University Student Health Service Research Articles

Routine outcome monitoring (ROM) and feedback in university student counselling and mental health services: Considerations for practitioners and service leads

AbstractAimRoutine outcome monitoring (ROM), including the use of feedback, has become a much vaunted method in psychological therapies but is little used in university/college counselling and mental health services, perhaps because its adoption raises questions for many practitioners and service leaders. There is a need for both clinical‐ and research‐based statements to clarify the reasoning and rationale for ROM. This paper aims to present and respond to common challenges of and reservations about using ROM in student counselling and/or mental health services.MethodThe article poses 15 questions and issues about the adoption of ROM drawn from the literature on this topic and further refined by practitioner‐ and researcher‐members of a consortium comprising service leads, practitioners, and researchers working in the field of student counselling in the UK. The questions address nine themes: (1) the purpose and yield of ROM; (2) the burden of measurement; (3) the impact on clients and process of therapy; (4) consistency with therapeutic theory; (5) client groups and settings; (6) concern from practitioners; (7) equality, diversity, and inclusion; (8) implementation; and (9) relationship with the paradigm of practice‐based evidence.FindingsResponses to each of the 15 questions are provided from a methodological, evidence‐based, and clinical perspective.ConclusionsThe responses provide practitioners with the necessary information to enable them to make informed decisions as to the value, or otherwise, of adopting ROM, including feedback, in the delivery of counselling interventions, and generating evidence created from clinical practice.

Mandatory immunizations for health students in Lyon (France), overview and evaluation

To establish an overview of vaccination amongst health students in Lyon 1 University and to evaluate the implementation of a new verification system of immunization obligations with an electronic vaccination card (EVC) from the “MesVaccins.net” website. A questionnaire was sent by the Lyon 1 University Student Health Service (SHS) to the first-year health studies students over the age of 18 in Lyon in 2020-2021 who shared their EVC; exploitation of these EVCs’ data. Amongst all students, 67.4% transmitted their information to the SHS. They reported organizational difficulties in updating (33.3%) and certifying their EVC with a healthcare professional (55.9%). Global satisfaction of the students was 78.0%. This study highlighted many differences between Lyon Est and Lyon Sud campuses, especially about general knowledge of the SHS, visibility of the promotion campaign, rate of students who transmitted their information to the SHS and rate of up-to-date students. Regarding mandatory immunization, 83.4% of the students were up-to-date with diphtheria-tetanus-poliomyelitis, 56.8% with hepatitis B, and 64.7% had done a tuberculin intradermal test; 43.4% of the students were simultaneously up-to-date with these three immunizations. The rate of up-to-date students is insufficient. This study stresses the necessity of an early campaign of immunizations promotion, with better access to healthcare professionals able to certify EVCs.

Assessing Body Measurements, Nutritional Behaviors, And Sleep Behaviors Following Implementation of Mhealth in Appalachian State University College Students

Upon completion, participants will be able to assess the potential impact of a mHealth-based health behavior and weight management intervention on college students. Chronic diseases such as obesity are common in college students. College students struggle to develop strategies to maintain healthy weight and lifestyle behaviors. mHealth programs are accessible to college students’ schedules. My Quest in the High Country collaborated with Appalachian State University (ASU) Student Health Services and the Blue Cross Institute for Health and Human Services Interprofessional Clinic to create a 24-week mHealth intervention to improve weight status, health behaviors and biometrics in ASU students.

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.].

Characteristics of teach-back as practiced in a university health center, and its association with patient understanding, self-efficacy, and satisfaction

ObjectivesThe purpose of this research was to investigate the extent to which recommended characteristics of teach-back were employed by providers in a university Student Health Services department, and to evaluate its association with patient understanding, self-efficacy, and satisfaction. MethodThe study employed a causal comparative design. Audio recordings of 87 primary care interviews were transcribed and coded for presence and characteristics of teach-back. Patients and providers filled out post-encounter questionnaires. ResultsWhen teach-back was used, most recommended characteristics of teach-back were regularly employed. However, providers rarely placed the onus for understanding on themselves, and almost never “closed the loop” by asking patients to repeat back information until they got it correct. Teach-back was associated with higher patient self-efficacy, and high fidelity of implementation with better patient understanding of the reason for the treatment plan. ConclusionsFindings add to existing evidence regarding effectiveness of teach-back. Additional benefits may be realized when implementation is true to recommended characteristics. More research is needed into the necessity of closing the loop and placing onus on the provider. Practice implicationsGiven that neither patients nor providers accurately gauged the level of patient understanding in the medical encounter, teach-back may offer a simple, quick means of reinforcing provider health information and raising patient self-efficacy.

Combatting the Epidemic of E-cigarette Use and Vaping among Students and Transitional-age Youth

Background: Over the past decade, the use of electronic nicotine delivery system (ENDS) devices such as e-cigarettes has increased dramatically, particularly among students and other transitional- age youth. Societal norms and the variety of ENDS devices available have also evolved dramatically in recent years. Objective: This article provides a comprehensive review and synthesis of contemporary literature, as it relates to ENDS use among transitional-age youth. Methods: Over 125 peer-reviewed studies, literature syntheses, legal reports and contemporary media works focused on ENDS use and vaping were reviewed. Results: Marketing strategies for ENDS devices have primarily targeted teens and young adults. Though ENDS devices are advertised as a safer alternative to cigarettes, accumulating data demonstrate significant health risks and consequences associated with use. The long-term health effects remain largely unknown; however, detrimental acute effects are apparent. Furthermore, rather than aiding in tobacco cessation efforts, the use of ENDS by transitional-age youth is correlated with the increased use of conventional tobacco products and other substances of abuse. Students appear to be ill-informed regarding the dangers of using ENDS products. Conclusion: Given the rapid increase in ENDS users each year, and accumulating concerns about health risks associated with use, university student health services must be prepared to address this growing problem. As clinical practice guidelines do not yet exist to encourage ENDS-product cessation, the use of the evidence-based strategies developed for tobacco cessation is advised. More research is needed to determine the most effective methods to prevent the initiation of ENDS use within this population.

A therapist-guided smartphone app for major depression in young adults: A randomized clinical trial

BackgroundMeru Health Program (MHP) is a therapist-guided, 8-week intervention for depression delivered via smartphone. The aim was to test its efficacy in patients with clinical depression in a Finnish university student health service. MethodsPatients (n=124, women 72.6%, mean age 25y) were stratified based on antidepressant status, and randomized into intervention group receiving MHP plus treatment as usual (TAU), and control group receiving TAU only. Depression, measured by the Patient Health Questionnaire-9 (PHQ-9) scale, was the primary outcome. After baseline (T0), follow-ups were at mid-intervention (T4), immediately post-intervention (T8); 3 months (T20), and 6 months (T32) post-intervention. ResultsThe intervention group and control group did not have significant differences in depression outcomes throughout end of treatment and follow-up. Among secondary outcomes, increase in resilience (d=0.32, p=0.03) and mindfulness (d=0.57, p=0.002), and reduction in perceived stress (d=-0.52, p=0.008) were greater in MHP+TAU versus TAU at T32; no differences were found in anxiety, sleep disturbances, and quality of life between groups. Post-hoc comparisons of patients on antidepressants showed significantly greater reduction in depression at T32 for MHP+TAU versus TAU (d=-0.73, p=0.01); patients not on antidepressants showed no between-group differences. LimitationsLimitations include unknown characteristics of TAU, potential bias from patients and providers not being blinded to treatment group, and failure to specify examination of differences by antidepressant status in the protocol. ConclusionsMost outcomes, including depression, did not significantly differ between MHP+TAU and TAU. Exploratory analysis revealed intervention effect at the end of the 6-month follow-up among patients on antidepressant medication.

Understanding barriers to prescription retrieval and attitudes toward mental health medications at a university student health services pharmacy

ObjectivesTo describe barriers affecting college students’ ability to retrieve prescription medications for mental health conditions from a community pharmacy embedded within a student health center on a university campus and then describe beliefs and attitudes toward the use of those medications. MethodsWe conducted a cross-sectional study of college students who were prescribed a medication(s) for a mental health condition(s) and left the medication(s) unclaimed at the pharmacy for at least 5 days. Eligible participants were identified through routine reminder telephone calls and then provided a link to an online survey via e-mail. The survey collected information on demographics, prescription retrieval barriers, and medication beliefs and attitudes using 2 validated questionnaires. Data were summarized using descriptive statistics and scoring methods specific to the validated questionnaires. ResultsA total of 83 e-mails were distributed with 46 usable responses received (55.4% response rate). Participants were undergraduate students (n = 38, 82.6%) and most frequently prescribed a medication(s) for depression (n = 21, 45.7%) or anxiety (n = 16, 34.8%). Forgetting to pick up their medication was the most commonly cited reason for prescription nonretrieval (n = 32, 69.6%) followed by limited pharmacy hours (n = 21, 45.7%). Participants generally viewed the necessity of their medication(s) as outweighing their concerns about their medication(s), and they generally viewed themselves as medication adherent. ConclusionsUniversity students taking medications for mental health conditions identified forgetfulness and limited pharmacy hours as the most common reasons for not retrieving prescriptions. Students generally viewed their medication(s) as necessary and themselves as medication adherent, suggesting that attitudes and beliefs may play a smaller role in medication use behaviors in this population. Future research is needed to develop and evaluate interventions that improve medication adherence in college students, potentially focused on reminder-based interventions.

Knowledge of Cervical Cancer and Adherence to Pap Smear Screening Test Among Female University Students in a Multiethnic Institution, USA

Background/PurposeThis study assessed cervical cancer knowledge and examined its correlation with adherence to Pap smear guidelines. MethodsWe carried out a cross-sectional survey in 141 undergraduate female college students. The response rate of the survey was 91.5%. Knowledge scores (0 - 4) were calculated based on students’ answers to four items. ResultsAbout 61.7% of the participants did not have annual checkups within a year, and 69% have never received Pap-test. Students who never received Pap-test mentioned procrastination (82%), lack of interest and fear as reasons for not practicing the behavior. About 92.9% of the students were not aware that the university student health service provides free Pap tests. More than double of annual checkup recipients undergone Pap test (33%) compared with those who did not have annual checkups (14.3%). Students who knew multi-partners sexual activity as a risk factor for cervical cancer had higher odds of receiving Pap test than those who didn’t know the correlation between the number of sexual partner and the risk of cervical cancer [aOR= 2.87; 95% CI 1.07- 8.90]. Students with knowledge scores about cervical cancer risk factors and prevention methods at least a median had higher odds of receiving Pap test than those with knowledge scores lower than the median [aOR=6.49; 95% CI 2.8 - 14.7]. The increase in receipt of Pap test was associated with an increase in the level of knowledge about risk factors of cervical cancer. ConclusionsThis study confirmed a correlation of the receipt of Pap test with knowing the causes and prevention mechanisms of cervical cancer. Adequate knowledge about cervical cancer causes, and prevention/control strategies may help to improve adherence to Pap smear testing in college students.

Assessment of Pharyngitis Management at a University Student Health Services Clinic

Objective: The objective of this study was to assess the management of students presenting with pharyngitis to a university health clinic. Methods: This was a retrospective cohort study. Electronic medical records of undergraduate students presenting to a university health clinic from January 1, 2012, through December 31, 2014, with complaints of sore throat and a diagnosis code for pharyngitis, tonsillitis, or sore throat were reviewed. Results: Records of 241 patients were screened and 197 patients were included. A rapid antigen detection test (RADT) was obtained in 145 (73.6%) patients. The incidence of group A streptococci (GAS) and non-GAS were 15.2% (30/197) and 10.1% (21/197), respectively. All patients with a positive RADT were prescribed antibiotics, with 13 (46.4%) receiving amoxicillin. Overall, 129 (65%) patients received an antibiotic prescription. Conclusion: Management of pharyngitis at the clinic appears inconsistent with current guidelines. Approximately 2 of every 3 students were prescribed an antibiotic with no clear indication.

What are the highly important and desirable patient engagement actions for self-care as perceived by individuals living in the southern United States?

AimThis exploratory survey study aimed to identify patient engagement actions that are the most frequently named as being highly important (top 30 by importance) or ones that they want to do (top 30 by desire) for community-dwelling adult patients living in the southern United States. Items not making the list of the top 30 by ability were also identified.BackgroundPatient engagement is still an ambiguous term among population health and health care professionals in the United States as we lack a clear understanding of what it entails.MethodsThis 2015–2016 study used convenience sampling to recruit subjects in a university’s student health service department and in eight senior centers. Two hundred and fifty adult patients older than 18 years in the Upper Cumberland region of Tennessee participated in the study (82% response rate). A 57-item inventory, “The Patient Action Inventory for Self-Care,” was developed and used to ascertain patients’ self-designated preferences and capabilities in order to understand their needs for education and support.ResultsRespondents included 159 (63.6%) women, 62 (24.8%) men, and 29 (11.6%) who did not indicate their gender. Combining the list of the top 30 importance items and the list of the top 30 desired items yielded a list of 35 items; noteworthy is the fact that the list of the top 30 ability actions contained nine items that were not found in a previously mentioned list of 35 high-ranking importance and desired items. This study validated the necessity of analyzing patient engagement actions by importance, desirability, and ability to accomplish it. These three levels are distinct from each other.ConclusionNurses may use future versions of the inventory to assist patients in identifying self-care actions to engage in. Use of the inventory will demonstrate respect for patients’ preferences and may thus improve engagement.

Integrating an Acupuncture Service at an Ivy League University Student Health Service

Abstract Background: Acupuncture is a commonly utilized complementary and alternative modality in the United States. Acupuncture is well-positioned to be integrated as a therapy in allopathic settings because there is strong evidence for its efficacy for addressing several conditions. College health populations use acupuncture more than other populations; therefore, college health centers are ideal locations to add acupuncture services Methods: The Integrative Medicine Working Group at Columbia University, New York, NY, added an acupuncture session for students on the university's Morningside Campus by aligning with the priorities of Columbia Health Services, including key stakeholders in planning, and developing a collaboration with the Pacific College of Oriental Medicine. Results: The new acupuncture session has been highly utilized with a low no-show rate and high patient-satisfaction scores. Conclusions: Program evaluation and collaboration between key stakeholders can guide the creation of a success...

Is Marijuana Use Associated With Health Promotion Behaviors Among College Students? Health-Promoting and Health-Risk Behaviors Among Students Identified Through Screening in a University Student Health Services Center

This study sought to examine whether student marijuana use identified by screening in a student health center is associated with health-promoting behaviors. Students completed a brief web-based, health behavior screening instrument. Those who reported marijuana use of monthly or more on the Alcohol, Smoking, and Substance Involvement Test (ASSIST)—and a subset of those who did not—were invited to complete additional baseline assessments, including questions about health-promoting behaviors, alcohol, and substance use ( n = 321). Results showed marijuana users were more likely to use a variety of substances and engage in hazardous drinking than non-users. Moreover, level of marijuana use was associated with greater likelihood of using a variety of substances but not with hazardous drinking. There was no evidence that marijuana use was associated with health-promoting behaviors. These findings highlight the concomitant substance-related risks associated with marijuana use but do not support the view that these students are less likely to engage in health-promoting behaviors than non-users.

Exploring treatment preferences for psychological services after abortion among college students

Objective: This study reports on the preferences for psychological treatment after abortion among college students who experienced psychological distress and desired mental health services, and provides validation of the Post Abortion Questionnaire (PAQ) as a measure of abortion intervention preferences. Background: The current study is part of a larger programme of research to develop an effective behavioural intervention for young women who seek treatment for psychological distress after abortion. Based upon an earlier study which found that college women who sought psychological treatment after abortion experienced moderate to severe symptoms of acute and chronic post-traumatic stress disorder, this study aimed to identify the components of a behavioural intervention to reduce distress after abortion that a college population would prefer. Methods: Participants were N = 45 self-selected college students from Canada and the United States who experienced psychological stress after abortion and desired psychological treatment. Data were collected from January 2007 to January 2010, and included demographic and reproductive data as well as preferences for interventions to reduce psychological distress after abortion. The study was conducted at the McGill University Student Health Services in Montreal. Results: Principal Components Analyses was used to analyse service components of the PAQ, which identified types of services that students desired, including assistance for unanticipated guilt, spiritual distress, coping, and education to understand their abortion experience. Conclusion: These findings provide evidence to develop targeted post-abortion psychological services for this population, which are generally not available in the clinical setting.

Appreciating Difference: Roy Schafer on Psychoanalysis and Women

The author describes and appreciates Roy Schafer’s critique of Freud’s view of female psychology and his other contributions to the psychoanalytic literature on women, noting his then-novel emphasis that took into account social and cultural factors in analytic treatment. She relates the influence on Schafer’s work of his ambiance in that era: the Yale University Student Health Services during the social turmoil of the 1970s (where she was his supervisee), with the university becoming coed, as well as the theoretical plurality even in the early days of the Western New England Psychoanalytic Institute.

Aurora CMHC Immediately Puts Crisis Plan Into Action

Aurora CMHC Immediately Puts Crisis Plan Into Action

College drinking: a call to physicians

The aim of this paper was to review literature related to pre­valence of drinking on college campuses and current prevention practices targeting this population. This paper focuses on current data surrounding alcohol use and misuse. It further discusses strategies which have been successful to prevent alcohol abuse. Finally, it discusses the need for further research to determine the role of the physician in alcohol prevention at university student health services.

Weill Cornell Medical College of Cornell University

Weill Cornell Medical College of Cornell University

Overbooking Increases Patient Access at East Carolina University's Student Health Services Clinic

The health-care clinic presented in this study experienced significant numbers of patients who failed to arrive for their scheduled appointments (no-shows). The cost of reducing patient access at this clinic because of no-shows is estimated to exceed $400,000 annually. An interdisciplinary quality-improvement team developed a novel health-care overbooking model that includes the effects of employee burnout. This model estimates the nonlinear nature of the costs associated with medical-provider burnout caused by overbooked appointments that exceed clinic capacity. Several key East Carolina University clinical staff members had been skeptical about the value of overbooking. The model was instrumental in convincing them that implementing an overbooking process would benefit patients and the organization. The clinic, which subsequently implemented such a process, attributes a savings of $95,000 per semester to the initiative.

What Your Patients Need to Know About Psychiatric Medicationsby Robert E. Hales, Stuart Yudofsky, and Robert Chew; Washington D.C., American Psychiatric Publishing, Inc., 2005, 356 pages, $59.95

Back to table of contents Previous article Next article Book ReviewFull AccessWhat Your Patients Need to Know About Psychiatric MedicationsDavid S. Heath F.R.C.P.C.David S. Heath F.R.C.P.C.Search for more papers by this authorPublished Online:1 Aug 2006https://doi.org/10.1176/ps.2006.57.8.1225aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This book is essentially a collection of patient education handouts about psychotropic drugs written by two psychiatrists, Robert Hales and Stuart Yudofsky, and a pharmacist, Robert Chew. It comes with a CD that the clinician can use to generate individual printed handouts. These handouts are of two types: information about a class of medications—for example, selective serotonin reuptake inhibitor antidepressants—and information about a specific drug, such as sertraline.As soon as I started reading this book, it was immediately apparent that it founders on the rock of readability. For example: "anticonvulsants…may be effective by controlling 'kindling' in the areas of the brain from which the psychiatric disorder emanates. Kindling is a phenomenon that occurs when repeated subthreshold stimulation…."Patient handouts should be easy to read, which means that they should be written at about a grade 6 reading level. Patient information provided by the American Medical Association, the American Academy of Family Physicians, and the U.S. Pharmacopoeia is written at an average reading level of grade 5 or 6.So, how is reading level measured? It's easy; you use Simple Measure of Gobbledygook (SMOG), Fog, or Flesch-Kincaid. These are all scales that measure reading level by using such items as average sentence length and number of words with three or more syllables.Applying these scales to a randomly picked section of the book resulted in the following conclusions. SMOG assessed the readability at grade 14. The Fog index score is 16; the ideal is 7 or 8. Above 12 indicates it is too difficult. Finally, the Flesch-Kincaid Grade Level Index, which can be automatically calculated on your Microsoft Word documents, is grade 12.Furthermore, in addition to not being easy to read, the book has no illustrations. It attempts to explain the biochemical theories of mental illness to patients without any diagrams. Even texts for psychiatrists have pictures.So, unless you work in a university student health service—and even in this setting the book should have illustrations—I would not recommend this book.Dr. Heath is a psychiatrist in Waterloo, Ontario, Canada. FiguresReferencesCited byDetailsCited byNone Volume 57Issue 8 August, 2006Pages 1225-1225PSYCHIATRIC SERVICES August 2006 Volume 57 Number 8 Metrics PDF download History Published online 1 August 2006 Published in print 1 August 2006