Session

College Health Initiatives

Christine Hackman, PhD, MCHES, AL

APHA 2021 Annual Meeting and Expo

Abstract

Adherence to preventive behaviors among college students during COVID-19 pandemic in China: The role of health beliefs and COVID-19 stressors

Cheuk Chi Tam, Ph.D.1, Xiaoyan Li2, Danhua Lin, PhD2 and Xiaoming Li, Ph.D.3
(1)University of South Carolina, Columbia, SC, (2)Beijing Normal University, Beijing, China, (3)University of South Carolina Arnold School of Public Health, Columbia, SC

APHA 2021 Annual Meeting and Expo

Background: As the COVID-19 pandemic is initially suppressed, many colleges have reopened and offered in-person lectures. Before effective vaccines are widely distributed, adherence to preventive behaviors (e.g., social distancing) still plays an important role in controlling the COVID-19 epidemic on campus. Health belief model (HBM) posits cognitive influences on preventive behaviors. However, most HBM studies on COVID-19 were conducted at the early pandemic. Little attention has been paid to the impacts of accumulative pandemic stress exposure on HBM constructs and preventive behaviors over time. This study aims to examine the association among COVID-19 stressors, HBM constructs, and preventive behaviors among Chinese college students. Methods: Longitudinal data were collected from 1225 Chinese college students using web-based surveys at wave 1 (w1; between January 31 and February 11, 2020) and wave 2 (w2; between March 20 and April 3, 2020). Paired t-tests were used to test the changes of preventive behaviors (social distancing, self-quarantine, and precautionary behaviors) between w1 and w2. Path analysis was utilized to examine a mediation model among COVID-19 stressors (w1), five HBM constructs (w2), and preventive behaviors (w2). Results: Between two waves, social distancing and self-quarantine behaviors decreased while precautionary behaviors increased. Two HBM constructs (perceived barriers and self-efficacy) mediated the association between COVID-19 stressors and precautionary behaviors. Conclusion: Perceived barriers and self-efficacy appear to be core factors contributing to preventive behaviors after the initial outbreak. Initial COVID-19 stressor exposure could shape later health beliefs and preventive behaviors. Tailored prevention intervention should address perceived barriers and self-efficacy. Individuals who are exposed to multiple pandemic stressors merit particular attention.

Planning of health education strategies, interventions, and programs Public health or related research Social and behavioral sciences

Abstract

College students' perceptions of social influence on COVID-19 health beliefs and behaviors

Afolakemi Olaniyan, NITP, RTP, MS, MPH, Laura Nabors, PHD, Kayleigh Fiser, MSW, LISW and Ashley L. Merianos, PhD CHES
University of Cincinnati, Cincinnati, OH

APHA 2021 Annual Meeting and Expo

Background: Social influences may shape the health beliefs and behaviors of college students related to COVID-19, such as wearing a mask. Our objective was to explore the perceptions of college students about the influence parents, friends, significant others, and the media have on their COVID-19 health perceptions and behaviors.

Methods: Participants were 41 college students (13 were of color) at a large, Midwestern university. Virtual interviews were conducted via Microsoft Teams to explore student perceptions of social influences on their COVID-19 health perceptions and behaviors. Qualitative data were analyzed using an open coding method.

Results: Interviews revealed common themes of parents typically following safety precautions, but a few participants perceived their parents did not wear masks or practice social distancing. Friends often wore masks; however, social gatherings could be a time when friends did not follow safety guidelines. Another common theme was that significant others could be a positive influence, by wearing masks and practicing social distancing. Positive behaviors, like social distancing, were portrayed in the media, and several participants followed positive media influencers and reviewed CDC guidelines. Conversely, some media sites showed individuals not wearing masks and not taking guidelines seriously.

Conclusions: Results may provide guidance for COVID-19 prevention messaging and interventions. Parents, friends, and significant others had a perceived positive influence on the COVID-19 health perceptions and behaviors of students. Social gatherings were perceived as having a negative effect, whereas there were varying perceptions about the media. Future research should promote safety behaviors of students during this pandemic.

Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Protection of the public in relation to communicable diseases including prevention or control Public health or related education Public health or related research Social and behavioral sciences

Abstract

Food and housing insecurity and the relationship with sleep health among students from eight North Carolina universities and colleges

Abby Macfarlane1, Aaron Carpenter1, Adam Hege, PhD, MPA1, Marina Rogers1, Aidan Estes1, Sydney Ayers1, Eliza Hancock1, Elizabeth Dull1, Rebecca Hagedorn, PhD2, Lanae Hood, PhD2, Julia Waity, PhD3, Jessica Soldavini, PhD, MPH, RD, LDN4, Amelia Huelskamp, PhD3, Elizabeth Wall-Bassett, PhD5, Lillian MacNell6, Christopher Paul, PhD7, J. Porter Lillis8 and Maureen Berner, PhD4
(1)Appalachian State University, Boone, NC, (2)Meredith College, Raleigh, NC, (3)University of North Carolina @ Wilmington, Wilmington, NC, (4)University of North Carolina @ Chapel Hill, Chapel Hill, NC, (5)Western Carolina University, Cullowhee, NC, (6)Campbell University, Buies Creek, NC, (7)North Carolina Central University, Durham, NC, (8)University of North Carolina @ Pembroke, Pembroke, NC

APHA 2021 Annual Meeting and Expo

Background: Two major social determinants of health, food and housing insecurity, are growing social and public health problems among U.S. university and college students and have significant implications for their health and wellbeing, including sleep health.

Methods: College and university students (N=6,263) at eight higher education institutions in North Carolina completed an online, cross-sectional survey. The 10-item Adult Food Security Survey Module was used to assess food insecurity status. Housing Security was measured by using six adapted questions from the national Survey of Income and Program Participation (SIPP) Adult Well-Being Module (if answering “yes” to any of the questions, the student was housing insecure). The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and sleep associated outcomes. Descriptive analyses were performed and Pearson’s chi-square tests were utilized for comparisons.

Results: Food insecurity (43%) and housing insecurity (48%) were prevalent across the sample. Almost one-third (30%) reported a ‘fairly or very bad’ sleep quality in the past month and 43.6% of students were obtaining less than seven hours of sleep nightly. The mean PSQI score was 7.34 (SD=3.56) and 65.5% had a score of six or greater. Food insecurity (OR=1.80; OR=2.69) and housing insecurity (OR=1.28; OR=1.51) were both associated with increased odds of a shorter sleep duration (<7 hours) and a PSQI score of six or greater.

Conclusions: As college and university administrators and officials plan and develop interventions for improved student health and well-being, it is vital to consider the food and housing security needs of students in relation to sleep-associated health outcomes.

Advocacy for health and health education Assessment of individual and community needs for health education Public health or related research Social and behavioral sciences

Abstract

Are university students willing to receive a COVID-19 vaccine?

Joshua Bishop, PhD, LMSW1, Kelsey Lantis, B.S., MSW Candidate2, Hannah Noorman, B.S. Candidate2, Alexis Emelander, B.S. Candidate2 and Ari Deherder, B.S. Candidate2
(1)Grand Valley State University, Grand Rapids, MI, (2)Grand Valley State University, Allendale, MI

APHA 2021 Annual Meeting and Expo

Although university students are at low risk for serious complications of a COVID-19 infection, they represent a high risk for increased disease transmission in the campus setting and the local community. In order for public health officials and university administrators to develop a successful vaccination strategy, they must understand what characteristics predict or inform willingness to receive the COVID-19 vaccine. This quantitative, cross-sectional study used a stratified random sample of 614 university students from a Midwestern public university to explore the perspectives, experiences, and attributes that predict willingness to receive a COVID-19 vaccination. Bivariate analysis and stepwise regression models demonstrate that identifying as female, identifying as conservative, and having hesitations about childhood vaccines predicted a decrease in willingness to receive the COVID-19 vaccine, whereas compliance with mask-wearing guidelines, identifying as white, and avoiding large gatherings predicted an increase in willingness to receive the COVID-19 vaccine. This study provides insights for public health officials and university administrators to consider how best to tailor messaging and improve vaccine access in order to create a safe environment for learning and university operations while reducing community transmission. Lessons learned during the COVID-19 pandemic may also provide guidance during future vaccine campaigns. Future research should build on the findings of this study to more deeply explore motivations and reasons for vaccine willingness, and should broaden the sample outside of the Midwest United States.

Key Words

university students, COVID-19, coronavirus, vaccine

Assessment of individual and community needs for health education Public health or related education Public health or related research

Abstract

Utilizing equitable language to design a survey on college faculty and staff attitudes, knowledge, and behaviors toward student basic needs

Mirna Sawyer, PhD, MPH1, Danielle Spratt, PhD1, Nelida Duran, Ph.D, M.S., RD2, Rosalia Garcia-Torres, PhD1, Imelda Vianzon, BS2 and Alexander Rueda1
(1)California State University Northridge, Northridge, CA, (2)California State University, Northridge, Northridge, CA

APHA 2021 Annual Meeting and Expo

This presentation provides an overview of the process of weighing distinct psychometric tools for measuring faculty and staff knowledge, behaviors, and attitudes about campus resources for student basic needs at a large, urban Hispanic-Serving Institution public university. The presentation emphasizes the challenges and strategies of creating or adopting survey language that avoids using potentially racist, classist, sexist claims and assumptions, which are inherent to many validated surveys for students or the general population.

Basic needs insecurity, including facing obstacles to secure housing, healthy food, appropriate mental and physical healthcare, child/eldercare, reliable technology or transportation, is a pervasive phenomenon facing today’s college students, especially those from traditionally marginalized groups.

We argue that it is essential, especially in this sociopolitical moment, to develop a new survey model grounded in equitable antiracist praxis to assess faculty and staff behaviors, knowledge, and attitudes regarding student basic needs, as basic needs insecurity is traditionally tied to the effects of systemic racism on underserved communities of color. We will examine examples of language from four previously validated surveys to pinpoint instances of structural racism, sexism, and classism and offer an alternative model. The survey, informed by this alternative language, is the first crucial step in designing educational materials and innovative pedagogical approaches that use a psychosociocultural framework to help foment institutional change. Materials informed by these approaches/methods will provide more inclusive, comprehensive, and accessible basic needs resources for students and create a more equitable, healthy, and socially connected campus community.

Assessment of individual and community needs for health education Diversity and culture Implementation of health education strategies, interventions and programs Program planning Public health or related organizational policy, standards, or other guidelines Public health or related research

Abstract

Mask use adherence behaviors among the college students and the surrounding campus community

Christine Fisher, Ph.D., MPH, CHES
East Stroudsburg Univeristy, East Stroudsburg, PA

APHA 2021 Annual Meeting and Expo

Since the start of the COVID-19 pandemic in 2020, the world has been challenged with how to reduce the spread of this virus, and how to keep people safe and healthy. Our college campus in collaboration with the Pennsylvania Department of Health and the U.S. Centers for Disease Control and Prevention, launched a study to observe mask use on and around college campuses. There were over 60 colleges and university that participated in this study across the United States. This presentation will highlight data collected for our universities campus community. This data was collected by both graduate and undergraduate students in public health, nursing, and school health educators who were trained data collectors during the spring 2021 semester. The presentation will focus on describing national trends and Pennsylvania state guidelines for COVID-19, examples of our campus’s preventative measures, and data collected from our campus for this study. With our data collection halfway complete we have found that 95% of our community members wore masks, 93% wore mask correctly, and the majority of mask worn were cloth (59%) followed by surgical mask (33%). Hopefully, this data and information can be used to encourage others to continue to wear a mask and to wear them correctly to protect those around them till we are at a time where heard immunity with the vaccines is sufficient for community protection from this virus.

Protection of the public in relation to communicable diseases including prevention or control Public health or related laws, regulations, standards, or guidelines Public health or related research Social and behavioral sciences

Abstract

The association between the sexual orientation of bay-area college students and their perceived mental and physical health.

Kelly Scherer, MPH candidate, B.S. and Kelly McDermott, PhD
University of San Francisco, San Francisco, CA

APHA 2021 Annual Meeting and Expo

Background: Sexual orientation continues to be shown in academic literature as a contributor to elevated life stressors and poorer mental health outcomes. The aim of our study is to research the impacts that sexual orientation has on college students perceived physical and mental health.

Methods: A survey of students from two private universities in the San Francisco Bay Area measured college student’s perceived physical and mental health in relation to student’s sexual orientation. We used descriptive, bivariate and multivariate statistics to investigate the relationship between college student’s sexual orientation and their perceived physical and mental health. Covariates included race, gender identity, work activities, age and current student debt total.

Results: 1,196 college students responded to the sexual orientation question, 65% of which identified as non-white and 74% identified as a cis-women. 25% of individuals identified with a sexual orientation other than heterosexual, 5% identified as homosexual, 16% identified at bisexual, and 4% identified with an “other” sexual orientation. College students that reported heterosexual identity demonstrated significantly increased odds of perceived good or excellent physical (OR 1.7 95CI[1.20-2.47]) and mental health (OR 2.9 95CI [1.93-4.43]) compared to individuals with non-heterosexual identities.

Discussion: These results that non-heterosexual students are experiencing worse perceived physical and mental health than their heterosexual peers. This issue needs to be explored with more rigorous study design and investment in targeted intervention strategies for LGBTQ+ university populations.

Diversity and culture Public health or related education Public health or related research Social and behavioral sciences

Abstract

Understanding the COVID-19 knowledge and behaviors of university students who are in quarantine

Mary Larson, PhD, MPH, RD, CHES1, Tanis Walch, PhD, MPH2, Brenda Vincent, MS1, Nkolika Nwankwo, MD1, Amanda Johnson, BS1, Ariana Zook, BS1, Paul Carson, MD, FACP1 and Joshua Wynne, MD, MBA, MPH2
(1)North Dakota State University, Fargo, ND, (2)University of North Dakota, Grand Forks, ND

APHA 2021 Annual Meeting and Expo

Background: The COVID-19 pandemic affected students of all ages. Post-secondary students, who are quarantined due to being a close contact to someone positive for COVID-19, are unique due to living away from home and managing challenges including social isolation and risk of infection from roommates. Purpose: To assess knowledge and behaviors related to COVID-19 of University students who were quarantined. Methods: Students (n=71) from two Upper Midwest state universities completed an online survey to assess knowledge and behaviors related to COVID-19 at the beginning of a 14-day quarantine. Results: Participants reported the type of infection (90% viral) and the main route of transmission (93% respiratory droplets); only 10% accurately identified the top five strategies to reduce transmission from a list. The most common protective behaviors reported (always or most of the time) masking indoors (96%), reducing travel (94%), physical distancing (92%), avoiding social events (92%) and washing hands (90%). The most common reasons reported for mask-wearing was to protect others (89%), follow university (85%) and CDC guidelines (85%), and protect self (82%). Few participants reported engaging in risk behaviors of spending time in large groups (7%) and going to bars/restaurants/coffee shops (11%). Conclusion: CDC guidelines appear to influence behaviors to mitigate transmission of COVID-19. Although our findings are not generalizable to the entire population of University students, the participants reported engaging in protective behaviors and are concerned about the welfare of others. It is important to continue educating populations as information is learned about how infection is transmitted and the most effective protective behaviors.

Protection of the public in relation to communicable diseases including prevention or control Public health or related research

Abstract

#wewill make our campus a safe learning environment:a social norming campaign encouraging mask wearing

Christina Selby, PhD, Kyle Holody, PhD, Elizabeth Carter, PhD and Sherer Royce, PhD
Coastal Carolina University, Conway, SC

APHA 2021 Annual Meeting and Expo

The #WeWill campaign was developed to educate college students on appropriate health and safety measures while on campus during the COVID-19 pandemic during the 2020-2021 academic year. The current study examines the effectiveness of the #WeWill social norming campaign to promote mask wearing among college students using the Extended Parallel Processing Model (EPPM) as the guiding theoretical framework. Previous research demonstrates a relationship between the behaviors of one’s social network and mask wearing behavior. The social norming framework has been found to be effective on college campuses when addressing a variety of health behaviors; however, to date, there is little research on social norming campaigns encouraging mask wearing behavior. A total of 307 students participated in this survey-based study of #WeWill campaign messages. Students’ risk perceptions of COVID-19, their perceptions of wearing masks, and normative message processing of campaign messages were evaluated. Results suggest respondents’ beliefs about COVID-19 and their evaluation of the #WeWill campaign messages were positively associated with mask wearing behavior and adherence to public health guidelines. This study fills a knowledge gap and provides new insight into social norming campaigns on college campuses promoting mask wearing.

Implementation of health education strategies, interventions and programs Social and behavioral sciences

Abstract

Poor sleep health and risky driving behaviors among college students

Adam Knowlden, CHES, MBA, MS, PhD1, Rebecca Robbins, PhD2 and Michael Grandner, PhD, MTR, CBSM3
(1)The University of Alabama, Tuscaloosa, AL, (2)Boston, MA, (3)University of Arizona College of Medicine, Tucson, AZ

APHA 2021 Annual Meeting and Expo

Introduction. Risky driving behaviors, such as texting while driving, are common among young people and increase risk of traffic accidents and injuries. We examine the relationship between poor sleep and risky driving behaviors among college students as potential targets for traffic injury prevention.

Methods. Data for this study were obtained from a cross-sectional survey administered to a college student sample in the United States Midwest (n=1,305). Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI). Risky driving behaviors were measured, including sending texts/emails; reading texts/emails while driving; talking on the phone while driving; falling asleep while driving; and driving under the influence. Risky driving behavior was defined as a response of “rarely,” “sometimes,” “fairly often” or “regularly” (reference = “never”). Logistic regression was used to examine the relationship between sleep and risky driving behaviors.

Results. Among participants, 69% reported sending texts/emails while driving, 74% reported reading texts/emails while driving, and 78% reported phone talking while driving; 20% reported falling asleep while driving; 8% reported driving under the influence; and 64% reported 3 or more risky behaviors. Compared to those demonstrating good sleep quality, those with poor sleep quality were more likely to report sending texts/emails while driving (OR= 1.3, 95%CI:1.0-1.7,p-value=0.024), reading texts/emails while driving (OR=1.4, 95%CI:1.1-1.8,p-value=0.012), talking on the phone while driving (OR=1.5, 95%CI:1.16-1.9,p-value=0.002), falling asleep while driving (OR=1.7, 95%CI: 1.3-2.4,p-value=0.000), and 3 or more risky driving behaviors (OR=1.3, 95%CI:1.0-1.7,p-value=0.020).

Conclusion. Future research may consider interventions that improve sleep, reduce drowsy driving, and restrict distracted driving behaviors among young people. Policy-based interventions based on geographic location are also discussed.

Administer health education strategies, interventions and programs Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related laws, regulations, standards, or guidelines Social and behavioral sciences