included significant increases in vaccination rate per visit and vaccination rate by gender, especially among male students. Conclusions Methods and resources from this toolkit could be successfully adapted and deployed by college health centers.

Injury Patterns in Collegiate Club Quidditch

BackgroundThe purpose of this study is to assess injury patterns in collegiate club quidditch athletes at a single university over three seasons. Injury data were gathered from athletic trainers that provided sideline medical coverage during competitions, the on-site athletic training center where athletes had daily access for evaluation and treatment for acute and chronic injuries, and a sports medicine physician at the on-campus student health center. Athlete exposures were estimated using available previous rosters, practice, and game schedules for the 2014–2017 quidditch seasons. Injuries were evaluated regarding the sex of the athlete, mechanism, body part injuries, and injury type. This is a retrospective descriptive epidemiology study.ResultsThe overall injury incidence rate (IR) for collegiate club quidditch injuries was 4.55 per 1000 athlete exposures (AEs). Male athletes had an IR = 5.22 (95% CI 3.77, 7.23). Females had an IR = 3.77 (95% CI 2.49, 5.72). The most common mechanism of injury in males was collision with another athlete (36%; IR = 1.88; 95% CI 1.09, 3.24). The most common injuries were lower extremity injuries (foot, ankle, lower leg, knee, thigh, hip/groin) at 57%. The most common injury type in males was sprains at 39% (IR = 2.03; 95% CI 1.20, 3.42). The overall incidence rate for all quidditch athletes for concussions was 1.18 per 1000 AEs.ConclusionsQuidditch is an increasingly popular mixed-gender collegiate club sport. This study helps identify areas for improvement in education, injury prevention, and care of athletes at the local and national levels. Concussion rates in quidditch are comparable to other contact sports and should encourage discussion to make rule changes to improve the safety of the sport.

Risk factors associated with concussions in a college student population

PurposeTo determine risk factors associated with concussion among the general collegiate population using a unique data linkage methodology. MethodsStudent health medical, counseling, and disability access service data were linked with university enrollment data to provide a comprehensive, deidentified dataset of students who sought care at the student health center for concussion from 2016–2020. Using chi-squared tests and logistic regression, characteristics of students with and without concussion were evaluated. ResultsDuring the study period, 506 concussions from 474 students were identified (cumulative incidence rate of 51.7 per 10,000 students). Significant predictors of concussion included: younger age (<21 years): odds ratio (OR) = 3.52 (95% confidence intervals [CI], 2.78, 4.50), Greek affiliation: OR = 1.89 (95% CI, 1.56, 2.30), and utilization of counseling and psychological services: OR = 1.92 (95% CI 1.59, 2.32). Of the students with concussion, 47% had at least one other concussion within the preceding year. History of prior hospitalization or medical imaging for head injury increased subsequent concussion risk by 4.5 fold. ConclusionsLinking unique datasets provides a richer understanding of the characteristics and risk factors associated with student concussions than analysis of a single data source. This comprehensive dataset will enable future targeted interventions to prevent and treat college student concussions.

Human papillomavirus (HPV) vaccination in the transition between adolescence and adulthood

PurposeYoung adulthood is characterized by changes in health care decision-making, insurance coverage, and sexual risk. Although the human papillomavirus (HPV) vaccine is now approved for adults up to age 45, and catch-up vaccination is currently recommended up through age 26, vaccination rates remain low in young adults. This study explored perspectives on HPV vaccination among young adults receiving care at the student health center of a large public university. MethodsWe conducted semi-structured interviews (n = 27) and four focus groups with female and male undergraduate and graduate students (n = 18) and semi-structured interviews with health care providers (n = 6). Interviews and focus groups explored perceived risk of HPV infection, benefits of the HPV vaccine, and motivations for and barriers to HPV vaccination. ResultsMany young adults cited their parents’ views and recommendations from medical providers as influential on their decision-making process. Students perceived that cervical cancer prevention was a main benefit of the HPV vaccine and sexual activity was a risk factor for HPV infection. Students often lacked knowledge about the vaccine’s benefits for males and expressed some concerns about the safety and side effects of a vaccine perceived as new. Logistical barriers to vaccination included uncertainty over vaccination status and insurance coverage for the vaccine, and concerns about balancing the vaccine schedule with school obligations. Providers’ vaccine recommendations were impacted by health system factors, including clinical infrastructure, processes for recommending and documenting vaccination, and office visit priorities. Suggested vaccination promotion strategies included improving the timing and messaging of outreach efforts on campus and bolstering clinical infrastructure. ConclusionsAlthough college may be an opportune time to reach young adults for HPV vaccination, obstacles including navigating parental influence and independent decision-making, lack of awareness of vaccination status, and numerous logistical and system-level barriers may impede vaccination during this time.

Associations in preventive sexual health service utilization and pre-exposure prophylaxis (PrEP) interest among young Black women in the United States, 2018

ABSTRACT Despite declines in HIV prevalence among all U.S. women, HIV remains a serious concern for Black women. PrEP is an effective biomedical intervention and has high acceptability among Black women. Therefore, offering PrEP, in addition to screening and testing for STI/HIV consistently, can reduce HIV risk among this population. We examine the associations of preventive sexual health service utilization (PSHSU) and PrEP interest among young Black women (YBW) (N = 209) in the United States in 2018. YBW, ages 18–25, completed a self-administered questionnaire, assessing sexual risk and prevention behaviors, HIV/STI testing, and PrEP interest. More than half of YBW were aware of PrEP and its benefits. YBW, who received an HIV test within the past three to six months, had higher odds of PrEP interest. The proportion of YBW who reported being interested in PrEP did not differ by PSHSU. Active contraceptive use was associated with PrEP interest. The results suggest YBW engage in preventive sexual health services, including HIV/STI testing, reproductive health, and sexual health behavioral counseling. Additional efforts should be made to normalize PrEP education for heterosexual, cisgender women at student health centers on college and university campuses, and other venues outside of traditional HIV/STI testing facilities.

The kids are not alright: A preliminary report of Post-COVID syndrome in university students

Objective To investigate the prevalence and features of protracted COVID-19 symptoms in non-hospitalized university students who experienced mild-to-moderate acute illness. Participants COVID-19 positive participants with symptoms ≥ 28 days (N = 22), herein referred to as post-COVID syndrome, were compared to those who fully recovered (N = 21) and those never diagnosed with the disease (N = 58). Methods Students completed online study to earn research credit for class. Results 51% of COVID-19 positive participants were classified with post-COVID syndrome. During acute illness, those with post-COVID syndrome experienced more chest pain, fatigue, fever, olfactory impairment, headaches, and diarrhea compared to fully recovered participants. They also reported more current exercise intolerance, dyspnea, chest pain, olfactory impairment, lymphadenopathy, gustatory impairment, and appetite loss than students who never contracted COVID-19. Conclusions Our results contradict the perception that this yet to be defined post-COVID syndrome predominantly affects middle-aged adults. Student health centers should closely monitor those who contract COVID-19 for lingering effects.

Healthcare services utilization among international students in Ankara, Turkey: a cross-sectional study

BackgroundWhile international students form an increasing population of higher education students in Turkey, there is limited empirical evidence about their health services utilization. The study aim was to investigate healthcare access among a group of international students studying in Ankara city and identify potential barriers that affect full healthcare utilization.MethodA total of 535 international students from 83 countries completed an online-based questionnaire. The survey was conducted from September until October 2020. Variables between groups within the study sample were compared using ANOVA and Chi-square tests (with Fisher’s exact test). Logistic regression analysis was used to evaluate the relationships between variables related to access to health services.ResultsOf the study population, 80.6% accessed the general practitioner (GP), 40% accessed the student health centres, and 11.4% were admitted to the hospital at least once. About 80% of international students reported changing their views to access healthcare more because of the COVID-19 pandemic.ConclusionLack of awareness of healthcare support systems, perceived stigma associated with mental health services, and language barriers were the main barriers affecting healthcare access by international students.ImplicationsStudy findings indicate the need for education of international students on available healthcare, targeted health promotion, and training of health providers on effective communication.