[Show abstract][Hide abstract] ABSTRACT: To determine whether alcohol use behaviors and alcohol-related consequences differed among students attending two-year versus four-year colleges.
Participants (N=13,700) from 7 two-year and 11 four-year colleges completed the 2010 College Student Health Survey. Alcohol use behaviors included past year alcohol use, past month alcohol use, and binge drinking over the past two weeks. Alcohol-related factors included average calculated blood alcohol level and average number of alcohol-related consequences. Cross-sectional mixed-effects regression analyses were conducted to determine if the prevalence of alcohol-related behaviors and consequences differed among two-year and four-year students.
Students attending four-year colleges, particularly males, were more likely to report past year alcohol use, past month alcohol use, and binge drinking, as well as a higher average blood alcohol content and a greater number of alcohol-related consequences than their two-year counterparts (p<0.05). Among female students there were fewer differences between two-year and four-year college students. Many differences remained after adjusting for socio-demographic factors (e.g., age, race/ethnicity), however, with the addition of living situation as a covariate, several of the differences among males were no longer significant.
Significant differences in alcohol-related behaviors and consequences exist among students attending two-year versus four-year colleges. While the prevalence of alcohol-related behaviors and consequences was lower among two-year college students, they are not a population to be over-looked. The prevalence of alcohol use remains high among both two-year and four-year college students, making it important for researchers to design appropriate interventions for all students regardless of the type of institution being attended.
[Show abstract][Hide abstract] ABSTRACT: To conduct and evaluate Quit & Win contests at 2 2-year college and 2 4-year university campuses.
During Spring semester, 2006, undergraduates (N = 588) interested in quitting smoking signed up for a Quit & Win 30-day cessation contest for a chance to win a lottery prize.
Participants (N = 588) completed a baseline survey, provided a urine sample to verify smoking status before joining the contest, and completed a follow-up survey at contest end to assess abstinence. Participants reporting continuous 30-day abstinence were surveyed again 2 weeks post contest to assess relapse.
Participants smoked an average of 9.8 +/- 6.7 cigarettes/day on 26.7 +/- 5.7 days/month. Among participants completing a follow-up survey (74%), 72.1% reported abstinence during the entire contest period (Intent-to-Treat Analysis = 53.2%). 55.3% of those abstinent at the end of contest had resumed smoking 2 weeks post contest.
Campus Quit & Win contests appear feasible, acceptable, and effective at facilitating short-term abstinence. Further research is needed to identify strategies to prevent postcontest relapse.
Journal of American College Health 01/2010; 58(4):365-72. · 1.45 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Young adults experience many adverse health behavior changes as they transition from adolescence into adulthood. A better understanding of the relationships between health promoting and risky health behaviors may aid in the development of health promotion interventions for various types of young adult post-secondary students. Therefore, the purpose of this study was to examine associations between alcohol and tobacco use and physical activity among 2-year and 4-year college students.
Cross-sectional analyses were conducted using 2007 survey data, collected as part of an on-going post-secondary health surveillance system in Minnesota. Students were randomly selected to participant from 14 Minnesota colleges and universities (six 2-year community and/or technical colleges, eight 4-year post-secondary institutions). The 2007 surveillance data included 9,931 respondents.
The prevalence of demographic characteristics and health behaviors (e.g., physical activity, tobacco use) differed between young adults attending 2-year and 4-year post-secondary institutions; in general, those attending 2-year institutions are representative of more at-risk populations. Overall, higher levels of moderate, vigorous and strengthening physical activity were associated with higher levels of alcohol consumption and lower levels of smoking. In general, despite the disparities in the prevalence of these risk behaviors, the associations between the behaviors did not differ substantially between 2-year and 4-year post-secondary populations.
These findings illustrate links between leading risk behaviors. Interventions targeting multiple risk behaviors among young adults may warrant further consideration. Overall, future research is needed to support and inform young adult health promotion efforts that may be implemented in a wide array of post-secondary institutions.
BMC Public Health 01/2010; 10:208. · 2.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: College students who engage in occasional or social cigarette smoking are less likely to identify themselves as smokers and to attempt to quit. This analysis aimed to determine: (1) the correlates of denying being a smoker among students reporting smoking in the past 30 days and (2) if denying this label was related to not attempting to quit smoking in the past 12 months.
A total of 9931 students at 14 colleges completed a random sample survey in 2007.
Of 2255 students reporting having smoked a cigarette in the past 30 days, 50.7% responded No to Do you consider yourself a smoker. Logistic regression indicated that, after controlling for the number of smoking days in the past 30, being younger (OR=0.94, p<0.001); being male (OR=1.59, p=0.009); attending a 4-year (versus 2-year) college (OR=1.73, p=0.004); and consuming alcohol in the previous 30 days (OR=2.14, p=0.03) were correlates of denying being a smoker. Logistic regression indicated that denial was related to not attempting to quit in the past 12 months (OR=1.72, p<0.001), after controlling for the number of smoking days, age, gender, type of school, and other health factors.
Half of college smokers deny being smokers, particularly those who are younger, male, attending 4-year colleges, and alcohol consumers. Denying being a smoker was associated with not attempting to quit smoking. Therefore, traditional methods of ascertaining smoking status may not be valid in this population. Healthcare providers should more specifically ask students about recent smoking behavior. Further research is needed to develop interventions targeting smoking among this population.
American journal of preventive medicine 02/2009; 36(4):333-6. · 4.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The perception of negative health consequences is a common motive for quitting smoking, but specific information on the immediate health effects of occasional smoking among young adults is limited.
To examine the relationship between cigarette use and symptoms of (a) cough or sore throat and (b) shortness of breath or fatigue after regular activities among young adults, we performed online health screening of a random sample of 25,000 college undergraduates. The screening survey assessed demographic characteristics, smoking and related health behaviors, and respiratory symptoms in the previous 30 days.
The response rate was 26% (6,492/25,000). Among individuals reporting no smoking in the prior 30 days and smoking on 1-4, 5-10, 11-20, or 21-30 days, the prevalence of one or more days of cough/sore throat increased from 62.5% to 68.3%, 72.0%, 71.4%, and 73.7%, respectively (p < .001). Similarly, the prevalence of shortness of breath/fatigue increased from 42.7% to 47.1%, 56.2%, 59.5%, and 64.6%, respectively (p < .001). After controlling for demographics, other important health behaviors (e.g., days consuming alcohol and getting adequate sleep), and environmental tobacco smoke (ETS) exposure, reporting symptoms of cough/sore throat was associated with smoking on at least 21 days, whereas shortness of breath/fatigue was associated with smoking on 5 or more days. Among those reporting symptoms, increased number of days with respiratory symptoms was associated with smoking on most days as well as ETS exposure.
In conclusion, this cross-sectional study found that occasional smoking and ETS exposure were associated with an increase in the rate of respiratory symptoms (cough/sore throat and shortness of breath/fatigue) among young adults.
Nicotine & Tobacco Research 02/2009; 11(2):126-33. · 2.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To assess influenza vaccine effectiveness against influenzalike illness (ILI) and ILI impact on health care use and school performance among college and university students.
Pooled analysis of 4 consecutive cohorts for the 2002-2003 through 2005-2006 seasons.
Twin Cities campus of the University of Minnesota (2002-2003 through 2005-2006 seasons) and St. Olaf College in Northfield, Minnesota (2005-2006 season).
Full-time students received e-mail invitations to participate in single-season cohorts. Internet-based surveys collected baseline (October) and follow-up (November-April) data.
Influenza vaccination. Main Outcome Measure: Proportion of students with ILI. Multivariable regression models assessed the effectiveness of vaccination for reducing ILI during months when influenza was circulating while controlling for confounders and after pooling data across the 4 cohorts.
There were 2804, 2783, 3534, and 3674 participants in the 2002-2003, 2003-2004, 2004-2005, and 2005-2006 cohorts respectively, and overall, 30.2% were vaccinated. In the pooled analysis, 24.1% of students experienced at least 1 ILI during influenza seasons. Vaccination was associated with a significant reduction in the likelihood of ILI during influenza seasons (adjusted odds ratio, 0.70; 95% confidence interval, 0.56-0.89) but not during noninfluenza periods (adjusted odds ratio, 0.98; 95% confidence interval, 0.73-1.30). Vaccination was also associated with significant reductions in ILI-associated provider visits, antibiotic use, impaired school performance, and numbers of days of missed class, missed work, and illness during the influenza seasons.
Influenza vaccination was associated with substantial reductions in ILI and ILI-associated health care use and impairment of school performance. College and university students can experience substantial benefits from influenza vaccinations.
[Show abstract][Hide abstract] ABSTRACT: Uncertainties regarding influenza disease impact and benefits of vaccination may contribute to low vaccination rates among adults aged 50-64 years.
This prospective cohort study assessed the burden of influenza-like illness (ILI) among working adults aged 50-64 years and the effectiveness of influenza vaccination in reducing the rate of ILI and productivity losses. Employees of the University of Minnesota (Minneapolis) were invited via e-mail to participate in the study during October 2006. The study data were collected using internet-based surveys at baseline (October 2006) and during the follow-up period (from November 2006 through April 2007). Months included in the 2006-2007 influenza season were identified retrospectively from Minnesota Department of Health surveillance data. Vaccine effectiveness for reducing the rate of ILI, ILI-associated health care use, the number of days of illness, work loss, and reduced on-the-job productivity during the influenza season were assessed using multivariable regression models after controlling for important confounders.
Four hundred ninety-seven persons were included in the study, 85 (17.1%) of whom experienced an ILI. Among unvaccinated participants, ILI was responsible for 45% of all days of illness during the influenza season, 39% of all illness-related work days lost, and 49% of all days with illness-related reduced on-the-job productivity. In the multivariable regression analyses, vaccination was associated with a significant reduction in the rate of ILI (adjusted odds ratio, 0.48; 95% confidence interval, 0.27-0.86) and fewer days of illness, absenteeism, and impaired on-the-job performance.
ILIs were common among our study participants, accounting for a large portion of illness, work loss, and impaired work performance during the influenza season. Vaccination was associated with substantial health and productivity benefits. Vaccine delivery should be improved for this high-priority group.
[Show abstract][Hide abstract] ABSTRACT: Helping young smokers to quit early in life substantially reduces the risk of later morbidity and mortality due to tobacco use. The RealU study demonstrated the efficacy of a smoking-cessation website for college students that incorporated both individually tailored feedback and peer e-mail support. The relationship between peer e-mail support and cessation outcomes among intervention participants is examined here.
This study was conducted at the University of Minnesota Twin Cities from Fall 2004 through Spring 2005. During the intervention period, peer-support students (E-pals) wrote weekly e-mails to intervention group participants (n=257) encouraging healthy behaviors including smoking abstinence. Ten survey items assessed perceived E-pal supportiveness. The number of e-mails replies sent by the participants to their E-pal was tracked as a measure of e-mail engagement. The primary outcome was self-reported 30-day abstinence at the end of the intervention period.
Over the course of the intervention, participants sent an average of 4.6 (SD=3.6) e-mails to their E-pals. Perceived E-pal support was significantly correlated with e-mail engagement (p<0.001). At Week 30, 40.5% of individuals in the RealU intervention group (104/257) reported not smoking any cigarettes in the prior 30 days. Bivariate analyses indicated that 30-day abstinence was related to both perceived support from the E-pal (p<0.001) and e-mail engagement (p<0.001). Multivariate analyses indicated that after controlling for age and baseline-level smoking, e-mail engagement remained a significant predictor of 30-day abstinence (p<0.001).
Greater peer engagement via e-mail was associated with increased smoking abstinence and reduced frequency of smoking. These findings suggest that online peer support may be an important strategy when delivering Internet-assisted cessation programs to young adults.
American journal of preventive medicine 12/2008; 35(6 Suppl):S471-8. · 4.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To determine the efficacy of providing online cessation intervention for college smokers.
This is a two-group randomized controlled trial. The intervention group received $10 weekly incentives to visit an online college life magazine that provided personalized smoking cessation messages and peer email support. Evaluation assessments occurred at baseline and 8, 20, and 30 weeks after enrollment. The primary outcome is self-reported 30-day abstinence at week 30. Carbon monoxide (CO) breath testing was performed for participants reporting 30-day abstinence at week 30.
Five-hundred and seventeen college smokers at the University of Minnesota were enrolled via internet health screening (control=260, intervention=257) in the fall of 2004. Intervention participants completed an average of 18.9 (SD 2.5) of 20 weekly website visits over the course of the study. The rate of 30-day abstinence at week 30 was higher for the intervention compared to the control group (41% vs. 23%, p<0.001). CO testing showed low rates of under-reporting. There was no difference in self-reported 6-month prolonged abstinence measured at week 30.
Providing personalized smoking cessation messages as part of a general interest online college life magazine increased 30-day abstinence by the end of this two semester intervention.
Preventive Medicine 05/2008; 47(2):194-9. · 3.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Internet-based cessation programs are promising. However, little information exists on how to recruit college smokers to participate in online interventions. Two studies assessed the feasibility of Internet health screening as a recruitment strategy for college smokers. The Internet Survey Study compared Internet (n = 735), mail (n = 1,490), and phone (n = 550) surveys as means to identify college smokers. The RealU Recruitment Study described the use of an Internet-based general health screening survey (N = 25,000) to recruit for an online cessation trial. The Internet Survey Study showed that, despite large differences in response rates (Internet = 38%, mail = 47%, phone = 90%; p<.001), the rates of past-month tobacco use were similar (Internet = 35%, mail = 38%, phone = 34%; p = .35). Among past-month users, a greater proportion reported daily use on the Internet (33%) and phone (37%) surveys versus the mail survey (23%, p = .007). In the RealU Recruitment Study, 517 college smokers were recruited in 1 week. The Internet survey response rate was 26%, the prevalence of current smoking was 29%, the eligibility rate was 87%, and the enrollment rate was 32% (517/1,618). Internet health screening can be used to quickly identify and enroll large numbers of college smokers in an online smoking cessation intervention.
[Show abstract][Hide abstract] ABSTRACT: High rates of Internet use among young adults make online intervention with this population particularly attractive. However, low adherence rates limit the exposure to and the potential effectiveness of these programs. This study identifies strategies for increasing adherence by examining the rates of participation for a 5-week beta (pilot) version and final version of the RealU Web site, an online intervention for college smokers. Three modifications from the beta to the RealU Web site were (a) changing format from a smoking cessation Web site to an online college life magazine, (b) providing proactive peer e-mail support, and (c) adopting a more linear site structure. Participants were recruited via Internet health screening and received US$10 for completing weekly study activities. Enrollment among eligible smokers was higher for the beta compared with the RealU intervention (47/69, 68.1% vs. 517/1618, 32.0%, p<.001), but participants did not differ in terms of age, gender, or past 30-day cigarette or alcohol use. Participation fell sharply during the beta test (53% in week 1 to 26% by week 5) compared with the RealU average of 95% (range 89% to 98%). Participation during each study's final week was much higher in the RealU (93% week 20) compared with the beta (26% week 5, p<.001). After 5 weeks, self-reported 30-day abstinence was higher for RealU intervention participants (16.0%) compared with the beta participants (4.3%, p=.03). The modifications from the beta to RealU Web site described above resulted in high rates of sustained participation over 20 weeks.
[Show abstract][Hide abstract] ABSTRACT: Upper respiratory illnesses, including colds and influenza-like illnesses, are common among college and university students. We have established an ongoing, serial cohort study to assess the occurrences of these illnesses among college and university students as well as the impact of these illnesses on overall health, school and work performance, and health care use. In this paper we report on the first 2 years of this study (2002-2003 and 2003-2004). For each year, more than 4000 students responded to the e-mail invitations to participate, and they provided more than 3000 person-seasons of follow-up information during the monthly surveys conducted November-April. In both years, colds and influenza-like illnesses were common and associated with significant numbers of bed days, reduced activity days, school and work loss, impaired school performance, and increased health care utilization. Efforts to prevent upper respiratory illnesses among college and university students could improve their health and reduce health care utilization during the winter months.
[Show abstract][Hide abstract] ABSTRACT: Invasive disease secondary to Neisseria meningitidis is a rare but devastating illness among university students. The Advisory Committee on Immunization Practices recommends educating college freshmen about meningococcal disease and vaccinating all college freshmen who live in residence halls. We conducted this survey to gain a better understanding of current immunization rates and factors associated with vaccination.
Journal of American College Health 01/2006; 55(3):169-73. · 1.45 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Upper respiratory tract illnesses (URIs) are a major cause of morbidity among adults, with substantial direct and indirect costs to society, but their impact among university students has not been well described. We sought to assess the impact of URIs (colds and influenza-like illnesses [ILIs]) on the health, academic and work performance, and health care use of university students.
This was a cohort study of college students at the University of Minnesota, Twin Cities campus (Minneapolis-St. Paul), who were recruited during October 2002 and followed up from November 2002 through April 2003. All 42,000 registered students were invited via e-mail to participate. Baseline information was obtained in October 2002. Monthly follow-up information about colds or ILIs was obtained for the period of November 2002 through April 2003. Data were collected by use of Internet-based questionnaires.
Of 4919 volunteers, 3249 completed all follow-up surveys. The mean age was 22.7 years; 68% of the volunteers were female. Ninety-one percent had > or = 1 URI (83% had > or = 1 cold, and 36.7% had > or = 1 ILI). These URIs caused 6023 bed-days, 4263 missed school days, 3175 missed work days, and 45,219 days of illness. Of the cohort, 22.2% had > or = 1 health care visit, and 15.8% used antibiotics to treat a URI; 27.8% did poorly on a test and 46.3% did poorly on a class assignment. ILIs versus colds had a much greater impact on all parameters (e.g., general health level was 55%-60% lower with ILI vs. no URI and 33%-39% lower for colds vs. no URI; P < .001 for each).
Colds and ILIs were common and associated with substantial morbidity in university students. Enhanced efforts to prevent and control URIs, especially influenza vaccination, could improve the health and well-being of the 17 million college and university students in this country.